Ask the Pediatrician: How can schools prepare for sudden cardiac arrest?

Did you know sudden cardiac arrest is the main cause of death in young athletes? This fact may be surprising. But it has prompted 43 states to require cardiopulmonary resuscitation (CPR) training for all high school students before graduation. In addition, many states now require automated external defibrillators (AEDs) in schools.

What happens with sudden cardiac arrest?

Sudden cardiac arrest is when the heart suddenly stops beating. It can cause death within minutes. Certain conditions can lead to sudden cardiac arrest, but not all the causes are known.

Sudden cardiac arrest is rare in young people. When it happens, it’s often to young athletes during competition or practice. But sudden cardiac arrest can happen at any time to any young person, even if they aren’t in sports.

When a person’s heart stops beating, quick action can mean the difference between life or death. CPR and AEDs save lives.

An AED checks the heart rhythm. If needed, it sends a shock that will get the rhythm back to normal. It won’t shock a person if they don’t need it.

According to the American Heart Association, about 9 in 10 people who get a shock from an AED within the first minute of cardiac arrest live. For every minute that passes in cardiac arrest, the chance of survival goes down by 10%.

The American Academy of Pediatrics advises all schools to place AEDs both inside and outside on school grounds as part of a cardiac emergency response plan. It should take no more than two minutes to get an AED and return to the victim.

At least 20 states plus the District of Columbia require AEDs to be in all public schools. In California, schools that offer sports must supply AEDs too.

Even if your state doesn’t mandate AEDs, you can still be an advocate for getting them at your school. Having AEDs available may just save someone’s life.

Although using an AED may seem intimidating, it will tell you if a shock is needed or not. You can even take a hospital or community CPR class to learn more about how to do CPR and how to use an AED.

Some young people may not have symptoms of heart problems until the sudden cardiac arrest occurs.

Others may experience heart-related symptoms before sudden cardiac arrest, such as:

• Chest pain
• Lightheadedness
• Dizziness
• Shortness of breath
• Feeling that your heart is racing
• Fainting, especially during exercise

These symptoms could indicate a serious underlying heart condition.

The AAP recommends that pediatricians should screen all kids for heart-related issues, not just athletes. This screening could help identify conditions that can lead to sudden cardiac arrest.

The AAP also recommends that all kids — from middle school to college age — have an annual sports physical. This can be scheduled alongside their yearly well-child visit with their pediatrician. Even if your child isn’t playing organized sports, they will benefit from this thorough exam, which examines heart health.

Of course, if you or your child have any concerns about their heart health, see your pediatrician or a pediatric cardiologist.

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Alex B. Diamond, DO, MPH, FAAP, FAMSSM, a member of the American Academy of Pediatrics Council on Sports Medicine & Fitness, is an associate professor of orthopaedic surgery, pediatrics and neurological surgery at Vanderbilt University Medical Center. He is also director of the Vanderbilt Youth Sports Center and team physician for Vanderbilt University and the Nashville Predators.

Stuart Berger, MD, FAAP, chair of the American Academy of Pediatrics Section on Cardiology & Cardiac Surgery, is division head of pediatric cardiology and Lurie Children’s Hospital.