Wednesday, October 24, 2012

Youth Sports Safety: 5 Questions Every Parent Should Ask, #4


An Automated External Defibrillator (AED) is a portable device that can assess a person’s heart rhythm and provide an electrical shock to restore a normal heart rhythm, if appropriate.  These devices are critical in the treatment of sudden cardiac arrest (SCA), since people who suffer from SCA often die within minutes of collapse if CPR is not initiated and an AED is not utilized.  The incidence of SCA in young athletes (< 35y/o) is quite low  at 0.4 – 0.6 per 100,000 in the United States, but because these events are often traumatic and catastrophic much effort has been focused on eliminating the possibility of SCA and improving survival rates when SCA does occur.  Discussing the details of SCA and its prevention is beyond the scope of this post, but if you would like more information on preventing SCA click, HERE.  The focus of this post is the role of AEDs in the treatment of SCA.  Studies have repeatedly shown that the availability of AEDs and their use within minutes of collapse significantly increase the survival rate, for anyone who has suffered SCA (whether young or old).  In order for the AED to be effective, it must be available.

As a parent it is important to know when and where AEDs will be available.  The American Heart Association (AHA) and other organizations have consistently encouraged the development of Public Access Defibrillators (PAD) programs across the country in an effort to improve survival rates from SCA.  According to recommendations by the AHA the following components should be part of a PAD program:
  • Targeted site placement of AEDs to maximize use (malls, arenas, schools, etc.)
  • Ongoing basic life support CPR and AED training of anticipated rescuers (eg, staff likely to be present during business hours) through an approved course
  • Maintenance and testing of the AED device to ensure continued functionality
  • Coordination with EMS and a medical provider, to include providing notification of or registering the type of AED and its location with the EMS communications or dispatch center in the EMS response area, by calling 9-1-1 when an AED is used, and through oversight be a medical professional with emergency response expertise
  • Continuous quality improvement through the use of a written medical emergency response plan or medically approved protocol, reporting each Out of Hospital Cardiac Arrest (OHCA) and clinical use of a PAD for evaluation by the program’s medical director, and use of the findings to improve program performance
  • Limited liability for AED users and others

Taken from HERE

Researchers used these guidelines to provide a current summary of PAD program legislation in the United States.  The researchers found that no state met all recommended guidelines.  To learn which guidelines your state meets click, HERE.  Please note, these results based on data available in 2010 and so your state may have since updated or changed its guidelines.  Refer to individual state AED legislative resources for the guidelines in your state.  A summary report that can help you get started is available HERE.  (This link has not been updated since January 2012 so any new legislation approved after its publication is not part of this chart.)

Currently 17 states require the availability of AEDs in schools.  Given this, there is a possibility that your athletic trainer will have access to an AED in an SCA emergency during high school sporting events, but is not a guarantee.  If your state does not require AEDs be available in schools I would encourage parents to work to develop a PAD for your child’s school.  AEDs cannot be effective if they are not available.  Lack of access is also of concern in youth sports.  Often times, practices and tournaments occur at local parks where PAD is not likely to be present.  If this is the case, it will be important to understand whether state legislation allows athletic trainers or other available emergency personnel to provide their own AED.

AEDs are designed so an untrained layperson can use the device appropriately when available.  Despite this, I encourage anyone who may be in a position to utilize an available AED to formally train in their use (coaches, parents, administrators) because not all states have instituted a Good Samaritan law related to AED use in the same way states have for the use of CPR.  This training also help care providers understand the relationship between CPR and AED.  AED training is available through the same organizations that provide CPR training.  For those trained in compression only CPR check out this video for how an AED would be utilized in this situation:

Again, SCA in youth athletes is a highly traumatic event and people are working to improve detection of risk factors and prevent it.  Should SCA occur the typical survival rate is about 8%, AEDs improve the survival rate to between 40% – 74%, making them a critical tool in the treatment of SCA.  PAD programs are increasing meaning more and more AEDs are becoming available, but recent research shows that many states have much work to do in legally supporting and implementing PAD programs, especially in schools.  The best thing parents can do for their children’s safety is to advocate for programs and resources that can help in emergencies.  Be an advocate for AEDs and AED training in your schools and communities.  

Next week's question:  Are coaches trained (and following) key sport safety guidelines?

Submitted by Heather L. Clemons, MS, MBA, ATC

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