While coaches and trainers keep track of a lot of equipment in youth sports, many physicians and sports groups are hoping that coaches will add one more to the pile: an Automated External Defibrillator, or AED.
While youth athletes are usually a fairly healthy group, cardiac emergencies can and do occur. The most common cause of these incidents in children is cardiomyopathy, a chronic disease of the heart muscle that affects about 30,000 children in the U.S. The condition often goes undiagnosed due to a lack of symptoms, and is the leading cause of sudden cardiac arrest among young people. The statistics are grim: only one in 10 student athletes who suffer sudden cardiac arrest survives. The presence and timely use of an AED can improve the chances of survival.
Late last year, the National Athletic Trainers’ Association released new guidelines on heart health and youth sports safety. Noting that survival rates improve greatly to between 41 and 74 percent if defibrillation with an AED occurs within three to five minutes of collapse, the group, working in conjunction with the Children’s Cardiomyopathy Foundation, advised that AEDs should be on-site and readily available within three minutes (with one minute being ideal) for all organized sports activities, and that school staff, medical professionals, parents, coaches and athletes should be educated annually about location and use of AEDs.
There are a plethora of anecdotal stories about AED saving lives, thanks to an increasing proliferation of the devices at youth sporting events. There are also tragic stories of youth athletes who died when an AED was not readily available. In Jacksonville, Florida, the parents of a boy who died from sudden cardiac arrest while an AED remained locked in a nearby building launched a charity called the AED Mission to help make the devices available to be borrowed for free by youth sports teams, church or scouting groups and anyone else with CPR certification, according to the Florida Times-Union.
Loaner programs may help improve the availability of AEDs, particularly to youth sports groups that cannot afford the $1,200 to $2,500 price tags of the devices. In some states, local hospitals, ambulance companies and clinics offer to loan AEDs to community groups for free. Camden County Fire and Rescue in Georgia has an AED loaner program, and in Wisconsin, Tri-State Ambulance also makes the devices available to borrow. In Oregon, the Clackamas Fire District will loan an AED to individuals who possess a current CPR certification card.
To date, state regulations are patchy on AEDs in schools, and there are few regulations requiring them at youth athletic events. Only 19 states in the U.S. require that at least some of their schools have automated external defibrillators (AEDs), according to research by Scripps Howard News Service. In some states, AEDs are required in public schools, but private schools are exempt. In other states, AEDs are required in high schools, but not elementary schools. Some states require AEDs only in schools offering athletics. (The Sudden Cardiac Arrest Foundation maintains an updated list of state laws regarding AEDs.)
While most parents and coaches would agree that greater availability of AEDs is a good thing, there are some concerns about liability. Last year, the parents of a student who collapsed during a soccer game at a Lee County, Florida school sued, alleging that the on-site AED was not used on their son. The boy was ultimately revived by emergency medical personnel, but remains in a vegetative state due to lack of oxygen, according to the Tampa Tribune’s Mark Miller and Deborah J. La Fetra. The ruling could have broad implications on AEDs in youth sports.
“If the Florida Supreme Court were to rule otherwise, by inventing a new legal duty for public schools to use an AED in life-threatening situations, the impact won’t be confined to this case or to Lee County, or even to public schools,” wrote Miller and La Fetra. “Potentially, every sports facility or program that is made available for youth athletics would be affected — whether operated by school districts, local or state government, parks departments, universities, even private property owners. They would all have to be prepared to use an AED if an athlete were to collapse — or face legal and financial liability.”
Still, few would argue that liability trumps student athletes’ access to a device proven to save lives, and in many states, “Good Samaritan” law protect coaches, administrators, parents or bystanders certified to provide CPR and use an AED. As state laws on the devices remain uneven, it’s parents groups and individual communities that will likely be behind the drive to ensure AEDs are readily available at youth sporting events.