Radius of Care in Secondary Schools in the Midwest: Are Automated External Defibrillators Sufficiently Accessible to Enable Optimal Patient Care?

CONTEXT

Sudden cardiac arrest is the leading cause of death among young athletes. According to the American Heart Association, an automated external defibrillator (AED) should be available within a 1- to 1.5-minute brisk walk from the patient for the highest chance of survival. Secondary school personnel have reported a lack of understanding about the proper number and placement of AEDs for optimal patient care.

OBJECTIVE

To determine whether fixed AEDs were located within a 1- to 1.5-minute timeframe from any location on secondary school property (ie, radius of care).

DESIGN

Cross-sectional study.

SETTING

Public and private secondary schools in northwest Ohio and southeast Michigan.

PATIENTS OR OTHER PARTICIPANTS

Thirty schools (24 public, 6 private) volunteered.

MAIN OUTCOME MEASURE(S): Global positioning system coordinates were used to survey the entire school properties and determine AED locations. From each AED location, the radius of care was calculated for 3 retrieval speeds: walking, jogging, and driving a utility vehicle. Data were analyzed to expose any property area that fell outside the radius of care.

RESULTS

Public schools (37.1% ± 11.0%) possessed more property outside the radius of care than did private schools (23.8% ± 8.0%; F = 8.35, P = .01). After accounting for retrieval speed, we still observed differences between school types when personnel would need to walk or jog to retrieve an AED ( F = 4.99, P = .02). The percentages of school property outside the radius of care for public and private schools were 72.6% and 56.3%, respectively, when walking and 34.4% and 12.2%, respectively, when jogging. Only 4.2% of the public and none of the private schools had property outside the radius of care when driving a utility vehicle.

CONCLUSION

Schools should strategically place AEDs to decrease the percentage of property area outside the radius of care. In some cases, placement in a centralized location that is publicly accessible may be more important than the overall number of AEDs on site.