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Why Cardiac Emergency Preparedness in Schools is Critical for Student and Staff Safety

Woman standing next to Heart Safe Schools posterSudden cardiac arrest (SCA) is a leading cause of death worldwide, with over 300,000 cases annually in the United States alone (American Heart Association, 2005). Shockingly, less than 10% of individuals who suffer from SCA survive, and those who do not receive immediate intervention, such as CPR (cardiopulmonary resuscitation) and an AED (automated external defibrillator) shock from a bystander, have little to no chance of survival. The first few minutes following a cardiac arrest are crucial, and the presence of trained individuals with the right tools can mean the difference between life and death.

In schools, the stakes are especially high. SCA is the leading cause of death among student-athletes, accounting for over half of all fatalities in this group. Given the large number of students, staff, and visitors present in schools each day, it is imperative that schools are prepared to respond effectively to cardiac emergencies.  This means not only having the right equipment in place but also ensuring that school staff are trained and ready to act swiftly.

Findings from a Recent Study on Cardiac Emergency Preparedness in Illinois Schools

Woman standing next ot Dorothy Simon Elementary School poster

Heather Baker, a Sudden Cardiac Arrest Survivor, Elementary School Principal, and Project ADAM Volunteer recently published her study “Is Anyone Ready to Save a Life? An Examination of Cardiac Emergency Preparedness in Schools” in the Journal of School Health. After suffering from sudden cardiac arrest at school at the age of 28, her life was saved by her coworkers who fortunately knew how to perform CPR/AED. The purpose of her study was to measure current levels of cardiac emergency preparedness in schools and determine how willing educators are to be CPR/AED trained.

The study was conducted in Illinois and surveyed over 1,200 school employees to assess their cardiac emergency preparedness and attitudes toward CPR and AED training. The study revealed several important insights into the current state of preparedness in schools:

1. Training Gaps and Inequities

While 59.4% of school employees reported that CPR/AED training was offered at their schools, significant inequities in access to training were found. Employees at larger schools were more likely to be offered training than those at smaller schools, and employees at high schools were more likely to have participated in training compared to their peers in elementary and middle schools. Additionally, employees working in urban schools or schools serving low-income students were less likely to receive CPR/AED training.

2. Preparedness and Confidence

Despite a majority of employees reporting that they had received CPR/AED training, only 39.5% felt prepared to respond to a cardiac emergency, and even fewer (26.5%) felt that their school provided enough training for them to handle such an emergency. Those who had participated in CPR/AED training were significantly more likely to report feeling prepared and confident in their ability to respond to a cardiac emergency. However, many trained individuals still lacked fundamental knowledge about CPR/AED techniques, suggesting that more training and practice are needed to reinforce skills.

3. Willingness to Act

Interestingly, while many employees expressed confidence in their ability to perform CPR and use an AED, there were disparities in willingness to act based on factors such as school type and socioeconomic status. Overall, a majority (83.6%) of school employees indicated that they were willing to perform hands-only CPR on a victim of SCA, and 74.5% said they were willing to use an AED. However, those working in schools with lower socioeconomic status (SES) were less confident in their ability to perform these life-saving techniques, highlighting the need for equitable access to training across all schools.

4. Cardiac Emergency Response Plans (CERPs)

The study also found that a significant number of schools lacked formal cardiac emergency response plans or had staff who were unaware of the steps in their school’s plan. While 97.2% of respondents believed that their school should have a CERP, 74.6% had never participated in a cardiac emergency drill. Without such plans and drills in place, school employees may not be fully prepared to respond in a high-pressure emergency situation.

5. Willingness to Be Trained and Implement CERPs

Although the majority of participants indicated that they were not prepared to respond to SCA, school employees were largely in support of measures to increase cardiac emergency preparedness. In this study, 97.4% of school employees indicated that they wanted their school to offer CPR/AED training and retraining, 98.7% believed that some or all school employees should be CPR/AED trained, and 84.7% believed that state law should mandate some or all school employees to learn CPR/AED at once in their career. The majority believed their school should require training for some or all employees through local policy (91.4%). Most school employees (97.2%) believed that their school should have a CERP, and 84.1% believed that their school should complete a cardiac emergency response drill. Over half (66.9%) of employees reported wanting more training on how to recognize and respond to a SCA at school, and 95.7% indicated they would attend a free CPR/AED class if offered by the school.

Implications for Schools and Policymakers

The findings of this study underscore the importance of ensuring that all school staff are adequately trained to respond to a cardiac emergency. While most school employees expressed a desire for more training and supported efforts to increase preparedness, gaps in training, inequities across school populations, and lack of formal response plans remain significant challenges.  Here are several key recommendations for schools and policymakers:

  • Increase CPR/AED Training for All Staff.  CPR and AED training should not be limited to a few individuals but should be provided regularly to all school employees. This includes teachers, administrators, coaches, custodians, and nurses. Offering training on-site, during school hours, can help overcome barriers related to time and cost.
  • Develop and Implement Cardiac Emergency Response Plans (CERPs).  Every school should have a CERP in place, which includes clear protocols for managing a cardiac emergency. School leaders should ensure that all staff are familiar with the plan and that regular drills are conducted to practice the procedures.
  • Address Disparities in Training Access.  Policymakers must ensure that all schools, especially those serving disadvantaged communities, have access to the resources needed for CPR/AED training. Efforts should be made to ensure equitable distribution of training opportunities across all schools, regardless of their size, location, or socioeconomic status.
  • Mandate Cardiac Emergency Drills.  Just as fire drills are a common practice in schools, cardiac emergency response drills should also be required. These drills will help staff become familiar with emergency procedures and build the confidence needed to act quickly and effectively in a real emergency.
  • Legislative Support.  Policymakers should consider legislation to require CPR/AED training for all school employees and mandate the creation of CERPs and regular emergency drills. This could significantly improve the chances of survival for students and staff who experience sudden cardiac arrest.

Cardiac emergency training

In conclusion, schools play a critical role in ensuring the safety of their communities, and this includes being prepared for cardiac emergencies. With proper training, cardiac emergency response plans, and regular drills, school employees can make a life-saving difference in the event of sudden cardiac arrest. The overwhelming support for increased cardiac preparedness among school staff, combined with the evidence that training improves confidence, willingness, and survival rates, should be a catalyst for change. It is time to prioritize cardiac emergency preparedness in schools to ensure that every student, staff member, and visitor is safe and supported in the event of an emergency.

Project ADAM helps schools become prepared for cardiac emergencies by equipping them with the tools, resources, and knowledge to become Heart Safe. The Heart Safe Schools program ensures AEDs are strategically placed around school campuses, offers ongoing support for cardiac emergency response plans and drills, and raises awareness about heart health and risk factors. By fostering a heart-safe culture and ensuring that all school personnel are prepared to act quickly, Project ADAM significantly improves the chances of survival in the event of a cardiac emergency, providing critical support for both prevention and response.

Heather K. Baker, EdD
Sudden Cardiac Arrest Survivor, Project ADAM National & IL Advocate