Radius of care in secondary schools in the midwest: Are automated external defibrillators sufficiently accessible to enable optimal patient care?

Abstract

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% 6 11.0%) possessed more property outside the radius of care than did private schools (23.8% 6 8.0%; F1,28 ¼ 8.35, P ¼ .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 (F1.48,41.35 ¼ 4.99, P ¼ .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.