A wall-mounted AED. (Courtesy of the American Heart Association)
Under a law recently passed by the General Assembly, Virginia will require public schools to acquire and maintain automated external defibrillators, or AEDs, a medical device commonly used to help a heart return to a normal rhythm in an emergency.
It’s unclear how many schools in the commonwealth already have defibrillators, but the new law will require school boards to develop a plan for their placement and care in every school. Under current law, schools have the option to develop their own plan.
“We have all the ingredients and all the training already in place, except on the books,” said Sen. Jeremy McPike, D-Prince William, during a January subcommittee hearing on the proposal. The actual requirement for a defibrillator, he continued, “is really the last missing link of the chain of survival.”
McPike said he introduced the legislation following the Jan. 2 heart attack suffered by Damar Hamlin, a then-24-year-old defensive back for the Buffalo Bills, minutes into the start of a nationally televised football game.
Athletic trainers administered CPR and used a defibrillator on Hamlin before emergency services rushed him to a local hospital. Hamlin was discharged nine days later. But the incident spurred broader awareness of the risks of heart attacks even among relatively young people.
McPike submitted a budget amendment for $400,000 to help school divisions without defibrillators cover the costs of acquiring them. That money is tied up in ongoing negotiations between Democrats and Republicans on how to amend the state’s biennial budget.
He said the funding would be available to both schools and nonprofit organizations. According to the American Heart Association, most units cost between $1,500 and $2,000.
On Wednesday, the General Assembly agreed to an amendment requested by Gov. Glenn Youngkin that would require the Virginia Department of Education to put together a public list of public and private funding sources that could be used to fulfill the new law’s requirements.
Increasing AEDs in schools
Virginia previously took steps to increase the availability of AEDs in schools following the death of a 13-year-old Virginian named Gwyneth Griffin, who in 2012 died after suffering cardiac arrest at school. Family and those connected to them said an AED was not readily available when the teen collapsed.
In 2013, lawmakers passed what became known as “Gwyneth’s Law,” carried by Sen. Richard Stuart, R-Westmoreland, and former Republican Del. L. Mark Dudenhefer, requiring teachers and students to receive training in emergency first aid, CPR and the use of AEDs.
The Virginia Department of Education and Department of Health were also required to adopt regulations and establish guidelines to ensure schools follow the law.
While Griffin’s death garnered statewide attention, the earlier death of 15-year-old Danica Canfield at Robinson High School in Fairfax County in 2002 due to cardiac arrest had already provoked local efforts to put defibrillators in all schools. At the time, Fairfax school officials estimated the district would need to purchase 580 AEDs to ensure one could be reached in any school within minutes.
The current picture in Virginia schools
The number of defibrillators in Virginia schools is uncertain. However, some schools, including those in Hanover and Henrico and many in Northern Virginia, said they are equipped with the units.
Betsy Looney, president-elect for the Virginia Association of School Nurses, said the group wrote 1,000 letters in support of McPike’s legislation to help close the gap.
“It was the missing link,” Looney said. “You require all of this, but you don’t have the $1,000 piece of machinery that is proven to save lives. Children go into cardiac arrest, adults go into cardiac arrest and if you put that AED on them, it saves them. That is a proven fact.”
“All nurses want this,” she continued. “The last thing you want to be is a school nurse, you see someone in cardiac arrest — knowing that an AED could save them — and you don’t have the life-saving piece of equipment. It’s devastating.”
According to ongoing research by the Athletic Training Locations and Services Project (ATLAS) that started in 2015, 97% of 238 secondary schools in Virginia with athletic training services have access to an AED, and 91% have access to an AED within one to three minutes of each athletic venue.
However, while most schools with athletic training services in Virginia have access to an AED, not all of the state’s 477 public and private secondary schools with athletic programs do.
Schools with athletic programs are those with at least one athletic team, according to the Korey Stringer Institute, which was formed to improve safety and prevent sudden death for athletes. Athletic training services go a step further: Schools with these services employ athletic trainers with specific medical and administrative skills.
Athletic trainers in most states, including Virginia, must pass a national certification exam and graduate from an accredited program.
Researchers from the Korey Stringer Institute said they have been unable to determine if the 188 other secondary schools in Virginia have AEDs. Those numbers also don’t include primary schools.
The National Center for Catastrophic Sport Injury Research at the University of North Carolina has found cardiac arrest to be the leading cause of death in sports and responsible for over 60% of all catastrophic sports injuries. A 2019 study published in Sports Health journal found that 83% of athletes who suffered a sudden cardiac arrest survived if an athletic trainer was onsite and involved in the resuscitation and 89% survived if an onsite AED was used in the resuscitation.
Researchers from the Korey Stringer Institute said ideally, an AED would be accessible for use within one to three minutes of every athletic venue for all competitions and practices.
“A sudden cardiac arrest in sports can happen at any time, in any sport, at any level of competition,” the institute said in a statement.
The institute also advocates for all athletic venues to have access to an AED, because even if a school has a defibrillator, cases have occurred where the unit is locked inside a room and not available to a team after hours.
“Unfortunately KSI has been involved with and is aware of many tragic cases where an athlete collapsed due to [sudden cardiac arrest] and an AED was not applied, despite the school having an AED because it was not accessible or no one knew where it was,” wrote Christianne Eason, president of sport safety and education with the Korey Institute.
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