Abstract 19536: Primary and Secondary Prevention of Athletic Sudden Cardiac Death in Suffolk County Public High Schools, New York

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Optimal strategies to prevent and treat SCD (Sudden Cardiac Death) in student athletes remain debatable. To identify students at risk of SCD, American Heart Association (AHA) has recommended a 12-point pre-participation evaluation (PPE) tool. NY State laws require the presence of Automated External Defibrillators (AEDs) during high school sports activities. Aim: To examine (1) adherence to AHA’s 12 element PPE (2) presence, training and implementation of AEDs in Suffolk County public schools. Methods: In 2010, voluntary surveys were sent out to 53 public school districts in Suffolk County. Each district’s PPE forms were requested to evaluate adherence to AHA recommendations. AED survey included its presence, training and use. Results: A total of 52 districts responded to PPE request (response rate 98.1%). No districts used all 12 elements in their forms; 11 districts (21.5%) used no elements; majority (35 districts, 67.31%) used ≤ 4 elements. Maximum number of elements used was 8 in 19 districts (15.38%). Most frequently used element was syncope (57.9%). Each elements frequency is tabulated. 27 districts completed AED survey (response rate 50.9%). Each school had at least 2 AEDs (range 2-34, mean 19.2); students per AED was 70.9. Coaches (92.6%) were mostly to be trained in AED formally followed by 85.2% of school nurses, 51.9% of security staff, 32.14% of teachers, and 17.85% of students. A total 25 districts (89.29%) had emergency response plan, 26 (92.85%) had access to early defibrillation, 21 (75%) had practiced emergency response plan. There was no significant correlation between number of AEDs in a school and number of AHA elements used in PPE forms (ρ = -0.3251, P < 0.2567). CONCLUSION: In the absence of legislation mandating implementation of the AHA PPE tool, suboptimal adherence persists. In contrast, implementation of AEDs appears more promising. Future management guidelines should focus on broader AED training of students and teachers.

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