Circumstances and Outcomes of Out-Of-Hospital Cardiac Arrest in Elementary and Middle School Students in the Era of Public-Access Defibrillation

Aiming for Zero Deaths: Prevention of Sudden Cardiac Death in Schools – Statement From the AED Committee of the Japanese Circulation Society –

“…It is important for the school staff to understand the following: (1) sudden cardiac arrest can occur in school; (2) the keys to successful rescue are hands-on teamwork at the scene and effective timing of each step of the "chain of had been diagnosed prior to the event. 4 Moreover, because there are a substantial number of commotio cordis cases in which ventricular fibrillation develops after an accidental blow to the chest, most frequently with a hard ball thrown at school or in the playground, it is almost impossible to predict the tragic event. According to the analysis cited above, which excluded cases of commotio cordis, in 97% of the cases of cardiac arrest in school the event was witnessed, in 84% of the cases the subject received chest compression, and a school AED was used in 38% of cases.…”

“…As a result, 72% of the victims were rescued and survived for at least 1 month. 4 As ventricular fibrillation was recorded in 94% of the cases, the survival rate would have been even higher if use of an AED was more thorough and timely at the scene for earlier termination of ventricular fibrillation. A 100% survival rate is not a dream but a real target well achievable through developing and intensifying life-saving programs in schools comprising rapid defibrillation using AEDs, which are placed in every elementary/middle/high school, combined with chest compression to circulate blood to critical organs both before and after defibrillation.…”

“…4 As commotio cordis also tends to develop during sports activities, placement of AEDs in such locations is strongly recommended. It is also advised that AEDs should be available 24 h, weekdays and holidays for unexpected cardiac arrest occurring during club activities after school.…”

Mismatch between Sites of Incidence of Out-of-Hospital Cardiac Arrest and Locations of Installed Automated External Defibrillator in the Tokyo Metropolitan Area

“…Witnessed cardiac arrests at schools are (97%), with high incidents bystander's CPR (84%), and school AEDs applied (38%) [7]. The bystander's CPR rate , ROSC rate prior to arriving at the hospital and one-month survival rate are thought to be high at "Schools" due to the fact that a high percentage of teachers, who have a strong possibility of witnessing the cardiac arrest, have received instruction on CPR [8], and according to an investigation by the Ministry of Education, Culture, Sports, Science and Technology [9], the rate of installation of AEDs at public and private schools was 92.3% as of 2010 and is now reached to 100%.…”

Outcomes of Pediatric Out-of-Hospital Cardiac Arrest

“…2 They found that school-aged children after OHCA were more likely to be resuscitated and defibrillated by bystanders (especially school teachers) and had a better outcome in school than out of school. They emphasize that the study results could be relevant to the efficient placement of AED and the focused education of CPR with AED in schools.…”