The Shocking Truth Behind Saving Lives at High School Athletic Events

Caleb Ellis

In partial fulfillment for

Rhetoric II
Mr. Adkisson
6 March, 2015

Ellis 1

Introduction
A normal Tuesday evening in Marlboro, New Jersey at Marlboro High School quickly
turned into one that would be remembered forever. The events scheduled to take place that
evening involved the Varsity and JV girls basketball teams of Malboro, against Middletown
High School. Mark Bramble, the licensed athletic trainer for Malboro High School prepared the
gym for the game and guided the athletes through stretches and injury prevention techniques just
like any other normal day. However, his usual work for the day would soon take a drastic turn.
Sometime after the start of the game, a spectator in the stands suddenly collapsed from a cardiac
episode. A nurse that happened to be in the stands watching her daughter play quickly tended to
the man and began CPR as Mark called 911 and retrieved the schools AED.1
Narration
Sudden cardiac arrest is the leading cause of death in the United States and can strike anyone at
any time. It is the cause of death for about 365,000 people each year, 7,000 of those being
children. Overall, ninety-five percent of people who experience SCA die from it, most within
minutes.2 An automated external defibrillator (AED) is a lightweight, portable, computerized
medical device that is used to examine a persons heartbeat. It is designed to recognize any
abnormal heartbeat through pads, called electrodes, and will advise a rescuer when to administer
a defibrillation shock in order to return the heart to a normal rhythm. The AED communicates
1 Athletic Trainers Society of New Jersey, Marlboro, NJ High School Athletic Trainer Saves the Life of
a Spectator, Accessed March 5, 2015, http://www.atsnj.org/article/marlboro-nj-high-school-athletictrainer-saves-life-spectator.
2 National Heart, Lung, and Blood Institute, What Is an Automated External Defibrillator, Modified
December 2, 2011, http://www.nhlbi.nih.gov/health/health-topics/topics/aed.

Ellis 2
this information with the rescuer through text messages, graphical instruction, and voice
prompts.3 Although many different types of AEDs exist, all follow the same basic procedures,
and are intended for use by those who have achieved certification through a CPR class.4 Among
some of the most important factors in smoothly responding to a victim who has experienced SCA
are maintaining the AED properly and notifying emergency officials of its location.5
The beginning of the AED dates back to the 19th century. Two physiologists, Jean-Louis Prevost
and Frederic Batelli from the University of Geneva in Switzerland, first used a defibrillation
shock in 1899. They discovered that even a small electrical shock could induce a ventricular
fibrillation, thus leading to the quivering of the lower chambers of the heart and resulting in the
stoppage of a heartbeat. Claude Beck, professor of surgery at Case Western Reserve University,
first performed defibrillation on a human in 1947 when he successfully resuscitated a fourteen
year old boy who was undergoing surgery for a congenital chest defect. In the 1960s, portable
defibrillators were implemented into ambulances. Today, defibrillators remain the only way to
resuscitate someone who has undergone SCA and is still experiencing ventricular fibrillation or
ventricular tachycardia.6
One must understand how the heart works in order to understand how an AED works. Every
heart has an internal electrical system that controls the rhythm and rate of the heartbeat. Each
3 The University Of Pennsylvania Division Of Public Safety, Automated External Defibrillator,
Accessed March 5, 2015, http://www.publicsafety.upenn.edu/pennready/AED/.
4 The University of Pennsylvania Division of Public Safety, Using an AED, Accessed March 5, 2015,
http://www.publicsafety.upenn.edu/pennready/AED/use/.
5 National Heart, Lung, and Blood Institute, How Does an Automated External Defibrillator Work?,
Modified December 2, 2011, http://www.nhlbi.nih.gov/health/health-topics/topics/aed/howdoes.
6 The University Of Pennsylvania Division Of Public Safety, History, Accessed March 5, 2015,
http://www.publicsafety.upenn.edu/pennready/AED/history/.

Ellis 3
time the heart beats, an electrical signal is sent from the top of the heart to the bottom. As this
signal travels, it causes the heart to contract and pump blood. This entire process is repeated
every time the heart beats. Problems with the internal electrical system of the heart can cause
abnormal heart rhythms, called arrhythmias. During arrhythmias, the heart can beat too fast, too
slow, or at an irregular rhythm, which can lead to SCA.7 SCA is a medical emergency that occurs
when an arrhythmia causes the heart to stop beating, which prevents the pumping of blood
throughout the rest of the body, causing it to shut down. Therefore, the victim will die within
minutes if CPR and an AED is not administered in an attempt to save their life.8
Two of the most common types of arrhythmias that cause SCA are ventricular fibrillation (VF)
and ventricular tachycardia (VT). Of the two, VF is the most serious cardiac rhythm disturbance
that involves the lower chambers of the heart quivering, so that the heart no longer pumps blood,
thus leading to cardiac arrest. Essentially, the electricity throughout the heart becomes
disordered, and the lower, or pumping chambers of the heart begin to contract in a rapid,
unsynchronized way, meaning the ventricles flutter rather than beat. Because of this, the heart
pumps little or no blood at all.9 On the other hand, VT is a rapid heartbeat that begins in the
ventricles of the heart. It is a heart rate of 100 beats per minute with usually at least three
irregular heartbeats in a row. It can occur with no former history of heart disease and can form

7 Nation Heart, Lung, and Blood Institute, What Is an Automated External Defibrillator, Modified
December 2, 2011, http://www.nhlbi.nih.gov/health/health-topics/topics/aed.
8 Medline Plus, Cardiac Arrest, Modified February 11, 2015,
http://www.nlm.nih.gov/medlineplus/cardiacarrest.html.
9 American Heart Association, Ventricular Fibrillation, Accessed March 5, 2015,
http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/VentricularFibrillation_UCM_324063_Article.jsp.

Ellis 4
after a heart attack through tearing of the muscle in the walls of the ventricles. 10 A heart beat that
is too fast is called a tachycardia, whereas a heartbeat that is too slow is called a bradycardia.11
Division
In the debate over AEDs, many questions relate to the necessity of an AEDs implementation at
all sporting events. Those in favor of having AEDs at all athletic events argue that AEDs help
save the lives of people that experience SCA. By using the defibrillator, one can increase chances
of survival while waiting for emergency medical services to arrive. They also argue that AEDs
remain the only form of treatment to resuscitate a victim of SCA. Opponents argue that AEDs are
not needed at all sporting events, as they are costly and require training to use effectively. They
argue that AEDs are only needed at certain events such as sports that involve high amounts of
contact. For example, this side would argue that an AED should be present at a football game but
does not need to be present at a tennis match because research indicates that the higher the
amount of contact and physical demand in a sport, the higher the risk of SCA.
Another point of contention lies around the cost-effectiveness of an AED and necessity of
having trained professionals available to respond at the time of SCA. Those who argue that
AEDs are cost-effective say that they are a large initial expense for an athletic program, but the
possibility of saving someones life is clearly worth the cost. They also say that all sporting
events should have at least one trained professional available, and that the school should alert
personnel beforehand of an emergency action plan. However, there are also those who argue that
the risk of SCA in athletes is very low and does not warrant the expense of purchasing an AED
10 Medline Plus, Ventricular Tachycardia, Modified February 15, 2015,
http://www.nlm.nih.gov/medlineplus/ency/article/000187.htm.
11 National Heart, Lung, and Blood Institute, What Is an Arrhythmia, Modified July 1, 2011,
http://www.nhlbi.nih.gov/health/health-topics/topics/arr.

Ellis 5
for most athletic programs. They question whether it is worth it to spend thousands of dollars on
a device that could possibly sit around and never be used. Furthermore, opponents point to the
possibility of a trained professional being absent when someone undergoes SCA, and thus
rendering the AED worthless.
Another commonly debated topic is the location of the AED(s). Some schools place their
AEDs in specific locations which are strategically decided upon to ensure that the AED is
equally in reach if SCA occurred anywhere on campus. Most schools will have signs throughout
buildings or on fields to point to the exact locations of the AEDs. Quick access to an AED is
critical in many SCA cases and can make the difference between life and death.12 On the other
hand, some schools do not place their AEDs in a specific location. For example, if there was a
football game at a school, trained personnel would have the AED directly on the sideline.
Otherwise, the AED would change from location to location depending on circumstances.
Another important argument involves the proper training of all school staff and personnel for
AED use. Some argue that schools should have all personnel that are directly involved with
athletes trained in emergency care.13 Key personnel may include coaches, equipment managers,
or officials.14They also argue that additional school administrators or personnel not trained in
AED use should receive training in activation of emergency action plans such as calling 911,
controlling crowds, identifying the victim, or directing emergency personnel to the correct area.
However, many argue that school personnel should not have the responsibility of providing
12 Eric E. Coris, Steve Walz, Anne B. Curtis, Frances Sahebzamani, and Kira Zwygart, Sports
Cardiology Essentials: Evaluation, Management and Case Studies (New York: Springer-Verlag, 2011),
12.
13 Ibid, 12.
14 Ibid, 12.

Ellis 6
emergency cardiac care for students and athletes. Some personnel that are not medically certified
in the use of an AED desire to avoid administering an AED completely. This is mainly due to
liability, in the case that they use the AED in an incorrect manner that possibly harms the victim
even further. These opponents argue that if they are not trained to use an AED, then they will not
have to use it, thereby avoiding liability issues.
To decrease the rate of SCD in high school athletes, at least one AED needs to be present
in all high schools and should be placed in as close proximity as possible to a sporting event in
the case that SCA occurs. Additionally, school officials such as coaches, equipment managers,
and trainers need to be certified in the use of an AED and made aware ahead of time of an
emergency action plan.
Proof
All people want to keep athletes as safe as possible, and having an AED at every sporting
event provides some confidence in this area. No one would argue in favor of providing a less
safe environment for athletes to participate in, and no school official wants to think about the
death of a student who is under their responsibility. Therefore, if resources are available, then an
AED should always be present, along with someone who is certified in its use. It is a moral
imperative that this be implemented especially when AEDs are so available and affordable.
Many AEDs now cost less than $1500, and the necessary training can be completed within one to
two hours.15 Furthermore, parents may feel morally compelled to aid in the purchase of an AED
if necessary. Parents obviously want the safest environment for their child to compete in, and
may even feel driven to become certified in AED use themselves, in the case that they need to
respond to a victim whether it be there child or not.
15 Sudden Cardiac Arrest Association, Saving Lives in Schools and Sports, Accessed March 5, 2015,
http://www.parentheartwatch.org/LinkClick.aspx?fileticket=jr8KD_8fpYQ%3D&tabid=83.

Ellis 7
The government, in some respects, should feel morally obligated when it comes to the use of
AEDs in high schools around the country. According the Sudden Cardiac Arrest association,
stationed in D.C., Over the past decade, more than 20 states have enacted laws to require AEDs
in at least some schools and athletic facilities. The debate about their value is quickly put to rest
when you hear reports such as two Houston, Texas students being revived within a month of each
other at the start of the 2008-2009 school year.16 Governments should want to provide their
nations educational systems with the proper tools to provide safe environments. They should
recognize that SCA is the leading cause of death around the United States and take one step to
preventing it by providing schools with AEDs.
The AED is still the only device to date that can resuscitate someone who has undergone cardiac
arrest.17 Exceeding 300,000 cases annually, sudden cardiac death is the leading cause of death in
the USA.18 Although sudden cardiac death during sports is a rare event, it always has a tragic
impact on the community because it occurs in apparently healthy individuals and assumes great
visibility through the news media due to the high public profile of competitive athletes.19 In
2011, CNN reported the deaths of four high school athletes within two weeks of each other,
which is shockingly constant with the national average. One of these victims, a native of North

16 Sudden Cardiac Arrest Association, Saving Lives in Schools and Sports, Accessed March 5, 2015,
http://www.parentheartwatch.org/LinkClick.aspx?fileticket=jr8KD_8fpYQ%3D&tabid=83.
17 The University Of Pennsylvania Division Of Public Safety, History, Modified March 5, 2015,
http://www.publicsafety.upenn.edu/pennready/AED/history/.
18 Eric E. Coris, Steve Walz, Anne B. Curtis, Frances Sahebzamani, and Kira Zwygart, Sports
Cardiology Essentials: Evaluation, Management and Case Studies (New York: Springer-Verlag, 2011), 3.
19 Domenico Corrado, Barry J. Maron, Cristina Basso, Antonio Pelliccia, and Gaetano Thiene,
Electrical Diseases of the Heart: Genetics, Mechanisms, Treatment, Prevention (London: SpringerVerlager, 2008), 911.

Ellis 8
Carolina, Jarvis Brinkley died of heart failure after playing basketball at a church Monday20
Because of the devastating impact of one dying from SCA, it is an important medical
responsibility to create an informed public and, to pursue when practical, early detection of those
diseases or conditions that may be responsible for catastrophic events in young athletes, as well
as to design potentially effective preventive measures.21 The most critical of these prevention
measures is the AED, especially its location. Barry J. Maron states that,
Automatic external defibrillators save lives in the community because they can elicit a rapid
response and early defibrillation and automatically provide an analysis of cardiac rhythm. If
these systems become more widely disseminated and available for use by the
general public
at schools and athletic facilities, they will undoubtedly result in the
survival of many
athletes who have cardiac arrest as a result of blows to the chest or cardiovascular disease.22
Since SCA can occur anywhere at any time, AEDs should be present in most places around the
world. They are especially needed, however, in high schools within the United States. A
paradox of sport is that in addition to the undisputed health benefits of physical activity,
vigorous exertion may transiently increase the risk of acute cardiac events. In general, the risk of
sudden cardiac death (SCD) approximately doubles during physical activity and is 2- to 3-fold
higher in athletes compared to non-athletes.23A study based on data assembled from a broadbased United States population revealed that seventy percent of the one hundred thirty-four

20 CNN, How can teen athlete deaths be prevented?, Accessed March 5, 2015,
http://www.cnn.com/2011/HEALTH/03/11/teen.heart.deaths/.
21 Barry J. Maron, Antonio Bayes De Luna, Francesco Furlanello, and Douglas P. Zipes, Arrythmias and
Sudden Death in Athletes (Netherlands: Kluwer Academic Publishers, 2000), 1.
22 Barry J. Maron, Sudden Death in Young Athletes, The New England Journal of Medicine (2003):
1068-1069. Accessed March 5, 2015. doi: 10.1056/NEJMra022783.
23 Christian Schmied, and Borjesson Mats, Sudden Cardiac Death in Athletes, Journal of Internal
Medicine (2014): 93-103. Accessed March 5, 2015. doi: 10.1111/joim.12184.

Ellis 9
incidents of sudden cardiac death involved football or basketball.24 This makes sense, because
basketball and football reflect intense physical exertion and are the leaders among participation
of team sports in the United States.25 Most of the athletes from the previous study were of high
school age (about sixty percent).26 Because of this, the demand for AEDs at high school athletic
events is more prevalent than at other public sporting venues. Also, a study done in Seattle
reveals that AED programs really do work. In this study, schools in the area with a program held
a remarkable survival rate of thirty-nine percent.27 The Sudden Cardiac Arrest Association goes
on to additionally say that, The presence of AEDs in schools, and more precisely, AED
programs, improves public awareness of what SCA is, what AEDs are, and the importance of
immediate bystander action. This occurs through the transfer of knowledge from students and
staff to family and friends and by direct observation of parents and visitors who see and learn
about AEDs when they visit the school.28
The vast majority of athletes who incur sudden death have been free of cardiovascular
symptoms during their lives and had not been suspected to harbor cardiovascular disease. 29
Relying solely on the screening of athletes to detect heart diseases and prevent SCD often reveals
unreliable information. For this reason, AEDs demand great attention when it comes to saving
24 Barry J. Maron, Antonio Bayes De Luna, Francesco Furlanello, and Douglas P. Zipes, Arrythmias and
Sudden Death in Athletes (Netherlands: Kluwer Academic Publishers, 2000), 3.
25 Ibid, 3.
26 Ibid, 3.
27 Sudden Cardiac Arrest Association, Saving Lives in Schools and Sports, Accessed March 5, 2015,
http://www.parentheartwatch.org/LinkClick.aspx?fileticket=jr8KD_8fpYQ%3D&tabid=83.
28 Ibid.
29 B.J. Maron, Antonio Bayes De Luna, Francesco Furlanello, and Douglas P. Zipes, Arrythmias and
Sudden Death in Athletes (Netherlands: Kluwer Academic Publishers, 2000), 4.

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someones life if they are experiencing SCA. It is easy to argue that other problems exist in the
world that need government attention more especially, until an athlete dies from sudden cardiac
arrest. This death will often cause the school to purchase an AED and train some of their faculty
to use it. No high school should have to endure the death of a student to then take measures to
protect them; they should prepare for SCA beforehand by having an AED available along with an
emergency action plan.
Schools must not either rely solely on emergency services to come to the aid of a victim of SCA.
In fact, in the case that a victim dies before emergency officials arrive, they are not to blame.
SCA must be treated within minutes for a successful outcome, but ideally responders need to aim
for aiding the victim as soon as possible. Therefore, if a school does not have an AED or
someone trained that is available to use it, they cannot hold emergency officials responsible. The
Sudden Cardiac Arrest Association states that, Emergency responders often cannot, and should
not, be expected to get to a victim of SCA fast enough wherever he or she is due to notification
and response logistics. School athletic facilities can be particularly challenging due to their
geographic location, size, and complexity.30 Because of this, the location of an AED can be the
difference between life and death when it comes to an episode of SCA. Each minute that passes
when a defibrillation shock is not applied, the chance of survival is decreased by seven to ten
percent.31 Therefore, time is very crucial, making it obvious that the closer the AED is to the
victim, the higher the chance of survival because of the quicker application. This is why it should
be implemented in all high schools, that if a school has an AED, then it should be on the sideline
30 Sudden Cardiac Arrest Association, Saving Lives in Schools and Sports, Accessed March 5, 2015,
http://www.parentheartwatch.org/LinkClick.aspx?fileticket=jr8KD_8fpYQ%3D&tabid=83.
31 The University of Pennsylvania Division Of Public Safety, Installing an AED in Your Building,
Modified March 5, 2015, http://www.publicsafety.upenn.edu/pennready/AED/installing-an-aed-in-yourbuilding/.

Ellis 11
or within the closest proximately possible to the athletic event. This is also where an Emergency
Action Plan can be the difference between life and death as well. Having faculty aware of the
location of the schools AED, as well as alerting emergency officials of the location of the victim
when they arrive, can increase the chance of survival.
Refutation
Implementing an AED at every sporting event results in non-cost-effective programs. The risk of
SCA is unlikely in most athletes, so if a high-school purchased an AED for usage at every
sporting event, they may end up wasting the money because they never needed to use the AED.
Especially sports such as tennis and golf where SCD appears near non-existent, having an AED
would most likely go unused, thus leading to waste of expense. A general formula for
determining the cost-effectiveness of an AED is as follows: cost per life saved = cost of the
program / number of lives saved. When one adds in incremental cost and other expenses, the
revised formula becomes: cost per life year gained = incremental costs of the program per year /
number of lives saved times the average numbers of years of survival after.32 AEDs cost
anywhere from 1300 to 3000 dollars depending on the features in the device.33 Studies took place
at high-density places with emergency responders and good Samaritans(uncertified individuals
aiding a victim), such as airports and casinos using the formula average cost per year of lives
saved, that was previously laid out in this paragraph.34At these places the cost added up to about
32 National Center for Early Defibrillation, How to Evaluate Cost-Effectiveness of Your AED
Program, Accessed March 5, 2015, http://www.early-defib.org/03_06_09.html.
33 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.
34 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.

Ellis 12
$35000 to $50000 a year per life saved.35 Placing AEDs in large public venues such as shopping
malls or sporting venues resulted in about $500,000 to $2 million per quality year of life saved.36
Furthermore, placing AEDs at large industrial sites, golf courses, health clubs or community
centers ranged from $1 million to $10 million per quality year of life saved.37 While
implementing an AED(s) into these venues resulted in a very costly expense, one cannot put a
cost on a life. For example, take a family who attended their childs sporting event, where AED
implementation expense seems anywhere from $500,000 to $2 million. The athlete in the family
experiences SCA, but fortunately the AED provided a defibrillation shock to return a normal
heart rhythm to the victim, who ended up surviving after ambulances transported them to the
hospital. In this case, say the price of their life resulted in a cost of $500,000 to $2 million, based
off the estimates made from the previous study. If any family member was asked if they would
pay this amount to save their loved ones life, they would not hesitate. Therefore, one cannot put a
price on a life, and all people are willing to go to whatever it takes to save those whom they love,
even if it warrants great cost.
Administering an AED often results in difficulty and confusion and heightens the fact that it
remains an inefficient device in respects to time. A school may possess many AEDs on campus,
but at the same time lack anyone there trained to operate it at the time SCA occurs. Even in a
crowded public place with many potential victims and bystanders, there is a very limited time
window during which an AED can be utilized successfully.38Survival rates of SCA fall
dramatically with every moment that passes in which an AED lacks application to a victims
35 Ibid.
36 Ibid.
37 Ibid.

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chest, warranting them inefficient in the aspect of time. Without the administration of early CPR
on an SCA victim, survival rate drops 7-10% a minute.39 Even with the administration of early
CPR, survival rates drop 3-4% a minute.40 Because of these factors, many things must fall in
place for an AED to be effective in its use, warranting it an inefficient machine. In the case that
the victim participated in a sporting activity at a high school before experiencing SCA, time
would not be an issue. Over the course of this thesis, many arguments have been presented
showing that the AED should be placed in as close proximity to the athletic field as possible.
Because the AED stays ready to use on the sideline, the AED will be administered without delay,
therefore making loss of time not an issue. Additionally, schools should have Emergency Action
Plans(EAPs) set up and practiced beforehand, so that when an emergency does arise, the school
loses no time due to panicking or searching for safety equipment, but can deliver quick and
efficient care. Since coaches are among individuals in the school officials that should be trained
in AED use, having someone present to use one would not be a problem.
A study done in which AEDs were placed in various communities reveals them as un-needed
devices in non-hospital settings (such as high schools.) Over a four year period, 3754 cases of
SCA were reported to medical emergency teams and the AED was only administered fifty
times.41 Each of the fifty victims that received the AED administration, also received by-standard
38 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.
39 Ibid.
40 Ibid.
41 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.

Ellis 14
CPR, in attempt to increase survival rates.42 Only twenty-five of these victims survived after a
defibrillation shock and a discharge to the hospital.43 This study suggests that, despite
community based dissemination of AEDs, they are used in only a very small fraction of out-ofhospital cardiac arrests.44 High schools could be considered among these out-of-hospital
settings. However, one reason the AEDs only reached fifty of the 3754 cases was because the
AEDs locations were not right alongside of the victim. As stated in the previous argument, since
this thesis covers AED implementation at high school athletic events, and pushes that they be
placed as close as possible to the event, getting the AED to the victim would not be a problem.
Another study suggested that if there exists an area inhabited predominately by people at highrisk for SCA, then the presence of an AED will not increase survival rates. The study played out
by placing AEDs in the homes of individuals at high risk for SCA and allowing spouses or
friends to administer CPR and the AED while emergency officials arrived.45 The individuals
were split into two groups, and nineteen patients were resuscitated out of about 150 cases of
SCA.46 The study concluded that if you are at high-risk of SCA, then having an AED right
alongside of you really does nothing to alter the rate of resuscitation, since you are already at

42 Ibid.
43 Ibid.
44 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.
45 Ibid.
46 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.

Ellis 15
such a high disadvantage.47 Some most likely incurred some sort of heart disease and had been
informed by a cardiologist that if they had a heart attack, their chances to live were already at a
low rate. Throughout high-schools, there are always a few students and student athletes that
exists that are at high-risk for SCA. Some of them may be aware and take pre-caution, but many
do not know, because SCA generally occurs in relatively healthy individuals. So if the above
study is true, then having an AED right alongside each student athlete in a high-school, which
was filled with athletes that were predominately at high risk, really wouldnt raise resuscitation
rates. However, the above study involved victims who were of ages long past high-school,
already warranting that they have less healthy hearts. Being at high risk for SCA and not
knowing it is different than being old and not active and having an un-healthy heart. In high
schools today, most of the students are healthy individuals and not many have heart disorders.
Furthermore, if a student knew they had heart problems warranting them at higher risk, the
family of the child needs to take time to seriously discuss if playing a sport is worth the risk and
danger. If they agree that it remains very important and the student wants to play, the school
needs to pay close attention to this student, or group of students, and acknowledge their
disadvantage compared to other students at risk for SCA.
After considering the data, these studies concluded upon the cost-effectiveness of an AED, and
its effectiveness in resuscitation. AEDs remain very good at detecting abnormal heart beats and
can alert a responder when a victim needs a defibrillation shock. The earlier they are placed on a
patient, the higher the chance of survival. The window of opportunity to save someones life
through a defibrillation shock is limited, and severely decreases if it is not administered within 3-

47 Ibid.

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5 minutes of collapse.48 Therefore when placed in areas with high numbers of victims and high
numbers of resuscitators, they are able to increase the yield of survival of out-of-hospital SCA.49
AEDs are cost effective only when used in situations where a reasonable number of cardiac
arrests are expected to occur, the arrests are likely to be witnessed, and there are enough AEDs
available to permit defibrillation within minutes.50 AEDs have minimal impact when placed
widely in the community and have little or no role in saving the life of any single high-risk
individual where ICDs are the preferred treatment.51
Conclusion
The spectator who collapsed at the Marlboro High School basketball survived because of a quick
response with CPR and AED use. When later asked about the situation Mark said, Having an
AED and an Emergency Action Plan in place is vital in protecting our student athletes as well as
those who attend interscholastic athletic competitions.52 The most important of the methods
used in the response to the victim was the AED. The dangers of SCA and the brutal impact SCD

48 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.
49 Ibid.
50 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.
51 Wiley Online Library: Clinical Cardiology, The Effectiveness and Cost Effectiveness of PublicAccess Defibrillation, Accessed March 5, 2015,
http://onlinelibrary.wiley.com/doi/10.1002/clc.20790/pdf.
52 Athletic Trainers Society of New Jersey, Marlboro, NJ High School Athletic Trainer Saves the Life of a
Spectator, Accessed March 5, 2015, http://www.atsnj.org/article/marlboro-nj-high-school-athletic-trainer-saves-lifespectator.

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leaves on a community needs to be made aware of to everyone, as well as the effectiveness in
saving a victims life that an AED can have with quick access and administration.
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