Priceless precaution? AEDs in schools
Recent cardiac deaths put focus on AEDs in schools, but cost still keeps some schools from having them
Saturday, April 14, 2012
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Keilea Swearingen remembers nothing about her second day at Evergreen High School.
The 15-year-old went into cardiac arrest on Sept. 1 while sitting in her fourth-period physics class, and awoke two days later in a hospital bed. School officials credit an automated external defibrillator with saving the freshman’s life.
Due to the trauma of the event, Keilea, then 14, has no memory of the two weeks before it or much of the week she spent in the hospital. But when she thinks about how close she came to death, she concludes she was “really lucky to be where I was,” near the AED’s location in the main office.
“I wasn’t really aware of AEDs’ being in the school before this whole thing,” said Keilea, who has since been diagnosed with the heart condition Long QT Syndrome Type 2. “Now I think it’s important ... it’s really important.”
Keilea’s story, contrasted with other cardiac arrest stories that ended tragically, has motivated Clark County school districts to increase their number of on-campus AEDs -- portable devices that can detect whether a heartbeat exists during a potential cardiac arrest situation and, if need be, provide a life-saving shock.
A person who suffers cardiac arrest on a school campus equipped with an AED has a 70 percent chance of survival, said Dr. Jonathan Drezner, an associate professor in the University of Washington’s Department of Family Medicine. He cited his as-yet-unpublished study of more than 2,100 cardiac arrest cases in high schools nationwide between 2009 and 2011.
Yet, cost concerns in today’s age of endless budget cuts have prevented universal embrace of the potentially life-saving technology. Each AED costs between $1,300 and $1,500.
Clark County’s school districts have around 100 AEDs on-campus, in hallways, gyms and stadiums. Districts have purchased the devices with budget dollars, parents’ fundraisers and donations. In 2007-08, Legacy Health notably provided high schools countywide with AEDs.
“It’s not just for the students,” said Jason Royse, founder and president of Northwest Health and Safety, which contracts with Clark County schools on AEDs. “It’s for the community and it’s for the teachers. So the trend has been more AEDs.”
Today most local school districts have AEDs at the majority of their schools. Vancouver and Battle Ground Public Schools are notable exceptions.
That will change with Vancouver’s installation of 43 new AEDs either later this month or in early May. Vancouver will pay the $70,000 tab using budget dollars and donations from the Quinn Driscoll Foundation, a nonprofit group whose namesake died from cardiac arrest while a student at Wy’east Middle School in Vancouver.
In the past three years, previously healthy teens at Evergreen High, Wy’east Middle and La Center Middle schools stopped breathing on campus without warning. A Fort Vancouver senior, Drake Blair, also died suddenly on a school bus in November 2010.
In situations like these, each minute that passes is of vital importance to protecting the patient’s brain, and ultimately keeping them alive, doctors say.
While chest compressions taught as part of CPR are useful as a starting point, they provide only 25 to 30 percent of the normal cardiac output, said Dr. Lynn Wittwer, medical program director for the county’s emergency medical services. Doctors and paramedics recommend switching from chest compressions to the AED as soon as possible.
Having the device on campus saves precious minutes waiting for emergency responders to arrive and apply the device. A cardiac arrest patient’s chances of survival drop 10 percent each minute a defibrillator is not used, Royse said.
School personnel who are required to take CPR training must also learn how to use AEDs. School district officials rave about how easy the devices are to use by following their voice prompts. Knowing where the devices are stored is also essential to capitalize on this time advantage.
The devices are “simple enough that a lay person could take them off the shelf and use them,” said Scott Deutsch, Evergreen’s risk and safety manager.
Still, having an AED on campus does not guarantee it will be used in a time of need.
Wy’east Middle’s AED was not readily available when Quinn Driscoll collapsed. In the Jan. 3 case of La Center Middle School basketball player Cody Sherrell, confusion between the 911 dispatcher and school officials resulted in an AED not being applied until paramedics arrived, approximately nine minutes after the 911 call was placed.
Cody collapsed at the end of the first day of eighth grade basketball practice. Coaches initially believed he might be suffering a seizure or dehydration.
It is unknown whether the AEDs would have saved the boys.
Keilea and Quinn had undiagnosed heart conditions that led them to have cardiac arrest. Quinn had hypertrophic cardiomyopathy.
Cody had no pre-diagnosed condition. His cause of death has not been publicly revealed.
A dreaded club
Scott Driscoll joined “a club no one wants to be a member of” on June 10, 2009.
On that day, his 13-year-old son collapsed on the track at Wy’east during a physical education class and died en route to the hospital.
Three years later, the Quinn Driscoll Foundation’s goal is to help Evergreen and Vancouver “bridge the budget gap” to purchase AEDs, his father said.
Evergreen is ahead of the game, thanks to planning and parents’ fundraising efforts to outfit elementary schools.
Vancouver Public Schools lacked AEDs in 24 facilities prior to its recent purchases, said Mick Hoffman, Vancouver Public Schools’ director of safety, security and athletics. Driscoll, whose foundation aided in Vancouver’s recent purchases, compared the 19,000-student district’s prior lack of AEDs with a city lacking ambulances or firetrucks.
Once Vancouver implements its new AEDs it will have at least one of the devices at elementary schools, two at middle schools and at least two at high schools.
“If they work one time they pay for themselves no matter the cost,” Hoffman said. “Because what cost can you put on one student’s life?”
The cost factor
Cost does factor into the AED discussion, both in Clark County and statewide, though.
This is apparent with Vancouver’s previous dearth of AEDs. So too with Battle Ground.
Laurin Middle in Battle Ground recently added an AED using its discretionary money and parent contributions.
But Battle Ground, the third most populated district in the county, still has a dozen elementary and middle schools without AEDs.
“The district does not have the money to buy them all,” spokesman Gregg Herrington answered.
Fourteen states have passed laws focused on placing AEDs in some or all schools within a district.
The state’s lone law referencing the devices provides AED users inside schools with immunity from lawsuits.
“It’s been introduced into legislation multiple times,” said Nathan Olson, spokesman for the Office of the Superintendent of Public Instruction. “The sticking point has always been money.”
Royse has heard this answer “a lot” in Clark County.
“There are budget constraints,” he said. “The reality is we don’t think it’s being presented appropriately.”
Swearingen’s cardiac arrest proves AEDs cannot be viewed as merely an item on a budget spreadsheet.
“It’s not just a number on paper,” Royse said. “(Evergreen officials) look at the number and associate it with the girl who is still alive.”
Keilea entered Evergreen High with the goal of being a three-sport athlete. She’s two-thirds of the way there.
An internal defibrillator implanted in her chest in November has allowed her to resume her busy athletics schedule -- basketball in the winter, golf this spring and cross-country next fall. Without the use of an AED the second day of school sports would be an afterthought. “She wouldn’t be here, period,” Keilea’s mother, Crystal Swearingen, said.
“It definitely costs money,” Keilea’s mother continued, “but when you ask a parent who has lost a child how important it is, it is priceless.”