The following is the opinion and analysis of the writer:
Nya Clemons
While sudden cardiac arrest (SCA) in children is rare (1-3 cases per 100,000 children/year), it is often fatal.
'Arizona has passed legislation aimed at improving emergency response to SCA in children, expanding access to automated external defibrillators (AEDs), which are computerized devices that send electric shocks during cardiac arrest. House Bill 2196 expanded AED access in high schools, reinforcing the state’s commitment to student safety.
This bill allocated $500,000 to improve AED availability.
Another bill, Senate Bill 1009, which stalled in the House, would have expanded high school requirements to include cardiopulmonary resuscitation (CPR) and AED training aligned with national guidelines, underscoring policy direction toward increasing access to life-saving training.
Arizona has taken steps in expanding AED access, but without required training, these policies fall short of saving lives. When a youth collapses, it will not be legislation rushing to their side; it will be a trained bystander … like you.
Cardiovascular screening is insufficient
Lower survival in children following cardiac arrest (5% vs. 9% in adults) shows gaps in youth screening and emergency preparedness. About 80% of youth with potentially lethal cardiac conditions are asymptomatic before SCA.
The most common causes of SCA in youth include hypertrophic cardiomyopathy in high school-aged children and congenital coronary artery abnormalities in middle school-aged children. Youth athletes are especially vulnerable, as physical activity may trigger SCA in children with these underlying conditions.
SCA can occur in schools, at home, or at club sport events. Many factors should be considered during child and athlete physical exams to improve awareness of potential risks. Physical exams and pre-participation screenings focus on medical history and physical examinations. But screening alone is not the only outlet to preventing deaths from SCA. Screening can help identify those at high risk, but it will not catch every case. A one-size-fits-all screening paradigm likely does not exist.
CPR/AED access, training crucial to survival
Arizona has made progress in facilitating access to life-saving equipment. Survival depends on emergency action plans (EAPs), bystander response, and AED use. Rate of survival is about 80% with CPR and an athletic trainer present.
In schools with AED access, SCA survival reached 71% overall, with survival as high as 85% in students and 89% in student-athletes during physical activity. These statistics demonstrate improvements in outcomes with AED access and EAP implementation.
In 42% of cases, citizens responded more quickly than emergency medical service, resulting in higher CPR initiation and greater AED use.
Survival decreases rapidly after a few minutes from the onset of cardiac arrest: 25% at 5 minutes, and to near zero survival 10 minutes after out-of-hospital care.
There are still barriers to action, including fear of doing something wrong, legal concerns, or uncertainty, that can delay life-saving intervention. Increasing bystander training is an achievable prevention strategy.
Encouraging CPR/AED training strengthens response alongside legislative action.
Become CPR/AED certified
CPR/AED training takes 1-2 hours and is available through the American Heart Association, the Red Cross, community colleges, and fire departments. These certifications could be encouraged or required for teachers, coaches, school volunteers, and parents. Taking these courses can improve preparedness, enhance response, and save a life. Efforts must be made to increase bystander CPR/AED use through public education and increased AED access.
Awareness is not meant to discourage participation in youth activities, but to clarify risks and encourage preparation. When SCA occurs, the difference between life and death often comes down to who is standing nearby. Without immediate action, survival drops within minutes, making trained bystanders the link in the chain of survival. Parents, coaches, and other bystanders must be prepared to act; immediate response can mean the difference between life and death.
