Only One Third of US States Require AEDs in Schools

Just one third of US states require schools to install automated external defibrillators (AEDs), but even among the 17 states that require AEDs, the legislation is far from comprehensive, according to the results of a new study.

In fact, only Oregon mandates AED installation in all public and private grade schools, high schools, community colleges, and public universities and provides unequivocal funding to support the legislation. AEDs are required in all public and private grade schools and high schools in New Jersey, where they’re funded through the local board of education, but are not mandatory in colleges or universities.

Published online March 27, 2017, in the Journal of the American College of Cardiology, lead investigator Mark Sherrid, MD (NYU Langone Medical Center, New York, NY), notes that various societies and organizations recommend all schools have emergency action plans for sudden cardiac arrest (SCA), “because the most important factor for successful survival after SCA is a trained responder who can start cardiopulmonary resuscitation and provide early defibrillation.”

As part of their review, Sherrid and colleagues found that 33 states had no legislation requiring AED installation. For the 17 states with some laws on the books, nine require AEDs only in public schools (including high schools), four require them in public schools and colleges, and two mandate them in public and private grade schools.

“Nearly 35 million public elementary and secondary students attend school in US states where there is no legislative requirement for a school AED,” state the investigators. The researchers add that placing AEDs is unlikely to improve outcomes after SCA alone and that installation should include plans so that all staff are trained in their use. 

They note that the main barrier to installing AEDs in school is typically cost. However, adding an AED to “educational budgets would be a small line item because of the high total expenditure for education per student in the United States,” according to Sherrid and colleagues. In the US, an AED costs between $1,250 and $1,500, with maintenance running about $250 per year, but devices typically last between 8 to 10 years, they note.