Grassroots Activation

Determined parents and new state laws are overcoming school officials' resistance to AEDs

Slowly but surely, activism on the local level and in statehouses is giving automated external defibrillators a foothold inside America’s schools.

“The reports that we get in are about 12 to 15 kids lose their life every day because of sudden cardiac arrest. In many states, mandates are coming down requiring schools to have AEDs,” said Doug Comstock, a Cardiac Science Corp. certified AED specialist who lives in East Granby, Conn.

He said despite tight budgets, schools have continued to buy automated external defibrillators this year, which Comstock credits to two things: Liability concerns have diminished and AED prices have fallen sharply in recent years.

Comstock said more than 40 percent of Connecticut’s schools already were equipped with AEDs before Gov. Jodi Rell signed two bills into law in June 2009 requiring the state’s school boards to have an AED in each school in their jurisdiction if funding is available and also extending Good Samaritan liability protection for AED users. The key bill she signed, Senate Bill 981, was prompted by the 2007 sudden cardiac arrest death of Larry Pontbriant, 15, of Norwich, Conn. A distance runner and lacrosse athlete, he collapsed midway through a three-mile run with teammates, his parents, a coach and others alongside, said Evelyn Pontbriant, his mother.

“He collapsed in front of us, halfway through, both my husband and I,” Pontbriant said. “We saw him struggling up the hill and he collapsed, and that was it,” she said in an Aug. 10 phone interview. “There was no AED there. People did CPR; his cross-country coach of the high school team had finished the course, and he did CPR on him. There was a nurse at our side. Our neighbors called 911. By the time the ambulance got there, a lot of time had gone by, but they did shock him with their AED. His heart did come back. He never regained consciousness, and three days later, he died at Hartford Children’s Hospital. So, unfortunately, we came to know the hard way what it is not to have an AED on hand.”

Many people wanted to contribute money after Larry Pontbriant’s death. The parents decided to establish the Larry Pontbriant Athletic Safety Fund to place AEDs in schools and on schools’ athletic fields, she said. “The amount of money that came in for this was just unbelievable. There were over 20 schools in Norwich, and they all have AEDs now. The high school itself has nine. That’s in addition to these other more than 20 schools.

“We’ve covered several other towns,” she said. “It’s over 60, 65 AEDs, and we should be able maybe to get in another 10 once the [2010-2011] school year starts. The schools are really more than schools—they’re community centers. And they’re used not just during the school year, but during the summers, during evenings for sporting events, and so on. So we thought that getting them into schools would be a great place to start, and it seems to work out well that way.”

The Pontbriants and their allies begin trying to persuade a district or school to deploy AEDs by having a conversation with the superintendent, athletic director, or principal.

“Very few places resisted, and even those people we did end up winning over,” she said. “One group felt it’s a liability to have those there. Others felt if our group could donate one or two and they have 10 schools, how could they single out those other eight schools? But we basically told them, ‘We have to start somewhere. Take these one or two, and it’s a start.’"

Comstock noted fears involving the devices have not entirely disappeared.

“There is still fear in terms of what an AED can and cannot do. The reality is, the AED will only shock the victim,” he said. “We try to tell people that when you use an AED, you can’t hurt the person, you can only help them.”

The Larry Pontbriant Athletic Safety Fund also has distributed AEDs to non-school sports organizations, including youth baseball and lacrosse organizations. Seeing this, some young athletes’ parents worried about the possibility of lawsuits, Evelyn Pontbriant said. She said the liability question went unsolved until the American Heart Association’s Connecticut branch, the Connecticut Athletic Trainers Association, and other allied groups jointly pushed for last year’s expansion of the state’s Good Samaritan law.

While there is no formal program to train students in Connecticut schools to operate an AED, some students at the school Larry Pontbriant attended, Norwich Free Academy, have been trained.

She said schools are relying on trained teams of employees, such as administrators, teachers and nursing staff, to respond with an AED if necessary.

Larry Pontbriant’s friends are doing their part in many ways, as well. Some have organized an annual memorial run, raising $13,500 in its first three years. A friend’s tennis tournaments have raised $9,400 so far in three years. Sales of a cookbook generated $3,700. A lacrosse tournament is being discussed.

The Connecticut Athletic Trainers Association is affiliated with the National Athletic Trainers’ Association, which is based in Dallas. NATA takes the position that every school should have an accessible AED and an emergency action plan, said Judy Pulice, NATA’s national manager of State Legislative and Regulatory Affairs.

Pulice said she had no statistics for the number of U.S. schools currently equipped with AEDs.

“There are pockets of them because parents have gotten busy and raised money for them,” she said.

Schools, school boards, and school districts usually fight laws intended to make them deploy AEDs because of the expense involved, Pulice said.

Both Cardiac Science and the National Conference of State Legislatures track state legislation about AEDs, including school AEDs. Their tallies indicate Colorado, Florida, Georgia, Illinois, Maryland, Michigan, Nevada, New York, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia require at least some of their schools to have AEDs. Wisconsin requires high school students to be given AED training. A California law encourages all public K-12 schools in the state to implement AED programs.

Timing an AED Response
Any school without one that experiences a student’s death from sudden cardiac arrest can expect someday to face a plaintiff ’s lawyer who compares spending by that school or district for band instruments, a scoreboard, or some other item with the approximately $1,500 cost of an AED, Comstock predicted.

“Again, one AED is the minimum,” he said. “It would require many more to follow the American Heart Association guidelines” recommending deployments that ensure no more than three minutes will elapse between someone’s collapse and a rescuer’s arrival with an AED in hand.

How much distance does that represent? When a school calculates it, officials should not consider an elevator as part of the response because that elevator may not always be available when needed. In the same way, because a physically fit rescuer can’t be assumed, school officials should not run while measuring the three minutes of travel to and from the AED, he said.

“It’s probably not more than 500 feet,” he said. “It’s not very far. “The beauty of a heart attack is, we frequently have time to respond,” Comstock said. “The limitation that we have with cardiac arrest

is we don’t have that time. We have a 10-minute window to respond.”

Evelyn Pontbriant said the local public health department serving Norwich recently filmed interviews with the Pontbriants, some sudden cardiac arrest survivors, and family members of other SCA victims. The interview footage will be used in a November 2010 public service announcement about AEDs and CPR, she said.

“The general population needs to know. Unless you’re aware of it, you might not realize what’s happening,” she said. “Larry just looked like a runner who was exhausted, only that wasn’t the case. He was not breathing. No pulse, but his heart should have been pounding.

“And you need to respond quickly. CPR is not going to bring the heart back. You need to get a shock from an AED. People need to know that. We just want to make sure people are aware of that.”

This article originally appeared in the issue of .


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