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Automated External Defibrillators in National Collegiate Athletic Association Division I Athletics

Eric E. Coris, MD^*,, Frances Sahebzamani, ARNP, PhD, Steve Walz, MA, ATC and Arnold M. Ramirez, MD

From the Department of Family Medicine, Division of Sports Medicine, University of South Florida College of Medicine, Tampa, Florida, and the Department of Athletics, University of South Florida, Tampa, Florida

^* Address correspondence to Eric E. Coris, MD, Assistant Professor, The University of South Florida College of Medicine, Department of Family Medicine, Division of Sports Medicine, 12901 Bruce B. Downs Boulevard, MDC 13, Tampa, FL 33612(e-mail: ecoris{at}hsc.usf.edu).

Background: Sudden cardiac death is the leading cause of death in athletes. Evidence on current sudden cardiac death prevention through preparticipation history, physicals, and noninvasive cardiovascular diagnostics has demonstrated a low sensitivity for detection of athletes at high risk of sudden cardiac death. Data are lacking on automated external defibrillator programs specifically initiated to respond to rare dysrhythmia in younger, relatively low-risk populations.

Methods: Surveys were mailed to the head athletic trainers of all National Collegiate Athletic Association Division I athletics programs listed in the National Athletic Trainers’ Association directory. In all, 303 surveys were mailed; 186 departments (61%) responded.

Results: Seventy-two percent (133) of responding National Collegiate Athletic Association Division I athletics programs have access to automated external defibrillator units; 54% (101) own their units. Proven medical benefit (55%), concern for liability (51%), and affordability (29%) ranked highest in frequency of reasons for automated external defibrillator purchase. Unit cost (odds ratio = 1.01; 95% confidence interval, 1.01-1.0), donated units (odds ratio = 1.92; confidence interval, 3.66-1.01), institution size (odds ratio = .0001; confidence interval, 1.3 E-4 to 2.2E-05), and proven medical benefit of automated external defibrillators (odds ratio = 24; confidence interval, 72-8.1) were the most significant predictors of departmental defibrillator ownership. Emergency medical service response time and sudden cardiac death event history were not significantly predictive of departmental defibrillator ownership. The majority of automated external defibrillator interventions occurred on nonathletes.

Conclusions: Many athletics medicine programs are obtaining automated external defibrillators without apparent criteria for determination of need. Usage and maintenance policies vary widely among departments with unit ownership or access. Programs need to approach the issue of unit acquisition and implementation with knowledge of the surrounding emergency medical service system, geography of their individual sports medicine facilities, numbers and relative risk of their athletes, and budgetary constraints.

Key Words: automated external defibrillator (AED) • sudden cardiac death (SCD) • hypertrophic cardiomyopathy • athlete • sports medicine