Student athletes, sudden cardiac death, and lifesaving legislation: a review of the literature.

PURPOSE The purpose of this article is to present findings of a literature review examining the use of automatic external defibrillators (AEDs) for student athletes experiencing sudden cardiac arrest and variances in state legislation regarding the mandatory placement of AEDs in school gymnasiums and athletic fields. METHODS A broad search of computerized databases was conducted utilizing PubMed, Medline, CINHAHL, and the Cochrane Databases, which provided a broad but not exhaustive review of the current literature related to student athletes, sudden cardiac death, and the use of AEDs. The articles were evaluated and graded using Stetler's strength of evidence guidelines. FINDINGS A total of 17 articles are included in this literature review (Stetler's Grade I, n = 1; Grade II, n = 2; Grade III, n =2; Grade IV, n = 5; Grade V, n = 3; and Grade VI, n = 4). The literature produced few meta-analyses of controlled studies, experimental studies, and quasi-experimental studies on the topic of student athletes at risk for sudden cardiac death. The majority of the literature is based on expert opinion, case reports, and retrospective data sets. The literature does support the correlation of early cardiopulmonary resuscitation and defibrillation with increased survival rates among persons experiencing sudden cardiac arrest. CONCLUSIONS Additional evidence-based research is needed to support the long-term outcomes of AED legislation and its utility in sparing the lives of student athletes. However, the evidence supporting early intervention, a coordinated emergency plan, and rapid emergency medical services response is conclusive enough to warrant state or federal legislation mandating that AEDs be present in all school gyms and athletic fields.