With the start of the school year upon us, local schools are busy installing automated external defibrillators (AEDs) under a new state law requiring them by October 24.
The law also applies to sports venues including local recreation centers and sports venues such as Browns Stadium.
At least one AED must be installed in every school or sports and recreation venue in the state. It will also require the Ohio Department of Health to develop a model emergency action plan for the use of AEDs. Schools will be required to adopt their own emergency action plan and practice it regularly.
"I think the most important part of this law is the requirement for an emergency action plan that has to be practiced and rehearsed and updated yearly," said Dr. Robert Flannery, a primary care sports physician at University Hospitals and physician for the Cleveland Browns. "As much as we want to believe that we will rise to the occasion when an event like this happens, the truth is, you rise to your preparation."
The goal is to ensure an AED is placed at every athletic venue within three minutes of the furthest spot at that venue, Flannery said, because time is critical during cardiac arrest.
How to use an AED
Cardiac arrest doesn't always appear the way it's depicted in TV and movies, Flannery said, adding that it's often overlooked in young athletes who are considered active and healthy.
If someone collapses, Flannery advised to check for a pulse and check their breathing.
"If you have any questions about whether or not you should start CPR, go ahead and start pushing hard and fast in the middle of the chest," he said. "If someone doesn't need CPR, they will let you know very quickly. They will stop you."
An AED works by delivering an electrical shock that helps a heart that is out of rhythm return to rhythm, Flannery said. A computer inside the AED determines if a shock is advised.
"They really are amazing little machines," Flannery said. "It will go through everything that you need, and then every two minutes or so, it will tell you to ... reanalyze the rhythm to see if another shock is needed, and that really can be life-saving."
The first step when using an AED is to ensure it's safe to use one, Flannery said. The next step is to begin CPR while someone else retrieves the AED and calls 911.
Once the AED is in hand, opened and turned on, the device will instruct the user to place the pads on the victim.
"The pads have pictures on them that show you exactly where to put them. You're going to stick the pads to the victim, and then you're not going to touch the patient," he said.
The machine will analyze the victim's heart rhythm, and will tell the user whether a shock is advised. If it is, the user should check to make sure no one is touching the victim, then press the button that will deliver the shock.
After the shock, Flannery said to restart CPR at a hard and fast rate of about 100 to 120 beats per minute.
"This would be about as fast as you would for the beat to 'Stayin' Alive', so you can kind of sing that in your head and push hard and fast, allowing the chest to completely recoil. You'll do that for two minutes," Flannery explained.
The AED will then analyze the victim's heart rhythm again and determine whether another shock is advised.
"If at any point you get a pulse back, then you stop," Flannery said.
From the NFL to Northeast Ohio high schools
Nine out of 10 people that die after sudden cardiac arrest could have been saved if an AED or other aid had been used, according to the American Heart Association.
For every minute that someone is in cardiac arrest without aid, their chance of survival decreases about 10%. The average time from collapse until paramedics arrive is about seven minutes, Flannery added.
That's why University Hospitals launched its AED in 3 program, which works with Northeast Ohio high schools by testing their facilities with a drill that determines if an AED would be on the field or court within three minutes during a cardiac event. Additional training and defibrillators are provided at no cost to schools who fail to qualify within the three-minute threshold.
The law was first introduced in February 2023, just over a month after Buffalo Bills safety Damar Hamlin suffered cardiac arrest during a Monday Night Football game in Cincinnati, bringing national attention to cardiac incidents.
That event was the catalyst that set the bill in motion, said Flannery. He also consults more than 60 Northeast Ohio high schools on emergency action plans for their athletic staff.
Flannery said that he hasn't seen a spike in cardiac arrest events in recent years, but certain cases have generated more attention.
"We really haven't seen a big spike in numbers, but I do think what you're seeing is a bigger spike in awareness of it because we've seen more high profile athletes, whether it's Hamlin or Bronny James," he said.
Bronny James, son of Lebron James, suffered a cardiac arrest in July 2023 due to a congenital heart defect. He recovered and has since been drafted by the Los Angeles Lakers.
Hamlin remains active on the Bills roster.
