Background-The purpose of the present study is to improve understanding of the epidemiology of cardiac arrest in the school setting, with a special focus on the role of school-based automated external defibrillators. Methods and Results-The investigation was a retrospective study of emergency medical service-treated, nontraumatic, out-of-hospital cardiac arrests in Seattle and King County, Washington, that occurred in schools between 1990 and 2005. Cases were identified with cardiac arrest location data from emergency medical service cardiac arrest registries. Patient characteristics, cardiac arrest characteristics, and outcome information were abstracted from the registries and incident report forms. During the study period, 97 cardiac arrests occurred in schools, accounting for 0.4% of all treated cardiac arrests and 2.6% of public location cardiac arrests. Of the 97 cases, 12 cardiac arrests were among students, 33 among faculty and staff, and 45 among adults not employed by the school (7 adults with indeterminate school association). School-based cardiac arrest occurred on average in 1 of 111 schools annually, with a greater annual incidence among colleges (1 cardiac arrest per 8 colleges) than high schools (1 per 125 high schools) or lower-level schools (1 cardiac arrest per 200 preschools through middle schools). The estimated annual incidence of cardiac arrest was 0.18 per 100 000 person-years among students and 4.51 per 100 000 person-years for school faculty and staff. Conclusions-The present study characterizes school-setting cardiac arrest and provides a framework within which to consider preparation efforts and outcome expectations.

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