New legislation requiring that automated external defibrillators (AED) be located within 1,000 feet of any high school athletic activity in Tennessee is a win-win for a team of physicians at Monroe Carell Jr. Children’s Hospital at Vanderbilt.
The Smart Heart Act, a sudden cardiac arrest prevention law, establishes various requirements for AEDs in schools serving grades 9-12 and requires response protocols for cardiac-related medical emergencies. Introduced in the state legislature in January, Gov. Bill Lee signed the statute on March 27.
English Flack, MD, MS, associate professor of Pediatric Cardiology, and Alex Diamond, DO, MPH, professor of Orthopaedic Surgery, Pediatrics and Neurological Surgery at Monroe Carell, have long been advocates of providing appropriate lifesaving responses for cardiac events as well as ensuring a safe and healthy environment at all sporting levels.
Flack is the medical director of Project ADAM, a national organization committed to making schools “heart safe” by preventing sudden cardiac death in schools and communities through education and lifesaving programs.
Diamond, a youth sports safety activist, is co-founder of Safe Stars, the first youth sports safety training system in the United States, and director of the Vanderbilt Youth Sports Health Center, an innovative program geared toward treating pediatric and adolescent athletes’ physical, mental and social-emotional well-being.
According to them, the Smart Heart Act compliments the school youth athletic activity guidelines they both worked to institute.
“The legislation is built around athletics for grades 9-12 in the public and private sector,” said Flack. “But it also highlights community safety that extends beyond the school environment.
“There is a lot of excitement surrounding this legislation because it will provide safety measures to everyone attending sporting events so that anyone who may be at risk of a sudden cardiac event will benefit,” she said. “The presence of AEDs in schools and throughout the community, combined with people who are prepared to respond, is key to saving lives.”
The law mirrors guidelines of the Smart Heart Sports Coalition, launched by the NFL in response to the 2023 cardiac arrest of Damar Hamlin during a nationally televised game. The nationwide campaign advocates for every state to adopt evidence-based policies to prevent fatal outcomes from sudden cardiac arrest among high school students.
The Tennessee law goes into effect in September. It states that any school serving grades 9-12 must maintain an AED that is accessible during the school day and after school hours for all youth athletic activities involving grades 9-12. The AED must:
- Be identified with signage.
- Be located on-site of the school youth athletic activity or placed and made available in an unlocked location on school property that is within 1,000 feet of the site of the school youth athletic activity.
- Meet the requirements of state law relative to training in AED use and CPR.
An estimated 350,000 out-of-hospital sudden cardiac arrests occur each year in the United States, and about 7,000 of those are in people younger than 18. The national survival rate for sudden cardiac arrest is less than 12%, according to the American Heart Association.
The Smart Heart Act is a collaborative effort that also involves Project ADAM’s Middle Tennessee coordinator, Angel Carter, RN, at Monroe Carell, the American Academy of Pediatrics Tennessee Chapter, Children’s Hospital Alliance of Tennessee, and the Tennessee American Heart Association, said Diamond.
“This legislation will save lives — plain and simple,” said Diamond. “I’m so proud of this collaborative effort that further sets our schools and sports programs up to succeed by ensuring that they have the right resources and training to respond to an emergency cardiac situation.
“Having an AED onsite at each athletic venue within one to three minutes where high school practices or competitions are held really builds upon the foundation of the Safe Stars Act, ensuring that we can further minimize risk for student-athletes in Tennessee.”
Flack said that while Project ADAM does not provide schools with AEDs, it will serve as a resource for schools on the next steps — implementation, training and assistance with securing the lifesaving devices through fundraising and grant applications.
Once high schools meet the new law’s requirements, the team will begin to work on the next phase of its plan — implementing the same programming for middle schools.
