Prompted by a health emergency incident this past fall at Pleasant Valley High School, the Scott County Health Department will send letters to Iowa Quad-City schools suggesting certain safety measures such as training staffers in CPR and possibly purchasing a device that can restart a heart when a person collapses.
The unprecedented action is the result of a months-long discussion that began after former University of Iowa Hawkeyes football player Brett Greenwood suffered an apparent heart attack while working out Sept. 9 at the Pleasant Valley football field.
Greenwood — a standout athlete at Pleasant Valley and defensive back for the Hawkeyes — was found lying on the ground after a workout. The young man’s heart had stopped. He was resuscitated with an automated external defibrillator, or AED, and ultimately transferred to University of Iowa Hospitals and Clinics in Iowa City. Having regained consciousness after being placed in an induced coma, he is recovering from a related brain injury.
Scott County Board of Health member Kathy Hanson of Bettendorf started a discussion among the five-member board, wondering how many schools in the county have AEDs and staff who can react quickly when such an event occurs on their premises.
A subsequent survey done by the health department showed that all of the public schools have AEDs — Pleasant Valley has three at the high school — but it also found that AEDs are in only three of all of the private schools.
No mandate, but a letter
Board members ultimately stopped short of requiring that the devices be placed in every school. Further, the board agreed that it is much more important to stress the need for many people in a school setting to be trained in CPR, or cardiopulmonary resuscitation.
The public health staff was directed to draft a letter to all schools, to be distributed in the spring. In the letter, officials will suggest that a school’s teachers and coaches be trained in CPR, and it also may be recommended that the school purchase and maintain an AED.
“I do know from my personal experience that AEDs come in handy. But we don’t want to make that mandatory,” said Denise Coiner, the health board chair. It is helpful to have an AED, but it is more important that CPR be started as quickly as possible on a person who collapses and is not breathing, she added.
Dr. Greg Garvin, another board member, pointed out that CPR techniques have changed in the past year, and it is no longer recommended that a rescuer perform mouth-to-mouth resuscitation. Garvin also balked at requiring schools to buy and maintain AEDs, saying that the devices are useful in certain circumstances, but adding that schools may be open to liability if they have an AED that is not properly maintained.
Doctors weigh in
Two physicians associated with Genesis Health System attended December’s health board meeting to discuss sudden heart attacks and the use of AEDs as well as CPR.
Dr. Richard Vermeer, an emergency physician, said the new CPR techniques are “easy to teach and simple to learn. It needs to be part of public education,” he added.
Dr. Edmund Coyne, a cardiologist, suggested that heart attack survival rates may more than double if there is effective use of CPR and AEDs after an incident.
There is extraordinary pressure on rescuers, he said, noting that there are only about eight minutes before injuries are likely to occur due to a lack of oxygen to the brain.
An AED is simple to operate, he said, and their use has been proven effective if they are maintained and widely available in public places.
Both doctors, however, agreed that heart attacks involving a high school athlete are very rare: one in 100,000 to 200,000, Coyne said. “It’s much less common, but not unheard of,” he explained.
Every school needs coaches and staff to know CPR, Coiner said. And “if you save just one life with an AED at the school … how can you put a price tag on that?” she asked.