Sudden cardiac death is a major cause of death in the United States. Most of these deaths result from an electrical abnormality in the heart called an arrhythmia. Ventricular fibrillation is the most common fatal cardiac arrhythmia. Using an artificial electrical shock called defibrillation to restore the normal heart rhythm is the single-most important therapy.

The American Heart Association estimates that 100,000 deaths could be prevented each year with prompt defibrillation. If defibrillation is performed within three minutes, the likelihood of survival is high. For every minute of delay, the chance of survival drops by as much as 10 percent.

Everyone knows that cardiac events can occur at athletics competitions or practices. Fortunately, student-athletes are rarely the victims. Officials, coaches and fans are usually at greater risk. I've had first-hand experience with a football official collapsing from a heart attack during a football game. In the case of the student-athlete, sudden cardiac events can be grouped into two categories: (1) previously unrecognized cardiac anomalies or (2) blunt impact to the chest causing ventricular fibrillation (commotio cordis).

The advent of the automated external defibrillator (AED) has provided greater public access to life-saving technology. This device, which costs approximately $3,000, can be operated by trained lay persons. The AED is portable, rechargeable, simple to operate and easy to maintain. Both the American Red Cross and the American Heart Association have training courses in addition to CPR available for the lay public.

Should every athletics venue be equipped with an AED and trained personnel? Some high schools and colleges have purchased AEDs. Many professional sports teams have AEDs. Currently, no sports medicine organization or association has endorsed universal sports-related AED use.

AED access should be considered when developing or reviewing a venue emergency plan. Many factors must be taken into consideration when contemplating obtaining an AED. These include availability and timing of external emergency medical services, proximity to a hospital or urgent care center, likelihood of participants to suffer commotio cordis, equipment and staffing costs, and state liability issues surrounding whether a lay person is permitted to operate an AED. One approach might be to house an AED in a central locale that several venues may access in an emergency. Institutions should be aware of this technology and plan accordingly. It may be useful to consult with university risk management officials as appropriate.