DC schools to adopt new cardiac response plans: Here's what you need to know

The D.C. Council passed a bill last week requiring schools to adopt a plan for cardiac emergencies.

All schools in the District — including public, private, public charter, independent and parochial —  must adopt a plan for handling cardiac emergencies by the 2025-2026 school year. The bill adds to existing legislation that requires schools to have automated external defibrillators available for athletic events and requires cardiopulmonary resuscitation and automated external defibrillator training for athletic coaches, trainers and school nurses.

What does this do?

The bill establishes guidelines for a cardiac emergency response plan (CERP). Along with a plan, the bill requires schools to have at least one AED that complies with the school’s CERP, have regular scheduled AED maintenance, and inform all school employees of the location of each AED and of the school’s CERP.

The bill also requires D.C. Mayor Muriel Bowser to establish a monitoring process for ensuring the requirements are followed.

Currently, schools are required to have a plan for responding to medical emergencies, including cardiac arrest, and the usage of CPR and an AED.

Who’s making the plan?

The bill requires D.C. Fire and EMS to coordinate with the D.C. Office of the State Superintendent of Education to develop and maintain a model CERP schools can use for people experiencing cardiac arrest, particularly during an athletic event or practice on campus grounds. The model will include “evidence-based” core tenets recommended by national experts in the field who will provide guidance on how the emergency response team should operate.

The guidance will include information about:

• Who should be on the emergency response team
• Where AEDs should be located 
• Staff trainings
• Specific emergency protocol like how emergency services will be contacted 
• How the CERP will be evaluated 

What are the costs?

D.C. Chief Financial Officer Glen Lee sent a memorandum to D.C. Council Chairman Phil Mendelson last month saying the funds are sufficient in fiscal year 2025 to fiscal year 2028 to implement the bill but didn’t specify the explicit costs of its implementation. He added FEMS and OSSE can develop the models utilizing “existing resources.” 

Are there racial disparities when it comes to cardiac arrest?

Although rare, more than 7,000 children and infants per year in the U.S. have a cardiac arrest outside of a hospital environment with disparities among different demographics, the out-of-hospital cardiac arrest rate for Black children was more than four times higher than white or Hispanic children, according to the American Heart Association.

For young athletes, sudden cardiac arrest is the leading cause of exercise-related deaths, but more than 80% of them survived if an athletic trainer administered CPR or used an AED.

How do leaders feel?

“MSDC supports appropriate public health measures such as access to timely care,” Dr. Ashesh D. Patel, the president of the Medical Society of D.C., testified during a public hearing in July. “Nothing can save a life more in an emergency health situation than proper training and adequate resources.”

Last month, the Council Office of Racial Equity said the bill’s requirement of each school having a response plan will likely decrease racial disparities for D.C. residents of color given it increases the emergency response protocols and increases survival rates. 

“Because of the efficacy of CERPs and due to the racial disparities that exist in cardiac arrest occurrence and outcomes, measures taken to improve the District’s emergency cardiac response interventions — as proposed by the bill — are particularly important for Black residents, Indigenous residents, and residents of color, both in District schools and on District school grounds,” the report said.

Andre Edwards, the assistant fire chief for EMS operations in D.C. Fire and EMS, said the department supports the legislation and the District-wide focus on cardiac arrest survival resulted in 69 patients being discharged from the hospital — the highest number of survivors since the department started tracking it in 2011.

“Improving patient care and outcomes, including cardiac arrest survival, is a key priority of Mayor Bowser and Fire and EMS,” Edwards said at the hearing.

ANC Commissioner Adam J. Prinzo testified the bill is “a crucial step toward improving public health outcomes in our community and our schools” and commended Jude Maboné, Miss D.C. 2023, for using her platform to advocate for cardiac education. 

What’s next? 

The bill was sent to the mayor’s office Thursday, and Bowser has until Oct. 31 to sign or veto it.