Key points
- Sudden cardiac arrest is a medical emergency.
- Preparation is key to survival because treatment is time sensitive.
- A cardiac emergency response plan (CERP) helps ensure actions occur quickly by making cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) readily available.
Why it's important
Sudden cardiac arrest occurs when the heart suddenly and unexpectedly stops beating, resulting in the stop of blood flow to vital organs. Approximately 23,000 sudden cardiac arrests occur in children every year, corresponding to about 15 out of every 1,000 pediatric emergency medical services (EMS) responses.1
Preparing to respond to a sudden cardiac arrest is key to survival because treatment is highly time sensitive. Bystander CPR can double or triple the odds of survival of out-of-hospital cardiac arrest.2
Planning and prevention
When schools, early care and education programs, and child care centers develop a CERP, they can more effectively respond to sudden cardiac arrest.
Component one: Cardiac emergency response team
Establishing a cardiac emergency response team (CERT) can support a coordinated response to sudden cardiac arrest. Team members may include, but are not limited to, teachers, administrators, and coaches. Ensuring that team members are trained in CPR and AED use and prepared to act during an emergency can strengthen response efforts. Designating a coordinator to oversee planning, training, and readiness can further support a successful response. Additional information on CERT roles and responsibilities can be found in publicly available CERP resources, such as the Project ADAM Cardiac Emergency Response Plan Protocol.
Component two: Training in CPR and AED use
Ensuring that CERT members receive training in CPR and AED use and refresh their skills regularly can help support an effective response to sudden cardiac arrest. Expanding training opportunities to all staff can increase the likelihood that sudden cardiac arrest is promptly recognized, emergency medical services (EMS) are activated, and CPR and AED use begin quickly. Training and certification requirements, as well as legal protections related to CPR and AED use, vary by state. See CDC's Public Access Defibrillation (PAD) State Law Fact Sheet for additional information.
Component three: Maintenance and placement of AEDs
Survival after sudden cardiac arrest is closely linked to the timely use of an AED or CPR. This action can be supported by strategically placing AEDs so they are always accessible, clearly marked, and available for use within 3–5 minutes of a sudden cardiac arrest. Careful planning and placement can help make the best use of available devices. Additional information on AED placement considerations can be found in publicly available CERP resources, such as the Project ADAM School AED Placement Assessment.
Component four: Communication of the CERP
Awareness of the CERP supports an effective response to sudden cardiac arrest. Sharing the plan with staff annually and posting it throughout the facility—including classrooms, common areas, spaces used for physical activity, and near AEDs—can help increase awareness. Ongoing education and inclusion in new staff orientation also support familiarity and readiness.
Component five: Local emergency medical service integration
Coordination with local EMS is an important part of an effective response to sudden cardiac arrest. Engaging EMS in planning and response efforts can provide valuable training, resources, and support for practice drills. Coordination may include sharing AED location information with local EMS or participating in an AED registry where available, as well as ensuring that 911 is activated during a sudden cardiac arrest emergency. These efforts can help support a smooth transition of care from bystanders to EMS, a critical link in the chain of survival.
Component six: Practice drills
Practicing the response through drills can help strengthen implementation of the CERP. Conducting drills at least once each year can help build staff confidence, strengthen communication, and improve coordinated response during sudden cardiac arrest. Drills also help identify gaps, and involving key staff and tracking performance can support updates to the plan and ongoing improvement.
Component seven: Review and evaluation of the CERP
Regular review and evaluation help ensure the CERP remains effective. Conducting an annual review, along with reviews after drills and sudden cardiac arrest incidents, can help assess response efforts, identify gaps, and guide improvements. Review of emergency supplies, AED maintenance, and response actions support updates to protocols and readiness. Incorporating continuous quality improvement (CQI) processes can also help organizations use lessons learned to strengthen preparedness and response over time. State requirements related to AED program evaluation and quality improvement vary; see CDC's Public Access Defibrillation (PAD) State Law Fact Sheet for additional information.
What CDC is doing
CDC's Healthy Schools program helps schools implement strategies to manage students' chronic health conditions, including cardiomyopathy, through care coordination, action plans, and referrals to community providers.
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- Okubo M, Chan HK, Callaway CW, Mann NC, Wang HE. Characteristics of paediatric out-of-hospital cardiac arrest in the United States. Resuscitation. 2020;153:227-233. doi:10.1016/j.resuscitation.2020.04.023
- American Heart Association Emergency Cardiovascular Care Committee. The American Heart Association Emergency Cardiovascular Care 2030 Impact Goals and Call to Action to Improve Cardiac Arrest Outcomes: A Scientific Statement From the American Heart Association. Circulation. 2024;150(19):e330–e365. doi:10.1161/CIR.0000000000001196