237629 A best practice model of a school preventive health program to identify conditions associated with sudden cardiac arrest in the young

Monday, October 31, 2011: 2:50 PM

Victoria Vetter, MD, MPH , Division of Pediatric Cardiology, University of Pennsylvania School of Medicine/The Children's Hospital of Philadelphia, Philadelphia, PA
Noreen Dugan, RN, BSN , Division of Pediatric Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA
Danielle Main, BS , Division of Pediatric Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA
Christopher Hall, BA , Division of Pediatric Cardiology, University of Pennsylvania School of Medicine/The Children's Hospital of Philadelphia, Philadelphia, PA
V. Ramesh Iyer, MD , Division of Pediatric Cardiology, University of Pennsylvania School of Medicine/The Children's Hospital of Philadelphia, Philadelphia, PA
Background: Over 1,000 school-aged children die in the United States (US) annually of sudden cardiac arrest (SCA), incidence of 0.68/100,000, representing 5% of childhood deaths. The electrocardiogram (ECG) identifies previously undiagnosed cardiac conditions responsible for SCA in at least two-thirds of cases. In Europe, screening includes an ECG, but in the US, only history and physical exam is used with no consensus as to the best screening model. Purpose: To develop a Best Practice recommendation of a feasible ECG-based screening model that could be applied to a school-aged population in the US. Significance: An effective method to identify those at risk is a first step toward the prevention of these untimely deaths. Methodology: We evaluated five models: three IRB-approved ECG screening models, one office-based and two school-based, a community-based mass screening, and two Italian Screening Center models. All included a health questionnaire and ECG. Some included echocardiogram and exam. Findings: One percent of 2347 healthy school children had previously undiagnosed potentially serious cardiac conditions that required intervention, follow-up medical care, and lifestyle modifications. Recommendations: The Best Practice model that we recommend utilizes schools, or existing offices or clinics. To identify children prior to a time of highest risk, we suggest targeted screening of all school-aged children, not just athletes, in the age group over 10 years. Our pilot screening and school studies have shown that it is possible to screen a population of school-aged children in the US using an ECG in addition to a history and physical exam.

Learning Areas:
Advocacy for health and health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research

Learning Objectives:
1. Identify the five most common heart condtions that cause sudden cardaic arrest/death in school-aged children. 2. Compare the different models that can be used to identify at risk children in a school preventive health program.

Keywords: School-Based Programs, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have performed the research described in this abstract, developed the model, practice pediatric cardiology and preventive public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.