When an athlete collapses in cardiac arrest, the most important lifesaving equipment may already be hanging on a nearby wall. The question is whether anyone can reach it fast enough.
An automated external defibrillator, or AED, analyzes the heart rhythm and can deliver a shock when a shockable rhythm such as ventricular fibrillation is present. For sports organizations, however, owning an AED is only the beginning. A complete system requires recognition, communication, CPR, AED accessibility, trained responders, practiced roles, and coordination with emergency medical services.
Cardiac arrest is a time-critical emergency
During cardiac arrest, the heart is no longer providing adequate circulation. The brain and other organs cannot wait for a lengthy decision process. Bystanders need to recognize sudden collapse, activate emergency medical services, begin CPR, and retrieve an AED.
The American Heart Association’s Cardiac Emergency Response Plan framework is built around coordinated preparation rather than improvisation after collapse.
AED access changes outcomes
Research from sports settings consistently associates rapid bystander response and AED use with better survival. In the FIFA Sudden Death Registry, cases in which an AED was used had substantially higher reported survival than cases without AED use. A meta-analysis of sports-related cardiac arrest also found strong associations between survival, bystander CPR, and bystander AED use.
These studies are observational rather than randomized experiments, but the biological rationale and consistency of the evidence support the same operational conclusion: defibrillation should not be delayed while waiting for hospital-level care.
An AED across campus may be functionally too far away
An AED can technically exist at a sports facility and still be practically inaccessible. If the device is locked in an office, stored in another building, available only during business hours, or unknown to staff, valuable time can be lost.
Teams should physically test retrieval. Start at the farthest point on the field, court, track, or facility. Send someone to retrieve the AED. Time the round trip. A plan that looks adequate on paper may fail under real conditions.
Emergency plans should assign roles
One person may call 911. Another begins CPR. Another retrieves the AED. Someone may meet EMS at the entrance and guide responders to the patient. Someone may unlock gates or control crowds. Athletic trainers and medical professionals can take clinical leadership when present.
These roles must be adapted to the actual venue. A football stadium, basketball gym, track complex, practice field, and off-site tournament do not have identical access routes or staffing.
Practice matters
Schools conduct fire drills because reading a fire plan is not equivalent to executing one. Cardiac emergency response deserves the same mindset. A realistic drill can expose an AED cabinet no one can open, poor cell service, a locked gate, uncertainty about the venue address, or confusion about who is supposed to call EMS.
South Carolina’s Smart Heart Act raises the floor
South Carolina enacted the Smart Heart Act in 2026. The law requires public schools to implement cardiac emergency response plans and ensure accessible AEDs at school athletic venues, including off-site events, with related requirements extending to certain private-school competition settings. Legal compliance is important, but operational readiness still depends on whether the plan works with real people in the real venue.
The RTH takeaway
An AED stored somewhere on campus is not enough. A CPR certificate earned years ago is not enough. A written plan buried in a binder is not enough. Cardiac readiness is a functioning system.
The athlete who collapses does not benefit from what an organization intended to do. The athlete benefits from what the organization is prepared to do immediately.
Educational note
Emergency-response training should follow current CPR/AED standards and local emergency protocols. This article does not substitute for certified training or venue-specific professional planning.
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RTH Resources | Schools & Organizations
Sources and further reading
- American Heart Association. Cardiac Emergency Response Plan (CERP).
- NCAA. Cardiac Health.
- American Heart Association, South Carolina. Smart Heart Act passes to improve cardiac readiness in schools. 2026.
- PubMed. Sports-related cardiac arrest survival meta-analysis.
Author: Restarting The Heart | Source review: September 25, 2026
Published August 7, 2026 · Last reviewed September 25, 2026