House Bill 157 (original filed version) introduced by Rep. Fred Hawkins, Jr., will empower high school students with at least one (1) hour of training in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED), thus creating the next generation of life-savers. And would require the pre-participation physical evaluation for interscholastic athletic competition to include an electrocardiogram (EKG or ECG), which will identify youth with heart conditions that may lead to sudden cardiac arrest and help prevent disabilities and death.

House Bill 157 (amended 3/31/2021) school districts are encouraged to provide basic training in first aid, including CPR and use of an AED for all students in grade 6 and 8. The same training would be required for all students in grade 9 and 11.

What is Sudden Cardiac Arrest?

Sudden Cardiac Arrest (SCA) is a life-threatening emergency that occurs when the heart suddenly stops beating. It strikes people of all ages who may seem to be healthy, even children and teens.

When SCA occurs, blood stops flowing to the brain and other vital organs, causing loss of consciousness or seizure-like activity in seconds. SCA leads to death in minutes if the person does not get help right away.

Survival depends on people nearby calling 911, starting CPR¹, and using an AED² as soon as possible.

¹ CPR: Cardiopulmonary resuscitation is when you push hard and fast on the center of chest to make the heart pump; compressions may be given with or without rescue breaths
² AED: Automated external defibrillator is a device that analyzes the heart and if it detects a problem may deliver a shock to restart the heart’s normal rhythm.

How common is Sudden Cardiac Arrest?

• SCA is the #1 killer of student athletes.
• Over 356,000 people suffer sudden cardiac arrest (SCA) each year in the U.S., including more than 23,000 youth under age 18.
• 1 in 300 youth has an undetected heart condition that puts them at risk for SCA or death.
• SCA is the leading cause of death on school campuses.

The real tragedy is most of these deaths could be prevented!

Why do heart conditions that put youth at risk go undetected?

• Standard history and physical evaluations miss up to 90% of youth at risk.
• Often youth don’t report or recognize symptoms of a potential heart condition.
• Parents/Guardians assume youth are okay and just “check the box” on medical forms without asking their child about symptoms.
• Youth experiencing symptoms regularly don’t recognize these as potentially life-threatening—it’s normal to them.

What is an electrocardiogram?

An electrocardiogram (also known as an EKG or ECG) is a quick, painless and noninvasive test that measures and records a moment in time of the heart’s electrical activity through small electrode patches attached to the skin of your chest, arms and legs by a technician.

Why add EKG testing to the pre-participation physical evaluation required by the Florida High School Athletic Association for interscholastic athletic competition?

While the prevailing perception is that heart disease is primarily an adult disease, there are thousands of seemingly healthy youth who suddenly and unexpectedly suffer fatal or severely debilitating consequences due to undetected heart conditions.

Adding an EKG to the pre-participation physical evaluation (PPE) will identify youth with heart conditions that may lead to SCA and prevent disabilities and sudden death.

• An EKG can detect 2/3 of heart conditions that can lead to SCA
• EKGs should be performed at regular intervals combined with cardiac risk assessment for new symptoms or relevant family history.
• Heart disease is leading cause of death in FL.

As advised to parent/guardian and student on page 1 of the FHSAA’s PPE form (EL2, revised 3/16) student should undergo a cardiovascular assessment, which may include such diagnostic tests as electrocardiogram (EKG), echocardiogram (ECHO) and/or cardio stress test.

How much does an EKG typically cost?

The cost can vary based on where it is performed:

• Nonprofit / Sudden Cardiac Arrest Advocacy Organizations – free or reduced cost of $20
• Doctor’s Office – $20 to $50
• Hospital – free at the hospitals that have an EKG screening program for youth, otherwise approximately $150

How would the cost of EKG testing a student-athlete be covered?

The same way pre-participation physical evaluations or sports physicals are covered. The cost of EKG would be covered by:

• Health insurance – ICD 10-CM Z03.89 with variety of symptoms or family history of heart disease
• Medicaid
• Florida Alliance of Information & Referral Services / 211 Network
• Public & Private Partnerships
  • Florida Association of Free & Affordable Clinics
  • Health Alliances
  • Hospitals
  • Nonprofits / Sudden Cardiac Arrest Advocacy Organizations
• Parent/Guardian

How would the cost of follow-up care be covered, if a student-athlete is found to have risk factors or a heart condition that puts him/her at risk for sudden cardiac arrest?

• Health insurance
• Medicaid
• Florida KidCare
• Public & Private Partnerships
  • Florida Association of Free & Affordable Clinics
  • Health Alliances
  • Hospitals
  • Nonprofits / Sudden Cardiac Arrest Advocacy Organizations
• Parent/Guardian

Why CPR & AED Skills Matter

• 9 out of 10 SCA victims die because they don’t receive help right away.
• 7 in 10 SCAs occur at home, being prepared means you could save the life of someone you love by starting CPR.
• Considering the national average of EMS arrival is 6 to 12 minutes, bystanders are a critical bridge to survival when every second counts.
• Survival rate decreases by 10% with each minute intervention is delayed.
• Immediate bystander CPR (3-minutes or less of collapse) can triple a person’s chance of survival.