You report moves to install defibrillators in English state schools (17 July). While I understand the commitment of parents to this programme, I am not convinced of its effectiveness. An audit of out-of-hospital cardiac arrest reported an annual rate of less than 10 per 100,000 males aged 15-19 and an even lower rate for females of this age group. Rates are lower still for younger children. A school comprising 1,000 male pupils aged 15-19 might expect one cardiac arrest every 10 years. Schools with female pupils and younger children will experience a cardiac arrest even less frequently. These figures also overestimate the likely arrests per school per year, as pupils will spend a substantial part of the year out of school, though they may be at higher risk during exercise at school.
Defibrillators that are not used for long periods of time are likely to fall into disrepair. Even if they are well-maintained, it is difficult to see this programme as an effective or cost-effective use of health or education resources.
Peter West
Health economist, London
