Too many young athletes die from sudden cardiac arrest. Does your kid's team have an emergency plan?

Across Massachusetts, spring practices are underway. Fields are filling. Gyms are echoing.

But before competition begins, there is one question every parent should ask: Where is the automated external defibrillator (AED)? This may feel like overkill, but it isn’t. According to recent estimates, there are 15,000 to 23,000 cases of pediatric out-of-hospital cardiac arrests annually. Sudden cardiac arrest is also the leading cause of death on school campuses.

When a young athlete collapses from sudden cardiac arrest, it is not a heart attack. A heart attack is a plumbing problem, a blocked artery. Sudden cardiac arrest is an electrical problem. The heart’s rhythm stops. The only effective treatment is immediate CPR and rapid defibrillation.

Survival decreases by 7% to 10% for every minute defibrillation is delayed. When an AED is used within the first few minutes, survival rates can exceed 50%. After 10 minutes without defibrillation, survival becomes far less likely.

Time is not theoretical. It determines whether someone lives or dies.

Cardiac arrest can happen anywhere kids spend time — on a field, in a classroom, or during a rehearsal. They are not common, but they are not rare. And when they happen, the outcome is often determined before an ambulance arrives.

As an oncology nurse, I spend my days caring for patients in some of the most serious moments of their lives. People often assume that work is the hardest part of what I do. But before oncology, I spent four years as a pediatric nurse. I have cared for too many children who died too young. I have sat in waiting rooms with parents as their son or daughter slipped away from them.

Caring for patients who have lived full lives is different. There is a weight to caring for children who never had the chance to grow up. And when that loss is preventable, it is even harder to accept.

Prevention shifts the focus from what we do after something happens to what we make possible before it does.

Even in medical settings where AEDs are available, placing additional devices closer to where care is delivered can improve outcomes. The time it takes to reach an AED is so critical that even seconds are considered meaningful gains.

Most schools in Massachusetts now have AEDs. But ownership is not the same as access. If the device is locked in the nurse’s office or in a different building across campus instead of on the field, you lose valuable time that could be the difference between life and death. I have seen how quickly a situation can shift. A goalie crumples on the field for no apparent reason. A runner slows, then collapses before reaching the sideline. A basketball player drops mid-play, with no contact at all. In those moments, no one is thinking about policy or process. They are trying to help. And the outcome is determined by whether they have easy, quick access to the tools they need.

That is what makes this a systems issue.

Cost is often an obstacle to having an AED on the sidelines, but it doesn’t have to be. Schools and sports organizations can rent AEDs for tournaments and club events. Booster organizations can cover the cost. Grants are available. And the Scholastic Sports Zone Foundation has donated more than 80 AEDs to schools across Massachusetts. In fact, they’ve never turned down a single request.

Most schools in Massachusetts now have AEDs. But ownership is not the same as access.

The real barrier is usually awareness. John Ellsessar, a Massachusetts father who lost his 16-year-old son to sudden cardiac arrest on his school’s football field, used a simple analogy when I spoke to him. “Fire extinguishers are everywhere,” he said. “Fire extinguishers save things. AEDs save humans. We would never accept a school without fire extinguishers. Why would we accept one where the AED is inaccessible?”

In health care, we think about preparedness as a system, not a moment. The goal is not just to respond well when something happens, but to reduce the amount of time that transpires between recognizing a problem and lifesaving action. In other words, survival depends on how quickly a system allows someone to act.

But in youth sports, reaction time still varies widely. Not because people don’t care, but because it is not always clear who is responsible, where the AED is, or how to use the AED to perform basic life support. I urge every parent of a young athlete to ask a few questions. Where are the AEDs located and how many are on campus? Are the devices accessible after school hours? Do the coaches carry an AED with them to away games? Is someone who is certified in CPR present at every practice and game? And have they ever rehearsed the emergency plan for cardiac arrest?

These are not political questions. They are practical. They are logistical. And when the right person asks the right question at the right time, they can change what happens next.

Spring sports are underway. This is the right time.