Objective Automated external defi brillators (AEDs) placed in public locations can save lives of cardiac arrest victims. In this paper, we try to estimate the cost-eff ectiveness of AED placement in Belgian schools. This would allow school policy makers to make an evidence-based decision about an on-site AED project.
Methods and results We developed a simple mathematical model containing literature data on the incidence of cardiac arrest with a shockable rhythm, the feasibility and eff ectiveness of defi brillation by on-site AEDs and the survival benefi t. This was coupled to a rough estimation of the minimal costs to initiate an AED project. According to the model described above, AED projects in all Belgian schools may save 5 patients annually. A rough estimate of the minimal costs to initiate an AED project is 660 EUR per year. As there are about 6000 schools in Belgium, a national AED project in all schools would imply an annual cost of at least 3 960 000 EUR, resulting in 5 lives saved.
Conclusions As our literature survey shows that AED use in schools is feasible and eff ective, the placement of these devices in all Belgian schools is undoubtedly to be considered. The major counter-arguments are the very low incidence and the high costs to set up a school-based AED programme. Our review may fuel the discussion about whether or not school-based AED projects represent good value for money and should be preferred above other health care interventions.