School administrators are faced with numerous responsibilities on a daily basis―school operations, instructional leadership, managing parent and community expectations and, of course, student safety on campus.

Student safety includes ensuring every school adopts a Cardiac Emergency Response Plan and continually reviews and improves upon the plan.

In 2013, the American Heart Association reported 9,500 cases of out-of-hospital cardiac arrest in youths. Jonathan Fussell was one of those cases. His life was saved in his high school by two staff members who rushed to his aid while he lay dying in cardiac arrest.

Prompt response saves lives

Across the United States, even the best emergency medical services (EMS) systems typically cannot reach cardiac arrest victims in 3 to 5 minutes, the vital timeframe for initiating care. Therefore, the actions taken by bystanders during the first few minutes of a cardiac emergency are critical. Prompt action can double or triple a victim’s chance of survival.

At Bixby High School, school staff members Josh Smith and Roland Vernon were prepared to act swiftly and confidently when student Jonathan Fussell went into cardiac arrest. Their school had a cardiac emergency action plan, and that very plan saved Jonathan’s life.

What is a Cardiac Emergency Response Plan?

A Cardiac Emergency Response Plan (CERP) is a written document that establishes specific steps to take action in a cardiac emergency in a school setting.

Essential elements include establishing an effective communication system; training anticipated responders in CPR and automated external defibrillator (AED) use; obtaining access to an AED for early defibrillation; acquiring the necessary emergency equipment; coordinating and integrating on-site responder and AED programs with the local EMS system; and practicing and reviewing the response plan.

Team of experts

In 2015, the American Heart Association assembled a task force composed of members from 11 other national health and safety organizations, including the Sudden Cardiac Arrest Foundation, to create a response plan template based on science and best practices. The following organizations participated:

  • American Association of School Administrators (Dr. Sarah Jerome)
  • American Heart Association (Douglas Dunsavage, Emily Gardner, Madeleine KonigDenise Miles, Sarah Poole, Jeffrey Ranous, Dr. Amber Rodriguez, Dr. Comilla Sasson, Colby Tiner, Laurie Whitsel)
  • C.S. Mott Children’s Hospital, University of Michigan Health System (Dr. Monica Goble, Gwen Fosse)
  • The Kimberly Anne Gillary Foundation (Randy Gillary)
  • Michigan Department of Health and Human Services (Kristina Dawkins, Maria Willoughby‐Byrwa)
  • National Athletic Trainers’ Association (Ron Courson)
  • National Association of School Nurses (Kathleen Rose)
  • Parent Heart Watch (Martha Lopez‐Anderson)
  • Project ADAM (Allison Thompson)
  • Sarver Heart Center/American College of Cardiology (Dr. Julia Indik) 
  • SHAPE America (Joe Halowich) 
  • Sudden Cardiac Arrest Foundation (Mary Newman)
  • University of California, Davis/American Academy of Pediatrics (Dr. Stuart Berger) 

The template they developed is free for any school to use and implement.

Why is it important?

A carefully orchestrated response to cardiac emergencies will reduce deaths in school settings and help ensure that chaos does not lead to an improper or inadequate response. Preparation is the essential key to saving lives.


The Cardiac Emergency Response Plan materials were based in part on information from the following scientific papers:

  1. Casa DJ, Almquist J, Anderson SA, et al. The inter‐association task force for preventing sudden death in secondary school athletics programs: best‐practices recommendations. J Athl Train. 2013;48(4)546-553.

  2. Drezner JA, Courson RW, Roberts WO, et al. Inter‐association task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement. Heart Rhythm. 2007;4(4):549‐565.

  3. Drezner JA, Rao AL, Heistand J, et al. Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators. Circulation. 2009;120(6):518‐ 525.

  4. Hazinski MF, Markenson D, Neish S, et al. Response to cardiac arrest and selected life‐threatening medical emergencies: the medical emergency response plan for schools: a statement for healthcare providers, policymakers, school administrators, and community leaders. Circulation. 2004;109(2)278‐ 291.

Download Cardiac Emergency Response Plan materials 

The Cardiac Emergency Response Plan template and implementation resources are free for any school to download here (see attachments) and at

NOTE: These documents may be updated from time to time. For the most current versions, be sure to check

SOURCE: American Heart Association