Heart safety bill looks to close gap in school emergency preparedness

A North Carolina bill would require every public school to have an AED and a clear cardiac emergency response plan, aiming to close gaps in preparedness after multiple student cardiac arrests across the state.

Not every North Carolina school has an Automated External Defibrillator (AED). A new bill moving through the North Carolina legislature could change that. 

Backed by the American Heart Association, Senate Bill 278—also called the Smart Heart Act—would require all public schools in North Carolina to have an AED on campus and a clear, practiced plan for how staff respond to cardiac emergencies. 

The measure passed in the House with bipartisan support.

Emma Kate Burns, the North Carolina government relations director for the American Heart Association says the bill’s importance only grows as incidences of cardiac emergencies rise among younger populations.

“The purpose of this legislation really is to ensure that every child is safe at a school in the event of a cardiac emergency,” Burns said. “Not only our kids, but also staff, visitors – everyone who comes into school if they do have a cardiac emergency, there is a plan in place and that they have the best chance of coming home to their families.”

According to a NC Department of Public Instruction survey during the 2023-24 school year, there were five North Carolina counties where not every school in the district had at least one AED. These counties included Wake, Martin, Hertford, Haywood, and Gaston. 

During the same school year, six North Carolina children had cardiac arrests at school, with one event turning fatal, according to the AHA. 

The AHA also reports 64% of North Carolina schools do not have an emergency cardiac plan, or are unsure if one exists.

“Schools are such a nucleus of our communities,” Burns said. “Everyone is at the football game, everyone is at the basketball game. When people gather, that's more of a chance that someone is going to have an emergency, and we need to be prepared in those situations.”

Being prepared for the worst-case-scenario is why 10-year-old Adeline Dinin carries around her own AED. Dinin has a rare heart disorder, known as Long QT Syndrome Type 2. 

“It’s an arrhythmic death syndrome,” Dinin explained. “You take medicine and you carry around an AED.”

When she’s not in school or running around Durham playgrounds, Dinin said she likes to play with dolls and put together Lego sets with her sister. Wherever she goes, her bright red AED isn’t far away. 

“I’ve definitely been places without an AED,” Dinin said of the importance of having her own defibrillator. “They’re important to have because if someone goes into cardiac arrest, these could save their life.”

The AHA reports more than 350,000 cardiac attacks every year occur outside of a hospital, known as Out of Hospital Cardiac Arrests (OHCA). 73.4% of OHCA occur in homes or residences, followed by 16.3% in public settings and 10.3% in nursing homes. In the event of an OHCA, only about 40% of people receive the immediate live-saving help they need before EMS arrives.

Burns said bystander intervention is key in improving survival rates.

“A cardiac emergency response plan can double survival chances,” Burns said. “Without a cardiac response plan we’re looking at a 10% chance of survival. We want to give our kids the best chance to come home. We really want to give them the best chance at survival and not having long-term consequences if there was to be an emergency.”

A Johnston County athlete survived a rare heart attack during a Cleveland High School football game in October 2025, thanks to an AED and quick actions by his coaches and parents. In 2015, an eighth grader in Wake Forest survived a heart attack after his teacher administered CPR. 

Dinin explained many modern AEDs, like the one she carries around, are now equipped with verbal instructions that walk you through how to apply the device.

“It gives you instructions so everyone technically knows what to do,” Dinn said. “Just because you can’t see someone with a heart condition doesn’t mean it’s not important to protect them.”

North Carolina is among the states with a Good Samaritan law, which protects people who give emergency care, including CPR or AED use, during a cardiac arrest.