Skip to main content Accessibility help

Cardiac Arrest on the Links: Are We Up to Par? Availability of Automated External Defibrillators on Golf Courses in Southeastern Pennsylvania

  • John Lucas (a1), A. Alex Davila (a1), Kevin N. Waninger (a1) (a2) and Michael Heller (a1)



A growing number of golfers are senior citizens, and it may be predicted that the number of golf-related medical emergencies, including the incidence of cardiac arrest, will increase. This study was designed to survey the level of preparedness of golf courses in Southeastern Pennsylvania to respond to cardiac arrest among their members.


A telephone survey of all of the 180 golf courses in the area was conducted to determine their type (public/private), volume in rounds per year, presence of automated external defibrillator (AED) devices, number of employees, and percentage of employees with cardiopulmonary resuscitation (CPR) training. Participants also were asked to estimate the time needed to reach the farthest point on their course in order to estimate a maximum time to the application of an AED device.


A total of 131 of 180 golf courses completed the survey (53 private, 78 public) for an overall response rate of 73%. Private courses reported a greater average number of employees with CPR training [private = 9.1, public = 3.6; p = 0.001] and in AED presence [public = 9%, private = 58.5%; p = 0.0001]. Public courses support a higher volume of play than do private courses [public = 32,000, private = 24,000; p = 0.001], yet have far fewer employees [public = 25, private = 44; p = 0.004]. The longest time necessary to reach the most remote point on the course was between four and five minutes in all courses. Analysis was performed using the Student's t-test and Pearson's Chi-square as appropriate.


Neither public nor private golf courses are well equipped to respond to cardiac arrest, but outcomes on public courses likely are to be far worse.


Corresponding author

Kevin N. Waninger, MD, MS Saint Luke's Hospital 2830 Easton Avenue Bethlehem, PA 18017-3560 USA E-mail:


Hide All
1Gratton, M, Lindholm, DJ, Campbell, JP: Public-access defibrillation: Where do we place the AEDs? Prehosp Emerg Care 1999;3(4):303305.
2Sachs, RG, Kerwin, J: Automated external defibrillators and sudden cardiac arrest. N J Med 2001;98(4):3941.
3Centers for Disease Control and Prevention (CDC): State-specific mortality from sudden cardiac death—United States, 1999. MMWR 2002;51:123126.
5Verizon Yellow Pages for Bethlehem, Pennsylvania. April 2002–March 2003.
6Portner, ME, Pollack, ML, Schirk, SK, Schlenker, MK: Out-of-hospital cardiac arrest locations in a rural community: Where should we place AEDs? Prehosp Emerg Care 2004;19(4):352355.
7Jorgenson, DB, Skarr, T, Russell, JK, et al. : AED use in businesses, public facilities and homes by minimally trained first responders. Resuscitation 2003;59(2):225233.
8Niemann, JT, Cruz, B, Garner, D, Lewis, RJ: Immediate countershock versus cardiopulmonary resuscitation before countershock in a 5-minute swine model of ventricular fibrillation arrest. Ann Emerg Med 2000;36:543546.
9Stiell, IG, Wells, GA, Field, BJ, et al. : Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS Study Phase II. JAMA 1999;281:11751181.
10Ornato, JP, McBurnie, MA, Nichol, G, et al. : The public access defibrillation (PAD) trial: Study design and rationale. Resuscitation 2003;56:135147.
11Stiell, IG, Wells, GA, Field, B, et al. : Advanced cardiac life support in out-of-hospital cardiac arrest. N Eng J Med 2004;351(7):647656.
12Hallstrom, AP, Ornato, JP, Weisfeldt, M, et al. : Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Eng J Med 2004;351:637646.
13De Vries, W, van Alem, AP, de Vos, R, et al. : Trained first-responders with an automated external defibrillator: How do they perform in real resuscitation attempts? Resuscitation 2005;62(2):157161.
14Moore, JE, Eisenberg, MS, Cummins, RO, et al. : Lay person use of automated external defibrillation. Ann Emerg Med 1987;16(6):669672.
15Atkins, DL, Bossaert, LL, Hazinski, MF, et al. : Automated external defibrillation/public access defibrillation. Ann Emerg Med 2001;37 (4 Suppl):s60–s67.
16Gundry, JW, Comess, KA, DeRook, FA, et al. : Comparison of naïve sixth-grade children with trained professionals in the use of an automated external defibrillator. Circulation 1998;97:13151320.
17Page, RL, Joglar, JA, Kowal, RC, et al. : Use of automated external defibrillators by a US airline. N Engl J Med 2000;343:12591260.
18Valenzuela, TD, Roe, DJ, Nichol, G, et al. : Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med 2000;343:12061209.
19Jorgenson, DB, Skarr, T, Russell, JK, et al. : AED use in businesses, public facilities and homes by minimally trained first responders. Resuscitation 2003;59(2):225233.
20Starr, LM: Automated external defibrillation in the occupational setting. J Occup Environ Med 2002;44(1):27.
21Groeneveld, PW, Kwong, JL, Liu, Y, et al. : Cost-effectiveness of automated external defibrillators on airlines. JAMA 2001;286(12):14821489.
22Bertrand, C., Rodriguez-Redington, P, Lecarpentier, E, et al. : Preliminary report on AED deployment on an entire Air France commercial fleet: A joint venture with Paris XII University training programme. Resuscitation 2004;63(2):175181.
23Usatch, BR, Cone, DC: Automated external defibrillator training and skill retention at a ski patrol. Prehosp Emerg Care 2002;6(3):325329.
24Coris, EE, Miller, E, Sahebzamani, F: Sudden cardiac death in Division I collegiate athletes. Analysis of automated external defibrillator utilization in National Collegiate Athletic Association Division I athletic program. Clin J Sport Med 2005;15(2):8791.
25Drenzer, J, Rogers, K, Zimmer, R, Sennett, B: Use of automated external defibrillators at Division 1 universities: Prevalence, outcomes, and cost analysis. Clin J Sport Med 2005;15(4):279 (abstract).
26Bartimus, HA, Rea, TD, Eisenberg, MS: Prevalence of automated external defibrillators at cardiac arrest high-risk sites. Prehosp Emerg Care 2004;8:280283.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed