It can happen in an instant.
A teenage athlete's powerhouse of a body freezes on the field, the court or the track.
A heart with the mask of fitness and youth stops -- whether from exhaustion or an undetected heart condition.
George Bailey said he has never seen it happen to a student on his Richmond County athletic fields, but he's ready if it ever does.
All middle and high schools in Richmond and Columbia counties have automated external defibrillators on hand in case an athlete's heart were to stop in a game or practice.
These AEDs use voice commands and lights to direct the user how to check a person's heart rhythm and administer a possibly life-saving shock.
According to the American Heart Association, it is designed so anyone from a spectator to a doctor could use it, and it can increase survival rates by 49 percent.
"I don't want to say we've been lucky, but outside of torn ACLs and broken bones we really haven't had serious injuries in that area," said Bailey, the Richmond County School System's athletic director. "But all our high schools and middle schools have (AEDs). It's important."
Bailey said his coaches and staffers were reminded of how important having AEDs can be in light of three student deaths this month:
- On March 3, a 16-year-old Michigan high school basketball player collapsed on the court and died after making the game-winning lay-up in overtime. Doctors said Wes Leonard's death was caused by complications from an enlarged heart.
- Two days later in Colorado, a 17-year-old high school rugby player collapsed on the field after being struck in the chest. Matthew Hammerdorfer died of sudden cardiac arrest from an enlarged heart, according to a coroner.
- On Wednesday, 17-year-old Sarah Landauer died in a Gainesville, Fla., hospital two days after collapsing during high school track practice.
"When these kinds of things happen, it just kind of arouses our attention, and we try to relate that to all our coaches," Bailey said. "Every child is important."
Richmond County acquired the $1,400 AEDs for all middle and high schools in 2005 through an American Heart Association grant, according to Dr. Carol Rountree, the district's executive director of student services. That was before the state required all schools to have the machines in 2008.
The devices are stashed in gyms, playing fields or front offices, and all sports' coaches and athletic assistants are trained to use them and perform CPR.
"Annually, the athletic directors and all of the athletic staff has to maintain up-to-date Red Cross CPR and first aid training," Rountree said. "You're only going to use the AED if there is ever that person who is not breathing, and that hasn't happened, thank goodness. We don't ever want to use them."
Columbia County Schools head nurse Lisa Whitlock said all county schools have the devices, and some have two on hand.
The county bought the AEDs around 2003 through an American Red Cross grant, Whitlock said.
"It just takes one incident where it could have saved a life where people go, 'Why didn't you have an AED?' " she said.
The Aiken County School District has AEDs only at its high schools but is in the process of developing a countywide policy, said spokeswoman Tammie Newman.
If student athletes were to fall on the field, their survival could depend on what happens in the next few minutes.
Dr. Natalie Lane, a pediatric emergency medical physician at Medical College of Georgia Hospital, said survival declines by 7 to 10 percent every 60 seconds after a heart stops.
AEDs cannot resuscitate a dying athlete in all cases, however.
"Unfortunately for these events in which athletes are unresponsive, they may have some underlying cardiac abnormality that has gone unnoticed," Lane said.
That fact has brought discussion to athletic groups and even legislators about what kind of health screenings should be required for student athletes.
The Georgia High School Association, which regulates athletics, requires only that each student athlete to have an annual physical exam before any practice or competition.
Physicals alone cannot always detect a heart condition that can bring athletes to their knees later on the field, some argue.
Ralph Swearngin, the executive director of the GHSA, said the health history disclosure portion of a physical has proved to be sufficient to allow students to play.
The more intensive electrocardiogram, or heart scan, does not always reveal underlying problems and could also pose logistic or financial problems for some students, he said.
For cases that can be prevented, Chris Hughes, the athletic director and football coach at Academy of Richmond County, said it's all about caution.
His team trains every day in the preseason, even when the heat index in Augusta can reach 110 degrees. In those cases, his players can practice without the added padding or in the air-conditioned gym.
"For football it's difficult because you have to get them acclimated to the heat, especially here in the South, because they're playing half the season when it's still really hot," Hughes said.
All Richmond County students follow the GHSA rules of frequent water breaks and practices that don't exceed four hours for middle school or go past 8 p.m. for high school.
Along with annual physicals, students who suffer head injuries are not allowed to participate in their sport until they are cleared by a doctor.
The precautions have paid off so far in Richmond and Columbia counties, with no reported uses of the AEDs on students since their purchase.
Hughes is not alone when he said he hopes it stays that way.
"It's something that's scary and worries us every year, but you have to get them out there," Hughes said of his players. "You hate to hear about it and hope it's not you the next time."