Project ADAM®: Public Access Defibrillation (PAD) Programs in Schools Third edition Produced and distributed by Maxishare (800) 444-7747

Sudden cardiac arrest (SCA) A rare problem in children and adolescents (500-1,000 cases per year in the U.S.). Occurs far more often in adults (350,000 cases per year in the U.S.).

What is SCA? Normal heartbeat and/or breathing stops suddenly. The lack of oxygen delivered to the heart muscle causes the muscle to die. * The lack of oxygen to body tissues causes ischemia. * Ischemia may be the cause or the result of sudden cardiac arrest.

The heart does not circulate blood properly How SCA occurs The heart does not circulate blood properly Blood flow decreases. Ischemia occurs. An abnormal heart rhythm results. OR…

An abnormal heart rhythm is present. How SCA occurs An abnormal heart rhythm is present. Blood flow decreases. Ischemia results. The heart stops.

Sudden cardiac death may be the first and only sign of a problem! Causes of sudden cardiac arrest in children and adolescents Congenital conditions Hypertrophic cardiomyopathy Coronary artery anomalies Dilated cardiomyopathy Long QT Syndrome Wolff-Parkinson-White Syndrome Marfan Syndrome Sudden cardiac death may be the first and only sign of a problem!

Other causes of sudden cardiac arrest Commotio cordis - a “blow” to the chest area Cocaine or stimulant abuse Electrolyte imbalances including sweating routines for weight loss and eating disorders

Ventricular fibrillation (VF or V-Fib) An abnormal heart rhythm is involved in most cases of sudden cardiac arrest The rhythm is not functional to pump blood Death will result if this rhythm is not treated promptly

Defibrillation The primary treatment for ventricular fibrillation (VF) A dose of electrical energy “short circuits” the abnormal rhythm

Defibrillation The faster defibrillation is applied, the greater the chance of survival Early CPR is essential but will not reverse VF Automated External Defibrillators (AEDs) allow defibrillation to be delivered rapidly S U R V I A L % Minutes

ALL of components of the chain of survival were in effect! Project ADAM® Four cases in Wisconsin within a one-year period (1999) One teen survived Why did that teen survive? Automated Defibrillators in Adam’s Memory ALL of components of the chain of survival were in effect!

Chain of Survival Early access - “Call 9-1-1” Early cardiopulmonary resuscitation (CPR) Early defibrillation (AED) Early advanced life support (Emergency medical services)

Why put AEDs in schools? Decrease the risk of sudden cardiac death. Increase educational opportunities to prompt improvements. * Pre-sports screening of student athletes. * Requirements for school staff and volunteers. Improved path for associated education. * Improved reporting of symptoms. * Avoidance of behaviors that increase risk of SCA.

Recognizing the need for a PAD program So, what’s required? Recognizing the need for a PAD program happens in two ways: 1. External drivers such as an individual or organization. 2. Internal drivers such as a recognized need, often due to a tragic event.

Planning steps Develop a workgroup. Determine program costs. Identify state legislative requirements and legal considerations. Enlist support. Seek financial resources.

Implementation steps Identify a program coordinator. Identify program budget details and obtain funding. Identify and work with appropriate resources such as a physician/medical director and the local EMS.

Implementation steps, cont. Develop PAD program policies and procedures. Assess facility for number and placement of AEDs. Select an AED. Select a provider of training.

Implementation steps, cont. Identify key individuals to be trained including school staff. Expand training to the students themselves. Plan continuing education programs

Train for success! CPR/AED training is perhaps the most important feature of any PAD program!

Summary A victim of sudden cardiac arrest may not have to die tragically – PAD programs can help! Over 500 schools in the state of WI have implemented a PAD program. PAD programs can help save the lives of children and adults in your community.