About Project ADAM
Project ADAM Tennessee is a program provided by East Tennessee Children's Hospital to serve children and adolescents through education and deployment of life-saving programs that help prevent sudden cardiac arrest.
The program provides schools with individual consultation on how to prevent sudden cardiac death in the school setting. Adults who work or visit in the school setting will also benefit if an emergency arises.
Project ADAM (Automated Defibrillators in Adam’s Memory) is a not-for-profit program of Herma Heart Center at Children’s Hospital of Wisconsin, one of the leading pediatric heart programs in the United States. Project ADAM began in 1999 after a series of sudden deaths among high school athletes in southeastern Wisconsin, including 17-year-old Adam Lemel. Many of these deaths appeared to be due to ventricular fibrillation. Adam’s parents, Patty and Joe Lemel, along with a childhood friend of Adam’s, collaborated with Children’s Hospital to create this program in Adam’s memory.
What Project ADAM Does
Project ADAM’s mission is to serve children and adolescents through education and deployment of life-saving programs that help prevent sudden cardiac arrest. Adults who work or visit in the school setting will also benefit if an emergency arises.
Project ADAM Tennessee’s goal is to have all schools in Tennessee participating in a comprehensive AED program to prevent tragedies of sudden cardiac death.
Project ADAM Tennessee focuses on preventing sudden cardiac death though both primary and secondary prevention.
Primary prevention is promoted through:
- Use of a comprehensive pre-participation history and physical exam for students participating in sports
- Awareness and recognition of signs and symptoms of undiagnosed cardiac disease by primary care physicians, coaches, PE teachers, school nurses and other adults who work with children
Secondary prevention is promoted through:
- Consultation on implementation of comprehensive automated external defibrillator (AED) program in schools
- Encouraging CPR/AED instruction for middle school and high school students
Since Project ADAM’s inception in 1999, there have been 56 documented cases of lives being saved in Project ADAM Heart Safe schools nationally. 35 of the lives saved were saved in Georgia, where more than 800 schools have implemented Project S.A.V.E., the Project ADAM affiliate in Georgia.
Heart Safe Schools in Tennessee
There are approximately 350,000 sudden cardiac deaths in the U.S. each year, equal to almost 1,000 every day. At least 600-1000 of these sudden cardiac deaths occur in children or adolescents each year, so it can be expected there might be 10-15 student deaths in Tennessee each year. Many of these deaths could have been prevented if an automated external defibrillator (AED) had been used. AEDs allow for early defibrillation, an electrical shock to the heart that enables the heart to return to its normal rhythm. For every minute that passes as sudden cardiac arrest occurs, the chance of survival decreases by 10 percent. With an AED on-site, school responders can immediately attempt to save a child's life.
All public Knox County high schools currently have an AED, but most middle schools do not have access to one. Project ADAM Tennessee's goal is to place an AED in every middle school in Knox County.
Project ADAM Tennessee provides schools with thoroughly-researched information and individual consultation on how to prevent sudden cardiac death in the school setting. Schools that request assistance will be provided up-to-date information and resources on:
- Screening and pre-participation sports physicals
- Training of staff and students in awareness of sudden cardiac arrest and CPR
- Implementation of a comprehensive automated external defibrillator (AED) program
All consultation and Heart Safe School certification is provided free of charge to schools in Tennessee thanks to the generous support of East Tennessee Children’s Hospital.
Becoming a Certified Heart Safe School
Schools in Tennessee who complete the checklist for Project ADAM Tennessee indicating a quality AED implementation program, will receive a framed certificate of recognition stating their school staff has been trained in case of an AED emergency. Schools will also get stickers for the doors and direction signs to identify the location of AEDs, as well as warning sign posters for school clinics and PE/sports areas. Schools will receive a video that can be used for staff awareness training.
Project ADAM Tennessee schools commit to implement all protocols provided in the Project ADAM Tennessee manuals. The manual directs school staff to form an emergency response team and implement practice AED drills, educate school staff, students and parents on the location of the AED, conduct appropriate maintenance and testing of equipment and keep an accurate record of staff trained in CPR.
Benefits of becoming a Heart Safe School include:
Certifications and Participation by Knox County Schools
- Comprehensive pre-participation physicals for student athletes
- Awareness of sudden cardiac death: incidence, warning signs and emergency response for all staff
- CPR/AED life skills for students and staff
- A comprehensive school AED implementation/deployment plan
- Increased awareness in the community
- Project ADAM Tennessee has presented Knoxville Catholic High School, Halls Middle School, Holston Middle School, South Doyle Middle School, Carter Middle School, Gresham Middle School and Forge Ridge School in Claiborne Co., Tenn. with an AED.
- Halls Middle School, Holston Middle School and Knoxville Catholic High School have passed a "Heart Safe" AED and emergency response drill within their school and have now been certified as "Heart Safe" schools.
- Project ADAM Tennessee also certified all wellness class students at Knoxville Catholic High School in CPR and AED use.
- Project ADAM Tennessee has taught CPR to faculty and staff at Forge Ridge School, Claiborne County High School, Powell Valley School, Jellico High School, Knoxville Catholic High School and Halls Middle School.
What is an Automated External Defibrillator (AED)?
An automated external defibrillator is a lightweight, portable device that delivers an electric shock to the heart. When the heart is in sudden cardiac arrest, a shock through the chest (which travels to the heart) can halt an abnormal, ineffective rhythm and enable a normal rhythm to resume. A shock delivered by an AED within 3-5 minutes can save a life.
The need for public access defibrillation programs
Public access defibrillation programs such as Project ADAM Tennessee ensure the best chance of survival for victims of sudden cardiac arrest by providing access to AEDs and trained responders. In addition, legal trends show that schools and other public places may be at risk of litigation for not having AEDs available.
In rural areas, the need for AEDs in schools becomes greater as the response time of emergency medical service is often longer than in urban areas. For each minute that passes as Sudden Cardiac Arrest occurs, the chance of survival falls by 10 percent. With an AED on-site, school responders can immediately attempt to save a life.
About Sudden Cardiac Arrest
Sudden cardiac arrest (SCA) is a condition in which the heartbeat stops abruptly and unexpectedly. This usually is caused by ventricular fibrillation (VF), an abnormality in the heart's electrical system. When this happens, blood stops flowing to the brain the heart and the rest of the body, and the person collapses. A quick combination of CPR and defibrillation can restore life.
Time is the critical element. Three to five minutes is the optimum time for emergency response. Don’t waste precious time trying to figure out what may have happened- someone on the staff needs to call 911, while a first responder initiates CPR and someone else brings the AED to the scene if there is one at the school.
During sudden cardiac arrest, the heart goes into ventricular fibrillation of “ineffective quivering” and can no longer pump blood to the brain and other vital organs. A shock delivered by an AED within three to five minutes can save a life.
Is SCA the same as a heart attack?
No. A heart attack is a condition in which a blood clot suddenly blocks a coronary artery, resulting in the death of the heart muscle supplied by that artery, unless the clot is opened within a few hours. Heart attack victims usually experience symptoms such as chest discomfort or pain and remain conscious. Most people who have a heart attack survive the event. Some will develop an SCA. Other people have an SCA independently from a heart attack and without warning signs. SCA results in death if it is not treated immediately.
Who is at risk for SCA?
SCA often occurs in active people who seem to be healthy and have no known medical conditions. In these patients, SCA is the first indication of a heart condition. However, some people can be identified in advance as being at risk for SCA.
Risk factors include:
What causes SCA in young people?
- Previous heart attack
- Coronary artery disease (and risk factors for CAD including smoking, high blood pressure,
- diabetes, elevated LDL cholesterol, family history of heart disease, sedentary lifestyle)
- Heart failure from other causes
- Abnormal heart rate or rhythm (arrhythmia) of unknown cause
- Episodes of fainting of unknown cause
- Low ejection fraction (EF) (<35%).
There are three common causes. Long QT syndrome is an often unrecognized congenital condition that predisposes the child to an abnormality in the heart's electrical system, which can lead to SCA. This is a genetic disease that affects 1 in 7,000 young people. Episodes are most commonly triggered by physical exertion or emotional stress. Commotio cordis is an electrical disturbance cases by a blow to the chest. It occurs most often in baseball, but has been reported in other sports and situations in which there is a blow to the chest. Researchers at the U.S. Commotio Cordis Registry studied 124 cases and found the average age is 14. Only 18 victims (14%) survived; most who survived received prompt CPR and defibrillation. Hypertropic cardiomyopathy is a congenital heart muscle disease. The walls of the heart's left ventrical become abnormally thickened (hypertrophy). The structural abnormality can lead to obstruction of blood flow from the heart, causing loss of consciousness and irregular heartbeat, leading to SCA. About 1 in 500 to 1000 young people have this condition.