The Children's Hospital of Philadelphia
Youth Heart Watch - Every Second Counts
Victoria L. Vetter, MD: A sudden cardiac arrest often has no warning signs but can be identified. The warning signs in those individuals and perhaps itÃÂ¢ÃÂÃÂs over 50 percent of individuals who do have some warning signs when one looks back closely. Often they donÃÂ¢ÃÂÃÂt recognize these warning signs, but this may simply be lightheadedness, dizziness, even more pronounced would be fainting. Many times these events are simply written off and not investigated. It may be a feeling of a difference in the heartbeat, palpitations, rapid heartbeats, skipped heartbeats, some feeling that the heartÃÂ¢ÃÂÃÂs stopping and starting again, or perhaps someone who has chest pain of a pressing nature, not sharp musculoskeletal type of chest pain, but a significant pressure in their chest. So those would all be potential warning signs.
Narrator: No matter how hard we try to raise awareness, cardiac arrest will occur. ThatÃÂ¢ÃÂÃÂs why every school should have AEDs.
Victoria L. Vetter, MD: Well, an A-E-D stands for Automated External Defibrillator. What an Automated External Defibrillator, an AED does, is recognize if someone has a rhythm that is not likely to be a pulsatileor an effective rhythm. So what initially happens if one comes upon an individual or is called to an individual who has collapsed, you should initially feel for a pulse, see if theyÃÂ¢ÃÂÃÂre breathing, and try to call 9-1-1. And then start CPR, which means starting the airway with breathing and starting chest compressions. You want to have the AED within a two-minute turn around time of the individual, if at all possible. So schools will often need more than one AED. And so one brings the AED to the individual, the defibrillator then has a computer in it that will recognize whether a rhythm that should be shocked and many of the AEDÃÂ¢ÃÂÃÂs will automatically shock. They do not make mistakes. ItÃÂ¢ÃÂÃÂs one of the few things on Earth that seems to be fail-proof. And they will recognize if itÃÂ¢ÃÂÃÂs a shockable rhythm. It will either tell you to push the button, or it will go ahead and shock the individual. It will then look again and see if there is a shockable rhythm still or if itÃÂ¢ÃÂÃÂs a normal rhythm, it will tell you if itÃÂ¢ÃÂÃÂs not a normal rhythm, you should start CPR again. Do that for a few minutes and then restart the cycle.
Vinay Nadkarni, MD: In most communities when a sudden cardiac arrest occurs, survival is very poor, often times reported to be 4 percent to 10 percent of those that collapse. But with CPR and ready availability of an AED, one can quadruple survival from sudden cardiac arrest in the community. So we can see some communities that have 20 percent to 30 percent survival after sudden cardiac arrest when before they only had 4 percent or 5 percent.
AEDs have been used in a variety of settings-- by school children, by lay persons, by paramedics, and even here in the hospital. ItÃÂ¢ÃÂÃÂs best if theyÃÂ¢ÃÂÃÂre used with a little bit of training, so that youÃÂ¢ÃÂÃÂre really sure how to use it. But theyÃÂ¢ÃÂÃÂre so simple that one can really figure it out by opening the box and turning it on.
Victoria L. Vetter, MD: If a school is interested in learning more about AEDs or if they have an AED and want to make sure that they are appropriately implementing their program, they can contact us here at The ChildrenÃÂ¢ÃÂÃÂs Hospital of Philadelphia through our Youth Heart Watch program numbers.
Narrator: We encourage you to become a Youth Heart Watch school even if you already have AEDÃÂ¢ÃÂÃÂs. We will evaluate their placement and accessibility and help find ways to raise money for more, if needed. And if you donÃÂ¢ÃÂÃÂt have CPR training, we can help you get started. There is no charge for any of these services. Youth Heart Watch and The ChildrenÃÂ¢ÃÂÃÂs Hospital of Philadelphia offers them free because of our mission to protect children.
Victoria L. Vetter, MD: We do have some training grants available that can be applied for to help them obtain funds to train somewhere around 20 to 25 individuals within the school.
We will help them with setting up a curriculum for CPR and AED training and help them setting up a program to do mock AED drills. We will then come back every year and work with them to make sure that everything is up to date.
So we will give them all of the information including forms and other information so that they can implement a program that involves use of the AED but also awareness of the conditions that cause sudden cardiac arrest, and the ability to do CPR and utilize the AED, if needed.