Dr. Dermot Phelan MD, Ph.D., FESC, FASE, FACC a staff cardiologist from the Cleveland Clinic interviews Samantha Krouse, Manager of GotAED about sudden cardiac arrest, the importance of early defibrillation and resources to get AED devices.
Dr. Phelan: The sudden cardiac death of a young athlete or pupil has a profound effect on the community at large. It often leaves people asking what more could have been done to prevent this tragic event. Could you describe the scope of this problem and what are the most common underlying causes of sudden cardiac death in the young?
Samantha: We believe that thousands of children die every year from sudden cardiac arrest. Unfortunately, we don’t know for sure because our medical community didn’t start tracking the causes of death of minors until recently. The NIH and CDC created the sudden death registry and it is being piloted in a handful of states. For instance, when a student is found at the bottom of a pool, the death certificate will say drowning or asphyxiation. But, what caused this student to drown? It could have been an arrhythmia, which is undetectable once the heart stops beating. The same for babies who die of SIDS or young adults who die in single-car accidents when the weather is good and there is no evidence of alcohol or drugs.
We can prevent these tragedies in a few ways:
- We must know that sudden cardiac arrest is not just an adult thing. There are some warning signs for us to watch: fainting during or right after exercise, a racing heart and sudden death of a family member under the age of 50.
- Our kids should get their hearts screened. Research shows that an ECG exam, when done with a physical and history, is more effective at detecting heart conditions.
- We need to be prepared. We need to know how to do chest compressions and have an AED around. The AED is the only tool that can save someone in cardiac arrest.
Dr. Phelan: Could you please tell us about the importance of early effective CPR and early defibrillation on outcomes in these events?
Samantha: CPR and early defibrillation are critical, but let’s remember that they are the backup plan. We need these tools because we failed to detect the condition before it causes harm. CPR or chest compressions circulate blood throughout the body when the heart stops pumping. Without blood and oxygen, our organs will quickly fail.
The AED delivers a lifesaving shock to our heart. It resets the rhythm. It is the only tool that can do this. If someone provides bystander CPR and the use of an AED device is used within 3-5 minutes of the collapse, the survival rates are between 41%-74% (Korey Stringer Institute). If you aren’t able to use an AED device or the device is inaccessible, the survival rates decline 7-10% per minute, every minute that defibrillation is delayed. That is why the best practice to save lives during a cardiac arrest event is to start chest compressions within 1 minute of collapse and grab the defibrillator within 3 minutes of collapse.
Dr. Phelan: How can we improve education on basic life support in our communities?
Samantha: The first step to improving education is demystifying the process. For decades, the heart community has required hours of training, certifications, and fees. There are stickers on AED cabinets claiming that the devices are professional use only. The public is scared and intimidated – for good reason. This stuff is easy. It’s super important but so easy. All students should be taught how to perform CPR and how to use an AED device in school. There are 38 states that encourage CPR education before graduation. That’s a start.
There is also technology like the PulsePoint app that alerts bystanders about cardiac arrests nearby so they can assist until the first responders arrive. Pulse Point also has an AED registry, so the devices are easier to find.
Dr. Phelan: Where should AEDs be made available?
Samantha: AED devices should be made available everywhere, including where kids learn and play. Think about all of the safety tools we have but rarely (or never) use – fire extinguisher, smoke detector, smoke alarm, and burglar alarm. These all add value and mitigate risk. So, does an AED device. Sudden cardiac arrest is the leading cause of death of adults in the US. The only tool that can prevent it should be everywhere.
Dr. Phelan: How much does an AED cost?
Samantha: AEDs range in value like every other appliance or tool. They can retail for $1,100 – $2,500. Cardio Partners is our AED partner for crowdfunding site, GotAED. We are able to provide devices at a lower cost because of the nature of our site.
Dr. Phelan: Please tell us about the work that GotAED does?
Samantha: GotAED is an initiative of Simon’s Heart, a nonprofit organization dedicated to raising awareness about the warning signs and conditions that lead to sudden cardiac arrest and death in kids. We created this site to empower places to get AEDs even when they don’t have the budget to do so. We heard too many stories about youth facilities that wanted an AED but gave up because they didn’t have the money.
GotAED allows youth related facilities to quickly set up a campaign and raise funds. It takes a few minutes to get started. The cost is the same for everyone – around $900 – depending on the way that you want to store the device (and your state’s sales tax). Once the campaign is fully funded, the device and storage container is delivered right to the door. We also partner with ProjectADAM to help create cardiac emergency response plans for the youth facility.
Within its first year, GotAED helped 30 different schools, youth organizations, libraries, community centers, sports clubs/associations, and museums get AED devices in over 18 states.
GotAED also launched an awareness campaign with the Philadelphia Flyers. It is called the Overtime Challenge. Every time the game enters the sudden death period, an AED is donated to a local youth facility. Sudden death is an exciting way to win a game, but a terrible way to lose a teammate.
Dr. Phelan: If someone in the community wishes to purchase an AED, where should they go to get information.
Samantha: There are a few places that provide funding for AED grants. However, money is scarce. So, if funding is not available, visit GotAED.org and click the red button to “Start a Campaign.” I am always available to answer questions – firstname.lastname@example.org.
If you have funds, we recommend Cardio Partners. To receive a special discount, please enter the code SIMONSHEART2019 on AED.com to get 20% off your total purchase. For more information, please contact Frank Mannino at email@example.com.
Dermot Phelan, MD, Ph.D., FESC, FASE, FACC is a staff cardiologist in the section of Cardiovascular Imaging in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, and Medical Director of the Sports Cardiology Center in the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic. He is an Assistant Professor at the
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. As Medical Director of the Sports Cardiology Center, Dr. Phelan is actively involved in the care of athletes of all levels. He has a national and international reputation as a passionate advocate for the promotion and protection of the cardiac health of athletes.
Samantha Krouse, 24, is the Manager of Programs and Initiatives at Simon’s Heart, an organization dedicated to raising awareness about the warning signs and conditions that lead to sudden cardiac arrest and death in kids. By providing free heart screenings, advocating for legislation to protect student-athletes, promoting research through its national cardiac registry of seemingly healthy kids, distributing AED devices through its crowd-funding site, and raising awareness with strategic partnerships and cause marketing programs, Simon’s Heart is protecting hearts and saving lives. Samantha manages GotAED placing over 50 AED devices across the country, runs GotAED Overtime Challenge with the Philadelphia Flyers, launched a scholarship program for high school students with Montgomery County and PulsePoint to improve the county registry of AED locations, and directs AED Madness working with NCAA basketball teams to educate fans about cardiac arrest. Samantha was also honored as the recipient, on behalf of Simon’s Heart, for the Game Changer Award at the Philadelphia 76ers.