Preventing Sudden Cardiac Death in Children and Adolescents

Our instinct, as parents, is to protect our kids. We do things like placing them on their back to sleep as infants, baby-proof their environment when they start crawling, and talk to them about “stranger-danger” before we start letting them go out into the world. Yet as hard as we try, there are some things we can’t predict or prevent. 

Sudden Cardiac Arrest (SCA) happens when the heart goes into a rapid, lethal heart rhythm called ventricular fibrillation. When this happens, blood is no longer pumped out to the rest of the body and, if left untreated, results in Sudden Cardiac Death (SCD). While cardiac arrest in this age group is rare, it does happen and is more likely to happen at school or during a sporting event.

SCA in children and adolescents has three primary causes, which include:

• Structural heart disease – they were born with a heart defect.
  • Structural disease is almost always caught early in life and is generally easily screened for.
• Electrical heart disease – the heart is structurally normal, but there is an issue with the electrical system.
  • Electrical disease can be much harder to detect during a routine screening and may be missed until there are symptoms.
• Situational – abnormal rhythm caused by an infection, or a hit to the chest.
  • People with heart infections often have very vague symptoms or no symptoms at all, so it is extremely difficult, if not impossible to identify when this is going on through routine screening.
  • A hit to the chest during a certain part of the heart cycle can cause a lethal heart rhythm. While the risk can be lessened with proper safety equipment during sports, it cannot be eliminated.

When a cardiac arrest does happen, it’s critical that the victim receives immediate Cardiopulmonary Resuscitation (CPR), and a shock from an Automated External Defibrillator (AED) within the first five minutes. An AED is a device that can automatically detect the dangerous heart rhythm and deliver a shock to reset the heart and restore it to a normal rhythm. 

While laws governing AEDs in schools vary from state to state, most do have at least one per building now. That said, having an AED in the school building isn’t enough. An AED is only helpful if:

• It is accessible anytime there are people at school. If the AED is locked in the school nurse’s or athletic trainer's office, then it can’t help anyone.
• It is properly maintained. Batteries and patches expire and need to be replaced. There needs to be a written log that shows preventative maintenance is happening.
• There are people who know how to use it. Often, these devices are hung on the wall, and no one is trained to use one. Make sure your school’s staff receives training at least yearly on how to use it.
• It can get to the victim quickly. Delivering a shock to the victim in the first few minutes of an arrest is their best chance at surviving and returning to normal function. This is why it’s important that schools have enough AEDs and keep them where they’re needed (e.g., athletic fields, sports facilities).

While it is uncommon, SCA is one of those things we’re unable to completely protect our kids from, but there are still things we can do to help keep them safe. We encourage parents to reach out to your children’s schools and ask the questions listed above. Hopefully, your school is prepared. If not, please have them reach out to us at projectadam@nationwidechildrens.org or go to the national Project Adam website for more information about our free program.