When a heart stops beating, moments matter.
For every minute without emergency care, chances of surviving cardiac arrest dip about 10 percent.
It’s statistics like this that have inspired local doctors, school officials and parents to come together to educate the community on how to prevent and respond to sudden cardiac arrests. Their efforts have led to most high schools in Orange County bringing automated external defibrillators, known as AEDs, onto campus to treat unexpected health emergencies.
The devices, along with increased awareness, CPR training and medical advances, have made a difference, said Dr. Anjan Batra, medical director of electrophysiology for the Children’s Hospital of Orange County’s Heart Institute.
“We still need to make progress,” he said. “We’re still seeing kids that don’t make it.”
In the past decade, six Orange County high school students have died after collapsing during sports practices or games. The most recent, 14-year-old Mitchell Cook, collapsed Aug. 7 toward the beginning of freshman football practice at Canyon High School in Anaheim Hills. Adults at the field immediately began CPR, and he was taken to a hospital, where he died several hours later. An autopsy was completed, but officials from the Orange County coroner’s office do not expect to reach a cause of death for weeks.
As of November 2012, 13 of the 28 school districts in Orange County reported they have a policy in place for AED use, said Pam Kahn, coordinator of health and wellness with the county Department of Education. The devices are most often present in districts that have high schools, where they are available for health emergencies during sports practices and games, she said.
“It doesn’t always work,” she said. “It certainly increases chances.”
REMEMBERING SHAUNA
Cook’s death hit close to home for Kirk and Lori Stuewe, parents of Shauna Stuewe. The 14-year-old cheerleader went into cardiac arrest during an Esperanza High School practice in 2006.
“My heart always goes out for the family,” Lori Stuewe said. “It is the most terrible thing to lose a child.”
In their daughter’s memory, they created the Shauna Ann Stuewe Foundation to raise money for AEDs at local schools. They’ve donated 72 of the devices, which cost about $2,000 each. At Canyon High School, however, their donation was not accepted, Lori Stuewe said.
The motivation behind this donation was particularly personal. Their younger daughter, Melanie, had been diagnosed with the same genetic disorder that had prompted her sister’s cardiac arrest and was set to begin classes at the school.
“We didn’t want to send Melanie there without an AED,” her mother said.
An offer of a donation was refused, but an Orange Unified School District staff member suggested that Melanie could carry an AED with her to class, Stuewe said.
“I was very upset and said, ‘No, that’s not going to be a solution,’” she said.
Melanie, instead, enrolled at Esperanza High School, where the foundation had already donated AEDs. Still seeing a need, however, her parents again offered a donation to Orange Unified, Stuewe said. They received an email back that the district wouldn’t be taking their offer.
“It’s unbelievable to us when a school district doesn’t accept the donation,” she said.
The district didn’t give a reason for the refusal, but the Stuewes said they have heard several reasons for hesitation in the past. Sometimes, there are concerns of liability or the financial obligations of the keeping the devices maintained.
To Kirk Stuewe, those challenges can be surmounted. Funding can come from private sources or grants, and California has long had Good Samaritan laws protecting those administering first aid.
“There really is no reason to turn it down,” he said.
The district could not accept donated AEDs without first having a policy for their use and maintenance in place, said Katherine Topor of the Orange Unified School District. Staff discussed the issue in 2007, but the matter has never been on the agenda of the school board, she said.
“Right now, the district is taking a look at it again,” she said.
Though sudden cardiac arrests are relatively rare, Kirk Stuewe added that the loss of even one child is a community tragedy. Though it’s impossible to know if an AED would have changed the outcome at Canyon High School, the Stuewes wonder if the device may have helped.
“It’s actually kind of sickening to us that this could have been a preventable situation, like Shauna’s could have been,” he said.
MORE SUCCESS STORIES
Even when everything goes right, however, sudden cardiac arrests can’t always be avoided, Batra said. The doctor has worked on preventing deaths in young athletes with a group that includes CHOC, the Stuewe foundation, local PTAs and the Orange County Department of Education.
“We can reduce the risk, but we cannot completely eliminate the risk,” Batra said.
The causes of cardiac arrest in young people vary. There are warning signs or defects that may be picked up with screening, but often, kids seem healthy.
When a young athlete does go into cardiac arrest, the chances of survival are better than they used to be, Batra said. Increased awareness, CPR training, AEDs and improvements in medical treatment have all played a role in saving lives, he said.
“There are more success stories than there are not,” he said.
Approaching the issue with collaboration from schools, doctors and parent groups has helped get AEDs into many Orange County high schools, he added, and the group will continue to help local districts find ways to bring the devices onto campuses.
“Every school should have an external defibrillator,” he said. “That can be huge in if these kids live.”
Whether or not to adopt the devices is up to individual school boards, but county education officials help connect those interested in adopting a new policy with resources.
“There is some apprehension about implementing these programs,” she said. “This is a life and death thing.”
Maintenance, training and funding must all be considered before one of the devices goes into place, she said.
“It is a bit of a challenge,” she said. “Districts that are dedicated to it find a way to do it.”
PROGRAM IN PLACE
In the Placentia-Yorba Linda Unified School District, home to Esperanza High School, an AED policy has been in place since 2008. Superintendent Doug Domene said adopting it involved six months of preparation.
“It was a long, challenging process,” he said. “We wanted to make sure we were doing it right.”
State regulations govern AED programs. Under the requirements, the devices must be tested monthly, an emergency response plan must be in place, and staff must be regularly trained on their use. State law also says that those who follow the regulations are exempt from civil liability.
Once the policy was in place, Domene said the district worked with PTAs, the Stuewe foundation and the local Rotary club to pay for 3-4 of the devices at each high school, two at each middle school and one at each elementary school. The location of each AED is determined so that it’s only minutes from any potential emergency, and at high schools, athletic trainers usually bring the portable machines along with them to practices and games.
So far, the district has used the machines twice during medical emergencies. In one case, an adult attending a school sporting event was successfully revived. In the other, a student was revived but died several days later at a hospital.
Maintaining the devices has become part of the district’s routine, Domene said, the staff are willing to help other districts develop their own policies.
“Once you get this in place, it’s not that difficult,” he said.
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