A high school soccer practice in Winston-Salem almost took a tragic turn when an otherwise healthy student-athlete suffered a sudden cardiac arrest. Through the quick responses of his teammates, coaches, and staff, and a little luck, the boy's life was saved.
Their efforts were guided by an automated external defibrillator, or AED, with survival rates nearly ten times higher than those in schools that lack them. Many states require AEDs on school campuses, but North Carolina is not among them.
After February rains and cancellations, students at Atkins High School were looking forward to their first soccer practice in weeks. Junior Pablo Hortal was in the middle of his warmup jog around the baseball field there when he suddenly became exhausted and dizzy. He slowed to a walk, put his hands on his knees, and quickly collapsed.
“I was trying to piece it together,” says Hortal. “Am I doing a really hard work out or something? My brain wasn't realizing where I was at the time. And then I remember waking up — crowd of people around me — and the guy told me, ‘Well you gave us a scare. Your heart stopped.'”
Coach Dylan Collier says after two teammates motioned him over to where Hortal was lying, he immediately went into reactionary mode.
“You know, I got down beside of him and checked his pulse, checked his breathing,” says Collier. “That's when CPR (cardiopulmonary resuscitation) started. And then within a minute our trainer was there with the AED. It all happened just so quickly.”
AEDs are essentially portable shock boxes able to immediately recognize when someone is in a life-threatening heart rhythm, guide caregivers through CPR steps, and if required, shock the patient's heart back into an appropriate rhythm. Each year in this country, thousands of young people under the age of 18 experience out-of-hospital cardiac arrest, and roughly one-third of them will survive.
Duke University School of Medicine pediatric cardiologist Dr. Andrew Landstrom says in Hortal's case, having an AED on campus was huge.
“When the heart is in that kind of rhythm, seconds matter,” says Landstrom. “And if this goes on for three, four, five minutes, the lack of blood flow to the brain can be terrible. And so, because he was defibrillated so quickly, he essentially had no neurologic injury at all.”
Landstrom says it can be tough to pinpoint why this happens, but many times it's hereditary. He says it often goes undetected, making AEDs invaluable and something he would like to see required in schools across the country. Currently, they are required in 17 states, but not in North Carolina.
Hundreds of schools here, however, have obtained them, and many through the state's High School Athletic Association. Commissioner Marilyn “Que” Tucker says their expectation is for every single one of the Association's high schools to have an AED on site.
“I can't imagine we have any schools that don't simply have one just simply because it is so critical not just to your athletic arena, but it's critical to just staff and students in general,” she says.
AEDs cost roughly $1,500, and the association's grant program assists those schools unable to afford them. Tucker says to be eligible they need to designate an AED School Coordinator, identify employees to be trained in the machine's use and CPR, maintain operational guidelines, and more.
But in total there are nearly 1,000 high schools in North Carolina, and many of them still do not have this life-saving equipment in place. Project ADAM is hoping to change that. It's a national organization that partners with schools to empower and support them in their efforts to become prepared to respond to cardiac emergencies.
Project ADAM North Carolina Program Coordinator Danielle Sturkey says having an AED is only one part of that equation.
“The other piece is CPR training, and awareness of sudden cardiac arrest, knowing how to recognize it, practicing AED drills annually with the staff just like schools practice fire drills,” says Sturkey.
Winston-Salem Forsyth County Schools Superintendent Tricia McManus came to the Triad following a 20-year academic career in Florida — the first state in the nation to enact AED laws requiring public schools to have an operational unit on the grounds at all times. She says she'd like to see that same commitment here.
“What we want is legislation that helps kids,” says McManus. “So, like if the state mandated an AED in every school and funded that mandate, how powerful would that be? Honestly, if one life were saved as a result of it, it would be well worth the cost.”
Pablo Hortal agrees. He's fully recovered from his sudden cardiac arrest and now wears an implantable cardioverter-defibrillator that prevents his heart from beating too quickly or too slowly.
“It's like an emergency room right on me at all times,” he says. “It's a safety net, so I never have to worry about that again. And my mom doesn't have to worry either which is the big one," he laughs. "So, I have my life back to normal and I could not be happier with the outcome.”
*EDITOR'S NOTE: This transcript was lightly edited for clarity.