Twenty-six minutes and 29 seconds: that is how long 15-year-old Grant Ketzle was without a heartbeat and the moment that his mother walked into the room at Cook Children’s Emergency Department – Prosper. Tiffany Ketzle saw her son lying on the treatment table, receiving chest compressions. As a nurse practitioner, she knew the magnitude of what those minutes meant and she recognized the level of care given to her son in one of the hardest moments of her life.

“Is my son alive?” It was a question she asked, but was hard to answer as the medical team performed CPR. Within minutes, the care team restored his heartbeat, however, it took more than four hours for Grant’s vitals to be stable enough to be flown via a Teddy Bear Transport helicopter to Cook Children’s Medical Center – Fort Worth.

It started that morning of Sept. 2, 2024, Labor Day weekend, when Grant was at football practice at Walnut Grove High School and he felt something wasn’t right. There were multiple times when he felt like he was going to pass out. He told an athletic trainer who was concerned and called his mother, Tiffany. 

Tiffany called her mother (Grant’s grandmother) who picked him up from practice and Tiffany gave her directions to Cook Children’s Emergency Department – Prosper. Grant felt like he was going to pass out and throw up during the car ride, but they made it. He passed out shortly after arriving and sitting in a wheelchair. 

Soon, Tiffany’s mother called her screaming and crying, telling Tiffany that Grant was coding. Tiffany, who was at work, grabbed her purse and keys as fast as she could, and a coworker drove her to the medical center.

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Grant Ketzle’s life was saved thanks to the quick actions of his family and the team at Cook Children’s Emergency Department - Prosper when he had a cardiac arrest.

“I just remember walking into the room where Grant was and the code clock said 26:29, which is an awfully long time to be coding,” Tiffany said. “He looked very pale, he did not look alive.”

Julio Castillo, M.D., Medical Director of Cook Children’s Emergency Department Prosper, debriefed with her and told her that when Grant arrived, his heart had stopped completely and he was in respiratory failure.

“What I just kept thinking is, No. 1, my child's not going to die today. This is not happening. And No. 2, I've been in his position as a nurse practitioner where I'm trying to tell a parent very terrible information,” Tiffany said. “And I just remember thinking he had such a grace about him and the things he had to tell me were awful, awful things. But he said it in such a kind and caring way.”

Grant had experienced blood clots in his lungs, strokes and acute respiratory distress syndrome (ARDS) which prevents the lungs from exchanging oxygen and carbon dioxide effectively. He was diagnosed with an incidental heart rhythm condition called Wolff-Parkinson-White Syndrome, which is an abnormal extra electrical pathway in his heart that he was born with.

Tiffany was not surprised to see so many people in Grant’s room, but what moved her was the compassion she received from the team members.

“That's what struck me the most about the ER is every single person in that room, you could tell they cared about my son. They were trying to do everything they could to keep him alive,” Tiffany said. “They were all very, very compassionate. From the nurses to all the doctors to the flight crew, every single person, including the security guard.”

Dr. Castillo said this was truly a team effort.

"This was a testament to the incredible skill and dedication of the team. From the moment Grant arrived, the response was swift and decisive,” Dr. Castillo said. “Every member of our team who was at the emergency department that day made a difference in this child’s life, whether they were clinical or non-clinical. To see this young man recover and return to his life is a profound reminder of the power of human resilience and the life-saving work we get to be a part of."

Tiffany shared a post about Grant’s experience on Facebook to share what they had gone through and to help raise awareness of the Cook Children’s Medical Center and Emergency Department in Prosper.

“I was very grateful for the care that we received there. Everyone there was top notch. We definitely wanted to get the word out that this resource of Cook Children’s is here,” Tiffany said. “If this had happened to my son two years ago, he would not be here. If this campus didn’t exist, he wouldn’t be here.”

“We're just very grateful that this campus is directly tied into Fort Worth. So within a 20-minute helicopter ride, you can get every resource that you need,” Tiffany said.

Recovery at Cook Children’s Medical Center – Fort Worth

When Grant arrived at the Pediatric Intensive Care Unit (PICU) of Fort Worth, Tiffany commended the communication and care from all the staff members. She said she truly felt like they were all one unit and was grateful for the involvement in his care.

“The first day was probably the worst day of our lives and as a parent, your worst fear is that your child is going to die,” Tiffany said. “It was such a horrible time in our lives... but somehow the staff just make it a little better, just to give some hope or grace. We got that every single day there.”

One of the great things about Cook Children’s is having easy access to a high level of care and specialists, Tiffany said. Within the first few hours of Grant arriving at Fort Worth, he was seen by many specialists, including gastroenterology, cardiology and pulmonology. Eventually, they also had appointments with hematology/oncology, nephrology and neurology. They were grateful that the specialties are also available in Prosper.

“They were able to coordinate a lot of the testing,” Tiffany said. “For example, he has an MRI coming up for his brain, he's got an ultrasound coming up and prior to this, we would have to go to Fort Worth to do those things. Well, now they can do those things here in Prosper.”

In the PICU, Grant was paralyzed because his respiratory condition was poor and he had a breathing tube placed. When Grant started to wake up after a day and a half, he made a heart shape with his two hands and pointed at the nurses. Even though he was unconscious while they spoke to him, he recognized their voices when he woke up.

As one nurse offered to wash his hair, Tiffany was impressed that she had all the tools and comfort items to wash his hair while he was in the ICU. Mom noticed that looking at his vitals, he became more relaxed as his hair was washed.

“It was wonderful to see people care for your child like you feel like they would care for their own,” Tiffany said. “That’s truly what it felt like.”

Grant was released from the medical center in Fort Worth on Sept. 11, and to the family’s surprise, Grant had recovered well enough to make it to homecoming at his school. Grant said this medical journey has brought him closer to his faith and that he hopes to use his story to encourage others to never give up.

“It was crazy to think how God works because I progressed so much in 10 days and on the final day I felt so much joy when I heard the words that we could go home,” Grant said. “What makes this place so special and unique is how kind and caring the staff are. They were amazing and they knew what to do. I trusted in God and all of them.”

Second Heart Incident

In late October, Grant went to the Cook Children’s Emergency Department - Prosper a second time when his heart caused him discomfort when he woke up in the middle of the night. He felt like his heartbeat was abnormal again.

The family rushed to the emergency department and his care team discovered that his heart was in a rare and dangerous arrhythmia called preexcited atrial fibrillation, which is associated with his Wolff-Parkinson-White syndrome. Through a telehealth visit at the emergency department, a Cook Children’s cardiologist in Fort Worth was able to identify his rare type of arrhythmia and the team at the emergency department in Prosper shocked his heart back into a normal rhythm.

He was flown to Cook Children’s Medical Center – Fort Worth where electrophysiology cardiologist Rohit Madani, M.D. cared for him. Dr. Madani performed an electrophysiology study in which he ablated the abnormal electrical pathway in his heart with a specialized catheter that burns heart tissue. Grant has recovered well from this procedure and Dr. Madani’s hope is that this will be a long-term cure for Grant’s arrhythmia.

“Grant at this point has the same risk of a heart event happening in the future as anybody else,” Tiffany said. “We’re very grateful.”

The Project ADAM program at Cook Children's hosted a FREE hands-only CPR/AED demonstration on Tuesday, Oct. 22 at Cook Children's Medical Center - Prosper alongside special guests Prosper Fire Rescue and Police Department. Cook Children's also shared resources for drowning prevention and safe sleep education, free car seat checks, Build A Bear and Kona Ice!

Another event will be held at Cook Children's Medical Center - Fort Worth at the Atrium on Thursday from 1 p.m. to 4 p.m. Join us to learn how to save a life! Kids, be sure to wear your Halloween costume! We look forward to seeing you! 

Resources and Being Prepared

More than 700 schools in North Texas have partnered with the Project ADAM program at Cook Children’s to become a “Heart Safe” school. The program trains school staff members on CPR, how to use an automated external defibrillator (AED), and helps create an emergency plan. It also provides resources and support to become a Heart Safe school, which is renewed every year through training and requirements. Project ADAM is a free resource for schools and the community.

The likelihood of sudden cardiac arrest in children and young athletes is known to be enhanced by athletic participation. On average, a seemingly healthy young person suffers a sudden cardiac arrest every three days in the U.S. and it's the leading cause of death in exercising young athletes.

Project ADAM reiterates the importance of being prepared for a cardiac emergency, especially in sports and school settings, with CPR and an AED.

Athletic personnel need to recognize the threat to young athletes and properly prepare for sudden cardiac arrest. Every school or organization that sponsors athletic activities should have an AED, trained coaches, and a written Emergency Action Plan.

Cardiac emergency preparedness training empowers people to use the AED device. Texas requires all schools to have an AED, but often people don’t know where it is located, how to use it in an emergency or rely solely on the school nurse to use the device.

Sign and symptoms of pediatric heart disease

Sudden cardiac arrest (SCA) is when the heart suddenly and unexpectedly stops beating. SCA often occurs in active people with no history of heart conditions. In children, common causes are genetic, congenital or related to a sudden blow to the chest. If treated quickly, using an automated external defibrillator (AED), it is possible to restart the heart and increase the chances of survival. 

Pediatric heart disease has warning signs and symptoms that can go unnoticed. It is important to recognize the following:

• Fainting or near-fainting during or after exercise, emotion or surprise
• Dizziness or lightheadedness
• Extreme fatigue associated with exercise
• Extreme shortness of breath associated with exercise
• Discomfort, pain or pressure in chest during or after exercise
• Skipping or racing heartbeats
• High blood pressure
• Congenital heart abnormality
• Family history of sudden death prior to age 50 or known heart abnormalities

Not all episodes of sudden cardiac arrest are preventable because many of the kids do not have symptoms until they have the episode. For this reason, secondary prevention strategies are important.

About Project ADAM

Project ADAM, which is nonprofit and nationwide, aims to educate school systems, nurses, coaches, trainers, parents and others about pediatric sudden cardiac death and to establish emergency programs to help provide a timely and lifesaving response as emergency medical services are on their way to an incident.

Project ADAM was started in 1999 after a 17-year-old Wisconsin student named Adam Lemel collapsed and died while playing basketball. His parents helped start the Project ADAM program at the Children’s Hospital of Wisconsin in his memory. Cook Children’s is one of 35 hospitals and program sites providing free cardiac resources, including training and AED devices.

RELATED: How to Become a Heart Safe School

Despite repeated calls from experts to lifeguard your child, 19 children have been rushed to Cook Children's for drownings and four children have died since May 1.

Corwin Warmink, M.D., medical director of Emergency Services at Cook Children’s, said parents and caregivers should take important steps to save their children from drowning, including taking CPR lessons.

"Seconds really do matter," Dr. Warmink said. "Quick, efficient CPR performed before EMS arrives has been shown to improve outcomes. Learning CPR should be an important part of any family's safety plan. You want to be prepared in critical situations."

Studies show CPR doubles the victim’s chance of survival. Learning CPR can save a child’s life by restoring breathing and circulation until advance life support can be given by health care providers. Please watch the following video from Steve Muyskens, M.D., medical director of the Cardiac MRI at Cook Children's.

Dr. Warmink describes drowning as the inability to breathe, normally due to submersion in a liquid, usually water. The outcome, including death, of the person who drowned depends on how long she or she is under water.

"Everything is based on getting oxygen to vital organs,” Dr. Warmink said. “The outcomes of drowning and the adverse effects are based on the lack of oxygen. The most effected parts of a drowning victim are the brain, lungs and the kidneys. The one that is most catastrophic and the one that will kill you is the brain.”

The amount of time children spend under the water while drowning usually determines their outcome. The lack of oxygen destroys brain cells and that causes damage to the brain, ranging from short term (forgetful, clumsy …) to severe (can’t walk to vegetative).

Dr. Warmink says there are several variables that shape how severe the brain damage will be, including how long the child was submerged in the water and how quickly he or she received CPR.

Once a child arrives at Cook Children’s Emergency Department, treatment begins that may include oxygen, X-rays, intubation or medication.

“But a lot of what we do is supportive care for the children that come in here,” Dr. Warmink said. “We may have to support their lungs because they have been damaged and they have difficulty breathing. Their kidneys could be damaged, so we will do lab work to see what’s going on there. But our biggest concern is the brain and honestly, there’s not a whole lot we can do. The vast majority of treatment for drowning is supportive. We see what we can do to keep that child alive. That said, the earlier you can intervene, the better. One of the things that helps outcomes is early, good CPR. By the time they get to us, it may be too late.”

Lifeguard Your Child 

It's time to make Texas #1 in drowning prevention. Drowning is the leading cause of accidental death for children ages 1 to 4, and the second leading cause for kids 1-14 in Texas. But with your help, we can change that. Please join us in our drowning prevention effort. Together, we can Lifeguard Your Child around water.

Want to know how you can get involved or create an awareness campaign in your community? Contact Dana Walraven, Safe Kids Tarrant County coordinator at 682-885-1619 or email safe.kids@cookchildrens.org.

More resources for you:

• Cook Children's Upcoming CPR Classes
• Project Adam
• Red Cross CPR Training
• Fort Worth Red Cross Safety Class, Including CPR
• American Heart Association
• Texas Heart CPR Training 
• DFW CPR Training Center
• Texas OnSite CPR
• CPR Training in Fort Worth, Texas
• CPR Training in Denton, Texas
• Drowning prevention page at Cook Children's
• Is your baby ready for swim lessons?