Every year, approximately 2,000 seemingly healthy people under the age of 25 die from sudden cardiac arrest (SCA), a tragic statistic that Cook Children's Health Care System is working to change.

In recognition of National Sudden Cardiac Arrest Awareness Month this October, Cook Children's is highlighting its year-round commitment to ensure schools and communities are prepared for such a medical emergency through its Project ADAM program, which provides life-saving training and resources.

Sudden Cardiac Arrest occurs when the heart stops beating, which leads to loss of breath or irregular breathing and prevents blood flow to the brain and other vital organs.

“With the proper training, anyone can do CPR and use an AED, and with enough of us trained and empowered to do so, we have the ability to potentially save someone’s life,” said Sarah Thieroff, Project Adam Program Coordinator.

Project ADAM (Automated Defibrillators in Adam's Memory) is a program named after 17-year-old Adam Lemel. In 1999, while playing high school basketball, Lemel collapsed and went into Sudden Cardiac Arrest. His family learned that he could have been saved with the right preparation and equipment. An automated external defibrillator (AED) was not available. His parents helped start the Project ADAM program at the Children’s Hospital of Wisconsin in his memory. Cook Children’s was the first in Texas and is now one of 52 hospitals and program sites to provide free cardiac resources, including training and AED devices. 

Thieroff recalled the motivating force behind the program's founding: "What we learned now is that Adam could have had a chance. I was faced with a choice. I couldn't save my son, but maybe I can save yours," Adam's father said.

More than 780 schools and 28 school districts are recognized to be Heart Safe. A designated Heart Safe school and district have completed a quality AED training program that includes a CPR/AED trained emergency team, an emergency plan for their AED and required AED drills.

“Knowledge of what to do, and muscle memory from practicing the appropriate steps may correspond to earlier action and in turn lead to a more successful outcome,” said Danielle Moyé, M.D., at Cook Children’s Heart Center.

Beginning the 2026-2027 school year under Senate Bill 865, also known as the Landon Payton Act, public and private schools will be required to implement a cardiac emergency response plan, mandate CPR and AED certification for specific school employees and volunteers, and require drills to test their emergency response.

“With the SB 865 bill, we have legislative support to encourage schools to act now and prepare,” said Dr. Moyé. “And we are ready to help them. We are here and happy to walk through what this looks like and ease some of the burden from the school’s administration, nursing team, and district.”

An AED is supported by the FDA to detect ventricular fibrillation. It has been designed and tested in both children and adults. Cardiac arrest is reversible in most victims if it is treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A shock delivered by an AED within 3-5 minutes can save a life and for every minute that passes, survival rates drop by 10%.

Through the Cook Children’s Project ADAM program, anyone can be trained. The program provides schools across Texas with the necessary tools and education to plan and develop their public access defibrillation (PAD) program.

“The expectation is that schools will be prepared for if it happens, not just putting it off or waiting to establish an emergency team, plan and/or drill if/when it happens,” explained Thieroff.

Signs and Symptoms of Sudden Cardiac Arrest

• Not breathing or irregular breathing (i.e. agonal gasps)
• Unresponsive and/or sometimes there are “seizure-like” movements.
• If someone witnesses a collapse:
  • Check for responsiveness.
  • Tap/lightly shake the person and ask if they’re okay, then if they’re not responsive, call for help/have someone call 911 immediately
  • Send someone to get the AED. If they’re unsure where the AED is, when they call 911, the 911 dispatcher should tell them the location of the nearest registered AED in the area.

Cook Children’s provides free Hands Only CPR/AED training, cardiac emergency response planning, and AED drill assistance to any school in Texas. Call 682-885-6755 or email ProjectAdamTexas@cookchildrens.org. For more information on free resources on the local Project ADAM program, visit www.projectadamtexas.org or the national Project ADAM page at www.projectadam.com

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

By Eline deBruijn Wiggins

A family and community are inspired after a 15-year-old boy was revived for the second time in his life by an automated external defibrillator from the Project ADAM program at Cook Children’s. Dirk Green symbolizes the importance of education and training for heart conditions, and having an AED in schools.

In April, Dirk, a sophomore at Weatherford High School, collapsed and lost consciousness when he was at school and heading to the restroom. Fortunately, just a few weeks earlier, the Project ADAM program at Cook Children’s trained school staff on how to use an AED, created an emergency plan and provided resources to become a “Heart Safe” school. 

Project ADAM is a nonprofit, nationwide program that creates Heart Safe schools through free training, support, cardiac emergency preparedness resources and AEDs. When Dirk collapsed, the school staff knew exactly what actions to take and how to use the AED properly.

The program’s mission is 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.

Weatherford High School is one of 532 schools in the Project ADAM program at Cook Children’s.

The first time Dirk was saved by the AED device from Project ADAM was while he was in middle school. He was shocked twice to get his rhythm back.

“I’m very thankful for Project ADAM,” Dirk said. “Please put one in your school because you never know when you’ll need it. It’s better to be safe and have it.”

During the April incident, Dirk was brought back by the AED and was taken to Cook Children’s Medical Center.

“They told me the AED’s eighth shock brought him back,” said Dirk’s mother, Amanda Green. “A 15-year-old kid is still here because God wanted him to be and because y’all put Project ADAM at his school.”

Project ADAM is a national nonprofit program that 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.

The Weatherford ISD Director of Health Services Ramona Villarreal, Weatherford High School Campus Nurse Echo White and the Weatherford High School staff took action to become a Heart Safe school and impact Dirk’s life.

“When our children walk into school we don’t know what’s going to happen,” said Sarah Thieroff, Project ADAM Project Coordinator at Cook Children’s. “Dirk is why we do what we do. There are so many people to be thankful for and it’s incredible how we can make this change and save lives just like Dirk. You just never know.”

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 how to use it in an emergency or rely solely on the school nurse to use the device, says Thieroff.

“I encourage parents everywhere to use your voice, ask these questions, and approach your school nurse,” Thieroff said. “Ask, do we have an AED? Does our school have an identified CPR/AED trained emergency team and does our emergency plan include the AED? Is our school doing a regular AED drill to test their response prior to emergency medical responders? We can all work together to save more lives and we need parents everywhere to advocate for that change.”

When Dirk was 8 years old, he was diagnosed with hypertrophic cardiomyopathy and ventricular tachycardia after he passed out during wrestling practice. That’s when he had a defibrillator placed in his heart. He says he has passed out nine or 10 times, and his defibrillator usually worked to bring back his heart rhythm. During the two worst times, Project ADAM was there.

“I’ve always seen it as if I’m supposed to be here then I’m supposed to be here. If I’m not supposed to be here, then it’s all planned,” Dirk said. “It’s sort of a reason to go out and live your life, live in the moment. You have to do stuff while you’re here and not wait until it’s too late.”

Dirk said he reminds his parents, siblings and friends that they shouldn’t worry because worrying won’t change anything.

“He doesn’t realize how much he gives me the strength to keep going,” Amanda said. “If he can handle it and be that mature at 15, what do I have to complain about? I’m just thankful for the higher power in God, the AED device and it being at Weatherford ISD but mostly for the strength that he gives me.”                                                                                                   

Amanda says she’s grateful that his episodes happened at school because, at the time, she didn’t have an AED device at home. Now, they will receive one for their home, just in case. She encourages all schools to sign up to be a heart safe school with Project ADAM.

“If they’re a parent or they love anybody, just think if something happened to that person and that was the device that could give them to you for a little bit longer,” Amanda said. “Our family needed it twice. I wouldn’t have my son right now if it wouldn’t have been there twice.”

Danielle Moyé, M.D., pediatric cardiologist and physician director for Project ADAM at Cook Children’s, met Dirk in April because she was on call on the day that he went to the emergency room. She encourages schools, parents and the community to see the large impact an AED can make on a person’s life if it’s utilized effectively.

“Project ADAM is a nonprofit organization and a free resource to schools and the community,” Dr. Moyé said. “We offer this education, ongoing safety training and AEDs when necessary, to make sure that if somebody collapses at school or on the field, they have an AED available and somebody in place to revive them."

The AEDs aren’t just placed in schools for students, but for the community, including teachers, parents, school staff and anyone who might need it. It’s also a lifesaving tool to keep during sporting events and games.

When Dirk was younger, he thought he would be an athlete, but he changed his plans after his heart condition. As a sophomore, Dirk loves to act in plays, whether he’s portraying Olaf in Frozen or the caveman in The Addams Family.

For his future, he’s interested in cooking, politics or theater, but one thing is for sure -- he’ll keep sharing his story.

“More people need to know about Project ADAM, AEDs, and that these heart conditions are a thing,” Dirk said. “Many people would never find out and they would end up dying before they never fully live.”

RELATED: How to Become a Heart Safe School

Project ADAM helps implement public access defibrillation programs (PAD) across Texas and the nation. The goal is to increase the awareness of sudden cardiac arrest (SCA) and establish emergency programs that help to provide a timely and lifesaving response.

Rosana Renzzo is the school nurse at Crow Leadership Academy in Arlington ISD. They became a Heart Safe School through Cook Children's in 2019. Below, Rosana shares how Cook Children's and Project ADAM have been beneficial for her school and others. 

What motivated you to work with Project ADAM?

“As a school nurse, my motivation to work with Project ADAM was promoting SCA awareness and getting the staff at my school prepared to act in case of emergency. At Crow Leadership Academy, the emergency response team, aka AED team, has the understanding that being prepared to perform hands-on CPR and use the automated external defibrillator (AED) can double or triple a person’s chance of survival from SCA. Their motivation is being ready to act and save a life. During our drills they practice calling 911, starting compressions and attaching the AED pads to the victim’s chest in less than three minutes.”

How has Project ADAM impacted your daily life?

“At Crow Leadership Academy, Project ADAM helped us understand the gap extends even to those trained in CPR, as to when to use the AED and why.”

What’s been the most beneficial Project ADAM resource for your school and/or district?

“The guidance and support to create our AED team/emergency response team, AED drill videos, hands-on CPR training and AED wall signs."

Do you have any advice for schools/others that are on the fence about working with Project ADAM?

“At Crow Leadership Academy, we film our AED drills so we can improve as a team. Our suggestion for other schools is to record the drill for team evaluation and improvement. We also started educating students in fifth and sixth grade, about SCA, CPR and AEDs. A good amount of our students live with their grandparents and they show great interest in learning CPR and when to call 911. Our suggestion is to promote a Heart Safe School week and involve students and parents to get information about heart disease and prevention.”

While this is the plot of a new movie, it’s based on  fact.  Sudden Cardiac Arrest (SCA) is the leading cause of death in young athletes. The Fort Worth based movie, The Last Whistle, takes a look at what happens when no one knows what to do after a high school football star collapses and dies at practice from sudden cardiac arrest.

Sarah Thieroff, Project ADAM Texas Coordinator at Cook Children’s, hopes The Last Whistle brings awareness to not only SCA, but also how to be prepared for such an event.

“Every school does a fire drill, but the last time a student died in a school fire was 1950. On the other hand, a young competitive athlete dies suddenly every three days. This is something we need to make people aware of and I hope The Last Whistle will do that,” Thieroff said.

Thieroff says that 20% of our population goes to school each day, and parents assume they’re healthy and safe, but there is always the chance for sudden cardiac arrest, which is why Project ADAM is so important.

The reality is that parents and staff often don’t realize their school keeps an AED on site for situations like the one portrayed in The Last Whistle, or with the Cook Children’s programs namesake, Adam Lemel. In 1999, Adam, who was 17 years old at the time, collapsed during a basketball game and died from sudden cardiac arrest. Like in The Last Whistle, knowing where there is an AED on site and how to use it could have saved his life. 

There are now 20 Project ADAM programs in 16 states, and 150 lives have been saved to date nationwide. These 150 lives saved are because students and staff were properly trained on how to react to sudden cardiac arrest, Thieroff says.

Currently in the Texas Project ADAM program there are 414 Heart Safe Schools and 14 Heart Safe School districts. In 2018 eight lives were saved in Project ADAM Texas schools. It is the hope that through movies like The Last Whistle and stories like Adam’s that people will be encouraged to learn what to do in the case a sudden cardiac arrest occurs.

Prevention

Pre-screening is an essential component of prevention. In Texas, the University Interscholastic League (UIL) requires a Pre-participation Physical Evaluation prior to student involvement in sports for grades (7-12). The physical may help determine whether a student athlete is physically capable of certain exercise, and may determine the need for further evaluation should warning signs be present.

However, athletes are not the only ones at risk, and not all children are athletes, many are active and some may have underlying heart conditions. 

Sign and symptoms

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.