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

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.