To those of you who know me well, you know that our youngest son, who had no prior medical history, died almost three years ago now, presumably due to a sudden heart rhythm disturbance at almost 13. (His autopsy was completely clean, and his cause of death is therefore a theory, not a certainty) Since then, many other young people have experienced a similar passing. One moment, they may be out on a soccer field, or playing (American) football or basketball, and another moment, they are inexplicably down, breathless and pulseless and require CPR. Despite rapid CPR that day, and two epinephrine injections, we never got Daniel back. The one piece of equipment which may have helped us that day is an AED. An Automatic Emergency Defibrillator delivers a shock which helps to synchronize the quivering of a heart in a near lethal rhythm, hovering near death. Unfortunately, there is only a short and narrow band of time in which an AED can be effectively used in a sudden arrhythmic death. Although the emergency helicopter that arrived to render care, had one and used it, it was beyond the narrow band of time in which it was most likely to have been effective. Of course, I had no idea that I probably needed to have an AED in our home. I also still have no guarantee that an AED would have worked, because although they help sometimes, they do not always. They are simply the best we have for such a situation.
First of all, children and teens who die suddenly of a heart rhythm disturbance are not having heart attacks. (A heart attack, or myocardial infarction, is a clot which forms in the coronary arteries which feed the heart, and normally, these children have absolutely clean coronary arteries.) What the children or teens of cardiac arrest are experiencing is a lethal heart rhythm disturbance, or lethal arrhythmia. Sometimes, this is due to a viral invasion of the heart and subsequent enlargement. Sometimes this is due to hormonally causes, as in hyperthyroidism. Other times, there is eventually identified a pre-existing rhythm disorder, such a Wolff-Parkinson-White Syndrome, Brugada Syndrome, or Long QT Syndrome. Other times, a child is simply tapped on the chest inadvertently and this disturbs the rhythm at a crucial part of cardiac repolarization. (This is called commotio cordis) Many times, as there was in Daniel, there were no prior symptoms, and the child or teen feels just fine. Daniel had no discernible cardiac abnormalities on autopsy done at a major US medical center, and reviewed by other centers since. Daniel had played soccer the day before. We did have a family history of heart rhythm disturbances, but this was felt only to afflict the elderly members of our family. No one believed Daniel should have a work up or as much as an EKG, and so, one was never done.
In the US, one can get an automated AED which is unlike the ones used in hospitals which require very specialized training and certification. Sam's Club sells one for $1200. Another reliable supplier of an AED and the education one generally should have to use the AED most effectively is:
The AED Superstore
Although there is no guarantee that Daniel would have survived his first and only cardiac arrest had I owned an AED, I still wish I had. I wish he had been given every chance for survival that day,in addition to the rapid CPR he received and the epinephrine injections.
In the US, one can purchase an AED for under $1200. and sometimes much less for a used reconditioned device. If you own one of these, it is important that you understand how it is to be used, because although it is automated, it is still important that you use it correctly to maximize the chance of saving someone's life. The one I have pictured below, can be purchased with a key which instantly turns it to a pediatric device delivering the appropriate shock to a pediatric patient. In Canada, you would need a prescription from your physician for one of these. Many government locations have one there. In Europe, more and more places are getting AEDs.
Since a fairly large number of cardiac arrests in children due to arrhythmia occur during sporting events and practices, each team should own an AED and it should be available to the coach at all times. This year, outside Richmond Virginia, a teenage girl's life was saved, as she experienced a cardiac arrest early one morning while walking stairs. Her two school nurses used an AED, saving her life. Later that day a local hospital identified her cardiac problem and installed an emergency internal defibrillator. She will be fine.
| An AED in a public place in another nation|
We miss Daniel immensely. Please consider the possibility of purchasing an AED, if this is a possibility for your family, or for your team, your employer, or for your school. Ours arrived yesterday. I could finally emotionally process the need to have one here.
Everything we do here on "Rational Preparedness" is dedicated to Daniel and to his memory.