Abstract 4366967: The Impact of 20+ Years of Project ADAM in Preventing Mortality from Sudden Cardiac Arrest in Schools

Abstract

Introduction: Project ADAM Ò (Automated Defibrillator’s in Adam’s Memory), was founded in 1999 after the sudden cardiac arrest of Adam Lemel in school. Since then, the project has partnered with more than 49 affiliated children’s hospitals in 33 states to provide automated external defibrillators (AED) training and cardiac emergency response plans to schools and has collected data on all subsequent AED events. This study aims to evaluate the outcomes of these events, correlating lives saved by age, gender, program affiliation status, rurality and AED use. Research Questions: We hypothesized that the use of AEDs would increase the odds of survival after an episode of sudden cardiac arrest. Methods: Project ADAM required affiliated institutions to report emergency events where an AED was used on school campus in a deidentified manner. Institutional Review Board approval was obtained through the University of Nebraska Medical Center before data review. The Project ADAM data was analyzed for all reported events, including saves, deaths, and non-arrest events when an AED was brought to the patient. Information was collected on available demographics and interventions and compared to the outcomes. Chi-square and Fisher exact tests were used for data analysis. Results: There was a steady increase in reported saves per year, as a greater number of institutions became affiliated with Project ADAM. Among cardiac arrests, both AED and CPR were used 70% of the time, and 91% of the cases survived to hospital discharge. There was a statistically significant association between survival and the event being witnessed (p<0.001) and shockable rhythm on AED (p=0.027). There was no association between survival and age, gender, location, or project ADAM affiliation (designated heart safe, in process or undesignated). Conclusions: Reported survival rates were much higher than known rates of survival for out-of-hospital sudden cardiac arrest. Increased availability of AEDs with appropriate knowledge of its use has likely had a significant impact on reducing the mortality rate from sudden cardiac arrest in schools. This study is limited by reporting bias. The data are worthwhile and underscore the need for improved long-term follow up with a more detailed standardized database to track outcomes of victims of sudden cardiac arrest.