AED Quest

How young is too young to save a life? The answer may be younger than you thought.

Under a novel community service project orchestrated by a Chicago emergency physician, a class of fifth-graders not only got an interactive, up-close-and-personal education on sudden cardiac arrest, CPR and defibrillation, they relayed important information out to their community and contributed to growing global databases that map AEDs for when they’re needed.

“We wanted to teach the kids about cardiac arrest and CPR and AEDs, but also about the idea of self-reliance—that sometimes the adults will need their help,” says David Beiser, MD, FACEP, an assistant professor of medicine and pediatrics at the University of Chicago. “One of our central themes was that even a fifth-grader can save a life. When an adult has a cardiac arrest—and that’s much more likely than a child having a cardiac arrest—a child who’s properly trained can potentially step in and provide a lifesaving intervention.”

The children who demonstrated that came from Beiser’s son’s class, 10- and 11-year-olds at a local laboratory school. Beyond learning what cardiac arrest is and what to do about it, their project involved mapping AEDs in their neighborhood, and in doing so raising awareness of the devices’ purpose, where to find them and how to use them when a life is on the line.

It all started at last year’s American Heart Association conference, where Beiser noted a push to record AED locations in comprehensive databases. One such endeavor is the iRescU project, an effort led by EMS safety expert Nadine Levick, MD, to map AEDs around the world and provide their location information, along with CPR help, to users via smart phones and various social media platforms. With iRescU and similar projects, AED locations are contributed and updated by crowd-sourcing; anyone who knows of one is invited to submit it.

That seemed within the realm of bright fifth-graders in need of a service project. “The idea,” says Beiser, “was that we could combine community awareness, through the mapping, and health education. You can’t just put a bunch of slides in front of fifth-graders and hope they understand something like this. You have to make it real.”

Making It Real

Nonetheless, the day of the project began with a lecture. Beiser told the kids they’d not only be getting his normal college-level material, but because they were especially bright, he’d be compressing two weeks’ worth of content into an hour. “I told them to get their notebooks out, and they all kind of looked at my son,” Beiser chuckles. “They were all shooting him glances, like, Your dad’s really mean!” Then he started in on cardiovascular physiology, escalating rapidly in complexity.

That set the stage for the real act: An observing parent suddenly feigned a cardiac arrest (hammily overacted, so as to not truly alarm any children). The lecture then gave way to a simulated rescue that involved calling 9-1-1, dispatcher-guided CPR and application of an AED. “That,” Beiser says, “really started things off in a hands-on manner.”

It was followed by a cardiac arrest survivor—a top-level young athlete who’d collapsed playing basketball. She told her story and fielded questions. By this time the students were wholly engaged, wanting to know what it felt like to have a cardiac arrest and be shocked, what she was thinking during the experience, and about her new implanted defibrillator.

“They really started to understand what cardiac arrest was, and I’ll tell you, that is no small feat,” says Beiser. “Most of the public equate cardiac arrest with heart attack. I do cardiac arrest research, and even my family thinks I research heart attacks. It’s an important distinction, but I think the kids really understood that a cardiac arrest is when the heart stops, there’s no blood flow, and the person is essentially dead.”

Then came the mapping. The kids were divided into a dozen teams and sent out, accompanied by adults, to find AEDs in assigned sections of the surrounding area. The plan was to focus on likely high-yield locations: schools, gyms, medical facilities, apartments, senior centers, churches, etc. To that end, the kids received maps displaying likely targets (vetted beforehand by the adults to facilitate success). Each team had about 20 potential sites from which to canvass and two hours to find as many AEDs as they could. Whenever they’d find one, they’d take its picture with a smart phone, embedding location coordinates, and e-mail it to Beiser. At each location, the kids also conducted a short survey, asking those in charge about their knowledge of CPR and AEDs and inquiring, if they didn’t already have one, if they’d be interested in getting an AED for their facility. They left educational information from the American Heart Association.

Back in class, each team noted the AEDs they’d found on a large map. They’d totaled more than 40 in two hours—“a pretty successful hunt,” says Beiser. The day then concluded with hands-on CPR and AED instruction and a visit from a local alderman’s representative to review the data and hear about places without AEDs that could really use them.

“There were some senior centers, for example, that didn’t have AEDs,” says Beiser. “There were schools that didn’t have AEDs. Those were all clearly visible on the map. So the final lesson for the kids was a lesson about advocacy and community engagement.”

Lessons for Adults

There was plenty for adults to learn from this exercise as well. Some people the kids encountered didn’t know what an AED was. Some facilities had them, but on-duty workers didn’t know about them. “There might have been a security guard who sat 50 feet from an AED every day and had no idea it was there,” says Beiser. The students also encountered misconceptions about Good Samaritan protections for people using AEDs in emergencies.

With their identification of so many AEDs for iRescU (they also submitted their findings to www.aed4.us), the students also won one of that project’s geolocation challenges. Their prize is an AED, and they will vote this fall on where in the community they’d like to put it.

Tips for Running a Similar Exercise

• Don’t reinvent the wheel. Partners can help with this kind of thing. The Chicago project drew resources from the AHA, Sudden Cardiac Arrest Foundation and Parent Heart Watch. CPR dummies were borrowed from a hospital. Says Beiser, “It was a nice collaboration of a bunch of organizations with common goals.” The whole thing cost around $100, mostly for snacks.

• Don’t be afraid to start young. The fifth-graders heard from a parent who’d lost a school-age child, but she was followed by a vivacious, relatable cardiac arrest survivor who answered all questions and cushioned any scariness. Relatedly, Illinois is incorporating CPR/AED education into middle school curricula statewide.

• Give students an opportunity to practice their scripts and approaches, so they’re more comfortable visiting establishments.

• Practice with the technology too. Some of the chaperoning adults didn’t know how to send photos with smart phones.

• Learn as much as you can. “Doing it again, we probably would have expanded our survey,” says Beiser. “That was a bit of an afterthought we added at the end. But it’s a great opportunity to find out about your community, and perhaps a more detailed and thoughtful survey would have yielded more actionable data.”

• Self-promote. Inviting local officials like aldermen/council members to participate has the multiple benefits of impressing the kids that this is important, educating lawmakers on a true life-or-death issue, and creating lots of everyone-wins photo opportunities for the local news.