In February 2022, a middle school student at Roanoke Rapids Graded School District (RRGSD) suffered a sudden cardiac arrest during recess and died. 

While the staff members who were present had known what to do and responded immediately, the incident prompted district leaders to reflect on their overall preparedness.

“You can never be too ready,” Sara Council, director of student services for RRGSD, told EdNC in an interview. “That event just kind of brought to light: What if the same thing had happened at another facility? Would they have been ready and able to respond appropriately in the same manner?” 

Since March, the district has been working to become the first in North Carolina to have all of its schools — including its pre-K center — designated as Heart Safe through a partnership with national nonprofit Project ADAM and its local affiliate, Duke Children’s Hospital.

Project ADAM and Heart Safe Schools

While sudden cardiac arrests (SCA) are rare among children, researchers estimate that about 2,000 kids die of SCAs each year. 

Adam Lemel was one of them. At 17, he died of SCA while playing basketball at his Wisconsin high school. In 1999, his parents worked with a local hospital to establish a nonprofit in his memory — Project ADAM.

Project ADAM establishes affiliations with hospitals nationwide to provide schools with the resources to plan for and implement cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) programs. Schools who complete the process are designated as Heart Safe Schools.

Evidence indicates that prompt use of CPR and the widespread availability of AEDs could prevent 25% of SCA deaths among children. 

Twenty-eight states now have Project ADAM affiliates, with four more in progress. According to Project ADAM’s website, its programs have resulted in more than 200 lives saved nationwide.

‘We can help with that’

Danielle Sturkey works as a pediatric nurse practitioner at the Duke Pediatric and Congenital Heart Center, and serves as the program coordinator for Project ADAM in North Carolina. 

“In pediatric cardiology, we’re the ones who see those patients who have survived a cardiac arrest, or sometimes we’re seeing the siblings of cardiac arrest victims who did not survive,” Sturkey told EdNC. “Project ADAM is a way that we can get into the community and help spread awareness about cardiac arrest, and hopefully prevent it.” 

Sturkey supports schools and other sites populated by children through the process of earning their Heart Safe designation, starting with a checklist of requirements.

“Our job with Project ADAM North Carolina is to help them work through that checklist in whatever way they need help,” Sturkey said. “For some schools, they need help with obtaining more AEDs for their campus. Some schools need help writing their cardiac emergency response plan. We can help with that.” 

In the three years since Project ADAM arrived in North Carolina, 11 sites in four counties have been designated as Heart Safe — Hillsborough Elementary School in Orange County, The Academy of Moore County, Chatham Charter School and JoyRide Equestrian in Chatham County, plus all seven locations of the Wake County Boys & Girls Club. 

RRGSD will add eight sites to that list when it completes the final item on the checklist — an SCA simulation drill that will take place annually at each school and the district office. 

Sturkey will be there to oversee the drill in the coming months. She’ll also be there to help the staff and community debrief if another SCA occurs on one of the district’s sites.

“We understand that that is a traumatic thing for the entire community,” Sturkey said. “It’s always important to bring everyone who was involved together and talk through it. Everyone feels like they have a chance to process what happened and feel heard. That’s another way that we have supported schools and communities.”

Support from Project ADAM affiliates, like Sturkey, is available at no cost to schools. Through relationships with vendors and knowledge about grants and crowd-funding, Sturkey can also help schools find funding to cover the costs of training and equipment. 

Becoming Heart Safe

RRGSD started training staff members in the use of CPR and AEDs in April, beginning with teaching assistants, school nutrition personnel, custodians, and the maintenance department. 

During staff development days in August, every teacher in the district — including substitute teachers — participated in the same training. 

Halifax Community College and members of the local fire department conducted the training sessions, which included practicing CPR on mannequins. 

“It’s changed since the last time I was trained,” said Shelley Williams, director of RRGSD’s Clara Hearne Pre-K Center. “It used to be 15 [compressions] and two [breaths], but now it’s 30 compressions.”

“I was exhausted around 30!” Williams added. 

She said she takes comfort in knowing that everyone she works with is trained and can take over from her in the event of an SCA anywhere in the district. And she can do the same for them. 

“This just helps to make sure that we have the continuity of care across the district,” Council said. “Everybody’s on the same page as to what their roles are in that event.”

Earning the Heart Safe Schools designation from Project ADAM also involves installing AEDs throughout every site in the school district.

When the last four AEDs are delivered, “we’ll be able to say that we can get an AED to any part of our campuses within three minutes or less,” Council said. 

‘Everybody can do it’

Knowing that every staff member is trained to do CPR, and that AEDs are easily accessible, is important to Juliana Thompson, not just as the superintendent of RRGSD, but as the parent of a district student. 

“My son’s in middle school, and I’m thankful that it doesn’t matter which staff members are present, that everybody can do it,” Thompson told EdNC. 

RRGSD leaders say their districtwide Heart Safe Schools designation is an investment in the future of their community.

“If you look at the statistics of health disparities locally or nationally, chronic health issues are on the rise,” Council said. “Due to the lack of accessibility to doctors right now, those issues can go undiagnosed.”

That means some children and their families may not even know when they are at higher risk of SCA. For the district, this is why having Heart Safe Schools and sharing their experience with others is so important.

“I want other districts to learn about it before they have an emergency the way we did,” Thompson said.

If you are interested in becoming a Heart Safe site, email Danielle Sturkey at projectadamnc@duke.edu