News

Project ADAM Strives to Save Lives Through Defibrillators and CPR

Karen Herzog

06/01/2014

May 31--Days after 17-year-old Adam Lemel of Whitefish Bay collapsed and died during a junior varsity basketball game at Grafton High School, a pediatric cardiologist reached out to his grieving parents to suggest Adam's three brothers be tested for the genetic heart condition that took the young athlete's life.

"He said, 'There's no timetable, but we need to make sure that the other boys are OK,'" recalled Adam's father, Joe Lemel, whose surviving sons were ages 13, 18 and 20 at the time.

It took several months for them to find the courage to face the battery of cardiac tests, and whatever those tests might reveal. When they were ready, the pediatric cardiologist, Stuart Berger, did the extensive tests over two days at Children's Hospital of Wisconsin.

"He literally set his life aside," Joe Lemel recalled.

"He took each boy into a room and stopped his heart," Lemel said. "Imagine the panic on their faces when I sent them into that room."

Adam's brothers thankfully did not have the heart condition, but the relationship between the family and the cardiologist did not end with the test results.

It evolved into Project ADAM (Automated Defibrillators in Adam's Memory), a national outreach aimed at giving other youths who suffer sudden cardiac arrest the best possible chance for survival. The project was further spurred by several other sudden, unexpected deaths of student athletes in southeastern Wisconsin around that time.

In the 15 years since Adam's death and Project ADAM's birth, the program that teams up with Children's Hospital of Wisconsin and has affiliates in nine states has been credited with saving 85 lives, including 28 in Wisconsin -- about 40% of them youths.

No doubt there are additional unreported saves, thanks to awareness built by the program, said Berger, who in addition to being a pediatric cardiologist is medical director of the Herma Heart Center at Children's Hospital and a professor of pediatric cardiology at the Medical College of Wisconsin. Berger also is Project ADAM's medical director.

Project ADAM has reached more than 800 Wisconsin schools with resources, training grants and funding assistance. The organization has pushed for installation in schools of automated external defibrillators and for training for staff, families and students to learn cardiopulmonary resuscitation and how to use the defibrillators.

Project ADAM does not purchase the AEDs, which cost about $1,000 apiece.

The project's ultimate goal is for every student in every school across the country to be certified in CPR and to know how to use an AED by the time they graduate from high school.

"It's incredible that as a result of a loss, you can bring people together," Berger said. "Out of something so tragic and sad, something good can come. The greatest commemoration is every time a life is saved. It's very humbling."

Though Wisconsin data isn't complete, Berger said, if an adult or child has a sudden cardiac arrest in a school with an external defibrillator and CPR program, the odds of survival may be 60% to 90%. On Wisconsin Ave. in downtown Milwaukee, the survival odds would be maybe 30% because an AED likely would not be easily accessible and someone who knows CPR may not be close by, the cardiologist said.

Five years ago, the general out-of-hospital survival rate for sudden cardiac arrest was 10% to 20%, Berger said.

"It's better now, around 30%, though it varies by community," he said.

"The key is recognizing a cardiac arrest, which is part of CPR training," Berger said. "The longer you wait, the less good the outcome will be. Effective CPR needs to be done right away, and AED within five minutes gives you the best rate of survival."

Immediate CPR and defibrillator application are part of what's called the chain of survival. Equally important is being willing, and not afraid, to jump in when needed, Berger said.

Through the Milwaukee Public Schools HeartSafe program, in collaboration with Project ADAM, all Milwaukee public schools have AEDs -- a total of 216 defibrillators at 147 sites. Two nurses run the program, and this year they trained 150 students and more than 1,200 staff in CPR and defibrillator use, according to Allison Thompson, Project ADAM coordinator, Children's Hospital of Wisconsin.

MPS schools do sudden cardiac arrest drills four times a year to make sure staff know who is trained in CPR and where the defibrillators are located. Nurses, teachers, maintenance staff, coaches, athletic directors and students typically are trained. Schools also commit to recertifying to keep skills fresh, Thompson said.

"We need to find a way for other families not to suffer," Lemel said. "We know we're not going to save everyone; just give them the best chance. I don't know if Adam would have been saved if there had been an AED right there. To me, the biggest issue we have to overcome is that people don't think of kids as having heart issues."

The American Heart Association earlier this year reported that each day in the U.S., more than 1,000 people suffer non-traumatic cardiac arrest outside hospitals, including about 26 children.

Sudden cardiac arrest in a young person usually stems from a structural defect in the heart or a problem with its electrical circuitry. Those at risk are hard to spot. Athletes used to pushing themselves may dismiss warning signs, such as dizziness and shortness of breath, though warning signs also can be rare.

"In our experience, it seems to be more of a risk factor for teenagers because of the intensity of sport activities," Berger said.

Adam had a rare heart condition called arrhythmogenic right ventricular dysplasia, which causes fat and scar tissue to replace damaged heart muscle in the right ventricle (pumping chamber). With this condition, the flow of blood through the right atrium of the heart is normal, but as blood enters the right ventricle, regular pumping patterns are replaced with irregular beats as the thin, misshapen heart muscles struggle to keep a smooth blood flow.

Genetic testing is available for families with a history of a heart condition that causes sudden cardiac arrest, but insurance companies have not widely embraced it, Berger said.

Adam was an honor roll student and gifted athlete at Whitefish Bay High School. He played basketball, but tennis was his sport, said his father, who is president of Lemel Homes Inc.

He was a member of the Whitefish Bay varsity tennis team as a freshman and sophomore and was the Blue Dukes' No. 1 singles player. He contributed to two straight Wisconsin Interscholastic Athletic Association Division 2 state championships.

"He had a hand-eye coordination that was a gift. He was tireless," his father said. "If you played pingpong with him, when he tired of beating you, he'd switch the paddle to the other hand and still beat you. He was a 'get out of my way, I want to do something' kind of kid. He was someone who could do anything."

Adam wanted to go into the medical field after graduation, and maybe become a surgeon, his father said.

On Jan. 22, 1999, Adam and his teammates had just come off the court during the game. Adam was joking around, then suddenly collapsed at the bench, his father said.

Joe Lemel was seated not far from the bench and remembers jumping up and running to Adam. It looked like Adam was having a seizure, and an athletic trainer for the Grafton team quickly started CPR. But Adam's chain of survival was broken -- there was no AED in the gymnasium.

It seemed like an eternity before paramedics arrived, Lemel said.

"I will never forget when they put that AED on him and we saw that straight line," Lemel said. "The paramedics never got him back."

Matt Rose, associate principal at Whitefish Bay Middle School, was the Grafton High School varsity boys basketball coach in 1999 and was in the gymnasium several feet from Adam when the teenager died.

Rose remembers running outside to wait for the rescue squad and clearing the gymnasium of spectators and students. Whitefish Bay High School students were escorted to classrooms to call their parents.

"We sat there and hoped and prayed he would survive," Rose recalled. "It was devastating."

While Rose no longer coaches, he says he's much more safety conscious and is a staunch advocate for CPR and AEDs.

Adam has not been forgotten in the village where he grew up.

The high school each year awards an Adam Lemel Scholarship to two well-rounded students. All Whitefish Bay schools now have at least one AED and several staff members trained in CPR.

"Kids deserve the protection the community at large may not realize is needed because they believe kids don't collapse and die," Adam's father said. "If there's any place a child should be safe, it's a school."