♪ ♪ THINGS CAN CHANGE IN A HEART BEAT, BUT THINGS REALLY CHANGE WHEN THE NEXT BEAT DOESN'T HAPPEN.

STAY WITH US AS WE TALK ABOUT SUDDEN CARDIAC ARREST IN THE PEDIATRIC POPULATION WITH PEDIATRIC ELECTROPHYSIOLOGIST Dr. SHAUN MOHAN NEXT ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.

>> STUNT MAN, PERFORMER AND MOTOCROSS COMPETITOR TRAVIS PASTRANA SAID EVERYTHING CAN CHANGE IN A HEARTBEAT.

IF YOU DON'T BELIEVE HIM, THEN ASK DAMARR HAMLIN, THE BUFFALO BILLS CORNER BACK.

ONE MINUTE HE WAS MAKING A TACKLE AND THE NEXT MINUTE HE WAS TAKEN OFF THE FIELD IN A BATTLE FOR HIS LIFE.

IT WAS A MUSCULOSCHEDULE TOLL TRAUMA THAT FELLED THIS 24-YEAR-OLD IN THE PEAK OF HIS PHYSICAL CONDITION.

IT WAS A SUDDEN CARDIAC ARREST.

THANKFULLY FOR Mr. HAMLIN THE TEAM ON THE FIELD KNEW WHAT TO DO AND HAD THE RIGHT TOOLS ON HAND.

SADLY THE SAME COULD NOT BE SAD FOR ADAM.

24-YEAR-OLD MALE, 17-YEAR-OLD BASEBALL PLAYER WHO COLLAPSED ON THE BASKETBALL COURT AND DIED FROM SUDDEN CARDIAC ARREST.

THEN WE DID NOT HAVE THE AWARENESS OR TOOLS TO ADDRESS SUDDEN CARDIAC ARREST.

NOW, THANKS TO HIS FAMILY, MANY ADOLESCENTS AND YOUNG ADULTS LIKE Mr. HAMLIN, ARE ALIVE AND FUNCTIONING, HAVING SURVIVED THEIR EPISODES OF SUDDEN CARDIAC ARREST.

TO TELL US MORE ABOUT SUDDEN CARDIAC ARREST AND OTHER ELECTRICAL CONDITIONS THAT CAN AFFECT THE PEDIATRIC AND YOUNG ADULT POPULATION, WE HAVE AS OUR GUEST TODAY Dr. SHAUN MOHAN.

Dr. MOHAN IS A GRADUATE OF THE UNIVERSITY OF STONY BROOK IN NEW YORK AND COMPLETED HIS RESIDENCY IN THE CHILDREN'S HOSPITAL IN PITTSBURGH PART OF THE UNIVERSITY PITTSBURGH MEDICAL CENTER AND THEN A FELLOWSHIP IN PEDIATRIC CARDIOLOGY AT THE CHILDREN'S HOSPITAL IN PHILADELPHIA.

HE THEN DID A FELLOWSHIP IN ELECTROPHYSICAL THERAPY AT BAYLOR HOSPITAL.

AND HE IS AN ASSOCIATE PROFESSOR AT THE DEPARTMENT OF PEDIATRICS AT THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE.

DIDN'T MEAN MEAN TO DEMOTE YOU.

DIDN'T WANT YOU TO THINK I HAD SOME INSIDE INFORMATION THERE.

THANK YOU VERY MUCH FOR BEING WITH US.

>> THANK YOU FOR HAVING ME.

>> I GUESS THE FIRST THING I HAVE TO ASK YOU, WHAT IS AN ELECTROPHYSIOLOGIST, CARDIAC ELECTROPHYSIOLOGIST TO BE EXACT.

>> MOST PEOPLE UNDERSTAND A CARDIOLOGIST IS A DOCTOR WHO WENT TO MED SCHOOL, BASIC TRAINING IN THEIR ADULT MEDICINE OR PEDIATRIC MEDICINE AND THEY DO A FELLOWSHIP, WHICH IS SPECIALIZED TRAINING FOCUSING ON CARDIAC-- ABNORMAL CARDIAC CONDITIONS OF THE HEART.

SO CARDIOLOGISTS, YOU KNOW, WHAT I LIKE TO CALL THE PLUMBERS, THE IMAGERS, TRANSPLANT DOCTORS AND THE ELECTROPHYSIOLOGISTS.

ELECTROPHYSIOLOGIST IS A CARDIOLOGIST WHO SPECIALIZES IN ABNORMAL HEART RHYTHMS AND CONDITIONS WHERE THE ELECTRICAL SYSTEM MAY BE ABNORMAL AND CONSISTING OF USUALLY PROBLEMS OF CONDUCTION OF THE HEART WHERE A PATIENT MAY NEED A PACE MAKER OR POTENTIALLY A DEFIBRILLATOR FOR A VERY SICK HEART THAT IS PRONE TO ABNORMAL FAST RHYTHMS OR EVEN ABNORMAL FAST RHYTHMS THAT START IN THE TOP CHAMBER OF THE HEART.

WE WORK IN CONJUNCTION WITH OUR OTHER CARDIOLOGY COLLEAGUES, VERY SICK PATIENTS THAT HAVE ABNORMAL PLUMBING PROBLEMS AND ELECTRICAL PROBLEMS.

>> TELL ME, WHERE DOES THE IMPULSE THAT TELLS THE HEART TO BEAT ORIGINATE?

I'M ASSUMING IT IS A SIGNAL THAT SAYS GO AND SOMETHING THAT SAYS NO GO.

HOW DOES THAT WORK?

>> SURE.

SO WHEN ONE OF THE BEST PARTS OF MY JOB IS BEING ABLE TO COUNSEL PATIENTS AND FAMILIES, WHEN THEY PRESENT WITH A KNOWN DIAGNOSIS OF A RHYTHM PROBLEM DIAGNOSED IN THE EMERGENCY DEPARTMENT OR THROUGH THEIR PRIMARY CARE DOCTOR AND TRYING TO EXPLAIN TO THEM WHAT HEART RHYTHM PROBLEMS ARE.

THE HEART IS BEATING ALL THE TIMES.

THERE ARE THINGS WE CONSCIOUSLY HAVE CONTROL OVER.

MOVING MY HANDS NOW, WORDS COMING OUT OF MY MOUTH AND THE HEART, MY HEART IS BEATING.

WHEN I GO TO SLEEP, MY HEART IS STILL BEATING.

YOUR HEART HAS ITS OWN AUTOMATIC BEAT ON ITS OWN BASED UPON SIGNALS COMING FROM THE BRAIN AND SPINAL CHORD.

THE SIGNALS COME FROM A PACE MAKER IN THE HEART, THE SINUS NODE TOP CHAMBER OF THE HEART AND TRANSMITS THE IMPULSES THROUGH SPECIAL FIBERS IN THE HEART THAT ACT LIKE WIRES IN YOUR HOUSE, TRANSMITTING THE ELECTRICAL IMPULSES TO THE MIDDLE OF THE HEART, BOTTOM OF THE HEART AND WORKS IN CONJUNCTION WITH THE REST OF THE HEART, ASSUMING THERE IS HEALTHY HEART MUSCLE, THE VALVES ARE CLOSING AND OPENING THE WAY THEY SHOULD.

AND THAT'S HOW THE HEART IS ABLE TO DO ITS JOB.

SO IT'S MORE THAN JUST HAVING HEALTHY HEART MUSCLE, HAVING NORMAL VALVES.

YOU NEED AN INTACT ELECTRICAL AND WIRING SYSTEM TEM LIKE YOUR HOUSE.

>> WHAT ARE EXTERNAL FACTORS THAT CAN IMPACT THE INITIATION OF THAT SIGNAL OR THE TRANSMISSION OF THE SIGNAL?

>> SO SOME OF THE THINGS THAT CAN IMPACT THAT, AND THIS IS WHERE IT GETS CHALLENGING BECAUSE MOST PEOPLE WALKING AROUND, YOU KNOW, PEOPLE WHO GO THROUGH MIDDLE SCHOOL AND HIGH SCHOOL, WE DON'T KNOW THIS, WE DON'T THINK ABOUT IT CONSCIOUSLY.

OUR HEART RATE IS NEVER A FIXED NUMBER.

THERE IS EBB AND FLOW TO IT THE ENTIRE DAY.

IF I GET UP IN THE MORNING AND YOU KNOW, I'M THURSDAY AT THIS FOR A DRINK OF THE QEART, 3:00 IN THE MORNING, STUB MY TOE ON THE SIDE OF THE BED, I MAY THROW A FEW FOUR LETTER WORDS AND MY HEART RATE GOES UP BECAUSE I HURT MYSELF.

>> NOT AS A KID YOU ARE NOT USING FOUR LETTER WORDS BUT GO AHEAD.

>> OUR HEART RATE HAS EBB AND FLOW THROUGHOUT THE DAY.

IF WE ARE ANGRY, UPSET, DEHYDRATED, ANEMIC, ANGRY, UPSET.

THE TEENAGE ATHLETE WHO IS PLAYING VARSITY FOOTBALL AND THEY'RE ON THE FIELD AND THEY BLOW THE WHISTLE, THEY GOT TO BE ABLE TO RAISE THEIR HEART RATE TO GET BLOOD TO THEIR MUSCLES TO DO WHAT THEY NEED TO DO AS AN ATHLETE.

>> SO WE TALK ABOUT THIS TERM SUDDEN CARDIAC ARREST.

WE ALLUDED TO IT, REGARDING YOUNG Mr. ADAM AND DAMAR HAMLIN.

WHAT IS SUDDEN CARDIAC ARREST.

>> USUALLY A DIAGNOSIS MADE OFF, DEPENDING ON THE CONTEXT OF WHEN IT ACTUALLY OCCURRED BECAUSE SOMETIMES YOU HAVE TO EXCLUDE OTHER CAUSES FIRST.

SO IT'S NOT ALWAYS READILY EASILY AVAILABLE, BUT WE KNOW THAT FOR THE SHORT ANSWER IS THE HEART STOPS BEATING.

THE QUESTION IS WHY DID THE HEART STOP BEATING.

DID IT STOP BEATING BECAUSE THERE WAS A BLOCKAGE IN A VESSEL THAT GOES TO THE HEART MUSCLE WHEN WHICH IS TYPICALLY A HEART ATTACK AND THAT'S MORE COMMON IN ADULTS, EXTREMELY RARE IN INFANTS AND CHILDREN BECAUSE USUALLY MOST CHILDREN AND INFANTS DON'T HAVE HIGH CHOLESTEROL LEVELS OR A LOT OF THE ADULT CORONARY RISK FACTORS.

BUT VERY RARELY, WE DO SEE THINGS THAT KIDS ARE BORN WITH LIKE AN ABNORMAL CORONARY VESSEL THAT MAKES IT MORE LIKELY THAT THEY COULD HAVE A CARDIAC ARREST FROM BLOOD NOT BEING ABLE TO GET THROUGH THAT VESSEL.

THE OTHER THINGS THAT CAN CAUSE IT WOULD BE AN ABNORMAL RHYTHM PROBLEM.

AND IT CAN BE AN ABNORMALAL FAST RHYTHM THAT COULD BE VERY DANGEROUS.

WHEN THE HEART BEETSZ CHAOTICALLY, IT CAN'T FILL WITH BLOOD AND DOESN'T GET TO THE BRAIN AND THEST OF THE ORGANS AND CAN GET STUCK IN THE ABNORMAL RHYTHM AND NOT BE ABLE TO PUMP EFFECTIVELY.

>> HOW COMMON IS SOMETHING LIKE THIS?

>> IT'S COMMON WHEN YOU SEE IT ON THE NEWS AND THAT MAKES MOST PEOPLE IN THE PUBLIC THINK THAT OH MY GOD LIKE IT MAKES THEM QUESTION, IS THAT WHY SO AND SO PASSED AWAY LIKE DOWN THE BLOCK?

IF YOU LOOK AT COMMON CAUSES OF DEATH-- IF YOU GO BUY PURE NUMBERS, .1% OF THE POPULATION.

IN A GIVEN YEAR IN THE UNITED STATES, IT'S QUOTED THAT SUDDEN CARDIAC ARREST IS ABOUT 350 TO 360,000 CASES A YEAR WITH THE MARKET OF THEM BEING IN THE 30 TO 40 AGE RANGE GROUP.

>> REALLY?

THAT MANY?

>> YES.

>> WHAT ABOUT IN THE PEDIATRIC ADOLESCENT AGE GROUP?

DOES THE NUMBER GO UP?

>> IT'S ACTUALLY MUCH LOWER, BUT YOU KNOW, IF WE LOOK AT COMMON CAUSES OF DEATH, IF YOU LOOK AT THE CDC WEBSITE, YOU KNOW, IN GENERAL FOR MOST YOUNG PEOPLE, YOU KNOW, IF YOU LOOK AT-- YOU HAVE TO THINK INFANTS, TODDLERS, SCHOOL AGED KIDS, TEENAGERS.

IF YOU LOOK AT THE TEENAGE POPULATION, IT'S ACTUALLY ACCIDENTS, YOU KNOW, CAR ACCIDENTS, DRUG INGESTION, SUICIDE, UNFORTUNATELY.

WE ALL KNOW THAT WE ARE IN THE MIDDLE OF A BIG MENTAL HEALTH CRISIS, ESPECIALLY, YOU KNOW, I THINK IT JUST BECAME MORE AWARE AFTER COVID AND THEN AS YOU GET YOUNGER, THEN ACCIDENTS ARE STILL A VERY COMMON CAUSE BUT ALSO CONGENITAL ANOMALIES.

SOMETIMES CHILDREN ARE BORN WITH AN ABNORMALITY OF NOT NECESSARILY THEIR HEART BUT LIKE A BRAIN ABNORMALITY, KIDNEY ABNORMALITY THAT UNFORTUNATELY LIMITS THEIR LIFESPAN.

>> MALE, FEMALE OR DOESN'T MATTER?

>> IF YOU LOOK AT ALL CAUSES OF SUDDEN CARDIAC ARREST, IT IS TWICE AS MORE COMMON IN MALE THAN FEMALE.

>> IS IT BECAUSE OF THE ACTIVITY.

>> MULTIFACTORIAL.

NOT AN EASY ANSWER FOR THAT.

THAT SEEMS LIKE A COPOUT SOMETIMES BUT IN GENERAL MEN TEND TO NOT SEE THEIR DOCTOR AS OFTEN, ESPECIALLY AFTER, YOU KNOW, THE PEDIATRIC AGE GROUP WHEN AFTER AGE 18, MEN ARE JUST LESS LIKELY TO BE CONSISTENT WITH FOLLOW-UP CARE SEEING THEIR PRIMARY CARE DOCTOR.

AND ALSO MEN TEND TO DO MORE RISKY BEHAVIORS AS WELL.

THAT SEEMS TO PUT THEM IN A SITUATION WHERE THEY'RE LIKELY TO HAVE A CARDIAC ARREST IN HIGH ADRENALINE STATES AND SITUATIONS.

BUT IT CAN HAPPEN TO WOMEN AS WELL.

>> IS IT ALWAYS THAT THE OUTCOME IS GOING TO BE DEATH OR IS IT POSSIBLE ONE CAN HAVE A SUDDEN CARDIAC ARREST AND RESPONSIBLE SPONTANEOUSLY RECOVER?

>> ABSOLUTELY.

THERE ARE CERTAIN GENETIC CONDITIONS.

WHAT I MEAN BY THAT, AS AN ELECTROPHYSIOLOGIST, SOMETIMES WE DON'T SEE ACQUIRED HEART DISEASE.

WE SEE CONGENITAL THINGS THAT PEOPLE ARE BORN WITH.

THERE ARE GENETIC DISEASES OUT THERE THAT PUT ONE'S HEART AT RISK OF HAVING A DANGEROUS FAST ABNORMAL HEART RHYTHM.

CHANNELLOPATHYS WHICH ARE ION CHANNELS IN THE HEART MUSCLE THAT REGULATE THE ELECTRICITY AND IF THERE IS AN ABNORMALITY, THERE ARE DISEASES THAT CAN PUT YOU AT RISK FOR DANGEROUS SHORT RHYTHM.

IF IT IS VERY SHORT AND YOU LOSE CONSCIOUSNESS BUT THE HEART IS ABLE TO GET BACK INTO NORMAL RHYTHM, THEY DO WAKE UP AND BE LIKE WHAT HAPPENED.

SO IT IS POSSIBLE.

>> WHEN YOU SAY CHANNELLOPATHY, YOU ARE TALKING ABOUT THE MINERALS CHARGED WITHY LIT EMITTING THE ELECTRICAL CHARGES.

>> THE CELLS OF THE HEART KIND OF LIKE ROOMS IN A HOUSE.

THERE ARE DOORS THAT WHERE, YOU KNOW,SODIUM POE TASSIUM, CALCIUM ARE GOING IN AND OUT OF.

CHANNELS IN THE OUTER SURFACE OF THE CELL.

IF YOU HAVE A GENETIC ABNORMALITY WHERE ONE OF THE CELLS ISN'T FUNCTIONING THE WAY IT SHOULD, IT CAN LEAD TO EITHER MORE CURRENT LIKE INITIATING AN ABNORMAL RHYTHM OR A NORMAL HEART RIDS I AM IMPULSE OCCURS BUT CONTINUES TO GO WHEN IT SHOULD HAVE STOPPED AND SO THAT'S WHERE SO SOMETHING IS WRONG WITH ONE OF THE CHANNELS THAT CAUSES ABNORMAL ELECTRICITY TO EITHER PERPETUATE OR INITIATE WHEN IT SHOULDN'T.

>> ARE THERE SYMPTOMS OR SIGNS THAT YOU CAN LOOK FOR THAT MAY TELL YOU HEY, THIS PERSON IS AT RISK OR HAS HAD ONE OF THESE EVENTS?

>> YES.

IN GENERAL, YOU KNOW, IF SOMEONE HIVE LIFE SO WE USE THE TERM SINK SYNCOPY WHERE YOU COLLAPSE AND YOU MAY OR MAY NOT LOSE CONSCIOUSNESS.

WHEN IT HAPPENS IN A STRESSFUL EVENT, IT IS A RED FLAG TO MOST CARDIOLOGISTS AND PHYSICIANS IN GENERAL BECAUSE THAT COULD BE THE FIRST SYMPTOM OF AN UNDERLYING DANGEROUS CARDIAC RHYTHM PROBLEM.

BUT IT'S NOT THE SAME AS GETTING DIZZY OR LIGHT LEADED WHEN YOU GET UP QUICKLY OR OUT OF THE SHOWER.

>> I WAS GOING TO ASK YOU, YOU THINK ABOUT SOMEBODY FAINTING SO THAT WOULD BE... >> THE MOST COMMON CAUSE OF SYNCOPY IS UNDERHYDRATION, NOT EATING ENOUGH OR WHAT WE CALL REFLECTION SYNCOY WHERE A PAIN TRIGGER CAUSES YOUR HEART RATE TO GO A LITTLE HIGH, YOU GET DIZZY AND LIGHT HEADED.

MAY OR MAY NOT LOSE CONSCIOUSNESS.

WE ALL KNOW PEOPLE WHO GO TO THE DOCTOR AND SEE A NEEDLE OR TURN PALE AS A GHOST.

WHEN YOU WAKE UP ON YOUR OWN, THAT IS USUALLY NOT RELATED TO A CARDIAC RHYTHM PROBLEM HOWEVER, IT IS IDEALLY THEY SHOULD HAVE SEEN THEIR PRIMARY CARE DOCTOR AND TOLD THEM THAT AND THAT'S WHEN A LOT OF PRIMARY CARE DOCTORS HAVE NOOLS THEIR ARSENAL TO START THE INITIAL STEPS.

THE SCARY THING ABOUT A LOT OF THESE CONDITIONS IS SOMETIMES, YOU KNOW, YOU CAN GO LIKE FIVE, 10, 15 YEARS, YOU KNOW, YOU HAVE THIS GENETIC ABNORMALITY AND YOU MAY NEVER KNOW ANYTHING UNTIL YOUR FIRST SIGNAL EVENT.

>> I KNOW SOMETIMES IT HAS BEEN REPORTED THAT YOUNG KIDS MAY GET BLUNT TRAUMA TO THE CHEST EITHER FROM PLAYING LITTLE LEAGUE BASEBALL OR SOCCER.

WHY IS IT THAT THAT TRAUMA TO THE CHEST IS CAUSING THEM TO HAVE SUDDEN CARDIAC ARREST?

>> THE TERM FOR THAT WHAT YOU ARE DESCRIBING IS ACTUALLY WHAT, YOU KNOW, NOW WE KNOW AFTER THE FACT, WITH DAMAR HAMLIN AND I'M SURE HE HAD A VERY EXTENSIVE MEDICAL WORKUP AND KUDOS TO THE TEAM ON THE FIELD THAT RECOGNIZED THERE WAS SOMETHING GOING ON WHY HE WASN'T GETTING UP.

THEY ASSESSED HIM AND WAS EVALUATED BY A VERY THOROUGH CARDIOLOGY TEAM.

SO THE TERM WHEN CLEARLY IT WAS WITNESS #-DZ AND THERE WAS BLUNT TRAUMA TO THE CHEST.

THERE IS A CRITICAL WINDOW DURING NORMAL CARDIAC RHYTHM WHEN YOU HAVE A BLUNT TRAUMA TO THE CHEST THAT CAN TRIGGER VENTRICULAR FIBRILLATION.

THAT'S A DANGEROUS RHYTHM WHERE THE HEART IS QUIVERING, NOT ABLE TO PROFUSE.

AND THE WAY WE KNEW ABOUT THIS WAS ACTUALLY THROUGH SOME BASIC SCIENCE MODELS, YOU KNOW, THERE WERE SOME STUDIES DONE AND I FEEL BAD FOR THE ANIMALS THAT HAD TO HAVE THIS DONE.

THEY DID A PIG EXPERIMENT AND THEY TESTED PROJECTILES LIKE LITERALLY SHOOTING AT THE PIG'S CHEST AND THEY REALIZED THAT OH IF IT OCCURS IN THIS PARTICULAR WINDOW, YOU KNOW, THEY HAD A RHYTHM MONITORING, IT TRIGGERS VF.

>> YOU BETTER HOPE YOU DON'T RUN INTO A PIG LATER IN LIFE.

>> RIGHT.

>> PROJECT ADAM.

TELL ME ABOUT THAT?

>> SO PROJECT ADD MANY WAS-- PROJECT ADAM, IN 1999, ADAM LAMEL WAS A TEENAGE BOY WHO ON HIS BASKETBALL TEAM WENT DOWN WHILE PLAYING BASKETBALL.

HE JUST COLLAPSED.

AND YOU KNOW, SADLY, YOU KNOW, BACK THEN, SUDDEN CARDIAC ARREST PROBABLY DIDN'T HAVE THE SAME AWARENESS THAT IT DOES NOW.

AND THERE WAS A DELAY IN RECOGNITION THAT IT WAS FROM A HEART PROBLEM.

AND I THINK THE CHALLENGE IS THAT MOST YOUNG KIDS, MOST CHILDREN OUT THERE WALKING AROUND ARE HEALTHY.

THEIR HEARTS ARE FINE.

AND YOU KNOW, SO CLEARLY CARDIAC DISEASES THAT I SEE ARE NOWHERE NEAR AS COMMON AS MY ADULT CARDIOLOGY COLLEAGUES SEE WITH PEOPLE IN THEIR 40S, 50s AND SICTDS.

NO ONE 60S.

NO ONE THINKS THAT A KID CAN GO DOWN FROM A HEART PROBLEM.

WHEN A KID GOES DOWN, THEY THINK WERE THIS DEHYDRATED OR PLAYING OPOSSUM.

THE FACT THAT SOMEONE DOESN'T THINK IT, IT IS NOT UNTIL THEY CHECK THE PULSE AND THEY THINK OH MY GOD AND START CHEST COMPRESSIONS.

BY THEN A FEW MINUTES COULD HAVE GONE BY.

NO ONE CHECKS THE PULSE AND IF YOU ARE NOT PROFUSING THE REST OF THE BODY AND THE HEART DOES NOT PUMP, THE HEART MUSCLE STARTS DIEING.

>> THAT BEGS THE QUESTION, IS THERE STILL A ROLE FOR CPR NOW DAYS OR SHOULD WE START THINKING ABOUT, OKAY, IT'S ONE OF THESE THINGS AND LOOK FOR AN AED WHICH I WILL WILL WILL HAVE YOU TELL ME ABOUT.

>> CPR DEFINITELY HAS A ROLE.

UNTIL YOU CAN GET THE HEART TO RESET ITSELF BACK INTO A NORMAL RHYTHM, HAVE YOU TO PROFUSE THE BRAIN.

EVEN IF YOU ARE ABLE TO SAVE THE HEART, IF THE HEART IS NOT PUMPING, YOUR BRAIN IS DYING.

>> WHAT IS AED STAND FOR?

>> AUTOMATIC EXTERNAL DIFFICULT FIBRILLATOR.

-- DEFIBRILLATOR.

>> WHAT IS THE BIG DEAL?

AEDES, THE MOST COMMON CAUSE ESPECIALLY IF YOU LOOK AT THE ADULT POPULATION, WHEN ADULTS GO DOWN FROM A SUDDEN CARDIAC ARREST, YOU DON'T INITIALLY KNOW IF IT'S FROM A PLUMBING PROBLEM, WHERE BLOOD WASN'T GETTING THROUGH THE HEART VESSELS TO, YOU KNOW, GIVE GOOD OXYGEN SUPPLY TO THE HEART MUSCLE.

AND WHEN THE HEART STARTS DYING, CAN IT THEN PROGRESSIVELY WORSE AND GO INTO VENTRICULAR FIBRILLATION.

AT THAT POINT, THE HEART IS NOT ABLE TO PUMP.

AND SO SOMETIMES YOU BASICALLY NEED TO ESSENTIALLY DEFIBRILLATION, WHAT AEDES DO IS CONTROL ALT DELETE, TRYING TO GET TO NORMAL RHYTHM.

WHILE THE HEART IS QUIVERING, YOU KNOW, SOMEONE HAS TO GET THE AED.

HAVE YOU TO TRY TO GET THE HEART TO PUMP AT A FIXED RATE THAT IS NORMAL TO SOMEONE AT THEIR NORMAL HEART RATE TO GET BLOOD TO THE BRAIN.

>> HOW DO YOU KNOW HOW TO USE AN AED?

CAN ANYBODY USE ONE OF THESE THINGS?

DO WE HAVE TO BE SPECIALLY TRAINED?

>> NOWADAYS, AEDES DON'T REQUIRE ANY SPECIAL FORMAL CLASSES OR TRAINING.

YOU KNOW, AS HEALTHCARE PROVIDERS, WE ARE ALL TRAINED ABOUT THE USE OF AEDES.

WE ARE REQUIRED, MOST PEDIATRIC DOCTORS GO THROUGH WHAT THE AMERICAN HEART ASSOCIATION HAS DESIGNED THE LIFE SUPPORT COURSE AND ADULTS HAVE TO GO THROUGH ADVANCED CARDIAC LIFE SUPPORT COURSE TO KNOW WHAT TO DO IN THE EVENT OF A CARDIAC ARREST AND THAT REQUIRES BEING ABLE TO USE AN AED.

>> SO THERE ARE-- ON THE MACHINERY, THERE ARE PADS THAT HAVE TO BE PUT ON, RIGHT?

>> YES.

>> AND IT'S THERE IT SAYS PUT THIS ON THE LEFT SIDE, THIS ONE ON THE RIGHT SIDE.

>> I REALIZE I DIDN'T FULLY ANSWER YOUR QUESTION BEFORE.

AEDES OVER THE LAST 1015 YEARS HAVE GOTTEN MORE COMMON AND THEY HAVE BEEN DESIGNED SO THAT THE LAY PERSON WHO YOU DON'T NECESSARILY NEED A NURSING DEGREE OR PHYSICIAN DEGREE TO USE THESE.

THAT'S WHY WE SEE THE AED IN AIRPORTS, TRAIN STATIONS, MANY PUBLIC HEALTH VENUES.

IT HAS BEEN SHOWN JUST HAVING ACCESS TO AN AED DOES IMPROVE THE ODDS OF SURVIVAL AND WITNESSED AND SOMEONE THINKING TO CHECK ON THE PERSON, CHECK THEIR PULSE AND BEING ABLE TO CALL FOR HELP.

>> I'M WALK AGO LONG, I SEE SOMEBODY GO DOWN.

I GET THE MACHINE OFF THE WALL OR BEING CARRIED AROUND.

I PUT THE LEADS ON.

IS THERE A BUTTON THERE THAT TELLS ME WHAT TO DO NEXT?

>> YES.

SO A LOT OF USE OF THE AED DEPENDS ON IF YOU HAVE HELP.

IS THERE NN ELSE THAT CAN DO THE CHEST COMPRESSIONS WHILE SOMEONE ELSE IS GETTING THE AED.

THE AED IS DESIGNED FOR THE LAY PERSON.

YOU DON'T NECESSARILY EVEN NEED MORE THAN MIDDLE SCHOOL EDUCATION TO USE.

YOU TURN IT ON AND THEN LITERALLY THERE IS A VOICE THAT TELLS YOU PLEASE PLACE PADS ON THE PATIENT AND THERE ARE PICTURES ON THE AED SHOWING WHERE TO PLACE IT.

>> GOT YOU.

>> AND FOR CHILDREN, YOU MAY HAVE TO PLACE IT ON THE FRONT AND THE BACK BECAUSE OBVIOUS THEIR THERE IS SMALLER REAL ESTATE AND YOU THE STARTS TO ANALYZE WHAT THE RHYTHM OF THE PATIENT IS IN AND THEN IT WILL TELL YOU IF THERE IS A SHOCKABLE OR NON-SHOCKABLE RHYTHM.

IF IT IS NOT SHOCKABLE, YOU SHOULD CONTINUE CPR AND CONTINUE DOING RESCUE BREATHING UNTIL EMS CAN ARRIVE.

IF IT IS A SHOCKABLE RHYTHM, IT WILL SAY IT'S A SHOCKABLE RHYTHM AND THEN YOU HAVE TO CHARGE IT.

YOU STILL KEEP DOING THE CHEST COMPRESSIONS AND THERE IS A BUTTON ON THERE THAT LOOKS LIKE A LIGHTNING BOLT.

CHARGE IT AND IT SAYS READY TO DELIVER SHOCK AND THEN THAT'S USUALLY THE PROMPT TO WHOEVER IS DOING CHEST COMPRESSIONS, STOP WHAT YOU ARE DOING AND YOU DELIVER THE SHOCK.

>> HOW IS THAT DIFFERENT FROM, WE ALL WATCH THESE THINGS ON TV, WHERE I DON'T CARE IF YOU COME IN WITH A TOE NAIL ACHE, SOMEBODY IS GOING TO GET DEFIBRILLATED.

ALL RIGHT, CLEAR, BOOM, SHOCK.

AND THEN THE PATIENT THUMPS.

IS THAT WHAT HAPPENS?

>> ESSENTIALLY THAT'S WHAT HAPPENS, YES.

>> SO YOU SEE THAT MOVEMENT OFF THE BODY.

>> YOU DO.

>> AND LIKE YOU SAID, WHETHER WE HAVE HAD FORMAL TRAINING OR NOT, THIS IS STILL SOMETHING THAT THE LAY PERSON CAN AT LEAST ATTEMPT TO TRY TO DO BECAUSE THE INSTRUCTIONS ARE THERE.

>> YES, AND DEPENDING ON YOUR VOCATION AND THE ENVIRONMENT YOU WORK IN AND YOU KNOW, IF YOU ARE AROUND A POPULATION WHERE THERE IS MORE LIKE HIGHER RISK OF AN EVENT HAPPENING, LIKE IF YOU ARE A COACH, YOU KNOW, YOU ARE REQUIRED TO USUALLY GET OR TAKE A CPR CLASS.

>> WHERE ARE WE RIGHT NOW AS FAR AS THE DISTRIBUTION OF THE AED MACHINES?

ARE THEY EVERYWHERE?

SCHOOLS, MOST WORKPLACES AND THINGS?

>> IN GENERAL, THEY SHOULD BE IN MOST PUBLIC VENUES LIKE AIRPORTS , TRAIN STATIONS, YOU KNOW, BUS STATIONS.

IT REALLY WASN'T UNTIL, YOU KNOW, ABOUT THREE OR FOUR MONTHS AFTER DAMAR HAMLIN'S EVENT THAT THERE WAS A BIG MOVEMENT NATIONALLY.

AND IN THE STATE OF KENTUCKY, A BILL WAS PASSED THAT BASICALLY NOW REQUIRED AED TO BE IN PUBLIC SCHOOLS.

IT ACTUALLY WASN'T REQUIRED BEFORE THEN.

A LOT OF HIGH SCHOOL STUDENTS DO GET A BASIC CPR COURSE PRIOR TO GRADUATION BUT YOU KNOW, WE HAVE LEARNED OVER THE LAST COUPLE OF YEARS THAT YOU NEED TO GET THE DEFIBRILLATOR A.S.A.P.

YOU NEED THE CPR BUT IF THE HEART IS SICK AND QUIVERING, YOU NEED TO RETORE NORMAL RHYTHM.

PROVIDING ACCESS TO AED IS A BIG MOVEMENT AND THAT'S WHERE A LOT OF OUR STATE LEGISLATURES HAVE BEEN PROPONENTS OF TRYING TO GET AED IN THE PUBLIC SCHOOLS.

IT ONLY RECENTLY GOT PASSED, SEEMS LIKE FOREVER AGO BUT IT WASN'T THAT LONG AGO.

IT WAS LITERALLY OH JEEZ, YOU ARE MAKING ME DATE MYSELF.

I CAN'T REMEMBER THE DATE DAMAR HAMLIN HAPPENED.

>> 2022 I THINK.

>> WHEN THE BILL GOT PASSED, OBVIOUSLY IT TAKES TIME TO GET THE AEDES INTO THE SCHOOLS, OUR PUBLIC SCHOOLS ARE STRAPPED, THINGS DON'T COME OUT OF THIN AIR.

IT HAS TO COME FROM PUBLIC FUNDS YOU KNOW, BUT THERE ARE A LOT OF ADVOCACY ORGANIZATIONS OUT THERE THAT WORK HARD TO TRY TO GET THESE INTO SCHOOLS.

>> BECAUSE THESE THINGS CAN HAPPEN, ARE THERE ANY AVAILABILITY OF SCREENING TO LOOK FOR SOMEONE WHO IS SUSCEPTIBLE FOR THIS?

OR EVEN IF A FAMILY MEMBER HAS HAD SOME PROBLEMS, DO WE LOOK MORE IN-DEPTH?

WHAT KIND OF TESTING DO YOU DO?

>> IT DEPENDS ON WHAT LEVEL OF SCREENING.

IN GENERAL, LIKE MOST CHILDREN SHOULD BE SEEING A PRIMARY CARE DOCTOR, A PEDIATRICIAN OR FAMILY PRACTITIONER AT LEAST ONCE A YEAR AFTER ONE YEAR OF LIFE, WE KNOW THEY SEE DOCTORS FREQUENTLY IN THE FIRST SIX MONTHS BUT AS THEY GET TO SCHOOL AGE, THE PARTITIONER SHOULD BE ASKING-- THE PRACTITIONER SHOULD BE ASKING THE FAMILY ANY FAMILY HISTORY OF HEART DISEASE OR SUDDEN CARDIAC ARREST AT A YOUNG AGE AND THAT WILL PROMPT THEM TO GO TO A PEDIATRIC CARDIOLOGIST FOR EVALUATION.

MANY PCP OFFICES HAVE THE ABILITY TO DO THE MONITORING IF THERE ARE SYMPTOMS THAT JUSTIFY DOING THE MONITOR, BUT WE LIVE IN AN AREA OF THE COUNTRY WHERE THERE ARE NOT A LOT OF BOARD CERTIFIED PEED RIGSES IN THE COMMUNITY OUTSIDE OF MAJOR CITIES LET ALONE PEDIATRIC CARDIOLOGISTS SO SOMETIMES WE SEE A LOT OF PATIENTS FROM TWO OR THREE HOURS AWAY THIS IS WHERE ACCESS TO CARE IS A BIG LIMITING FACTOR FOR FAMILIES.

BASIC SCREENING IS ASKING THE RIGHT QUESTIONS.

PRESCREENING REQUIRE ASKING THE RIGHT QUESTIONS OF THE PARENTS.

>> IF A KID HAS EXPERIENCED SUDDEN CARDIAC ARREST AND SURVIVED, AS WE SEE WITH Mr. HAMLIN, HE CAME BACK.

WHAT DO YOU TELL THE PARENTS OF A CHILD WHO HAS HAD ONE OF THESE EVENTS GO AHEAD AND LET THEM PLAY.

>> IT IS LIKELIHOOD OF LIGHTNING STRIKE.

WHAT IS THE ODD HE WILL GET HIT WITH A FOOTBALL.

HE WAS TACKLED AT JUST THE RIGHT TIME THAT TRIGGER HIS HEART GOING INTO VENTRICULAR FIBRILLATION F. HIS EVALUATION AFTER THAT RESUSCITATION REVEALED HE HAD A STRUCTURAL PROBLEM WITH LIST HEART OR AN ELECTRICAL PROBLEM WITH LIST HEART, HE MAY NOT HAVE BEEN RELEASED TO GO BACK TO PLAY.

SO THERE ARE DEFINITELY SOME CONDITIONS WHERE YOU MOW WELL YOU KNOW, IF WE HAVE RULED OUT THE LIKELY CULPRITS AND THERE MAY NOT HAVE TO BE ACTIVITY RESTRICTED.

IF THE WORKUP REVEALED THERE IS SOMETHING LIKE A GENETIC ABNORMALITY OR STRUCTURAL HEART PROBLEM, THAT WOULD HAVE HAD TO TAKE HIM DOWN ANOTHER PATH TO HAVE THAT ADDRESSED AND TREATED.

>> HOW OFTEN DO YOU SEE SECOND EVENT OCCURRING AFTER THE FIRST ONE?

>> EXTREMELY-- WELL, DEPENDS ON WHAT THE UNDERLYING CAUSE, IF THEY HAVE A CARDIO MY CARDIOMYOPATHY OR CHANNEL MYOPATHY, WE HAVE TREATMENTS TO THEANT VENT THAT FROM PG AGAIN.

CAN I GUARANTEE IT WILL NEVER HAPPEN AGAIN?

NO.

IT'S NO DIFFERENT IF YOU GET INTO A CAR ACCIDENT, EVEN IF YOU FOLLOW THE RULES OF THE ROAD, WEAR YOUR SEATBELTS, SOMETIMES IT HAPPENS.

THERE IS NEVER A GUARANTEE IN LIFE.

>> IF YOU WOULD, GIVE ME YOUR BIG THREE TAKE HOPE POINTS WE SHOULD UNDERSTAND ABOUT SUDDEN CARDIAC ARREST.

WHAT WE SHOULD DO ABOUT IT.

>> THREE TAKE HOME POINTS IF SOMEONE HAS A CARDIAC ARREST, YOU KNOW, BELOW THE AGE OF 40, THAT IS NOT NORMAL.

ESPECIALLY AND SO THAT USUALLY SHOULD WARRANT, YOU KNOW, TALKING WITH A DOCTOR OF THAT PATIENT, CONSIDERING, YOU KNOW, MAKING SURE THAT FIRST DEGREE RELATIVES ARE EVALUATED THOROUGHLY.

TALK TO THEIR PRIMARY DOCTOR AND THAT MAY REQUIRE REFERRING TO A CARDIOLOGIST DEPENDING ON THE AGE OF THE RELATIVE IF THE SIBLING IS 20 YEARS OLD OR POTENTIALLY A FIVE-YEAR-OLD COULD BE SEEN BY AN ADULT CARDIOLOGIST OR PEDIATRIC CARDIOLOGIST.

IT MAY NOT HAVE TO COME TO AN ELECTROPHYSIOLOGIST AND SO THAT'S ONE.

NUMBER 2: IS THAT JUST BEING AWARE THAT CHILDREN CAN GO DOWN FROM A CARDIAC CONDITION AND JUST KEEPING THAT IN YOUR MIND SET.

>> AND THE THIRD ONE QUICK.

>> THE THIRD ONE IS THAT ANYONE CAN BE AN ADVOCATE.

>> AND ANYBODY CAN USE AED.

>> YES.

>> WE SHOULD NOT BE INTIMIDATED.

GRAB THE BOX OFF THE WALL AND DO IT.

Dr. MOHAN, THANK YOU VERY MUCH FOR BEING WITH US AND DISCUSSING WHAT IS I FIND A VERY INTERESTING TOPIC AND ONE WE CAN SAVE PEOPLES LIVES OVER.

THANK YOU FOR BEING WITH US TODAY.

I HOPE HAVE YOU A BETTER GRASP AND UNDERSTANDING OF SUDDEN CARDIAC ARREST AND ARE A BIT LESS INTIMIDATED ABOUT USING AN AED UNIT WHEN NECESSARY.

IF YOU WISH TO WATCH THIS SHOW AGAIN OR ARCHIVED VERSION OF PAST SHOWS PLEASE GO TO ket.org/HEALTH.

IF YOU HAVE A QUESTION ABOUT THIS OR OTHER SHOWS, WE CAN WITHIN REACHED AT KYHEALTH@ket.org.

PLEASE LOOK INTO THE AED, MAKE SURE WHERE YOU WORK OR YOUR CHILD'S SCHOOL, THEY HAVE ONE AVAILABLE AND DON'T BE INTIMIDATED.

LOOK AT A FEW VIDEOS AND SEE HOW EASY IT IS TO USE.

YOU MIGHT SAVE SOMEONE'S LIFE.

THANK YOU AND WE'LL SEE YOU AGAIN NEXT WEEK ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.