No one knows the impact school preparedness can have better than the Witcher/Schrader family from Lincoln, Neb. In January 2023, 9-year-old Angelina, a student at Kooser Elementary School, collapsed in her fourth-grade classroom during math.
Angelina experienced ventricular fibrillation (VF), a life-threatening arrhythmia that’s considered the most serious abnormal heart rhythm. It’s extremely dangerous because it can lead to sudden cardiac arrest if not treated immediately.
Although rare in pediatric patients, sudden cardiac arrest can’t be prevented.
“The best thing we can do for now is to prepare for these events by having life-saving medical equipment nearby and people trained to use the equipment,” says Matt Sorensen, M.D., pediatric electrophysiologist at Children’s.
CPR was administered immediately to Angelina by the school nurse. When the paramedics arrives, they continued CPR, defibrillated Angelina’s heart and intubated her. Once stable, she was transported to a hospital in Lincoln before being flown to Children’s.
“This was by far the worst day of our lives. Our fear of losing her or a poor outcome was overwhelming,” says Jeffrey, Angelina’s great-uncle and guardian.
According to Christopher Erickson, M.D., a cardiologist at Children’s, VF is a life-threatening and often fatal heart rhythm that occurs when the lower pumping chambers of the heart have no coordinated heartbeat. Instead, due to many rapid electrical impulses, the bottom chambers just quiver with no effective pumping. To remedy this abnormality, surgery is often needed.
The Children’s team of Ali Ibrahimiye, M.D., a cardiothoracic surgeon; Jeffrey Robinson, M.D., an electrophysiologist; and Peter Hunt, PA-C, worked together to place an implantable cardioverter-defibrillator (ICD) in Angelina’s chest. ICDs are often used as the treatment of choice for potentially life-threatening ventricular arrythmias.
Angelina’s ICD, which is about two-thirds the size of a hockey puck and half as thick, tracks her heart rhythm. Dr. Erickson says that for most patients, the ICD observes and analyzes the heart. If Angelina experiences an irregular life-threatening rhythm, it will deliver a shock to her heart if needed. Her physicians and family feel confident that her ICD will keep her safe while they wait for genetic testing results to further explain the cause of her arrhythmia.
Prior to collapsing, Angelia was a healthy child who participated in dance, volleyball and basketball and took piano and violin lessons. She exhibited no signs or symptoms of a heart condition.
While VF is not common in pediatric patients, doctors at Children’s often treat up to four cardiac arrest cases each year; some patients have had cardiac arrest before, while others exhibit identified risk factors for cardiac arrest.
Unfortunately, the first symptom of VF is cardiac arrest. Some patients may experience fainting spells or even seizure-like symptoms, while others have noticed palpitations.
According to Dr. Erickson, VF can be caused by multiple factors, including genetic syndromes that make the heart more vulnerable to the condition. Other factors may include infections of the heart and poor blood flow to the heart that results in muscle injury.
Angelina’s future is bright because of the swift actions of her school nurse and the medical intervention of the paramedics and the expert team at Children’s. Since her procedure, Angelina has returned to school full time and has resumed her piano and violin lessons. In May, her school received a Heart Safe School designation through Children’s Project ADAM program, signifying a commitment to having a response plan, CPR and automated external defibrillator (AED) training and advanced preparedness to keep students, staff and visitors safer in the event of an unexpected cardiac event on campus.
“CPR and AEDs save lives! Angelina would not be here today had it not been for the quick response from her teachers and school nursing staff and the expert care from Children’s,” says Kevin, Angelina’s great-uncle and guardian.
Click here to learn more about Children’s Criss Heart Center Team.