Blunt trauma to chest can cause heart to stop beating, a condition that has killed 7 players. Prompt response, however, has saved 7 others.

By Dr. Jeffrey S. Mandak, Special to The Baltimore Sun – 5:37 PM EST, March 8, 2012

Sudden cardiac death is the most common mode of death in this country with more than 300,000 deaths per year, a third of which occur during physical activity. It is estimated that approximately 1,000 children die of sudden death each year.

Sudden cardiac death most often occurs as the result of ventricular fibrillation (VF), an abrupt irregular heart rhythm that causes the heart to quiver inneffectively rather than pumping normally.

In lacrosse and other sports such as baseball and hockey, however, another unpredictable and relatively uncommon source of cardiac death has been recognized — commotio cordis. Commotio cordis can occur when a blunt injury to the chest sends a small electrical charge to the heart. If this occurs within a specific time frame — just milliseconds — relative to the heart’s electrical cycle, VF may be induced.

To date, there have been 14 cases of commotio cordis in lacrosse, including the Feb. 7 death of a 12-year-old player in upstate New York. Seven victims have survived, however, thanks to prompt response with a defibrillator. Several of the victims were goalies and were wearing chest protectors at the time of their injury. Research has shown that no currently available chest protector can prevent commotio cordis.

While commotio cordis is rare, most young athletes who die of sudden cardiac death have an underlying cardiac abnormality. The most common in the U.S. is hypertrophic cardiomyopathy, a thickening of the heart muscle that can cause fatal irregular heart rhythms. Having relatives with hypertrophic cardiomyopathy increases the risk of that disease. Signs and symptoms may include a heart murmur and chest discomfort during exercise, shortness of breath, lightheadedness or passing out.

Coronary artery disease, blockages in the arteries that deliver blood to the heart, can lead to a heart attack, the most common cause of sudden death over all age groups, though rare in young athletes. The predominant risk factors include a family history of coronary disease, diabetes, high blood pressure, high cholesterol and smoking.

Congenital coronary abnormalities can result in fatal cardiac arrhythmias in young athletes. Other causes of sudden death in athletes include myocarditis, inflammation of the heart muscle from a virus or toxin; right ventricular dysplasia, a genetic abnormality of the right ventricle of the heart more common in those of Italian ancestry; prolonged QT, a genetic abnormality of the cardiac electrical system predisposing individuals to arrhythmia; significant mitral valve prolapse, or excessive floppiness of a heart valve; and asthma. In these disease states, victims may be potentially identified and treated before a devastating event occurs.

When VF occures, CPR can help sustain the vital organs, particularly the brain, for a few minutes, but only the application of a controlled electrical shock from a defibrillator or automatic external defibrillator can restore normal heart rhythm and save the victim. The likelihood of survival drops 10 percent for each minute that passes after a cardiac arrest until the rhythm is restored. The faster victims are defibrillated, the more likely they will survive.

Those who have a family history of one of these disease states or of unexplained sudden death should undergo a cardiac evaluation before participation in athletics. There is much debate regarding the routine screening of all athletes to assess risk of sudden death with electrocardiograms or echocardiograms (heart ultrasounds). While proponents advocate routine screening as a way to identify potential victims, opponents point out that these diseases are quite rare and often do not manifest as abnormalities on these tests. In addition, while these initial tests carry little direct risk to the patient, they may lead to false-positive results; these false positives can unnecessarily preclude participation in athletics or lead to further testing procedures with inherent risks that lead to more danger than from the disease itself.

Organizations such as the Louis J. Acompora Memorial Foundation and US Lacrosse have recognized the risk of sudden death and specifically commotio cordis in the sport of lacrosse. The message is getting out. Research is being conducted to possibly prevent the occurrence of commotio cordis. Educational efforts prepare responders to more quickly recognize this injury and respond in prompt fashion to save victims.

How can you help? Get trained in CPR and the usage of AEDs, and promote the availability of AEDs in your community.

Dr. Mandak is a cardiologist in south-central Pennsylvania with the Fulton County Medical Center and Pinnacle Health Cardiovascular Institute. He has been a member of the US Lacrosse Sport Science and Safety Committee for more than 10 years and serves on the Women’s Game Committee.

Copyright © 2012, The Baltimore Sun

Just before 2:30 last Thursday afternoon, Eagle Point sophomore Daniel Hinkle ran up a ramp during PE class, then collapsed at the feet of Diana Swopes. Eagle Point Principal Allen Barber says “he had a siezure and collapsed right at her feet, so she held his hand and he squeezed back” While Swopes sent for help Saniel’s seizure stopped, but so did his heart. The Principal says “He was actually not with us for 5 to 8 minutes.” That sent a group of 4 into action, using the automated external defibrillator they worked to get Daniel breathing once again. One of those 4, School Resource Officer Mike Anselmi says “it said ready for charge and then I actually had to shock him and it stablized his heart and we started doing compression…it was a relief after he took his first breathe.” He was breathing, but wasn’t done fighting for his life. Daniel’s mother says “he was siezing for 5 hours straight, it wasn’t until a day and a half later before he came around and gained consciousness”
Daniel was released from a Portland hospital today, but couldn’t be there today as the story was retold.
But his mother was and it was her first opportunity to thank the 4 heroes who helped save her son’s life.
“As soon as I saw them I just wanted to touch them and hug them for saving my son’s life.” The tears flowed as all 4 were honored by the school district for what it called a near perfect response to the emergency.

UPPER MARLBORO, Md. (CBSDC)

— Employees of the Maryland National Capitol Park and Planning Commission saved the life of one of their own Thursday afternoon.

Shortly after noon, an adult male employee working at Watkins Regional Park in Kettering went into cardiac arrest. His coworkers quickly began performing CPR and used an Automatic External Defibrillator (AED) to aid the man until rescue personnel arrived on scene. The AED administered two shocks to the man.

Paramedics found the patient alert and conscious upon their arrival. He survived the heart attack and was admitted to the Intensive Care Unit at the hospital.

“This incident demonstrates the necessity for community involvement in CPR training. This gentleman was afforded a much better chance of survival from his cardiac arrest due to the efforts of his co-worker who started CPR immediately,” said Fire/EMS Department Assistant Chief Dennis Wood. “Survival rates in sudden cardiac arrest drop drastically in cases where CPR is not started until after the arrival of EMS units. Recent changes to American Heart Association recommendations describe excellent improvements where bystanders initiate chest compressions only until EMS units can arrive. The addition of a facility automated external defibrillator again improves outcomes significantly.”

Save a heart this Valentine’s Day! The Corporate Volunteer Council of Montgomery County, MD, in conjunction with Rescue One Training For Life and Firestation 1, is offering a “CPR Training” lunch and learn session for American Heart Month. You will learn: correct CPR techniques to provide life saving assistance for adults and children in emergency situations; how to use an AED (Automated External Defibrillator). CPR training is important knowledge for everyone; be prepared to serve your community with a certification to perform emergency CPR at home, work and beyond.

CPR training and certification provided by Rescue One Training for Life, Inc.

Buffet lunch provided by Fire Station 1 Restaurant & Brewing Co.

Date/Time: Tuesday, February 14th from 12:00 PM to 4:00 PM

Location: Fire Station 1 Restaurant & Brewing Co. - 8131 Georgia Avenue, Silver Spring, MD 20910

CVC Members: $15

Non-members: $25

Register for this Event >

On December 3, 2011 a male member of Fitness First in Olney, MD collapsed during a kickboxing class from a sudden life threatening cardiac event. The staff at Fitness First, along with class members and other club members, were able to revive this man (twice) and keep him alive until emergency personnel arrived. CPR was begun within seconds of his collapse. They did not give up, even though he appeared dead. The on-site AED had to be used no fewer than eight times to stimulate a heartbeat.

The man was rushed to Montgomery General Hospital a few miles away and then airlifted to Washington Hospital Center. On December 5 he received triple bypass surgery because of widespread heart disease.

This man is now at home and recovering nicely. It will be three months before he can rejoin his class. This is not just a story of someone passing out and reviving on their own after a few seconds. One of the main reasons this man is alive today is because of the on-site AED purchased by Fitness First as well as the CPR/AED training the staff just recently received from Rescue One Training For Life. All of the emergency procedures worked perfectly and the patient was deprived of oxygen for only a very short time.

Congratulations to Fitness First for providing a heartsafe facility by being well prepared with the tools and knowledge to respond to such life threatening events.

Schedule your CPR/AED training class with Rescue One Training For Life. Visit our website at www.rescue-one.com

You may think that CPR training is not important for a babysitter, who is only going to be taking care of kids for a few hours at a time. This is far from the truth. CPR training is very important for babysitters to have, no matter how infrequent their babysitting jobs and how short the time is that they are in care of the children. Here are five reasons why as mentioned by http://www.babysitters.net/blog/:

1. Caregiver –Any caregiver needs to know CPR. Being a caregiver means that you are the person responsible for the well-being of those you care for. In the case of a babysitter, you are responsible for the care and well-being of other people’s children. This is a very weighty responsibility and should be entered into with training that will cover as many different scenarios as possible.
2. Kids get into trouble –Kids do not fully understand all the dangers around them and seem to manage to find ways to get themselves into dangerous situations, no matter how hard you try to keep them safe. They find their way to water, which could drown them. They swallow things that can make them choke. They ingest things that can be harmful to them. They wrap things around their necks, put bags over their heads and shut themselves in small spaces. When a babysitter has more than one child in her care, at one time, it is especially easy to lose track of the most adventurous one. Even with just one, it is amazing how fast they can disappear, when you turn your back.
3. Emergencies cannot be predicted –To think that ‘nothing’ is going to happen in the few short hours that a babysitter is caring for children is naïve. Although, the risk may be lowered, it still remains. Emergency situations can happen at any time. They only take moments to develop; they cannot be predicted.
4. Time is of the essence –When a person has stopped breathing and/or their heart is no longer beating, you cannot wait for someone else to arrive; CPR needs to be started immediately. The longer a person’s brain is deprived of oxygen, the lower their chances of being revived and recovering. If a child should require CPR, while in a babysitter’s care, the babysitter is most likely the one who will need to provide it.
5. The only ‘adult’ in the house –The children are not the only ones, whom a babysitter may need to administer CPR to. Unexpected situations can arise where a babysitter may find themselves giving CPR to a parent, prior to or upon returning to the home. In other cases, it may be a neighbor who is in need of emergency assistance.

CPR training is important general knowledge for everyone once they reach their teenage years and beyond. Emergency situations can arise at any time and in any place. You never know when you will be the only one available to administer CPR.

For full article, please visit http://www.babysitters.net/blog/5-reasons-why-cpr-training-is-important-for-sitters/

Talk about a life lesson — literally.

Teacher Sean King had just popped into the gym to grab a practice defibrillator for the class he was teaching on first aid at Silverthorn Collegiate when he spotted teacher Sharon McConnell cradling a Grade 12 basketball player whose heart had abruptly stopped.

Suddenly, while his Grade 9 students practiced CPR on “dummies” in the gym next door, King joined McConnell in a life-or-death first-aid drill. In the precious minutes that followed, they used a real defibrillator and CPR to restore the teen’s pulse before emergency crews arrived.

Today the 17-year-old is recovering, although he does not want his name made public.

“The timing was ironic, because I had just been telling my students how important it is to know CPR, especially with the holidays coming up when they visit with elderly relatives,” King said.

McConnell knows first aid from her days as a lifeguard, and began delivering CPR and mouth-to-mouth as shocked students watched. She had been teaching at the Etobicoke school less than two weeks, yet ironically, one of the first classes she had taught was in CPR.

“It’s amazing because the defibrillator tells you exactly what to do, including what rhythm to use when you compress the chest and when to give air,” McConnell said.

Toronto’s Emergency Medical Services has nominated both teachers as well as hall monitor Linda Armstrong and vice-principal Tim Brethour for EMS Citizens’ awards for quick thinking in fetching the defibrillator, calling 911 and delaying the bell between classes so emergency crews could wheel out the stretcher without having to battle crowds.

“In cardiac arrest, seconds count,” noted EMS acting superintendent Shawn Murphy in a letter of praise to school officials. “Had it not been for the rapid and skilled actions of the staff, the outcome would not have been as positive.”

EMC Editorial – You wish you never have to use it, but if you do you’re glad it’s there.

That was the case at the Nov. 11 when the quick work of emergency personnel and effective use of a public access defibrillator saved the life of an Orleans man at the Smiths Falls Memorial Community Centre.

Joe McGrath was there to watch his grandson Connor play a Central Canada Hockey League game for the hometown Bears against the visiting Cumberland Grads. Towards the end of the first period, the gentleman passed out after his heart stopped as a result of cardiac arrhythmia.

Almost immediately, volunteer firefighter Paul Bisonette left his spot at the rink and came to his aid. He administered CPR while awaiting the arrival of the defibrillator that was on site at the rink. Equipment manager Tom Arnold knew exactly where it was located and left the players bench to retrieve the vital equipment and rush it to the scene. By then, Bears’ trainer Dale McCabe, a Lanark County paramedic, was also on hand and ready to place the pads and administer the initial shock to get the heart beating again.

Within seconds after resuming CPR, the gentleman’s breathing returned and he was even able to utter some words to those around him.

Having returned to life, emergency personnel were able to transport Mr. McGrath across the road to the Smiths Falls hospital before he was transferred to the University of Ottawa Heart Institute in Ottawa.

Some might call it a miracle. That so many capable individuals would be on site and be ready to take action to save this person’s life is truly remarkable. There are no words, Mr. McGrath says, to describe the thanks he has for all of them.

But there’s no denying this tale of survival can also be attributed to good planning. For had this occurred even just a few short years ago, when there was no such thing as a public access defibrillator, there’s a good chance this life might not have been saved.

The cost of a defibrillator is prohibitive, no doubt. In this case, however, it’s paid for itself many times over. And it’s why Mr. McGrath is now back home, resting comfortably, and looking forward to the time he can again watch his grandson play hockey in Smiths Falls.

Quick response helps man who collapsed near finish line.

Like many veteran marathoners, Bob Pohl always had an eye on the clock.”I used to tell my wife that if I drop in a race to stop my watch because I don’t want to go to the hereafter with a bad time,” he said. “The joke was funnier before.”

The 55-year-old Marriottsville runner did collapse during a race. He was about 200 feet from the finish line of the Baltimore half-marathon on Oct. 15 when a blockage in a main artery stopped his blood from flowing — and his heart from beating.

The minutes lost in receiving aid typically make it rare for someone to survive sudden cardiac arrest outside a hospital. But close on Pohl’s heels this day were a Baltimore police officer, a Columbia chiropractor, some Howard County paramedic trainees, a Union Memorial Hospital doctor and other medical professionals who swiftly provided CPR, a shock to his chest from an AED, and a trip to the emergency room.

“He went from dead to alive in a matter of minutes,” said Dr. Cynthia Webb, chief of Union Memorial’s emergency room who has been coordinating medical care at the Baltimore Running Festival for three years along with the event organizer, Corrigan Sports Enterprises.

As Pohl neared the finish line outside Camden Yards around noon, he dropped to his knees and then fell to the ground. Some other runners stopped to help, including Baltimore Police Lt. Col. Ross Buzzuro. One runner checked for a pulse and another held Pohl’s head, said Allen Manison, a chiropractor with special training in emergency and sports medicine, who jumped a fence onto the course.

“It was so impressive those runners stopped their race to help,” said Manison. He normally tends to the muscles and bones of the elite athletes but immediately recognized Pohl’s heart rhythm was irregular. His position, on his back with his arms bent in toward his chest, also was a possible sign of brain damage. Manison called for help.

Howard County paramedic trainees came with a gurney. Within minutes they were inside the tent, with Webb and a team from Union Memorial, Franklin Square and Harbor hospitals and Baltimore City Emergency Medical Services. They took over resuscitation, provided defibrillation and placed a breathing tube down Pohl’s throat. Then he was taken to the hospital. It was determined that he’ll require cholesterol and blood pressure medicines for the rest of his life.

For now, Pohl says he’ll enjoy time with friends and family, including twin grandchildren Ryan and Abby, born to his daughter Jennifer just weeks before the race. He and his wife also plan to learn CPR and encourage others to learn about their family history and to get more regular checkups.

WASAGA BEACH – It wasn’t a normal day on the job for five Wasaga Distribution workers on Monday. Bryan Cunliffe, Shawn Maltas, John McKnight, Frank Van Laarhoven and Myles Southorn helped save a man’s life. The crew was working in the area of Blue Water Lane when they were alerted that one of the residents – a 52-year-old man – was having a heart attack. Cunliffe said he and Maltas started performing CPR. Maltas performed mouth-to-mouth and Cunliffe performed chest compression.”The other guys, when they found out what was going on, went out and got the defibrillator (AED),” he said. “Shawn and I started CPR. We put the defibrillator on him, gave him a shock and basically brought him back.” The hydro trucks have been equipped with the devices for about two years and workers are required to take CPR training.
This is the first time the crew has had to use the defibrillators or perform CPR in an emergency situation. “We’ve had CPR training, that’s what they tell us, go to do CPR as soon as possible,” Cunliffe said. “It was definitely different. You go through the training, that’s one thing, to do it in real life is totally different,” he said. Van Laarhoven said the group worked together to ensure everyone was calm. “All of us together kept each other calm and we talked our way through what was going on,” he said. “It was pretty surreal to actually be in that situation. It was a scary thing.” But, they saved a man’s life.