Sudden Cardiac Arrest

Do your athletes know the importance of heart health?

October is Sudden Cardiac Arrest (SCA) month. Although athletes are generally healthy, they are not immune to cardiac problems. According to The American Heart Association, The NCAA is moving forward with developing guidelines to detect college athletes at risk for sudden cardiac death, including mandated heart screenings. Due to this, time and early detection are vital when these events occur. This makes it essential for athletes, trainers, coaches, and sports organizations to be proactive when responding to sudden cardiac arrest incidents. Taking preventative measures on and off the field is key to ensuring long term safety, heart health, and peak performance in athletes. 

 

Triggers of SCA in Athletes:

• Underlying heart conditions: Physical examinations don’t always detect heart abnormalities, leaving athletes to believe that they are fine, when in fact they may have an underlying heart condition. This can make them more susceptible to SCA, especially in vigorous sports that demand more stress on the heart.
• Family history: Many athletes may have a family history of heart conditions that they are unaware of, putting them at higher risk.
• Overtraining syndrome: Sage Journal explains how Athletes who engage in excessive training or exercise without proper rest may develop hormonal imbalances that could disrupt the heart’s function.

Blunt Force Trauma:

Athletes who participate in high-contact sports are at a higher risk of experiencing sudden cardiac arrest due to the physical nature of these activities. Since high school and college sports can be utterly competitive, this is extremely important to acknowledge. When a blow to the chest occurs at just the right time during the cardiac cycle, it has the potential to be fatal. This is something that all athletes and coaches need to consider, since this can happen without any preexisting heart abnormalities.

 

Remind Your Athletes To:

• Cardiac evaluations:  Undergo specific cardiac evaluations to identify any underlying heart conditions or risk factors before the season, such as EKGs.
• Periodic checkups:  Schedule regular checkups with a healthcare provider to assess blood pressure, blood sugar, and cholesterol levels. 
• Rest if needed: Take a break if needed. Do not ignore symptoms such as chest pain, shortness of breath, or heart palpitations – inform the coach or trainer immediately.

SCA Prevention by Athletic Trainers and Coaches:

• Regular drills and testing: Conduct emergency response drills that involve the use of AEDs and CPR to get coaching staff and all players familiar with using the equipment.
• Maintenance and inspection of AEDS: Evaluate all AED units and accessories, verify that they are strategically placed throughout the facility, and replace batteries when needed.
• Hydration and recovery: Ensure players are hydrated by allowing regular water breaks to prevent dehydration or heat-related illnesses.

Stay Prepared:

SCA does strike without warning among athletes. However, there are tactics that sports facilities, coaches and athletes can focus on to minimize these risks, but they must work as a team. Staying prepared and informed about heart health is an important thing to do – this month, and every month. 

School Heath offers AEDS, AED accessories, CPR training kits, hydration products, and more to support the health and safety of your school athletic program.

 

Resources:

https://www.utphysicians.com/what-to-know-about-sudden-cardiac-arrest-in-young-athletes/#:~:text=Most%20SCA%20cases%20are%20due,never%20detected%2C%E2%80%9D%20he%20said.

https://www.yalemedicine.org/conditions/pulse-oximetry                      

https://www.sportsmedtoday.com/commotio-cordis-va-88.htm

https://www.drdavidgeier.com/blunt-trauma-and-sudden-death-in-young-athletes/

https://www.merckmanuals.com/home/injuries-and-poisoning/sports-injuries/overview-of-sports-injuries

https://www.healthxchange.sg/fitness-exercise/sports-injuries/prevent-running-hazards-dehydration-sudden-cardiac-event

https://www.momsteam.com/health-safety/cardiac-safety/automatic-external-defibrillators-aeds/onsite-placement-of-an-aed-is-critical#:~:text=This%20means%20the%20AED%20should,to%20access%20and%2For%20see.

 

Due to recent incidents at sporting events and schools, there has been increased attention on CPR training. During health emergencies, performing CPR on an individual suffering from cardiac arrest could be the difference between life and death. According to the National Lung, Heart, and Blood Institute, there are around 300,000 to 450,000 deaths caused by cardiac arrest in the US every year.

 

The process to perform general CPR due to a cardiac arrest emergency is straightforward. Check to see if the individual is responsive and confirm that the surrounding area is safe. Call 911 immediately or have a bystander call for help. The individual should be on a flat surface, with their body and head in a neutral, laying position. Perpendicular to the chest of the individual, place your palm on the center of their chest, while interlacing your other hand on top. While positioning on your knees, stack your shoulder joints directly over your wrist joints with locked elbows for optimal compressions that will push the chest inward, about two inches deep, in a quick, constant rate until medical professionals arrive.

 

Men vs Women

It may come as a surprise that women are not only less likely to have CPR performed on them, but they are also found to have lower rates of survival than men, even when CPR is performed. According to the American Heart Association, the factors that play into this difference include fears of accusations relating to sexual assault or sexual harassment, fears of causing physical harm to the female receiving CPR, or the person administering CPR may feel uncomfortable or unsure working near breasts.

 

Most manikins that people train with are modeled after men’s anatomy. However, in recent years, models and attachments have been created to mimic female anatomy, such as School Health’s PRESTAN Female Accessory. This creates a more accurately designed manikin and allows for an individual to practice performing CPR in a more realistic situation.

 

Infants, Toddlers, Adults

Differences in CPR application do not end there. CPR can be performed on all individuals to continuously help pump blood through the body, but certain individuals require different techniques.

 

CPR is taught using the two-hand method, however, if the individual suffering a cardiac arrest emergency is not an adult, different styles of CPR may be used instead. A toddler or child would usually not require the full force of two adult hands. For a smaller child or toddler, a one-hand method can be used to provide CPR. This is similar to the regular CPR method, but without the second, overlaying hand. For an infant, a two-finger or two-thumb method may be used to compress the chest, so as not to hurt the newborn.

 

Results

Performing CPR on an individual can double, or even triple, their chances of survival if administered immediately. It is important to perform CPR correctly on both men and women to give each a better chance at survival. While a child or infant may have a lower chance of a cardiac arrest emergency that requires CPR, giving those individuals a higher chance of survival matters, too. Every second counts!

 

 

 

 

References

https://cpr.heart.org/en/resources/cpr-facts-and-stats

https://www.ahajournals.org/doi/10.1161/circ.142.suppl_4.139

https://www.heart.org/en/news/2020/11/23/why-people-fear-performing-cpr-on-women-and-what-to-do-about-it

https://www.nhlbi.nih.gov/health/cardiac-arrest

https://www.redcross.org/take-a-class/cpr/performing-cpr/child-baby-cpr

1. Not having enough AEDs to cover the building properly.According to the American Heart Association, the goal of every AED program is to deliver defibrillation to a sudden cardiac arrest victim within 3 to 5 minutes of collapse. Perform response drills within your school building to make sure you can reach a victim within that timeframe. ¹

2. Placing AEDs where they are inaccessible after hours, such as behind locked doors.Schools often have events after-hours, such as night games in the gym, when sudden cardiac arrest can occur. Make sure AEDs are available wherever and whenever people congregate on the school grounds.

3. Not having enough signage indicating the placement of the AEDs throughout the school.Clearly designate where AEDs are located within the school so staff and school visitors can easily locate them during an emergency. Sudden cardiac arrest is a very stressful event, so make it as clear as possible for rescuers to locate the device.

4. Not checking the AED’s pads’ expiration dates.All AED pads have an expiration date stamped on the outside of the package. These pads need to be replaced by their expiration date to perform optimally in an emergency. Keep your AED rescue ready by having a procedure in place for checking and replacing your AED’s pads. School Health offers an AED Program Management Programto help you keep track of pad expiration dates.

5. Removing the batteries from the unit to save battery life.Your AED’s battery is what powers the AED to deliver life-saving shocks. In the event of an emergency, your AED should be ready to deploy. Every second counts, and if a rescuer must delay the life-saving shock in order to insert the battery, the results may not be optimal. The rescuer may not realize the battery is not in the unit until after the unit is already on the patient or may be unfamiliar with how to insert your device’s particular battery. Always keep your battery in the unit.

6. Not checking the unit’s battery life.Similar to replacing an AED’s pads, the other key replaceable component on an AED is its battery. As the power source for the AED, it is imperative that a school has a procedure in place that periodically checks on the AED’s battery life. Be sure to order a replacement battery well before your existing one needs replacing. You do not want your AED to be out-of-service because you’re waiting for a battery replacement to ship. School Health’ AED Program Management Program will keep track of your AED’s battery life.

7. Having too few people trained to respond to a sudden cardiac emergency within the district.According to the American Heart Association, an AED operator must know how to recognize the signs of a sudden cardiac arrest, when to activate the EMS system, and how to do CPR. It's also important for operators to receive formal training on the AED model they will use so that they become familiar with the device and are able to successfully operate it in an emergency. Training also teaches the operator how to avoid potentially hazardous situations. ² School Health’s AED Program Management Program will help you manage staff training.

8. Not having a Policy and Procedure in place.Schools should have a policy in place that clearly defines the responsibilities and protocols for use of the AED. The policy should document all aspects about your AED program, such as the medical director, the location of AEDs, responsibilities of rescuers, operational steps for use, post event procedures, and the maintenance of the AEDs. The procedure should include guidelines for determining when it should be used, and a protocol written by a medical doctor outlining the operation of the AED. Sample policy and procedures are readily available from School Health, EMS organizations, AED manufacturers, or other schools. Visit the School Health Safety Center for more information.

9. Misunderstanding the warranty and indemnification length of their unit and the impact these have on the district.Every AED differs in their lengths of warranty and the indemnification policy. Always follow the manufacturer’s recommendations for normal use and service so units remain covered by the warranty. Remember that once your AED warranty expires, the school must pay for any service or technical support. The indemnification policy states that the manufacturer will defend and indemnify any person or entity who purchases or uses an AED against any claims, damages, liabilities, or actions asserted by a third party. The indemnification policy is often limited in years and places the financial burden upon the school after it expires.

10. Not having an AED program coordinator and/or a designated emergency response team.Identifying these people as part of an AED program is extremely important to the success of your program. An AED program coordinator will be responsible for communication with the medical director, emergency response team members, administration, the local EMS and the public about the AED program. The AED program coordinator will also perform quality assurance activities such as ensure first responders are CPR/AED trained and re-trained, that the AEDs are properly maintained, and participate in case reviews. The emergency response team will complete a CPR/AED training course, understand the policy and protocol for responding to medical emergencies, and follow the procedures outlined in the AED protocol when responding to SCA victims. When choosing how to manage your AED program — keeping your school compliant, your staff trained, your AEDs serviced, and your data tracked — trust School Health to be your one stop solution.

School Health AED Program Management

School Health Safety Center

 

References: ¹ American Heart Association. Working Against Time Brochure. 2003

²American Heart Association. Web. 19 Apr 2011. http://www.heart.org/HEARTORG/CPRAndECC/WorkplaceTraining/AEDResources/AED-Programs-Q-A_UCM_323111_Article.jsp#If AEDs are so easy.

You work each day to keep students healthy as they receive an education and prepare for future life. But what about preparing them to save a life during a cardiac emergency?

Sudden cardiac arrest (SCA) in school affects 7,000 students annually.¹ There is no warning before SCA strikes and is witnessed 50% of the time.² High-quality CPR and an automated external defibrillator (AED) are a victims best chance of survival. When a victim collapses from SCA, you have three minutes to begin CPR and apply an AED. Every minute of delayed defibrillation leads to a 10% decrease in the survival of the victim.³  When time is of the essence, is your school prepared to respond?

Follow these steps to help a victim of SCA. And most importantly, don’t panic. 

1. Check the area for safety. Before beginning treatment to the victim assess the scene for safety. Make sure you put yourself in the best position to help the victim. You do not want to put yourself in danger and become a victim yourself.

2. Check for responsiveness and call for help.Once you’ve determined the scene is safe, check the victim for responsiveness by asking, “Are you okay?”. Scan the victim to see if they are breathing and if a pulse is present. If the victim is unresponsive, ask someone to call 911 and get an AED. Next begin CPR.

3. Apply proper chest compressions.Chest compressions at the proper rate of 100 to 120 beats per minute at a depth of 2 to 2.4 inches are critical to move blood out of the heart and to the vital organs. Try to avoid leaning on the chest and minimize any pause between compressions. High-quality CPR is critical to ensure the survival of the victim.

4. Follow the AED prompts. When the AED arrives, turn it on, attached the pads to the victims bare chest, and follow the prompts. Make sure not to touch the patient while the AED analyzes the victim’s heartrate. If the AED advises a shock, make sure to stand clear until the shock is delivered. If the victim remains unresponsive, resume CPR until emergency responders arrive.

Download this poster with step-by-step guidance on assisting SCA victims and help your school be prepared to respond to an SCA emergency.

To learn more about how the ZOLL® AED Plus® can protect your school, click here.

 

Sources:

¹Atkins DL, et al. Circulation. 2015;132(suppl 2): S519–S525.

²Mozaffarian D, et al. Circulation. 2015;131:e29–e322

³AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science 2010:122:S706