Medical Experts Discuss Prevention and Emergency Planning and Management of Sudden Cardiac Arrest in Athletes

As part of an ongoing effort to reduce the catastrophic athletic injuries and illnesses among athletes in New Jersey, the Athletic Trainers’ Society of New Jersey (ATSNJ) holds it 25th annual educational conference.

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(Left to Right) Robb Rehberg, Eric Nusbaum and Mike Prybicien Discuss Health Care Issues

It’s vital that comprehensive emergency planning, management and preparations are in place and that a licensed athletic trainer is on staff to ensure a timely and efficient response to sudden cardiac arrest (SCA) at sporting events and practices.

Plainsboro, NJ (PRWEB) March 5, 2011

A group of leading medical experts to in the field of catastrophic athletic injuries and illnesses presented the latest in science and practical management techniques, at the Athletic Trainers’ Society of New Jersey (ATSNJ) 25th Annual Educational Conference in Plainsboro. The ATSNJ holds the conference each year as a means to educate health care providers who play a role in the management of sports related injuries and illnesses.

While rare, sudden cardiac death (SCD) is the leading cause of death in young athletes. Approximately, 100 sudden cardiac deaths are reported in the United State each year, accounting for about one in every 200,000 high school athletes.

Christine Lawless, MD, the only physician in the United States to be dual certified in cardiology and sports medicine discussed the importance of the role that parents and athletic trainers play in the early detection of cardiac issues. According to Dr. Lawless, “good listening skills are the key to early detection and prevention of sudden cardiac death”. Chief cardiac complaints that she specifically noted were chest pain, shortness of breath, fatigue, black out spells and heart palpitations. She stated “these should always be considered cardiac complaints until proven otherwise.”

Dr. Perry Weinstock , the Director of Clinical Cardiology at Cooper University Hospital stated that “while it is impossible to prevent all sudden cardiac deaths, with proper screenings we can reduce the number of incidences.” He continued “ that if either a parent, an athletic trainer, primary health care provider or school physician has concerns after an initial health screening or because of complaints from the child, a referral to a child heart specialist, a pediatric cardiologist, is recommended.”

In the event of sudden cardiac arrest, the strongest determinate of survival is the time from cardiac arrest to defibrillation. Dr.Robb Rehberg, a professor at William Paterson University and ATSNJ Past-President, expressed the ATSNJ’s support of sports programs to prepare comprehensive guidelines for emergency planning and management of sudden cardiac arrest in athletics. “Increased training and the practicing of emergency action plans will help rescuers correctly identify sudden cardiac arrest (SCA) and prevent critical delays in beginning resuscitation.” He also emphasized that sudden cardiac arrest can happen to not only athletes but to officials, team staffs and spectators alike. “It’s vital that comprehensive emergency planning, management and preparations are in place and that a licensed athletic trainer is on staff to ensure a timely and efficient response to sudden cardiac arrest (SCA) at sporting events and practices.”

To manage SCA during athletic practices and competitions, many health-related organizations have issued management guidelines.
The ATSNJ recommends following a consensus statement that was developed with input from the following groups: American Academy of Emergency Medicine, American Academy of Pediatrics, American College of Emergency Physicians, American College of Sports Medicine, American Heart Association, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy for Sports Medicine, American Physical Therapy Association Sports Physical Therapy Section, National Association of Emergency Medical Service Physicians, National Association of Emergency Medical Technicians, National Athletic Trainers’ Association, National Collegiate Athletic Association, National Federation of State High School Associations, and Sudden Cardiac Arrest Association. Its key recommendations include:

1.         Emergency Preparedness 

•     Every school, group or institution that sponsors athletic activities should have a written and structured emergency action plan (EAP).
•     The EAP should be developed and coordinated in consultation with local EMS personnel, school public safety officials, on-site first responders and school administrators.
•     The EAP should be specific to each individual athletic venue and encompass emergency communication, personnel, equipment and transportation to appropriate emergency facilities.
•     The EAP should be reviewed and practiced at least annually with certified athletic trainers, team and attending physicians, athletic training students, school and institutional safety personnel, administrators and coaches.
•     Targeted first responders should receive certified training in CPR and automated external defibrillator (AED) use.
•     Access to early defibrillation is essential, and a target goal of less than three to five minutes from the time of collapse to the first shock is strongly recommended.
•     Review of equipment readiness and the EAP by on-site event personnel for each athletic event is desirable.

2.         Management of Sudden Cardiac Arrest 

•     Management begins with appropriate emergency preparedness, CPR and AED training for all likely first responders, and access to early defibrillation.
•     Essential components of SCA management include early activation of EMS, early CPR, early defibrillation and rapid transition to advanced cardiac life support.
•     High suspicion of SCA should be maintained for any collapsed and unresponsive athlete.
•     SCA in athletes can be mistaken for other causes of collapse. Rescuers should be trained to recognize SCA in athletes with special focus on potential barriers to recognizing SCA including inaccurate rescuer assessment of pulse or respirations, occasional or agonal gasping and myoclonic or seizure-like activity.
•     Young athletes who collapse shortly after being struck in the chest by a firm projectile or by contact with another player should be suspected of having SCA from a condition known as commotio cordis.
•     Any collapsed and unresponsive athlete should be managed as a sudden cardiac arrest with application of an AED as soon as possible for rhythm analysis and defibrillation, if indicated.
•     CPR should be provided while waiting for an AED.
•     Interruptions in chest compressions should be minimized and CPR stopped only for rhythm analysis and shock.
•     CPR should be resumed immediately after the first shock, beginning with chest compressions, with repeat rhythm analysis following two minutes or five cycles of CPR, or until advanced life support providers take over or the victim starts to move.
•     Rapid access to the SCA victim should be facilitated for EMS personnel.

Rehberg also advocates that sports programs develop formal emergency action plans and practice them to best prepare themselves for emergency situations when they occur.

ABOUT THE ATHLETIC TRAINERS’ SOCIETY OF NEW JERSEY

ATSNJ, Inc. consists of licensed athletic trainers, physicians and other allied health care
professionals whose goal is to promote quality healthcare for athletes in any setting. For more information please visit http://www.atsnj.org

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References*
1.    Hazinski MF, Markenson D, Neish S, et al. Response to cardiac arrest and selected life-threatening medical emergencies: the medical emergency response plan for schools: A statement for healthcare providers, policymakers, school administrators, and community leaders. Circulation 2004;109(2):278-91.
2.    Andersen J, Courson RW, Kleiner DM, McLoda TA. National Athletic Trainers' Association Position Statement: Emergency Planning in Athletics. J Athl Train 2002;37(1):99-104.
3.    Drezner JD, Courson RW, Roberts WO, Mosesso VN, Link MS, Maron BJ. Inter-Association Task Force Recommendation on Emergency Preparedness and Management of Sudden Cardiac Arrest in High School and College Athletic Programs: A Consensus Statement