" Health Alert for Community Baseball Players!"

"Commotio Cordis: Concussion of the Heart”

Commotio Cordis is a blunt trauma to the chest, usually from the ball at speeds from 30 to 50 mph. The trauma occurs on the upswing of the T-Wave in the Cardiac cycle. This timing of impact will ultimately result in ventricular fibrillation, which can lead to death. A combination of the location (center of the ventricle), timing and force of the impact are the primary causes of the injury. The only way to recover a regular rhythm to the heart is to use an AED (Automated External Defibrillator).

Commotio Cordis is a profoundly significant injury that is often unreported, but there are incidents every year. Parents, coaches, and communities are not aware of how many children die each year because most cases are documented as accidental death. One problem is parents usually do not want an autopsy. The victims of this injury have normal hearts. The injury is not the cause of a deformity of the heart. The tragedy of this injury is that it can be prevented.

Commotio Cordis can occur at any age, but young children are more prone to this injury because their thoracic walls are weaker and pliable (not rigid). Approximately 40% of these injuries occur at home, school, or in the playground.

There are many sports with documented cases. The most common sport this occurs in is baseball and softball, but some other sports include ice hockey, football, lacrosse, boxing, and karate. One major problem with hockey and football equipment is when the arms go up, the heart is open and not covered. But, there are more deaths in youth baseball and softball than any other sport, including football.

There are approximately 3% of people saved from cardiac arrest nationally each year with CPR. If early defibrillation is used within 5-7 minutes, then 35 to 40 % of the victims could be saved. One in every 200,000 students athlete die from sudden cardiac death every year. More children die from trauma to the chest than to the head.

CPR doesn’t save lives, it saves time. CPR is important, but the AED SAVES LIVES. An Automated External Defibrillator analyzes the heart’s rhythm and tells the user to deliver a shock if it is needed. AED's are designed for people who are not medically trained to use easily and safely. Although this unit can be costly, there is no value on a human life. If the use of an AED is not initiated within a 2-minute window the athlete will probably not survive. AED’s are simple to use and to train other people to use them.

Children are dying because they are not protected. Athletes need to be trained to wear chest protectors routinely as they would head and face gear, groin cups, etc. One current method of prevention is the use of a chest protector. There are some different chest protectors available.

Here are some options for different chest protectors:

1. Parker Athletics/ OSI SPP
   It is one of the best products available. It has mesh breathable fabric with fiberglass/ casting insert. Micro-perf EVA foam surround insert. It is lightweight and is molded over the athlete’s chest (material hardens within 20 minutes). It provides appropriate coverage of the chest and heart area for left and right-handed batters. Adjustable velcro straps around the back and over the shoulder. Available in all sizes; sizes based on body weight.
   Cost = $30
   * Highly Recommended. If you would like to order this chest protector, please call
   1-800-848-8244. You must specify left or right handed batter and body weight of child.
2. Rawlings OSI BCP 950
   It is an upside down Large T shaped pad. Fiberglass/ casting material insert, which is molded to the athlete’s body. Adjustable velcro straps around the back and over the shoulder. Available in all sizes; sizes based on body weight.
   Cost = $30
   www.rawlings.com
3. Heart-Gard (Square)
   It has a plastic outer surface with the center 50% thicker and has _” low density foam inside. May not cover entire chest/heart area. Made specifically for ages 5 – 14. Cost = $20
   www.heart-gard.com
4. Adams Batters Vest (BV 1530)
   It is nylon with plastic fiber insert and foam padding surround. Sizes S/M and LG/XL. It is not size appropriate and does not completely protect the heart. There are some spaces between pads. Cost = $60
   www.adamsusa.com
5. Cooper Vest (BV 10)
   It is similar to the Adams vest and umpire vest, except it has low density foam inserts. Same problems as the Adams vest.
   Cost = $20 (S/M) / $25 (L/XL)
   www.dunhamssports.com

Although you can use any chest protector on the market because something is better than nothing.

Here are some ideal goals for your community to reach:

• Mandatory use of chest protectors by athletes in all sports at risk.
• Mandatory presence of CPR/AED certified coaches/trainers.
• All schools and sports facilities should be equipped with AED’s.
• An AED is to be available during all competitions with trained sports personnel available.
• Proper education of avoidance techniques, defensive batting stances, and sliding techniques.
• Increase awareness of this injury among the community.

For more information on this or any other topic, please call Brian Bernasconi, ATC at 412-389-8125, or John Bonaroti, PT, ATC at 412-856-8060 x210.

Commotio Cordis

"Concussion of the Heart" Commotio Cordis is a blunt trauma to the chest. The trauma occurs on the upswing of the T-Wave in the Cardiac cycle. This timing of impact will ultimately result in Ventricular Fibrillation, which can lead to death. The only way to recover a regular rhythm to the heart is to use an AED (Automated External Defibrillator).

Commotio Cordis is a highly unreported injury, but there are incidents every year. Parents, coaches, and communities are not aware of how many children die each year because most cases are documented as accidental death. The victims of this injury have normal hearts. The is not the cause of a deformity of the heart. The tragedy of this injury is can be prevented.

There are many sports with documented cases. The most common sport this occurs in is baseball and softball, but it may occur in Ice Hockey, Football, Lacrosse, Boxing, and Karate. Commotio Cordis can occur at any age, but young children are more prone to this injury because their thoracic walls are weaker and pliable (not rigid).

CPR doesn’t save lives, it saves time. CPR is important, but the AED SAVES LIVES. An Automated External Defibrillator analyzes the heart’s rhythm and tells the user to deliver a shock if it is needed. They are designed to be used safely by people who are not medically trained. Although this unit can be costly, there is no value on a human life. If the use of an AED is not initiated within a 2 minute window the athlete will probably not survive. AED’s are simple to use and to train other people to use them.

Children are dying because they are not protected. One current method of prevention is the use of a chest protector. There are some different chest protectors available, but the Parker Athletics/ OSI SPP Chest Protector is one of the best products available. If you would like to order this chest protector, please call 1-800-848-8244 or go to www.Parker-Athletic.com. You can use any chest protector on the market because something is better than nothing.

Here are some ideal goals for your community to reach:

• Mandatory use of chest protectors by athletes in all sports at risk.
• Mandatory presence of CPR certified coaches/trainers.
• All schools and sports facilities should be equipped with AED’s.
• An AED is to be available during all competitions with trained sports personnel available.

For more information about anything you have read, please contact East Suburban Sports Medicine anytime.