Dr. Neal Thomas and colleagues from Penn State Children's Hospital, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, and Minneapolis Heart Institute Foundation reported a healthy 13-year-old boy who suffered cardiac arrest after being hit in the chest by a pitch while at bat in a baseball game. The coaching staff immediately began administering CPR, and 6-8 minutes later the paramedics arrived and used an AED. The boy was taken to the emergency room and was awake, talking, and following commands within one hour of his arrival; he was discharged from the hospital after three days.
Since 62% of cases of commotio cardis have been reported to occur during competitive sporting events, Dr. Thomas points out that "more effective first-responder therapy is needed." Timeliness, training, and equipment are all important aspects of delivering effective treatment. Although the average cost of an AED is $2,500, survival rates for commotio cardis may increase to 25% if resuscitative measures are taken within three minutes of impact; delayed efforts or CPR-only can reduce the survival rate to 3%. Chest protector equipment can reduce the risk of commotio cardis, but 28% of cases of commotio cardis occurred in spite of this protection. Dr. Thomas suggests that "communities and school districts reexamine the need for accessible AEDs and CPR-trained coaches at organized sporting events for children."
The study is reported in "Efficacy of bystander cardiopulmonary resuscitation and out-of-hospital automated external defibrillation as life-saving therapy in commotio cordis" by Erik A. Salib, DO, Stephen E. Cyran, MD, Robert E. Cilley, MD, Barry J. Maron, MD, and Neal J. Thomas, MD, Msc. The article appears in The Journal of Pediatrics, Volume 147, Number 6 (December 2005), published by Elsevier.
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