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Sudden Cardiac Arrest in

Intercollegiate Athletics

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Sudden Cardiac Arrest�in Intercollegiate Athletics�Are you prepared ?

Sudden Cardiac Arrest (SCA) in Collegiate Student Athletes

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• Sudden fatality from a heart condition remains the leading medical cause of death in college athletes

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• Prevention starts with the Pre Participation Physical

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• Emergency Action Plan for Cardiac Arrest must be established, communicated, and rehearsed

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Pre-Participation Evaluation of Student Athlete

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• Cardiac specific portion of PPE consists of the following:
• Comprehensive personal and family history
• Physical Examination
• American Heart Association 14 point evaluation or
• Pre-Participation Physical Evaluation Monograph, 4^th Edition

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• If ECG is included with the above, best practices include:
• Pre ECG screening planning is performed with a multidisciplinary team
• The student-athlete is provided an in-depth explanation for the rationale of the ECG screening and the possible risk vs benefit of adding ECG Screening
• Modern athlete-specific ECG interpretation standards are used
• Skilled cardiology oversite is available

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Common Causes of SCA

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• Arrythmias
• Hypertrophic Cardiomyopathy
• Inherited Cardiac Conditions
• Commotio cordis
• Myocarditis

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Preparation and Planning

• Preparation is the key to survival once sudden cardiac arrest has occurred
• Emergency Action Plan that encompasses Sudden Cardiac Arrest
• Protocols must be location and situation specific
• All staff, including coaches, must be aware of protocols
• EAP must be widely distributed and rehearsed regularly

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Taking Action:�Recognizing Signs and Symptoms

• Collapsed and unresponsive
• SCA should be suspected in any non-traumatic collapse
• Gasping, agonal breathing
• Seizure like activity, involuntary arm and leg movements
• Seizure=SCA until proven otherwise
• A blow to the chest: Direct impact to the chest can cause cardiac arrest

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Taking Action:�Activate EMS and Begin CPR

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• Activate EAP and contact EMS immediately
• Locate and acquire AED, begin CPR according to training
• Those not performing CPR or preparing AED should clear path for ambulance
• Continue CPR until EMS arrives or patient shows signs of life

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Availability of AEDs

• The single greatest factor affecting survival is the time from cardiac arrest to defibrillation (shock)
• AEDs improve survival through early defibrillation
• Survival rate decreases by 10 % for ever minute an AED is not being used

References

• Hainline B, Drezner J, Baggish A, et al. Interassociation Consensus Statement on Cardiovascular Care of College Student-Athletes. J Am Coll Cardiol. 2016 Jun, 67 (25) 2981–2995. https://doi.org/10.1016/j.jacc.2016.03.527
• 2014-15 NCAA Sport Medicine Handbook 
• K. Harmon, I. Asif, D. Klossner and J. Drezner “Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes”. Circulation. 2011;123:1594-1600; originally published online April 4, 2011
• National Athletic Trainers' Association Position Statement: Preventing Sudden Death in Sports. JAT. 2012 Jan-Feb 47(1) 96-118
• NCAA Cardiac 3 Minute Drill Handout. (https://ncaaorg.s3.amazonaws.com/ssi/cardiac/SSI_Cardiac3minDrill.pdf)
• Sudden Cardiac Death in Athletes - Cardiovascular Disorders - Merck Manuals Professional Edition

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