East Jefferson General Hospital

Each year young athletes across the United States are dying on the field from serious health related conditions that are often preventable. According to a recent article published in The New York Times, these conditions that ail our students are sudden cardiac arrest, heatstroke and concussion. While serious death rarely occurs from a sudden blow to the head (concussion), cardiac arrest and heatstroke can most certainly result in death, if not, serious brain injury. In fact, sudden cardiac arrest is the number one killer of young athletes today.

Statistics show that a young athlete dies once every three days in the United States alone due to sudden cardiac arrest. Heatstroke is also a serious contender for death among young athletes. These statistics, of course, are terrifying to any parent of a student athlete. Let's examine the symptoms, causes and preventative steps to take when trying to protect our youth from avoidable death.

Director of Emergency Medical Services at East Jefferson General Hospital, Mike Guillot, says, "we are always aware of the heat levels when athletes are working out, practicing, or in a game." He recalls a moment in the past year when he had to aid a young athlete whose core body temperature had spiked (hyperthermia) leading to potentially life threatening danger. Guillot says, "[The danger was] so much so that we needed to infuse chilled saline solution into [the athlete's] IV's in order to bring his core temperature down." This athlete was, in actuality, suffering from heatstroke, a condition that results in exhaustion and subsequent collapse of the body under severe heat exposure.

According to the Mayo Clinic, "you are considered to have heatstroke when your body temperature reaches 104 F (40 C) or higher." If the body is not properly hydrated, and loses more water (sweat) then it is taking in, it could experience such symptoms as headaches, muscle cramping, debilitating fatigue, rapid breath and disorientation (to name a few). If symptoms are severe enough, one may experience cardiac arrest, or even death.

Sports safety advocates are under the impression that preventative measures such as "introducing gradual levels of exercise at the beginning of a sports season in hot temperatures" could seriously reduce the number of complications due to heatstroke and sudden cardiac arrest.

Sudden cardiac arrest is most commonly induced as a result of a structural heart defect, or a complication with the heart's electric circuitry. The most frequent cause is hypertrophic cardiomyopathy (the thickening of the heart muscle—with few warning signs). Unfortunately, these resulting complications are not often found in a standard physical.

Currently, young athletes are evaluated based on the sound of their heart, blood pressure, and a review of the individual's medical history. While these tests can help determine some medical conditions, many doctors agree that an electrocardiogram (EKG) should be added to the test to completely determine the athlete's health and readiness to handle the demands of their respective sport. It was determined that introducing an EKG test as a preventable measure could detect two thirds of "deadly, concealed heart trouble aggravated by exercise in competition."

In Italy, young athletes are required to have an EKG in order to play sports. However, since EKGs can be expensive and they are not always covered by insurance, they are not as easy to come by in the U.S. Governing bodies like the NCAA and the NFL have implemented steps into keeping their players involved in uniformly regulated practices, however, since there is no governing body for high school (or younger) sports, there are no uniformly regulated practices. Therefore, I find it of the upmost importance for coaches and parents to be aware of the steps to take if conditions like sudden cardiac arrest and heatstroke occur on the field.

Many high schools still implement two-a-days during the later summer months (particularly in August), and this is often considered a standard routine amongst coaches. Staggering evidence shows that this outdated form of practice is not the safe way to get a student into shape. Just this past February, sports safety advocates met in Washington to discuss these matters more in depth. They determined conditions like heatstroke are completely preventable, and should be recognized as a serious threat to the safety of these young athletes. Heatstroke can also induce cardiac arrest, as the body's inability to produce sweat due to dehydration does not allow for it to regulate its temperature.

Should sudden cardiac arrest arise, CPR and an available A.E.D. (Automated External Defibrillator) can make the difference in an individual's rate of survival.

Guillot notes, "If an athlete or anyone else was, in fact, suffering from a cardiac arrest event, CPR would be immediately started to prolong heart fibrillation (rapid, irregular, unsynchronized heart beat) and continued until the A.E.D. could be hooked up and ready to deliver the life-saving shock."

An A.E.D. used to resuscitate a victim of cardiac arrest can boost the individual's survival rate by 60 percent or more. Regrettably, roughly 30 percent of schools in the U.S. do not carry this life saving device.

CPR and A.E.D. implementation can be performed by anyone with minimal experience. I recently prepared for such a scenario as administering CPR and A.E.D. at East Jefferson General Hospital, as part of our employee safety training. CPR is a balance of chest compressions, airway opening, and breathing (CAB), as these are the three components of this lifesaving technique.

The AED, which is a computerized device that can identify cardiac rhythms that need a shock, has clear instructions both written and audible showing the user where to place the leads and what simple steps to follow with verbal commands.

It is important to note that the A.E.D. will only deliver a shock if it is needed, so there is no need for nervousness about potential electrocution, as the real threat to life happens when CPR and A.E.D. are not used at all.

I encourage parents and coaches of young athletes to head this warning, and to implement a routine that can detect and prevent these serious health conditions from occurring. There is no need for any unnecessary deaths to exist because of ignorance. Ignorance is most certainly not bliss, especially when our youth is involved. And, if you have not already done so, learn how to use lifesaving techniques such as CPR and AED usage.