Automated External Defibrillator (AED) and Little League Sudden Cardiac Arrest (SCA) Jeff Vining American Red Cross
Causes of death in the U.S 350,000 300,000 250,000 200,000 150,000 Cause 100,000 50,000 0 Fire Guns Car SCA
The Stakes Annual Sudden Cardiac Arrest (SCA) Events U.S. 350,000 events per year 7,000 are children 950 patients per day (one every 2 to 3 minutes) 5% survive 75% out-of-hospital 95% die without very early treatment Total Events 350,000
The Healthy Heart A Series of Events An electrical event stimulates a mechanical event...resulting in coordinated heart pumping, and regular pulse. Main Pumping Chambers
Commotio Cordis Concussion of the Heart Impact directly over the heart Mechanical energy (blow to the chest) is converted into electrical energy Heart s normal electrical rhythm is disrupted sending it into SCA Ventricular Fibrillation- V-Fib
Timing of the blow Between heart beats is the most vulnerable time
Commotio Cordis Event Stats 128 well-documented cases in the past 6 years Reported/studied by the Commotio Cordis Registry in Minn. Vastly underreported Average age 14 43% younger than 12 95% Male 60% are struck by a baseball/softball 28% wearing some type of chest protection Survival occurred in approximately 15%
The Moment The person who is struck collapses immediately in approximately 50% of instances. The other 50% - a transient period of consciousness occurs during which a brief purposeful activity, movement, or behavior Persons in sudden cardiac arrest typically are found to be unresponsive, not breathing, and no pulse
After Collapse- The Clock Starts! Time to defibrillation is probably the single most important determinant of survival in sudden cardiac arrest. Generally, every 1-minute delay in defibrillation decreases the likelihood of survival by approximately 10%.
The Case for Early Defibrillation 100 90 80 70 Chances of of survival reduced 7% 7% to to 10% each minute % Survival 60 50 40 30 20 10 0 0 1 2 3 4 5 6 7 8 9 Cummins RO, et al. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC, Circulation (Suppl) 2001;102:8, August 22 Time (minutes)
What Happens When You Call 911? Best Case Scenario Identify emergency/ Activate emergency response plan 911 call Alert ambulance and rescue squads (dispatch) Responders to their units Travel time to location Unload equipment/ Distance to patient Assess patient/ Apply defibrillator/ Deliver shock 30 seconds 1 minute 30 seconds 30 seconds 5 minutes* 2 minutes 1.1 minutes** *Travel time varies depending on weather, traffic, distance (vertical and horizontal), and ambulance (with defibrillator capability) availability. **Cummins RO, et.al. Automatic external defibrillators used by emergency medical technicians: a controlled clinical trial. JAMA. 1987; 257:1605-10 TOTAL 10.6 minutes
The Response- RISE to the occasion! 1. RECOGNITION of no pulse-possible sca 2. IMMEDIATE CPR until AED arrives 3. SECURE AED to victim 4. Early Defibrillation 3 Minutes
Baseball Types/Speed and Sudden Cardiac Arrest Swine chest wall blow study published in American Academy of Pediatrics- 2002 Forty animals received up to 3 chest wall impacts at 40 mph with a safety ball of varying hardness and a standard ball Impacts all occurred between heart beatsvulnerable time Compared to similar study at 30 mph
Degree of Baseball Hardness/Speed V-FIB % 70 60 50 40 30 20 10 0 RIF 1 RIF 5 Standard Degree of ball hardness 30 mph 40 mph
Action Steps to Reducing Little League Deaths from SCA Secure yearly CPR/AED training for all coaches Purchase an AED Be sure an AED is reachable in 90 seconds from all fields Consider the use of safety balls in league play Consider the use of wooden bats to reduce speed of hit balls towards pitchers/infield Consider the use of chest protection equipment for all players
Red Cross Contact Information AED Presentations Jeff Vining AED Specialist 404-575-3127 jvining@redcrossatlanta.org AED Sales Training