Posted by Bob Trenkamp on 02/17/2011

There is a deadly phenomenon named 'commotio cordis'. It can occur when a person receives a hard blow to the chest at a certain time during the normal cardiac rhythm. This can happen in ice hockey, lacrosse, baseball, football, karate, or any sport where a hard blow to the chest can happen. It is so significant a problem that US Lacrosse adopted a position statement (…) on it in 2008.

Barry J Maron, PhD, has been investigating the incidence of cardiac arrest via commotio cordis and has established a national registry to collect the data necessary to better understand the phenomenon. The registry data show an average frequency of occurrence of 17 instances per year with only about 12 percent of the victims surviving. Intuitively, it is highly unlikely that the registry has captured all instances. The problem is probably worse than reported.

When such an instance occurs, the heart cannot pump blood because it is beating in a disorganized way at first. The brain begins to die. The victim stops breathing, and as time passes, the heart stops moving at all, and the odds that the victim can survive with major brain functions intact decrease to near-zero.

What is the Bystander treatment for a person who is non-responsive and is not breathing? Call 911 if the personis non-responsive, and start chest compressions, 100 per minute, at least 2 inches deep. Defibrillate promptly.

The biggest challenge in trying to prevent needless loss of life from sudden cardiac arrests is making sure that a CPR-trained person and an AED is on the scene with someone arrests. It's impossible to put an AED every 400 feet, as you see in the the Chicago and Atlanta airports, but most of the commotio cordis deaths occur at school-organized sporting events. This is a setting where the ratio of AED need vs AED availability is high. Yes, many schools have a policy of always having an AED at every school-sponsored sporting event, but many don't, and I've personally seen cases where there was an AED at the event, but the electrode pads and the battery were out-of-date. I've also seen a number of high school sporting events where there wasn't an AED available.

There is no organization who is going to make it their business to run around the country checking every secondary school and college to make sure the AED situation is under control. It is up to each of us to deal with our own patch of the countryside. What I am asking is that you call the Board of Education and all the private schools in your county, that you ask them if they have AED's at every sporting event, and that you ask how they make sure that the pads and batteries are not beyond their expiration dates. If the answers aren't comforting - e.g., the answers are "I don't know" or "no, we don't have enough money in the budget", raise a stink. Take the issue to the media. Make it a cause. Because, if you don't and someone dies needlessly at a sporting event in your county, you are going to be kicking yourself for a long time to come.

...and don't worry about hopping in where someone else is already on the case. The odds are high that they are not, and if someone else is on the mission, the person you are asking the questions of will be quick to say, "This is the second call I've had like this. What's going on?" Trust me. I've made a few of these calls myself.

Be safe.


Submitted by SCAFoundation on 02/17/2011


Well said, Bob. For those who are unaware, we have an award winning publication, "You Can Save a Life at School," designed to raise awareness about the issue in schools. It is targeted to school boards, school nurses, administrators, teachers, coaches, students, and other stakeholders and decision-makers. The publication is available for downloading at Interested parties may also request print copies by contacting the Sudden Cardiac Arrest Foundation at