Hi all - just thought I would pass this information on from another forum I am on. Just wondering what your thoughts were on this...........? Hi All, This is worth remembering when you are teaching children and even adults. Blows to Chest Pose Threat to Kids By Liza Jane Maltin WebMD Medical News (Nov. 12) -- Every now and then, we hear of a perfectly healthy child or teen dying after being struck soundly in the chest with a hockey puck, baseball, or some other, usually sports-related, projectile. Now, researchers taking a closer look at the phenomenon have discovered that far more innocent strikes to the chest of a child -- to relieve the hiccups, for instance, or with a hollow plastic bat -- can also cause sudden death. Lead researcher Barry J. Maron, MD, with the Minneapolis Heart Institution Foundation, presented his team's findings Nov. 12 at the American Heart Association's Scientific Session 2001 conference. They investigated the 106 deadly and 18 near-deadly cases of commotio cordis, or blunt chest blows, registered in the U.S. through 2001. Victims ranged in age from 1 to 44 years, but 43% of them were younger than 12, only 22% were over 18, and most (95%) were male. "These fatal chest blows often occurred inadvertently in young children and under bizarre circumstances not usually associated with sudden death risk, that is, from projectiles such as ... a snowball, the head of a pet dog, a plastic sledding saucer, as well as from bodily contact during play "shadow" boxing, parent-child discipline, or in the course of terminating a scuffle," the researchers write. Commotio cordis is a medical term that means "concussion of the heart." Because the syndrome is almost always fatal and appears to occur in otherwise healthy people, especially children, it has gained wide attention over the past decade. Doctors believe that commotio cordis occurs when a chest blow disrupts the normal electrical activity of the heart. Depending on timing, the chest blow could cause fainting but not death, or it could cause the heart to cease pumping, leading quickly to death. According to the researchers, the most vulnerable children are boys younger than 12 with a narrow rib cage and underdeveloped chest muscles. The phenomenon is indeed rare, but all children are potentially at risk. Any blow to the chest can produce cardiac arrest, even one that seems quite harmless, says Maron. The most effective way to get a heart beating again is CPR and defibrillation (those electric shock paddles we've all seen on TV). But time is of the essence. For every minute lost, the chance of survival is reduced about 10%, and resuscitation attempts are rarely successful after 10 minutes. Parents would be advised to caution their children about the danger of striking others, or allowing others to strike them, in the chest, even in fun. "Striking the chest at any time is not advisable under any circumstances, even when the blow is trivial," says Maron in a news release. "The general public is largely unaware of the fact that striking the chest, even lightly, can sometimes result in death."
Its a good point Melanie but I would say from reading the article there is not a lot we could do to prevent this from happening in the class short of wrapping everyone in cotton wool. The martial arts require a certain amount of contact, there is no way round it and as there is no way of knowing who would be effected by this unfortunate phenomenon I do not see a way in which we could guard against it. Cooler
True, All we can do to help prevent this is to watch and control or younger students and teaching them good control and fair contact, even light to no contact with the real little ones and then just making sure the older students understand that they could get hurt sparring. Other than that our hands are tied. -Chazz
I think the strike discussed here is timed precisely between heart contractions. I've read a bit about it before. It's too true that nothing can really "prevent" this occuring unless we just don't train. Not even using a chest guard will eliminate the impact of a strike. The only thing an instructor can do is make sure every instructor under them is certified in CPR as it sometimes will reverse the ventricular fibrillation that is set off by the impact. Or as the article Melanie posted about defribrillation have at least one person certified to use an AED (Automated External Defibrillator), which increases the survivial rate to as high as 90%. http://jama.ama-assn.org/issues/v287n9/abs/joc11253.html http://www.momsteam.com/alpha/features/health_safety/defibrillators.shtml http://www.momsteam.com/alpha/features/story/karen_acompora.shtml For information on classes in the USA go here http://www.aha-cpr.org/ Rob
I'm really perplexed at the responses to Melanie's article. Seems like a lot of throwing up of hands and shrugging. "nothing to do unless we stop training" "MA needs contact". Well, what about wearing bogu? Or chest protectors? How about the body armor, coupled with our insistance on control? We are talking about kids here, aren't we? Rob
Kosokun, That was why I included links to articles on it. Of 128 confirmed cases, 122 (95%) were in males and the mean (SD) age was 13.6 (8.2) years (median, 14 years; range, 3 months to 45 years); only 28 (22%) cases were aged 18 years or older. Commotio cordis events occurred most commonly during organized sporting events (79 [62%]), such as baseball, but 49 (38%) occurred as part of daily routine and recreational activities. Fatal blows were inflicted with a wide range of velocities but often occurred inadvertently and under circumstances not usually associated with risk for sudden death in informal settings near the home or playground. Twenty-two (28%) participants were wearing commercially available chest barriers, including 7 in whom the projectile made direct contact with protective padding (baseball catchers and lacrosse/hockey goalies), and 2 in whom the projectile was a baseball specifically designed to reduce risk. Only 21 (16%) individuals survived their event, with particularly prompt cardiopulmonary resuscitation/defibrillation (most commonly reversing ventricular fibrillation) the only identifiable factor associated with a favorable outcome. In many of these cases, body protection and control were both exhibited. The strike in question is more a matter of timing than force. If impact comes at a precise second between heart contractions, the force doesn't matter, it sends the heart into ventricular fibrillation which is a fatal rythm. Control is a good start, but someone has to be prepared for the "if" factor as well. If it happens, what will you do? Rob
Hey Rob, (Nice name, BTW) Seems that in the predominance of these events, the force of the trauma is still significant. That ball in Lacrosse, baseball and the puck in hockey still travel with considerable velocity, which will translate into considerable impact. As the JAMA article you cite suggests, "These findings also suggest that the safety of young athletes will be enhanced by developing more effective preventive strategies (such as chest wall barriers[\I]) to achieve protection from ventricular fibrillation following precordial blows." Rob A
Well put Rob. I feel you misjudge us Kosokun I do not think anyone on these boards has the attitude of shrugging there shoulders and saying well thats life. What we are saying is that according to the article this unfortunate phenomenom is random and unpredictable. I have taught for many years and never had a serious injury in any of my classes and would never like one. In martial arts there is a certain amount of contact now as you said we could make everyone wear chest guards but you can still feel a punch through it and as Rob has just stated above this seems to have little effect, so what do we do next say ok no more contact. Cooler
I think that more centerline padding in chest protectors would help some. But nothing will eliminate the possibility other than just not doing it. That's why I am so big on being prepared and trained to handle these things if and when they happen, although none of us would ever want to see it. I also have a personal feeling that parents and students should be educated about these risks and that they are present in all sports. Too often an excellent instructor would be blamed when the fault is on no single person. But back to what I was originally saying. Even with better preventative measures in place, we shouldn't dismiss the possibility and decide we don't need to know what to do "if" it does occur. Rob
Ive been to tournaments where they ware the chest protectors. They do work some but ive seen them not work at all (many times) The only thing i can say is to teach control. We all know that when in class or a tournament we dont have to kill the person we are against. That how we have gone so long without anyone getting hurt badly. -Chazz
At the end of the day it all comes down to acceptable risk. Put this in proportion to risks kids take every day that people don't worry about - being a passenger in a car, playing football, climbing trees etc. The chances of injury/ death in these scenarios must be greater. Personally, I believe we have to make decisions for ourselves and those we have responsibility for based on what is acceptable risk and get on with living. This isn't to say we should not take reasonable precautions but you'll live a sad and limited life if it's taken too far.
We definitely can't shelter oursleves from any danger in life. Personally I think that would be dull even if we could. Being prepared for any eventuality is the only really responsible way to deal with it other than just admitting the risk is there and educating others on those risks and what to do to prevent them, and then get on with the fun Rob
I think that training in the arts makes it less likely a kid will suffer harm, than if they don't. Anybody else
