A mother watching her 13-year old son play a hurling match helped save his life after a sliotar blow to his chest stopped his heart beating.
In the incident, the woman — who is a nurse — ran onto the pitch and started to perform CPR on her son after seeing him collapse and determining there was no pulse on a quick examination.
The boy experienced cardiac arrest after receiving the sliotar blow to the left of his chest.
The boy’s heart stopped beating for less than four minutes. Along with the CPR, a defibrillator was applied and one shock delivered achieved return of spontaneous circulation.
In a paper in the June edition of the Irish Medical Journal (IMJ), medics state that “prompt resuscitation and automated external defibrillation (AED) enabled a full recovery”.
The medics at Galway University Hospital and Our Lady’s Children’s Hospital, Crumlin state that the incident is the first reported case of Commotio Cordis (CC) caused by a sliotar.
Commotio Cordis is an often lethal disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart at a critical time during the cycle of a heart beat causing cardiac arrest.
The medics in the IMJ paper state that while there is a Commotio Cordis registry in the US this does not exist in Europe and CC is likely underreported here.
They state: “Considering that most CC cases occur in adolescents and have a high mortality rate, timely management of cardiac arrest is key.”
In the incident, an ambulance arrived on site and the boy had a normal examination and electrocardiogram (ECG) for his heart on admission to hospital.
In hospital, the teenager was advised not to return to competitive sport for three months while beta-blockade therapy was continued during this period.
In their discussion of the incident, the medics state that primary prevention of CC centres around the use of protective chest wall shields or of soft balls.
However, they state that even when worn chest shields are not wholly protective against CC and replacing the sliotar with a soft ball is unlikely to be acceptable as the fundamental characteristics of hurling would be significantly altered and CC is such a rare event.
They state that efforts should instead focus on the response to cardiac arrest.
They state that CPR training and rapid access to AEDs are lifesaving measures, as seen in the case reported on.
Indeed, prompt resuscitation and access to AEDs are associated with increased survival rates in CC, which are now as high as 58 per cent.
They state: “Due consideration has been given to introducing a public access AED programme, however the cost benefit analysis of implementing an effective scheme and the large number of AEDs already provided on a voluntary basis suggest public expenditure be otherwise appropriated.”
They point out that there is no mandated upkeep of voluntary AEDs nor an AED registry in Ireland.
They state: “We believe that prompt access to existing, well maintained AEDs, effective CPR and integration with emergency services will improve survival in out of hospital cardiac arrests whether from rare causes like CC or more common causes.”
