{"id":1255483,"date":"2023-04-24T10:10:43","date_gmt":"2023-04-24T14:10:43","guid":{"rendered":"https:\/\/bugaluu.com\/news\/the-damar-hamlin-upshot-what-to-do-about-commotio-cordis\/1255483\/"},"modified":"2023-04-24T10:10:43","modified_gmt":"2023-04-24T14:10:43","slug":"the-damar-hamlin-upshot-what-to-do-about-commotio-cordis","status":"publish","type":"post","link":"https:\/\/bugaluu.com\/news\/the-damar-hamlin-upshot-what-to-do-about-commotio-cordis\/1255483\/","title":{"rendered":"The Damar Hamlin upshot: What to do about commotio cordis?"},"content":{"rendered":"
<\/a><\/div>\n

Rob Vito has built a reputation as a smooth salesman since he began making military-grade protective gear for athletes more than a decade ago.<\/p>\n

He once had someone smash a Louisville Slugger across his chest to prove his confidence in one of his products.<\/p>\n

He personally guaranteed<\/em> that Michael Vick wouldn\u2019t reaggravate his bruised ribs while wearing a custom-fitted protective vest.<\/p>\n

He often casually brings up that his company has outfitted everyone from Tom Cruise to Tony Romo to the Pope.<\/p>\n

And yet for all Vito\u2019s marketing savvy, it isn\u2019t a catchy slogan or publicity stunt that did the most to elevate his company\u2019s stature. Unequal Technologies attracted a horde of new customers the past few months because of Damar Hamlin\u2019s near-fatal collapse during a Monday Night Football game last January<\/a>.<\/p>\n

When a national TV audience watched Hamlin go into sudden cardiac arrest on the field after making a seemingly routine tackle, viewers scrambled to better understand what happened to the Buffalo Bills safety. Medical experts quickly suggested that a lowered shoulder to the chest from Cincinnati Bengals receiver Tee Higgins may have caused Hamlin, 25, to experience a rare but often lethal heart disruption known as commotio cordis.<\/p>\n

It was at that point, Vito says, that the threat of commotio cordis \u201cbecame real\u201d for the layperson. Parents who sought to protect their kids from what happened to Hamlin hunted for gear created to reduce the risk of commotio cordis and purchased chest protectors and padded shirts from Unequal and other manufacturers. Several NFL owners even contacted Vito to learn more.<\/p>\n

\u201cOur sales went up about 800% almost overnight,\u201d Vito told Yahoo Sports. \u201cWe were running to UPS and FedEx in the afternoons until about 8 p.m. at night. It was nonstop around the clock six, seven days a week trying to get all the product out to satisfy the need.\u201d<\/p>\n

Last week, Hamlin confirmed for the first time that commotio cordis<\/a> indeed was what caused his heart to stop beating. He\u2019s only alive and functioning normally today because medical personnel on site were able to administer CPR to restore the flow of blood to his vital organs before using an automatic external defibrillator to shock his heart back into rhythm.<\/p>\n

Hamlin\u2019s story has shined a spotlight on a condition that is among the most common causes of sudden cardiac death in competitive sports. Cardiologists say that approximately 10 to 20 cases occur annually and that teenage boys are the most vulnerable. Commotio cordis is seen most often in baseball, lacrosse and hockey, all sports where it\u2019s common for an athlete to take a solid hard ball to the chest. In other sports, commotio cordis can be triggered by the impact of an elbow, fist or helmet.<\/p>\n

While the prompt and effective response of the Bills medical staff saved Hamlin<\/a>, most athletes don\u2019t have access to the NFL\u2019s vast resources and well-drilled emergency personnel. It raises the question whether commotio cordis protective gear should be more prevalent \u2014 or even required \u2014 in certain sports.<\/p>\n

\u201cIf there\u2019s something out there that can protect our kids from dying of sudden cardiac arrest, why aren\u2019t we using it?\u201d said Maureen Legg of Parent Heart Watch. \u201cWe have the tools we need to start saving lives. We just need to use them.\u201d<\/p>\n

Before Damar Hamlin collapsed on the field during a Monday Night Football game, most people had never heard of commotio cordis. (Michael Allio\/Icon Sportswire via Getty Images)<\/figcaption>
Icon Sportswire via Getty Images<\/div>\n<\/figure>\n

Death on the field<\/h2>\n

Louis Acompora awoke with nervous anticipation on the morning of March 25, 2000. Later that day was his first high school lacrosse game, a major milestone for a 14-year-old freshman who began carrying a lacrosse stick under his arm soon after he learned how to walk.<\/p>\n

Early in the second quarter, Acompora used his chest to block an opposing player\u2019s routine shot from distance. The teenage goalie took a couple steps forward to scoop up the ball. Then, out of nowhere, he collapsed.<\/p>\n

At first, John and Karen Acompora didn\u2019t even leave the stands to check on their son because they assumed he tripped or got the wind knocked out of him. Only after Louis didn\u2019t get up did his parents realize something was dreadfully wrong.<\/p>\n

For Karen Acompora, the next few minutes are a nightmarish blur. She recalls the coaches and athletic trainers rushing out and yelling that Louis didn\u2019t have a pulse. They then administered CPR in hopes of maintaining the flow of blood and oxygen to Louis\u2019 brain and other vital organs until paramedics arrived with a defibrillator.<\/p>\n

\u201cUnfortunately the paramedics didn\u2019t come for almost 15 minutes,\u201d Karen said. \u201cLouis didn\u2019t even have a chance at survival.\u201d<\/p>\n

The coroner who conducted the autopsy of Louis\u2019 body found nothing out of the ordinary \u2014 no underlying issues, not even a bruise on his chest. He wanted to write that Louis died of \u201cnatural causes\u201d on the death certificate, but Karen wasn\u2019t willing to accept that explanation.<\/p>\n

\u201cWe thought he had to have something<\/em> wrong with him,\u201d she said.<\/p>\n

The search for answers led Karen to Mark Link, a cardiologist who had recently helped unlock the mystery of why some adolescent athletes die from relatively innocent blows to the chest from a ball or similar projectile. Link and several colleagues demonstrated that a moderate blow could stop the heart if it occurred at exactly the wrong segment of the cardiac cycle.<\/p>\n

Link listened to Karen\u2019s account of Louis\u2019 death. Then he told her, \u201cSounds like commotio cordis to me.\u201d<\/p>\n

At the same time that Karen Acompora was grappling with the riddle of how her son died, the executive director of an athletic safety nonprofit was trying to assess the threat that commotio cordis presented. Mike Oliver of the National Operating Committee on Standards for Athletic Equipment wanted to figure out, \u201cDoes this happen once in 10 years? Does this happen three or four times a year? And in what sports and to what extent?\u201d<\/p>\n

What NOCSAE-funded research efforts revealed, Oliver said, was this was \u201cno small thing.\u201d There were about 10 to 20 documented cases of commotio cordis per year, almost all involving otherwise healthy teenage boys like Louis. Many of the victims went into cardiac arrest after being tackled in a football game or struck by baseballs, lacrosse balls or hockey pucks. It also occurred as a result of play-fighting with friends, a snowball to the chest or even an ill-advised attempt to terminate hiccups.<\/p>\n

\u201cIt didn\u2019t happen every day or every weekend, but when it did happen it was nearly universally fatal,\u201d Oliver said. \u201cIf you didn\u2019t have cardiac defibrillation immediately, the chance of surviving was extremely low.\u201d<\/p>\n

Desperate to find some good in their son\u2019s tragic death, John and Karen Acompora partnered with NOSCAE in hopes of preventing similar future tragedies. The Louis K. Acompora Foundation\u2019s<\/a> immediate goal was to place a portable device known as an automated external defibrillator at every school, gymnasium and athletic field across New York and beyond. Had an AED been available when Louis collapsed, someone might have been able to revive him by shocking his heart back into rhythm.<\/p>\n

The long-term goal for the Acompora family was to raise money to aid in the development of safety gear athletes could wear to prevent commotio cordis. At the time of his death, Louis was wearing a chest protector. Karen would soon come to find out that, when it came to protecting his heart, it didn\u2019t do him a lick of good.<\/p>\n

The quest for real protection<\/h2>\n

In the mid-2000s, with the backing of NOSCAE and the Acompora Foundation, Dr. Mark Link and a handful of colleagues began assessing the effectiveness of commercially available chest protectors at preventing commotio cordis.<\/p>\n

Of the 12 chest protectors that they tested, none significantly decreased the occurrence of commotio cordis in juvenile pigs struck by a baseball or lacrosse ball. Even a product called the Heart Gard provided nothing more than a false sense of security.<\/p>\n

\u201cWearing those chest protectors was no better than wearing no chest protector,\u201d Link said.<\/p>\n

Out of that eye-opening discovery came Link\u2019s next challenge. He needed to pinpoint the exact conditions under which commotio cordis occurred. And then he needed to use that data to help NOSCAE establish a performance standard that manufacturers had to meet to prove that their safety gear would significantly reduce the risk of injury and death from commotio cordis.<\/p>\n

Through further testing with pigs, Link determined that a confluence of certain critical variables was necessary to induce commotio cordis with a ball. The timing in the cardiac cycle was the most important. A direct hit over the center of the left ventricle was also key, as was the hardness of the ball and the pliability of the victim\u2019s chest wall. Impact usually had to occur at least 30 miles per hour but anything faster than 50 miles per hour decreased the rate of cardiac arrest and often instead led to cardiac rupture and trauma.<\/p>\n

At the same time as Link conducted testing with pigs, Dr. Nathan Dau worked tirelessly inside a Wayne State laboratory building a biomechanical chest surrogate that mimicked the response of the human chest and heart to testing impacts. When a baseball or lacrosse ball is shot at the surrogate at just the right speed, internal censors measure the impact force to assess whether a chest protector performs well enough to prevent commotio cordis.<\/p>\n

\u201cOnce we know what the performance threshold is, we don\u2019t design the safety equipment,\u201d Oliver said. \u201cWe just say, \u2018Hey, here\u2019s the standard. Manufacturers, you\u2019ve got all the engineers, all the expertise. You figure it out.\u201d<\/p>\n

For athletic equipment manufacturers, the challenge was to conceive of a product that was lightweight and comfortable for athletes yet met NOCSAE\u2019s standard. Link said manufacturers had little choice but to experiment with harder, stiffer materials than the soft, spongy chest protectors of the previous era.<\/p>\n

In the past five years, more than a half dozen athletic equipment manufacturers have developed commotio cordis protective gear for baseball and lacrosse that is certified as meeting NOCSAE standards. Nike, Adidas, Rawlings and Wilson are among the corporate giants with a foothold in the market. Then there are also up-and-coming companies like Unequal.<\/p>\n

\u201cOne of the approaches by manufacturers was to design a pad that resembled a shallow dome,\u201d Oliver said. \u201cIf the ball hit right in the middle of the cardiac silhouette, the energy transferred out to the edges of the pad beyond the cardiac silhouette.<\/p>\n

\u201cAnother thing they realized was you probably aren\u2019t going to be able to do it with a single type of foam. You need layers. You might have a hard external layer, a secondary layer that was a little less rigid and then a layer that was next to the body and a little more conforming.\u201d<\/p>\n

No sport has embraced commotio cordis safety like lacrosse. Scarred by the death of Acompora and more than a dozen other high school or college athletes, USA Lacrosse began requiring all goalies to wear NOCSAE-certified chest protection in 2021 and all boys\u2019 and men\u2019s field players to do the same the following year. The NFHS and NCAA followed suit and made those rule changes universal.<\/p>\n

To Karen Acompora, it was a victory two decades in the making.<\/p>\n

\u201cIt was like hallelujah!\u201d she said. \u201cIt took way too long but here we are.\u201d<\/p>\n

\"Commotio
Commotio cordis may not be commonplace, but Rob Vito’s Unequal Technologies asks the question, “Why risk it?” (Unequal Technologies)<\/figcaption><\/figure>\n

The debate: Should chest protectors be mandatory?<\/h2>\n

The lingering question in the wake of Hamlin\u2019s collapse and recovery \u2014 Hamlin has been cleared to return to team activities<\/a> \u2014 is whether other sports will start to follow lacrosse\u2019s lead regarding commotio cordis protective gear.<\/p>\n

Could the requirement of chest protectors and padded shirts save lives? Or is that overkill given that NOCSAE-certified gear costs up to $100 an item and that commotio cordis impacts so few athletes each year?<\/p>\n

So far the NFL doesn\u2019t appear to be throwing its resources behind the development of shoulder pads that would extend lower on the chest to better protect the heart. Asked about the league\u2019s plans regarding commotio cordis safety gear, an NFL spokesperson said she had no updates. She instead highlighted the league\u2019s efforts to persuade all 50 states to prioritize emergency preparedness in order to prevent sudden cardiac arrest from having a fatal outcome.<\/p>\n

To cardiologist Barry Maron, one of the world’s foremost researchers on commotio cordis, the NFL is correct to emphasize AED availability and CPR\/AED education for high school coaches. Maron considers that to be a more practical prevention tool than the widespread adoption of chest protectors and other safety gear.<\/p>\n

\u201cIt\u2019s the secondary prevention, the resuscitation and defibrillation,\u201d Maron said. \u201cThe secondary prevention works.\u201d<\/p>\n

Link agrees that CPR education is the most critical, pointing out that \u201cgood CPR can keep the brain alive until an AED gets there.\u201d But Link argues that paying for NOCSAE-certified chest protection is also essential for young athletes in \u201cany sport in which you get hit in the chest all the time.\u201d<\/p>\n

For Link, that means baseball pitchers and catchers. Or hockey and lacrosse players. Or softball corner infielders who crash the plate to cover bunts. It doesn\u2019t mean that a centerfielder needs a chest protector while playing in the field.<\/p>\n

\u201cI\u2019m not advocating for everyone in youth sports to wear a chest protector,\u201d Link said. \u201cI\u2019m not advocating for that at all. I\u2019m saying if you take frequent hits to the chest, you should wear a good chest protector.\u201d<\/p>\n

The fight to protect young athletes from commotio cordis is especially personal for Karen Acompora. That\u2019s why she\u2019s pleased that the phenomenon has been in the national limelight for the past few months because of Hamlin. And that\u2019s why she seethes whenever a writer or TV analyst refers to commotio cordis as \u201cextremely rare.\u201d<\/p>\n

\u201cWhen you write that, a parent looks at it like, \u2018I don\u2019t even have to think about that. It\u2019s never going to happen to me,\u2019 \u201d Acompora said. \u201cBut it happened to me. My child died from that. And if it happened to me, it could happen to you.\u201d<\/p>\n

From:AOL<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

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