Syncope and sudden death in student athletes – EMS 12-Lead podcast Episode #1

EMS 12-Lead podcast – Episode #1 – Syncope and sudden death in student athletes.

Tom Bouthillet, David Baumrind and Christopher Watford are joined by Dr. John Mandrola from the Dr. John M blog. We discuss sudden death in student athletes, the controversy surounding the prescreening of student athletes, the need for AEDs in the schools, abnormal ECG findings that indicate higher risk, and the EMS evaluation of syncope patients in general.

Related content from EMS 12 Lead:

13 year old female CC: Syncope

17 year old male CC: Syncope

37 year old male CC: Unconscious (syncope in an endurance athlete)

From the Pedi-U podcast:

Done Fell Out! Pediatric Syncope

From the Dr. John M blog:

CW: The ECG of the athlete

What is a normal heart rate?

Screening seemingly healthy young athletes?

The feasibility of routine ECG screening of athletes?

The mysterious athletic heart

Related media

See also:

The Ongoing Controversy Over Screening Young Athletes With ECG – The Wall Street Journal Health Blog

Experts create "cook book" for interpreting young athletes' ECGs – heartwire

Doctors frequently make mistakes when interpreting young athletes' ECGs – heartwire

Accuracy of interpretation of preparticipation screening electrocardiograms. J Pediatr 2011 Jul 9

Interpretation of the Electrocardiogram of Young Athletes. Circulation. 2011;124:746-757 (subscription)

How Important Is the Electrocardiogram in Protecting and Guiding the Athlete? Circulation. 2011;124:669-671 (subscription)

5 Comments

  • Dave says:

    GREAT podcast and congrats!

    Well conditioned athletes, marathon runners included, may be at risk for sudden cardiac arrest. Among one of the earliest documented cases: Pheidippides, a Greek soldier and conditioned runner ran from Marathon to Athens to announce the military victory over Persia (490 B.C.).  After he delivered his message, he collapses and dies (perhaps HCM?).

    In more recent times, recently, SCD has claimed the lives of some high-profile athletes including basketball players Reggie Lewis, Hank Gathers (a video of Hank) and Olympic gold-medal ice skater Sergei Grinkov.

    Death from sudden cardiac arrest is not inevitable. Because of CPR, defibrillation and effective advanced and post resuscitation care, we can celebrate the survival of many, like soccer player Anthony Van Loo and marathon runner Carlton Smith, a 64 year old from Metairie, Louisiana.

    Based on available evidence, early CPR by bystanders and rapid defibrillation, combined with effective advanced and post resuscitation care can result in high long-term survival rates for witnessed cardiac arrest. If bystander CPR was initiated more consistently, if AEDs were more widely available, and if every community could achieve a 20 percent cardiac arrest survival rate, the AHA estimates that 40,000 more lives could be saved each year.

    Communities must be recognized as “ultimate coronary care units” in order to effectively increase survival and improve outcomes from sudden arrest. Community wide interventions that will improve overall quality and increase the likelihood of early bystander initiated CPR and prompt defibrillation are critical aspects of any effort to reduce death and disability from out-of-hospital cardiac arrest. The optimal strategy is one that actively engages a community at all levels.

    Programs like HEARTSafe, HeartRescue, and other similar strategies can be used to effectively advance a full spectrum of survival priorities spanning signs and symptoms, EMD, bystander CPR, early defibrillation strategies (including LEA), early STEMI identification, ACLS and post resuscitation care.

  • Josh Chason says:

    Good podcast and I'm sure this may be outside the scope of this webpage/podcast but I believe there needs to be some mention of Certified Athletic Trainers available to student-athletes in schools along with the medtioned AED and Emergency Action Plans for Sudden Cardiac Arrest. Athletic trainers can be a valuable resourse to the pre-hospital medial team and if given the additional training may be a good option to increase the screening tools already available and the response teams handling these situations.

  • Josh,

    Are Certified Athletic Trainers required to be CPR/AED certified as part of their certification?

  • Dave says:

    Chris/Josh-
    Training is not usually an issue with CATs…but having a robust ERP and devices can be.

  • AJ says:

    I have not listened to the podcast but there is someone who goes to my college that experienced this. He did arrest in the field at a football game and later had an ICD implanted
    The story is the one in the lower right corner at http://www.whyimalive.com/
    http://associationdatabase.com/aws/SCAA/pt/sd/news_article/21569/_PARENT/layout_details/false
    http://www.ksfy.com/story/13175486/avera-medical-minute-sudden-death-in-athletes?clienttype=printable&redirected=true
     
    I would be interested to see what the medical record would have.

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Kevin
44 year old male CC: Palpitations
Why on earth would you risk VF, by giving Adenosine to rule out rhythms.. This is dangerous, and foolish. There might be a slight chance that this is WPW.. You might as well just give him Cardizem, they are both AV nodal blockers... I don't know why the AHA even added this stupid idea..
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Vince DiGiulio
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It is standard practice in electrocardiography to label the first 90 degrees counter-clockwise from "zero" that way. When you see a patient with "left axis deviation" you'll see that their measured QRS axis is somewhere between -30 and -90 degrees. Imagine if you saw someone with a mean QRS axis at 5 degrees. Now imagine…
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Eric Strong
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