Stop sudden death in students

| September 11, 2012 | 0 Comments

By Walter Kloeck

Recently, the sudden unexpected collapse and cardiac arrest of world-famous footballer Fabrice Muambo during a Football Association (FA) Cup quarterfinal match in the UK, and the collapse and cardiac arrest of Spanish footballer Sergio Granero the very next day, were widely publicised.

Both incidents draw attention to the real possibility that anyone, no matter how fit or healthy they may appear to be, is at risk of sudden death without warning. Both players’ hearts suddenly stopped beating while playing soccer, but because they both received immediate cardiopulmonary resuscitation (CPR) and their heartbeats were restarted by a life-saving electrical shock provided by an automated external defibrillator (AED) at the scene, both men are thankfully alive and recovering from their terrifying ordeals.

Sudden death can result from variety of conditions

According to a report published by the University of Washington,1 sudden death in athletes occurs approximately once every three days in the USA. Immediate CPR and defibrillation is the only treatment for sudden cardiac arrest. Incidents of sudden unexpected deaths in schoolchildren in South Africa have been reported on several occasions. Even a hard strike to the chest with a fist or cricket ball can result in instant death by causing ventricular fibrillation (a condition known as commotio cordis). Starting CPR and providing an electrical shock to the heart with an AED within one to two minutes of cardiac arrest can result in successful cardioversion rates exceeding 90%.

Beside a hard strike to the chest, sudden death can also result from a wide variety of previously unrecognised heart conditions in children. Of concern is a condition now known as a ‘channelopathy’, which can cause sudden collapse in an apparently healthy child. This condition can be caused by a genetic ion channel abnormality in the heart, such as a medical condition known as a ‘long QT syndrome’. Being hereditary, it may occur in several members of the same family. The American Academy of Pediatrics published an official statement on 26 March 2012,2 recommending that in order to predict and prevent the risk of sudden cardiac arrest, if the answer to any of the following questions is ‘yes’, children should undergo a cardiovascular risk assessment by a doctor knowledgeable in these conditions:

  • Has your child fainted or passed out during or after exercise, an emotional incident or as a result of being startled?
  • Has your child ever had extreme shortness of breath and/or discomfort, pain or pressure in the chest during exercise?
  • Has your child had extreme fatigue associated with exercise (different from other children)?
  • Has your child ever been diagnosed with an unexplained seizure disorder, or exercise-induced asthma not well controlled with medications?
  • Are there any family members who have had a sudden, unexpected, unexplained death before the age of 50 (including unexplained car crashes or drowning)?
  • Are there any family members who died suddenly of ‘heart problems’ before the age of 50?
  • Are there any family members who have had unexplained fainting or seizures?
  • Are there any family members who have been diagnosed with a serious heart condition?

What to do in an emergency

If a child suddenly collapses and is unresponsive and not breathing normally, immediately call for an ambulance and start chest compressions by pushing down on the centre of the chest to a depth of about 5 cm. Push hard and push fast (almost two compressions per second). After 30 compressions, give two rescue breaths by tilting the child’s head back, lifting the chin up, pinching the nose closed and covering the mouth with your mouth. Blow until you see the chest rise. Immediately resume compressions. Continue cycles of 30 compressions followed by two breaths until trained rescuers take over or normal breathing returns. Avoid interruptions. If you are unable or unwilling to give rescue breaths, continue with chest compressions until trained rescuers take over.

Not enough of us trained in CPR

The majority of schools in the USA have laws or standards requiring the inclusion of CPR training programmes in school curricula. The American Heart Association, for example, trains over 12 million people in CPR every year, and public places like Atlanta’s Hartsfield-Jackson Airport have over 200 AEDs, located on average no more than a minute away from anyone who may need it.

It is a sad fact that very few South African pupils or teachers know how to do CPR. Even fewer have any idea as to what an AED is, or how vitally important and life-saving this simple little machine can be. Anyone can use an AED, and it takes no more than one to two hours to learn the techniques of CPR and use of an AED. Details of CPR and AED training are available from the Resuscitation Council of Southern Africa’s website (www.resuscitationcouncil.co.za). In South Africa, although AEDs are located in airports, some airlines, gymnasiums and selected shopping malls, we are light years behind other countries when it comes to the knowledge and availability of this life-saving technology.

We must get serious about saving lives

If we are to be serious about saving lives in South Africa, the Resuscitation Council of Southern Africa appeals to all schools to train every teacher in CPR and first aid, and have at least one AED located somewhere on the school premises or sports field. Although prices vary considerably, if each child brought just R20 to school, this would probably cover the cost of purchasing a simple AED.

Instruction in CPR must be incorporated as a standard part of every school curriculum, and every teacher and each pupil should also know how to save a life. Appointing a few teachers to become CPR instructors, and teaching CPR as an essential life skill, would be a simple and cost-effective way of achieving this goal. You or your students’ life could be at stake. Every life is precious, and you will never forget the first time you save a life, or the first time you don’t.

References:

1. Available at: http://www.washington.edu/news/articles/suddencardiac- death-affects-about-1-in-44-000-ncaa-athletes-a-year.

2. Available at: http://www.aap.org/en-us/about-the-aap/aap-pressroom/ pages/Understanding-Pediatric-Sudden-Cardiac-Arrest.

Category: Spring 2012

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