herald

Monday 16 December 2019

Mum saves life of son (13) hit in the chest by sliotar during match

The young hurler’s heart stopped beating after the blow
The young hurler’s heart stopped beating after the blow

A woman who was watching her 13-year old son play in a hurling match helped save his life after a sliotar blow to his chest stopped his heart.

The woman, who is a nurse, ran on to the pitch and started performing CPR after seeing him collapse and determining there was no pulse.

The boy had the cardiac arrest after receiving the sliotar blow to the left of his chest.

Defibrillator

His heart stopped beating for less than four minutes. Along with the CPR, a defibrillator was used and one shock delivered the return of spontaneous circulation.

In a paper in the June edition of the Irish Medical Journal (IMJ), medics said that "prompt resuscitation and automated external defibrillation (AED) enabled a full recovery".

Experts at Galway University Hospital and Our Lady's Children's Hospital, Crumlin said the incident was 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 quoted in the IMJ paper said that while there is a commotio cordis registry in the US, one does not exist in Europe and CC is likely to be under-reported here.

They added: "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) on admission to hospital.

There, he 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 said primary prevention of CC centres on the use of protective chest wall shields or of soft balls.

However, they stated 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.

They added that CC is a rare event, and that efforts should instead focus on the response to cardiac arrest.

CPR training and rapid access to AEDs are life-saving measures.

Prompt resuscitation and access to AEDs are associated with increased survival rates in CC, which are now as high as 58pc.

Expenditure

The medics said: "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."

There is no mandated upkeep of voluntary AEDs nor an AED registry in Ireland.

"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," the medics added.

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