Student Well-Being

Cardiac Arrests Can Happen to Student-Athletes, Too. How Schools Can Be Ready

By Elizabeth Heubeck — January 04, 2023 4 min read
Buffalo Bills players and staff pray for Buffalo Bills' Damar Hamlin during the first half of an NFL football game against the Cincinnati Bengals, Monday, Jan. 2, 2023, in Cincinnati. The game has been postponed after Buffalo Bills' Damar Hamlin collapsed, NFL Commissioner Roger Goodell announced.
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Jeremy Parr, an avid NFL fan and Baltimore-area school athletic trainer, was driving home from an out-of-town family trip on Monday, oblivious to the frightening scene unfolding at Cincinnati’s Paycor Stadium when Buffalo Bills football player Damar Hamlin suffered a cardiac arrest on the field following a hit to the chest.

“Prior to arriving home, my phone starting buzzing like crazy,” said Parr, a staff member at independent boys’ school Loyola Blakefield, who fielded phone calls from concerned colleagues and friends later that night. “It brought back a lot of memories.”

Parr is referring to the spring of 2021, when a Loyola freshman lacrosse player was hit in the chest with a ball during a game and collapsed, suffering from commotio cordis, a rare but often fatal injury that triggers a sudden change to the heart’s rhythm and primarily affects adolescent males. The student-athlete’s pulse stopped, requiring the immediate use of an automated external defibrillator, or AED, to help restore his heart’s normal rhythm. “It was the only mechanism that would have saved him,” Parr said of the student-athlete, who made a full recovery.

Guidelines from the American Medical Society for Sports Medicine advise using an AED within three to five minutes of someone experiencing cardiac arrest for the best chance of survival. Though it’s not a common occurrence, 2 in 50 U.S. high schools can expect a sudden cardiac arrest event each year, according to the American College of Cardiology, and an estimated 2,000 children each year will die from cardiac arrest. But a 2017 study reported that only 17 states have laws or regulations requiring AED installation in K-12 schools. Further, many schools that do house AEDs lack broader emergency action plans related to athletic injuries that include training of and access to the life-saving devices such as the model plan developed by The National Athletic Trainers’ Association.

For those that do have such emergency action plans, there isn’t a single driver behind them.

A sampling of plans by schools shows that parent-led advocacy groups, strong partnerships among relevant statewide associations, and individual schools committed to student wellness and safety can all play a part in their adoption.

Parent advocacy leads to legislative change

New York state residents Karen and John Acompora launched the Louis J. Acompora Memorial Foundation after their 14-year-old son Louis died from commotio cordis while playing lacrosse in his first-ever high school game. In his case, defibrillation efforts were applied, unsuccessfully, more than 10 minutes after he was injured. The foundation, which aims to improve sports safety and heighten schools’ awareness of the importance of possessing AEDs, led to the adoption in 2002 of a state law proclaimed by then-New York Gov. George Pataki as Louis’s Law, which mandates that all public schools in New York be equipped with AEDs in buildings and at sporting events.

In a similar effort, a New Jersey family started the Janet Zilinski Memorial Fund and lobbied for legislation after their daughter, 11-year-old Janet Zilinski, a cheerleader, collapsed of cardiac arrest during cheerleading practice at school, where there was no AED on site. The family’s efforts led in 2014 to the enactment of Janet’s Law, requiring K-12 schools in the state to establish an emergency action plan, including the presence of AEDs, in the event of a sudden cardiac arrest. The legislation has been credited with saving an estimated 20 lives in the state since its inception, according to the Janet Zilinski Memorial Fund’s website.

Efforts vary, from statewide campaigns to individual school initiatives

Oregon has for several years been at the forefront of school safety. Since 2016, the Oregon School Activities Association requires all schools to have an emergency action plan in place for responding to life-threatening emergencies in after-school practices and school-sponsored events.

Rob Younger, the executive director of the Oregon Athletic Coaches Association, credits his state’s proactive stance in obtaining AEDs with active and ongoing partnerships among professional statewide associations that include coaches, athletic directors, and athletic trainers. A few years ago, these associations together executed a yearlong campaign to heighten awareness around emergency action plans in the state’s school communities.

“We’re really fortunate in our state to have these great relationships [among professional associations],” Younger said. “We are unique. We’re kind of the exception.”

While statewide efforts like Oregon’s aim to have far-reaching effects, some schools act independently to protect their student-athlete populations. Such is the case at Loyola Blakefield, where the close proximity of an AED and trained faculty saved the life of the lacrosse player in 2021.

In recent years, Loyola has put increasing resources into safety and wellness initiatives. This past August, 100 percent of faculty and staff were certified in both CPR and AED use, said Robert Robinson, the school’s spokesman. In addition to having AEDs near athletic playing fields and gymnasiums, all school buildings now house them as well.

It’s a trend that’s gaining ground nationwide, say experts.

“More and more schools are getting AEDs. We’ve seen more cardiac saves because of it,” said Bob Colgate, the director of sports and sports medicine for the National Federation of State High School Associations. “I like to think that we have made very good progress, but it still can never be enough.”

A high-profile incident such as NFL player Hamlin’s injury may further push into the public consciousness the need for ready access to AEDs on athletic fields at every level.
“Now, there’s a level of awareness,” said Parr, Loyola’s athletic trainer. “If it happened in the NFL, it could happen at college or in high school.”

Emergency Action Plans: Strategies for Schools

  • Devise a plan that is comprehensive, practical, and adaptable to any emergency situation.
  • Provide written instructions for the plan that are visible and accessible to all relevant school personnel.
  • Make the plan thorough enough for a first responder to follow but not so detailed that it results in information overload, which may prevent its use.
  • Equip all athletic venues with their own emergency action plan, as access to each venue varies and so, too, will directions to reaching them.
  • Ensure that the plan includes ready access to AEDs at all times, and that school personnel know where they are.
  • Consider extending an invitation to local emergency medical service personnel to tour school campuses, which may identify potential access issues.

Sources: Oregon State Activities Association Board, National Federation of State High School Associations, National Athletic Trainers’ Association

A version of this article appeared in the January 18, 2023 edition of Education Week as Cardiac Arrests Can Happen to Student-Athletes, Too

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