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{{Commotio cordis}}
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==Overview==
There are different measures to prevent or reduce the risk of [[commotio cordis]]. One preventive measure is the use of safety baseballs which are softer than regular balls. Other preventive measures include the use of [[chest wall]] protectors. Chest wall protectors, such as those used in ice hockey, can help soften the impact of projectiles. However, recent studies indicated that there is no clear evidence of the effectiveness of chest protectors in reducing the risk of [[commotio cordis]]. Also, ensuring the availability of defibrillators at sporting events is essential in preventing deaths from commotio cordis. Education and awareness among coaches, trainers, and participants in high-risk sports events are also important preventive strategies.
the decision to return to sports after experiencing commotio cordis should be carefully evaluated on an individual basis, considering factors such as the underlying cause of the event, the severity of the injury, and the presence of any underlying cardiac conditions.


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==Primary Prevention==
==Primary Prevention==
[[Image:Sports-dress-codes.jpg|thumb|left|300px|Equipment and dress used in several sports. clearly demonstrating the lack of protection against chest concussion. From left to right, top to bottom: boxing, field hockey, baseball, karate, cricket, lacrosse and soccer.]] The mandatory use of heavily padded special vests in front of the thorax is generally sufficient to prevent high energy impacts to the precordium. The problem with many sports such as soccer, baseball and karate is that, despite the danger posed by a multitude of punches, kicks, pads, mallets, bats, pucks and balls moving at high speeds, etc., their dress codes represent an obstacle to the use of mechanical protection to the precordium for all players, or at least for goalkeepers, batters, ball catchers, etc.
The prevention of [[commotio cordis]] is crucial in reducing the incidence of this life-threatening condition.
* One preventive measure is the use of safety baseballs, which have been shown to reduce the risk of commotio cordis in experimental models. These safety baseballs are designed to be softer than regular balls, and they have been recommended by the Consumer Product Safety Commission as a means to decrease injuries in youth baseball. Experimental models have demonstrated a relationship between the hardness of the baseball and the likelihood of ventricular fibrillation, the primary mechanism of commotio cordis.
* Other preventive measures include the use of chest wall protectors. [[Chest wall]] protectors, such as those used in ice hockey, can help soften the impact of projectiles and reduce the induction of [[ventricular fibrillation]]. However, recent studies indicated that there is no clear evidence of the effectiveness of chest protectors in reducing the risk of commotio cordis.
* Immediate initiation of [[cardiopulmonary resuscitation]] ([[CPR]]) and [[defibrillation]] is important in improving outcomes. Therefore, ensuring the availability of [[defibrillator]]s at sporting events is essential in preventing deaths from commotio cordis.
* Education and awareness among coaches, trainers, and participants in high-risk sports events are also important preventive strategies<ref name="pmid28587536">{{cite journal |vauthors=Menezes RG, Fatima H, Hussain SA, Ahmed S, Singh PK, Kharoshah MA, Madadin M, Ram P, Pant S, Luis SA |title=Commotio cordis: A review |journal=Med Sci Law |volume=57 |issue=3 |pages=146–151 |date=July 2017 |pmid=28587536 |doi=10.1177/0025802417712883 |url=}}</ref><ref name="pmid37252546">{{cite journal |vauthors=Okorare O, Alugba G, Olusiji S, Evbayekha EO, Antia AU, Daniel E, Ubokudum D, Adabale OK, Ariaga A |title=Sudden Cardiac Death: An Update on Commotio Cordis |journal=Cureus |volume=15 |issue=4 |pages=e38087 |date=April 2023 |pmid=37252546 |pmc=10209547 |doi=10.7759/cureus.38087 |url=}}</ref><ref name="pmid37435128">{{cite journal |vauthors=Matusak ME, Yau CC, Fibel KH |title=Medical Sports Injuries in American Football Players |journal=HSS J |volume=19 |issue=3 |pages=277–284 |date=August 2023 |pmid=37435128 |pmc=10331267 |doi=10.1177/15563316221144284 |url=}}</ref>.
 
== Resume of activities ==
The decision to return to sports after experiencing commotio cordis should be made on an individual basis, taking into account factors such as:
* The underlying cause of the event
* The severity of the injury
* the presence of any underlying [[cardiac]] conditions
It is recommended that athletes who have experienced commotio cordis undergo a comprehensive evaluation by a healthcare professional with expertise in sports [[cardiology]]. This evaluation may include a thorough medical history, physical examination, [[electrocardiogram]] ([[ECG]]), [[echocardiogram]], and [[exercise stress testing]].


For example, boxing traditionally requires a naked chest, cricket gear protects the legs but not the chest, and soccer has practically no protection gear at all; although the ball weights 450 grams, may reach speeds of 30 meters per second, and barrier defenses actually encourage the reception of the ball against the chest.
In some cases, it may be necessary to restrict or modify sports participation to reduce the risk of recurrent commotio cordis. This may involve avoiding high-velocity moving projectiles or contact sports that pose a higher risk of chest trauma. The decision to return to sports should be made in collaboration with the athlete, their family, and their healthcare team, taking into consideration the individual's goals, preferences, and overall health status<ref name="pmid37252546">{{cite journal |vauthors=Okorare O, Alugba G, Olusiji S, Evbayekha EO, Antia AU, Daniel E, Ubokudum D, Adabale OK, Ariaga A |title=Sudden Cardiac Death: An Update on Commotio Cordis |journal=Cureus |volume=15 |issue=4 |pages=e38087 |date=April 2023 |pmid=37252546 |pmc=10209547 |doi=10.7759/cureus.38087 |url=}}</ref>.


Parents of children active in these sports are advised to adopt simple protective measures, particularly in informal "backyard" games, which are often much more dangerous than formal ones, which require some protection.
== References ==
==References==
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{{reflist|2}}
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Latest revision as of 07:55, 29 August 2023

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Maryam Hadipour, M.D.[2]

Overview

There are different measures to prevent or reduce the risk of commotio cordis. One preventive measure is the use of safety baseballs which are softer than regular balls. Other preventive measures include the use of chest wall protectors. Chest wall protectors, such as those used in ice hockey, can help soften the impact of projectiles. However, recent studies indicated that there is no clear evidence of the effectiveness of chest protectors in reducing the risk of commotio cordis. Also, ensuring the availability of defibrillators at sporting events is essential in preventing deaths from commotio cordis. Education and awareness among coaches, trainers, and participants in high-risk sports events are also important preventive strategies. the decision to return to sports after experiencing commotio cordis should be carefully evaluated on an individual basis, considering factors such as the underlying cause of the event, the severity of the injury, and the presence of any underlying cardiac conditions.

Primary Prevention

The prevention of commotio cordis is crucial in reducing the incidence of this life-threatening condition.

  • One preventive measure is the use of safety baseballs, which have been shown to reduce the risk of commotio cordis in experimental models. These safety baseballs are designed to be softer than regular balls, and they have been recommended by the Consumer Product Safety Commission as a means to decrease injuries in youth baseball. Experimental models have demonstrated a relationship between the hardness of the baseball and the likelihood of ventricular fibrillation, the primary mechanism of commotio cordis.
  • Other preventive measures include the use of chest wall protectors. Chest wall protectors, such as those used in ice hockey, can help soften the impact of projectiles and reduce the induction of ventricular fibrillation. However, recent studies indicated that there is no clear evidence of the effectiveness of chest protectors in reducing the risk of commotio cordis.
  • Immediate initiation of cardiopulmonary resuscitation (CPR) and defibrillation is important in improving outcomes. Therefore, ensuring the availability of defibrillators at sporting events is essential in preventing deaths from commotio cordis.
  • Education and awareness among coaches, trainers, and participants in high-risk sports events are also important preventive strategies[1][2][3].

Resume of activities

The decision to return to sports after experiencing commotio cordis should be made on an individual basis, taking into account factors such as:

  • The underlying cause of the event
  • The severity of the injury
  • the presence of any underlying cardiac conditions

It is recommended that athletes who have experienced commotio cordis undergo a comprehensive evaluation by a healthcare professional with expertise in sports cardiology. This evaluation may include a thorough medical history, physical examination, electrocardiogram (ECG), echocardiogram, and exercise stress testing.

In some cases, it may be necessary to restrict or modify sports participation to reduce the risk of recurrent commotio cordis. This may involve avoiding high-velocity moving projectiles or contact sports that pose a higher risk of chest trauma. The decision to return to sports should be made in collaboration with the athlete, their family, and their healthcare team, taking into consideration the individual's goals, preferences, and overall health status[2].

References

  1. Menezes RG, Fatima H, Hussain SA, Ahmed S, Singh PK, Kharoshah MA, Madadin M, Ram P, Pant S, Luis SA (July 2017). "Commotio cordis: A review". Med Sci Law. 57 (3): 146–151. doi:10.1177/0025802417712883. PMID 28587536.
  2. 2.0 2.1 Okorare O, Alugba G, Olusiji S, Evbayekha EO, Antia AU, Daniel E, Ubokudum D, Adabale OK, Ariaga A (April 2023). "Sudden Cardiac Death: An Update on Commotio Cordis". Cureus. 15 (4): e38087. doi:10.7759/cureus.38087. PMC 10209547 Check |pmc= value (help). PMID 37252546 Check |pmid= value (help).
  3. Matusak ME, Yau CC, Fibel KH (August 2023). "Medical Sports Injuries in American Football Players". HSS J. 19 (3): 277–284. doi:10.1177/15563316221144284. PMC 10331267 Check |pmc= value (help). PMID 37435128 Check |pmid= value (help).

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