Members of the National Athletic Trainers’ Association are taking action to ensure that schools nationwide will be prepared to act if a student-athlete experiences sudden cardiac arrest.

At its annual meeting last month, the organization released a list of recommendations for institutions interested in creating an emergency-preparedness plan for sudden cardiac arrest.

Last year, the NCAA and NATA held a joint summit on commotio cordis, one of the two major causes of sudden cardiac arrest in student-athletes. Commotio cordis occurs when a blunt, non-penetrating chest blow leads to sudden cardiac arrest.

Ron Courson, head athletic trainer at the University of Georgia, said the other common cause of sudden cardiac arrest in young people is a structural flaw in the heart called hypertrophic cardiomyopathy, a condition that causes the heart wall to enlarge and decreases efficient function of the heart muscle. Doctors know of no cause for the condition.

"With athletes and sudden cardiac arrest, they have no symptoms at all. In fact, usually their first symptom is death," said Courson, past president of the NATA who has experience dealing with cardiac arrest issues.

Foremost among the NATA recommendations is creating and rehearsing an emergency-preparedness plan. While many institutions do have and practice such a plan, Courson said surveys indicate that some schools don’t have them or don’t rehearse them.

A template for creating such a plan is available along with the NATA position statement on emergency preparedness at www.nata.org/publicinformation/files/emergencyplanning.pdf.

Elements of the plan include developing a relationship with local emergency medical responders, training potential first-responders such as coaches and athletic trainers in CPR and first aid, and plans of action in the event of an emergency. Courson said something as simple as providing a detailed campus map to emergency medical technicians or knowing how to give detailed directions to a location on campus should be a part of the plan because it’s often difficult to direct EMTs to a practice field or to an exact location within a football or basketball stadium.

"I can’t recommend enough being prepared ahead of time," he said. "Institutional ownership — everyone should be invested in the emergency plan. Medical staff might not always be available. Everybody needs to be trained in simple things like how to recognize an emergency and basic first aid training."

Courson also suggested athletics departments screen their athletes for possible heart problems and keep automated external defibrillators (AEDs) in easily accessible locations.

Courson stressed the importance of a pre-participation physical exam for all student-athletes, including gathering a heart history of the patient and the patient’s family.

"Generally once of the most sensitive predictors is if they had anybody in their family die of cardiac problems under the age of 40," Courson said. From there, student-athletes deemed at risk can undergo further screening with electrocardiograms or echocardiograms, either of which will indicate whether some structural abnormality such as hypertrophic cardiomyopathy exists. While Courson acknowledged such screenings involve costs, some institutions take advantage of programs that bring cardiologists and equipment to campus for a single day of testing student-athletes at a rate less than paying for single tests for each student-athlete.

Purchasing AEDs might be cost-prohibitive for some schools, but Courson indicated that because of the connection between sudden cardiac arrest and cocaine use, law-enforcement grants could be used to provide AEDs in campus police squad cars. Rapid response is necessary in sudden cardiac arrest situations, he said, because for every minute defibrillation is delayed, the chances of survival decrease by 10 percent. With a national average EMS response time of eight to 12 minutes, relying on the ambulance to arrive in time isn’t advised.

"EMS cannot reach them in time to help them survive. If we have staff members there in a short amount of time, it only makes sense to get the equipment in their hands to save a life," he said.

Courson pointed to the case of Davis Nwankwo, a basketball student-athlete at Vanderbilt University who collapsed during practice and was revived with an AED by athletic trainer Michael Meyer. Nwankwo was later found to have hypertrophic cardiomyopathy, but he survived the episode.

Courson said the equipment could also be used to save administrators, coaches and officials who often are at higher risk for cardiac arrest than student-athletes. An athletic trainer with an AED helped save the life of Gerry Bram, a football referee, at a game at Syracuse University in September 2001.

"I’ve been there. We’ve had somebody arrest and had to shock them," Courson said. "You can’t put a price on a life."