Once it was apparent that 8-year-old Ian
McGreevy was doing "great" after being struck in the chest by a ball
during a youth baseball game last weekend, many North Jersey parents
focused on safety.
KEVIN R. WEXLER/STAFF PHOTOGRAPHER
McDavid USA makes a shirt with built-in chest padding that sells for $39.99.
Ian's mother, Lisa McGreevy of Northvale, said Sunday that she will lobby for children to wear chest protectors on the field, similar to those worn by lacrosse players.
While chest protectors could help with traumatic
injuries like broken bones and serious bruising, there is no evidence
that they protect against cardiac events caused by the trauma of being
hit in the chest.
"If there is any evidence on that topic at all, it is
actually to the contrary," said Mike Oliver, executive director of
National Operating Committee on Standards for Athletic Equipment
(NOCSAE), an independent and non-profit standard-setting organization
trying to improve athletic safety through scientific research and the
creation of performance standards for protective equipment. "It's a real
difficult issue."
The evidence goes against common sense.
"Logically if there's a chest protector that would
prevent the transmission of the energy of that blunt trauma to be
transmitted to the chest and then to the heart then, theoretically, it
might prevent it," said Fuad Kiblawi, pediatric cardiologist at St.
Joseph's Children's Hospital in Paterson.
However, none of the chest protectors on the market,
according to Kiblawi, have been proven to decrease the chance of
ventricular fibrillation, a problem with the heart's rhythm that will
cause victims to collapse within seconds and stop breathing.
Kiblawi added it might be worth taking a chance that a
chest protector could slow down the impact to a speed that wouldn't
cause the medical chain reaction.
"Chest protectors, they haven't been proven to help,
but there's no reason to assume it's impossible that they would have any
sort of benefit," he said.
What happened Saturday to Ian McGreevy and the conversation about safety equipment that has followed isn't new.
In 2010, 16-year-old Garfield
resident Thomas Adams was hit in the chest with a baseball during a
practice. He was wearing a catcher's chest protector at the time and
died.
In 2006, Wayne's
Steven Domalewski, was 12 when he was hit in the chest by a line drive.
He was left brain-damaged after his brain was denied oxygen.
Thomas' death and Steven's disability were both
attributed to commotio cordis, ventricular fibrillation caused by blunt
trauma to the chest.
Commotio cordis is the second highest cause of death in
athletes younger than 14, according to the American Academy of
Pediatrics (AAP). Children ages 5 to 14 may be uniquely vulnerable to
this blunt chest impact, the AAP said, because their chest walls are
more elastic and more easily compressed.
It is unknown if commotio cordis caused Ian to stop
breathing, but descriptions of the event make it a possibility,
according to Kiblawi.
A policy statement from the AAP's Council on Sports
Medicine and Fitness in 2012 said, "Although protective gear can be a
key preventive measure, it is not always effective. Research has shown
that even with protective gear, the fatality rate for commotio cordis is
alarmingly high at 90 percent."
Beyond typical chest protectors worn by baseball and
softball catchers, as well as lacrosse and hockey players, there are
commercially available items like shirts with chest pads or plastic
"heart guards."
Charlie Coleman, who owns Farrier Sporting Goods in Wyckoff, regularly sells a protective shirt that has a pad in the chest area.
Coleman can date the uptick in sales to the Domalewski
tragedy. After that incident, there was a call by some to take aluminum
bats out of the youth games. Now, there is a discussion about chest
protectors. There is no single, simple answer, however.
"Anything that would alter these variables might help,"
said Kiblawi. "The softness of the ball and compactness of the ball,
they're directly related to the incidence of commotio cordis. So softer,
more like safety balls for kids may help. Still, there's no studies
showing that."
One issue with certain types of protective shirts,
according to Oliver, is that the padding is typically in the center of
the chest and not the "cardiac silhouette" where impact causes commotio
cordis.
Preparation is as important as possible prevention,
according to Gregg Heinzmann, director of the Youth Sports Council at
Rutgers University.
"We should do all we can to minimize the risk of injury
in young athletes," Heinzmann said. "And we should include this injury
among the considerations. The appropriate strategy on the part of the
leagues and the recreation departments that administer youth sports is
to train the coaches and re-evaluate their emergency action plans so
that in the event of a serious injury, emergency medical personnel can
arrive on the scene as quickly as possible."
The Youth Sports Council recommendation is that there
is one person at every game and practice with the skill and training to
effectively administer CPR and use an automated external defibrillator.
Death is preventable, the AAP policy notes, by
immediate response of CPR and the use of an automated external
defibrillator. It was the quick-thinking CPR of Maureen Renaghan that
Lisa McGreevy credits with saving her son Ian's life.
Email: yoriok@northjersey.com
