Despite at least 8 on ice deaths in 9 years Hockey Canada’s Head of Safety, Todd Jackson told CBC that "We are at a point where we are delivering something we are very comfortable with" when asked if his organization was doing enough to prepare for and respond to cardiac arrest.
In Ontario,
OPHEA, the organization charged with setting guidelines for safe and healthy
schools has given Arrhythmia Diseases a place of prominence in their Sample Information Letter to
Parents/Guardians and Medical Information Form and
provides a brief overview of Heart Arrhythmia Diseases as Appendix “M” in their guidelines. Unfortunately
Boards, Principals and Teachers are not mandated to follow these guidelines. In my significant personal experience I have
found Educators in Ontario to be largely unaware of all aspects of arrhythmia
disease including common warning signs.
Legislatively no
Canadian province has passed a bill targeted at preventing Sudden Cardiac Arrest
in Youth, the #1 killer of young people at schools and at community sports
venues. (At the time of writing a Private Members Bill is being drafted in Ontario.
Thank you Christine Elliot and Dr. Kirsh) In the United States there are at least six states
with legislation passed and six or more with legislation pending.
In this century
alone at least 10,500 young Canadians have died suddenly of cardiac causes. For the entirety of this century organizations
such as The Canadian SADS Foundation (Sudden Arrhythmia Death Syndromes) have
been promoting the warning signs of Heart Arrhythmia. Paediatric Electrophysiologists (physicians that specialize in treating
electrical diseases of the heart) have provided the scientific rationale for
the warning signs and endorsed the widespread dissemination of them. Sadly awareness and prevention initiatives have
gained zero traction in this country. If
the road to an effective national prevention strategy for sudden cardiac arrest
in youth is 100 miles long Canadians have taken no more than one or two steps
since the 1990’s. The investments (mostly non-monetary) required to reduce the
700 young person deaths each year have simply not been made, rarely even discussed.
In contrast, I
sat at my desk, on a cold and drizzly October afternoon in 2009, and watched
parents drag their children a kilometer or more down a busy roadway to line up
outside in the rain for up to two hours to receive a vaccine for a strain of
flu (H1N1) that despite its advanced billing ended up being relatively benign. Health Canada estimates of the potential for
between 2,000 and 8,000 flu related deaths in Canada that year vastly overestimated
the reality of the 428 H1N1 deaths, mostly older adults with co-morbidities, reported
in Health Canada’s final report on the pandemic.
The point I want to make is that with
little to no evidence to back their play healthcare officials used their legal
and moral authority to mobilize resources, spend significant public monies often
by accessing emergency funds, require healthcare workers to put in overtime,
mandate lower levels of government to respond immediately to demands for human
resources and facility space. In all it
was an impressive, expensive, coordinated, lightning quick response, that while
probably unnecessary, demonstrated what the various levels of Government in
Canada are capable of when they set their collective minds to a task. The 62 page final report from Ontario’s Chief
Medical Officer of Health is at least 60 more pages than any government official
working in healthcare has ever written on prevention strategies for the heart
arrhythmia diseases that claim the lives of 700 otherwise healthy young people
each and every year.
On October 27,
2014 I will be attending the first ever National Strategy for the Prevention of Sudden Death in the Young meeting at the Canadian Cardiovascular Congress
in Vancouver. (Thank you Dr. Sanitani and Dr. Krahn) A small group of EP’s and
other stakeholders will hopefully begin to delineate some critical pathways and
kick start some meaningful prevention activities across the country. This
meeting coupled with the proposed Private Members Bill in Ontario is as much
positive activity as we have ever seen. In my next blog I will report on the
discussions at the Vancouver meeting as
well as work we are doing with Ontario School Boards and Hamilton area Family
Health teams. By October 2015 perhaps we
can be a mile or more into the 100 mile journey.
