This year, like every year, more than 7,700 people age 35
and under will die suddenly of cardiac causes in the US and Canada. Roughly
half of them will experience fainting episodes or exhibit other warning signs
in the months, weeks and days prior to their death. If these sentinel events
are recognized and acted upon a great number of at risk young people will not
die. Several of the diseases that underlie paediatric Sudden Cardiac Arrest are
genetic, with a dominant gene transmission pattern, and therefore many
asymptomatic first degree relatives might also be saved.
All properly taught certification level CPR training
includes a discussion on Heart Attack and Stroke warning sign recognition and
management. It is time to include a discussion on recognizing and responding to
the warning signs of paediatric heart arrhythmia diseases in every CPR class
with extra attention being given to the discussion for classes being taught to
educators, coaches and any adults that are responsible for the well-being of
children.
The basic warning signs of inherited heart rhythm disorders
are as follows:
·
Fainting (syncope) or seizure during or shortly
after physical activity, especially if it happens repeatedly
·
Fainting (syncope) or seizure resulting from
emotional excitement, emotional distress, or auditory startle
·
Family history of unexpected sudden death during
physical activity or during a seizure, or any other unexplained sudden death of
an otherwise healthy young person
Other warning signs include; brown outs (near fainting); a
strong sensation of palpitation or racing heart; extreme shortness of breath
(new) with exertion - more so than other children.
The recommended response to all loss of consciousness
fainting is to Call 911, even if the child quickly regains consciousness and
“seems fine”. For both fainting and all other warning signs parents should be
advised of the event, provided with information (a pamphlet or a link to a web
page) on heart rhythm disorders and encouraged to consult a physician that is trained to recognize paediatric arrhythmia.
Every CPR Training Agency, both not-for-profit and private,
should be required by state or provincial law to include a discussion of the
warning signs of Paediatric Inherited Heart Rhythm Disorders in every class. Special attention should be given to the topic
when the audience is educators, coaches or any other group that works directly
with young people. Already eight states have passed or are considering legislation
that will make awareness training of paediatric heart rhythm disorders
mandatory for coaches, sport officials and physical education teachers. We need
every state and province to mandate this training as a required component of
every CPR class.
The evidence to support the inclusion of Arrhythmia
Awareness in every CPR class is abundant und unequivocal. The International Liaison
Committee on Resuscitation (ILCOR) was asked to consider a recommendation to
include Arrhythmia Awareness in all Basic Life Support training classes as part
of the 2010 BLS Guideline Recommendations. They chose a softer position regarding
the follow-up by coroners of all potentially cardiac related deaths of young people.
Even if ILCOR chooses to ignore the evidence state and provincial legislators
can still choose to act in the best interest of at-risk young people.
