Amateur Hockey Player Killed After Puck Strikes Chest
Richard
Saturday, October 27, 2007
SHELTON, CT (AP) - An amateur hockey player died after a puck struck
him in the chest and caused him to go into cardiac arrest late
Thursday, officials said.
Nathan Crowell, 22, a University of New Haven student, was pronounced
dead at Bridgeport Hospital shortly after the incident during a league
game at a Shelton hockey rink, police and team officials said.
His death remained under investigation Friday, but police said no foul
play is suspected.
Crowell, who is from Portsmouth, R.I., tried to block an opposing
player's slapshot with 3 seconds left in the game when the puck struck
him and he collapsed, said Howard Saffan, a co-owner of the
SportsCenter of Connecticut facility.
Crowell was wearing the required chest protector and other gear, but
the puck apparently struck an unprotected part of his torso just below
the pad, Saffan said.
A doctor playing in the game immediately began treating Crowell and
gave him CPR until an ambulance arrived to take him to Bridgeport
Hospital, but he could not be revived.
The rink's staff and fellow hockey players are "devastated," said
Saffan, who also is president of the Bridgeport Sound Tigers team of
the American Hockey League.
"You build a rink for the community and to make a positive impact in
the community, and to have something like this happen is devastating,"
he said. "It has sent shock waves throughout the facility."
The referee and the player who made the shot are both devastated,
Saffan said.
"He is tormented by what happened," Saffan said.
Similar fatal injuries have occurred in other sports, such as youth
baseball, when an unprotected player is struck in the chest by a ball
and the blow stops the player's heart.
In 1998, St. Louis Blues defenseman Chris Pronger suffered an acute
heart attack after being hit the chest during a National Hockey League
Stanley Cup playoff game. He recovered, but was sidelined for a few
games.
DGH
The condition is called "commotio cordis".
A Pubmed search will give many references.
Drezner JA, Rogers KJ., Sudden cardiac arrest in intercollegiate
athletes: detailed analysis and outcomes of resuscitation in nine
cases., Heart Rhythm. 2006 Jul;3(7):755-9. Epub 2006 Mar 28. PMID:
16818200
BACKGROUND: Public access defibrillation programs have demonstrated a
survival benefit in persons with out-of-hospital cardiac arrest.
However, little is known about the effectiveness of early
defibrillation in young competitive athletes with sudden cardiac
arrest (SCA). OBJECTIVES: The purpose of this study was to investigate
the details and outcomes of resuscitation in a cohort of
intercollegiate athletes with SCA. METHODS: Nine cases of SCA in
intercollegiate athletes occurring between 1999 and 2005 were
identified through prior research and public media. A detailed
questionnaire was completed by the certified athletic trainer involved
in the resuscitation, and direct phone follow-up was achieved in every
case. RESULTS: Nine intercollegiate athletes with SCA (4 basketball, 2
football, 2 lacrosse, and 1 swimming) had an average age of 21 years
(range 18-30 years). All 9 athletes had a witnessed collapse, 7
occurred during practice, 1 during competition, and 1 during organized
weight training. Cardiopulmonary resuscitation (CPR) was initiated
within 30 seconds after cardiac arrest in 6 cases and by 1 minute in 2
additional cases. An automated external defibrillator (AED) was
provided by an athletic trainer in 5 cases and by arriving emergency
medical services (EMS) in 4 cases. The initial cardiac rhythm was
confirmed or suspected ventricular fibrillation in 7 athletes,
pulseless idioventricular rhythm in 1 case, and unknown in 1 case. In
7 cases a shock was deployed, with an average time from cardiac arrest
to defibrillation of 3.1 minutes (range 1-7.5 minutes). The average
time from arrest to defibrillation decreased significantly if an AED
was provided by an athletic trainer as compared with the responding
EMS (1.6 vs 5.2 minutes; P = .046). Eight of the 9 athletes died. The
underlying cause of sudden cardiac death was hypertrophic
cardiomyopathy in 5, commotio cordis in 2, and myocardial infarction
in 1. Diagnostic studies in the survivor demonstrated no structural
heart disease or precise cause of SCA. CONCLUSION: Despite witnessed
collapse, immediate CPR, and prompt AED use in most cases, early
defibrillation showed limited success, and survival was less than
expected in this small cohort of intercollegiate athletes. More
research is needed to determine the effectiveness of early
defibrillation and factors that affect survival in young athletes with
SCA.
and
Maron BJ, Gohman TE, Kyle SB, Estes NA 3rd, Link MS. Clinical profile
and spectrum of commotio cordis. JAMA. 2002 Mar 6;287(9):1142-6. PMID:
11879111
CONTEXT: Although blunt, nonpenetrating chest blows causing sudden
cardiac death (commotio cordis) are often associated with competitive
sports, dangers implicit in such blows can extend into many other life
activities. OBJECTIVE: To describe the comprehensive spectrum of
commotio cordis events. DESIGN AND SETTING: Analysis of confirmed
cases from the general community assembled in the US Commotio Cordis
Registry occurring up to September 1, 2001. MAIN OUTCOME MEASURE:
Commotio cordis event. RESULTS: Of 128 confirmed cases, 122 (95%) were
in males and the mean (SD) age was 13.6 (8.2) years (median, 14 years;
range, 3 months to 45 years); only 28 (22%) cases were aged 18 years
or older. Commotio cordis events occurred most commonly during
organized sporting events (79 [62%]), such as baseball, but 49 (38%)
occurred as part of daily routine and recreational activities. Fatal
blows were inflicted with a wide range of velocities but often
occurred inadvertently and under circumstances not usually associated
with risk for sudden death in informal settings near the home or
playground. Twenty-two (28%) participants were wearing commercially
available chest barriers, including 7 in whom the projectile made
direct contact with protective padding (baseball catchers and lacrosse/
hockey goalies), and 2 in whom the projectile was a baseball
specifically designed to reduce risk. Only 21 (16%) individuals
survived their event, with particularly prompt cardiopulmonary
resuscitation/defibrillation (most commonly reversing ventricular
fibrillation) the only identifiable factor associated with a favorable
outcome. CONCLUSIONS: The expanded spectrum of commotio cordis
illustrates the potential dangers implicit in striking the chest,
regardless of the intent or force of the blow. These findings also
suggest that the safety of young athletes will be enhanced by
developing more effective preventive strategies (such as chest wall
barriers) to achieve protection from ventricular fibrillation
following precordial blows.