re: commotio cordis

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Would he have a pulse but have no spontaneous respiration?

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Yes if they defibrillated him in time and/or gave approximate meds then he can certainly regain a pulse. He may not immediately breath on his own depending on how long he was without oxygen, but also if the intubated his respirations would be supported and he would likely be sedated if any signs of consciousness reappeared.

I sent the wiki page to my wife. This seems to make sense with what happened. Just terrible.

Witnessed it in practice in 1979 as a player in High School.

My teammate passed away that day. We didn’t know he was gone until after practice. Yes, you read that right.

After the ambulance drove away, we continued to practice. Nobody really realized how serious it was

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If he has a heartbeat but is not breathing on his own, does that mean the damage is in his brain? That seems obvious, but I genuinely don’t know.

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Not necessarily. It is extremely common with cardiac arrest to start intubation and introduce hypothermia using chilled fluids and/or cooling blankets. This has been shown to improve outcomes.

Just saying he isn't breathing on his own doesn't mean much since intubation is pretty much standard op.

I think you are correct. Hopefully we can build better shoulder pads in the future to prevent this

So obviously not every hit to the chest causes this condition. I have read that it has to happen at just the right moment in the cycle of the heartbeat. Are there other factors that might make it more likely to occur, such as an enlarged heart, clogged arteries, etc?

ETA: thanks for sharing some of your knowledge/expertise. With a son playing MS and soon to be HS football, it is a bit scary to have one more thing to worry about .

How far do footballs shoulder pads extend downwards? Is the whole heart region covered? It’s been so long since I’ve worn shoulder pads that I can’t remember

Reportedly, over 40 athletes dropped dead during sports in the last two years but not from contact. Those cases weren't comodo cordis but they were due to arrhythmias. Usually less than 6 athletes die during sports in a two year period.