Sudden cardiac arrest in student athletes: What are schools’ responsibilities?

There is renewed attention on how quickly the health of athletes can change following the on-field collapse of NFL player Damar Hamlin on Jan. 2, when the Buffalo Bills safety suffered cardiac arrest during a game.

In Hamlin’s case, those on the scene quickly sprung to action, administering CPR, oxygen and using an automated external defibrillator (AED) before the 24-year-old was taken by ambulance to a hospital, according to USA TODAY. By Jan. 6, Hamlin was on the road to recovery, according to ESPN, and had begun to talk again after having his breathing tube removed. Doctors reported that his neurological function was intact. He was discharged from the hospital on Jan. 11 and set to return home and continue rehab, according to Yahoo Sports.

The incident has left many families wondering what protocols are in place to prevent student athletes from experiencing similar situations and what plans are in place to potentially save their child’s life should they go into cardiac arrest.

During the 2021–22 academic year, 763,606 student athletes across California competed in education-based athletic programs, according to the California Interscholastic Federation.

Under Education Code §35179.6, as of July 2019, “if a school district or charter school elects to offer any interscholastic athletic program, the school district or the charter school shall acquire at least one AED for each school that participates in the program within the jurisdiction of the school district or the charter school. The school district or the charter school is encouraged to ensure that the AED or AEDs are available for the purpose of rendering emergency care or treatment within a recommended three to five minutes of sudden cardiac arrest to pupils, spectators, and any other individuals in attendance at the athletic program’s on-campus activities or events and shall ensure that the AED or AEDs are available to athletic trainers and coaches and authorized persons at these activities or events.”

The AED must also be maintained and tested regularly.

Any expected users (such as coaches) have to undergo CPR and AED training as well as training on sudden cardiac arrest (SCA).

In 2016, the Eric Paredes Sudden Cardiac Arrest Prevention Act was passed in California. In accordance with the act, “information on sudden cardiac arrest symptoms and warning signs will be posted to the internet and a pupil’s parent or guardian will be required to review, sign, and return an acknowledgement of receiving such information before the pupil participates in an athletic activity as specified in California Education Code (EC) 33479. Most importantly, pupils who pass out or faint during or following participation in an athletic activity must be removed from participation until evaluated and cleared in writing by a physician and surgeon, or a nurse practitioner or physician assistant practicing in accordance with standardized procedures or protocols developed by the supervising physician and surgeon and the nurse practitioner or physician assistant.”

Sudden cardiac arrest

Coalinga-Huron Unified School District has information and resources regarding SCA conveniently located on its website for families to access.

One student athlete experiences a SCA every three days in the U.S. and as many as one in 300 kids are at risk of a SCA, according to video “A Parent’s Guide to Sudden Cardiac Arrest” featured on the Coalinga-Huron USD webpage.

SCA is not a heart attack, but an “abnormality in the heart’s electrical system that abruptly stops the heartbeat. It’s caused by an undetected congenital or genetic heart condition,” according to the district website.

SCA can happen unexpectedly and without warning, but potential symptoms to look out for include unexplained fainting, shortness of breath, extreme fatigue, becoming dizzy or lightheaded or experiencing chest pain or heart palpitations as well as a family history of SCA or an unexplained, sudden death under age 50. For some, the first and only symptom is death.

“If not properly treated within minutes, SCA is fatal in 92 percent of cases,” according to the district website.

As athletes often experience symptoms such as fatigue or shortness of breath, it can be difficult to determine whether a situation requires medical attention. However, SCAs are preventable if underlying causes are diagnosed and treated by medical professionals.

The California Department of Education has resources including a free SCA prevention training, fliers and fact sheets, FAQs and more available for local educational agencies.

To view related policies, subscribers of CSBA’s GAMUT Policy and Policy Plus can access sample Board Policy/Administrative Regulation 5141 – Health Care and Emergencies and Administrative Regulation 6145.2 – Athletic Competition.