Improving Youth Sports Safety: Implementing an Emergency Action Plan for Sudden Cardiac Arrest

Sudden cardiac arrest in athletes and strategies to optimize preparedness

Sudden cardiac arrest (SCA) is the leading cause of death in young athletes. Despite efforts to improve preparedness for cardiac emergencies, the incidence of out-of-hospital cardiac arrests in athletes remains high, and bystander awareness and readiness for SCA support are inadequate. Initiatives such as designing an emergency action plan (EAP) and mandating training in cardiopulmonary resuscitation (CPR) and automated external defibrillator use (AED) for team members and personnel can contribute to improved survival rates in SCA cases. This review provides an overview of SCA in athletes, focusing on identifying populations at the highest risk and evaluating the effectiveness of different screening practices in detecting conditions that may lead to SCA. We summarize current practices and recommendations for improving the response to SCA events, and we highlight the need for ongoing efforts to optimize preparedness through the implementation of EAPs and the training of individuals in CPR and AED use. Additionally, we propose a call to action to increase awareness and training in EAP development, CPR, and AED use for team members and personnel. To improve outcomes of SCA cases in athletes, it is crucial to enhance bystander awareness and preparedness for cardiac emergencies. Implementing EAPs and providing training in CPR and AED use for team members and personnel are essential steps toward improving survival rates in SCA cases.

Promoting an Emergency Action Plan for Sudden Cardiac Arrest in Youth Sports During a Pandemic

INTRODUCTION

Pandemic-related restrictions increased the risk of delayed emergency response of bystanders to sudden cardiac arrest among youth athletes. Education and SCA emergency preparedness, implemented by nurse leaders and adapted to environmental changes, can greatly reduce the risks associated with an SCA episode.

METHOD

A nurse-led, quality improvement pilot project was implemented in a recreational youth soccer league. The project included the implementation of an emergency action plan (EAP; with or without the pandemic and social-distancing restrictions) for bystanders responding to SCA.

RESULTS

Participants showed significant improvement in knowledge and perceptions of SCA and emergency response (p < .001). Willingness to initiate cardiopulmonary resuscitation (CPR) improved (p = .127), and fear to engage in EAP decreased (p = .119) following an educational intervention on SCA.

DISCUSSION

Nurse-led SCA education and implementation of youth league EAP successfully demonstrated safety in SCA preparedness and best practice recommendations for youth sports from the Interassociation Task Force.

Fisetin, a major component derived from mulberry (Morus australis Poir.) leaves, prevents vascular abnormal contraction

Mulberry (Morus australis Poir.) leaves have long been consumed in the form of tea or tincture especially in Asia, owing to their high antioxidant and blood pressure-regulating properties. Although it is thought that vascular abnormal contraction may be involved in the blood pressure-suppressing effect, the effect of mulberry on vascular abnormal contraction is still unknown. Therefore, we investigated mulberry leaves as a potential source of bioactive compounds that prevent vascular abnormal contraction. Mulberry leaves were divided into fresh leaves and tea leaves and further classified according to the age of the tree: more or less than 20 years old, into roasted and unroasted. Mulberry fruits were also evaluated. We assessed the preventive effect of mulberry extracts on vascular abnormal contraction. Extracts from mulberry leaves of trees more than 20 years old showed a strong preventive effect on vascular abnormal contraction of human coronary artery smooth muscle cells. Therefore, to identify the active components in mulberry leaves, we fractionated the active fractions by gel filtration chromatography and reversed-phase high-performance liquid chromatography. The active fraction was further analyzed by mass spectrometry and nuclear magnetic resonance; an active component of the mulberry leaf extract was fisetin. In addition, our results indicated that the hydroxyl group at the C-3 position of fisetin is crucial for its activity. These results prove that fisetin is effective in preventing vascular abnormal contraction. Overall, mulberry leaves and fisetin are expected to be used in a wide range of fields such as functional foods, nutraceuticals, and drug targets.