Sudden cardiac arrest (SCA) is the abrupt and unexpected loss of heart function. SCA can be fatal if not treated immediately by cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED). Even with these measures, death may still occur. The Dominic Murray Sudden Cardiac Arrest Prevention Act which took effect on July 1, 2022,  was written to provide schools, students, and parents with critical, lifesaving information on sudden cardiac arrest risks, signs and symptoms, and to ensure students at risk are evaluated prior to participation in athletics.

Act Requirements:

• All schools must include SCA information in any permission form, consent form, or similar document that may be required for a student to participate in interscholastic athletics or reference how to obtain this information from the Department of Health websites, or on the school website.

• Any student displaying signs or symptoms of pending or increased risk of sudden cardiac arrest will be immediately removed from athletic activities, and will not resume athletic activities until the student athlete has been evaluated by and received written and signed authorization from a licensed physician. This written authorization must be retained on file in the student’s permanent health records. 

• Schools are required, pursuant to Education Law Article 19 section 917, to have at least one staff member who has undergone training mandated in Public Health Law for CPR and AED use, and assure that AED equipment is provided in school buildings where students are present and during any school-sponsored athletic contest or competitive athletic event held at any location. 

Although the incidents of SCA are low during participation in athletics, there are ways to determine who may be at risk and help identify students exhibiting signs or symptoms. The Department of Health, in collaboration with pediatric cardiologists, developed the following list of signs and symptoms - risk factors indicating when a student may be at risk for SCA. 

Signs and Symptoms

• Fainting or seizures, especially during or right after exercise or with excitement or startle
• Racing heart, palpitations, or irregular heartbeat
• Dizziness, lightheadedness, or extreme fatigue with exercise
• Chest pain or discomfort with exercise
• Excessive shortness of breath during exercise
• Excessive, unexpected fatigue during or after exercise

These signs may be misinterpreted or disregarded by the student, parents/guardians, or coaches, but are an important indication that a student should be seen by a healthcare provider for an evaluation. Students should be educated on the risks and symptoms of SCA and encouraged to immediately report any signs or symptoms to their coaches or athletic trainer, and parent/guardian.

The following personal or family history risk factors may indicate that the student is potentially at increased risk for SCA and should be evaluated by a healthcare provider prior to participating in athletic activities.

Risk Factors

• Personal Risk factors:

  • Use of diet pills, performance-enhancing supplements, energy drinks, or drugs such as cocaine, inhalants, or recreational drugs

  • Elevated blood pressure or cholesterol

  • History of health care provider ordered test(s) for heart related issues

• Family History Risk Factors:

  • Family history of known heart abnormalities or sudden death before 50 years of age

  • Family member with unexplained fainting, seizures, drowning, near drowning or car accidents before 50 years of age

  • Structural heart abnormality, repaired or unrepaired

  • Any relative diagnosed with the following conditions:

    • Enlarged Heart/ Hypertrophic Cardiomyopathy
    • Arrhythmogenic Right Ventricular Cardiomyopathy
    • Heart rhythm problems, long or short QT syndrome
    • Brugada Syndrome
    • Catecholaminergic Ventricular Tachycardia
    • Marfan Syndrome - aortic rupture
    • Heart attack at 50 years or younger
    • Pacemaker or implanted cardiac defibrillator (ICD)

Athletic Clearance and Return to Play

The Interval Health History for Athletics must be completed prior to each sport season unless a physical examination has been conducted within 30 days before the start of the season. The updated form contains questions to elicit potential risk for cardiac conditions and to identify students who need to see a healthcare provider for further evaluation. 

• Rush-Henrietta uses FamilyID to complete the Interval Health history form prior to athletic participation. 

• A student with signs or symptoms, family history or personal risk factors should be evaluated by a healthcare provider before participating in athletics. This is important because SCA can be triggered by athletic activities in students at risk.

Athletic Participation

A student displaying signs or symptoms of pending SCA must be immediately removed from athletic activities and may not resume until they have been evaluated by and received signed authorization to return to activity from a licensed physician. This authorization must be kept on file in the student’s cumulative health record. 

Coaches

This law requires that coaches of athletic activities complete a course in first aid knowledge and skills from a nationally recognized organization. This course must include instruction in recognizing signs and symptoms of cardiac arrest or sudden cardiac arrest. Administration, coaches and athletic trainers will want to foster a culture of acceptance, as health and safety of the athletes is foremost and early identification and treatment of a student at risk for SCA may save their life.