Wednesday, May 21, 2003
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Wednesday, May 21, 2003 |
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Experts: Medics correctly treated boy struck by ball By JOHN MUNFORD
Two medical experts contacted by The Citizen have said Fayette County paramedics acted properly while treating a local youth baseball player who later died after he was struck in the chest with a baseball. Dr. Paul Robinson, a cardiologist and associate professor of medicine at Emory University, and David Bean, the state's director of emergency medical services, were presented with a detailed account of how John Ashmore was treated from the time emergency crews arrived on the scene. Judging from that information, both men said the medics acted appropriately in treating the 13-year-old boy, who died from commotio cordis, a condition caused by blunt force trauma to the heart area. Paramedics used an EKG machine to monitor Ashmore's heart rhythm, and when they first got there, he had a weak pulse that did not need to be shocked, said Allen McCullough, assistant chief of the Fayette County Department of Fire and Emergency Services. As they continued treating Ashmore, he eventually developed a shockable heart rhythm and he was shocked as medics were able to restore his heart rate and breathing, McCullough said. Dr. Robinson said trauma to the heart muscle can cause a slow heart rate in the victim such as the pulse first noticed by paramedics in Ashmore's case. The blow from the baseball could also have caused a problem with the heart's electrical signals, Robinson said. An autopsy revealed that Ashmore's heart was bruised, according to the state medical examiner. Robinson said it is possible Ashmore could have survived that injury had it been the only medical problem he faced. Bean, the state's medical director, said the paramedics did a good job of getting the victim on the way to the hospital just over 12 minutes after the ambulance arrived because the likely remedy would be surgery at a hospital. "The most important thing you have to do is airway, breathing and circulation, and stopping bleeding if there is any," Bean said. "The transport time without good airway and circulation would be certain death," Bean said. If the patient's heart is not in a shockable rhythm, the patient shouldn't be shocked by a defibrillator, Bean said. "We get a few of these calls a year," statewide, Bean said. "... On some of them their heart just stops. Sometimes these kids don't come back because you can't get them back." Of 128 confirmed cases of commotio cordis, there is a survival rate of less than 17 percent. A study published in the Journal of the American Medical Association last year indicated that very early use of cardiopulmonary resuscitation and use of an automatic external defibrillator are the only identifiable factors for those who did survive.
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