NOCSAE’s Role in Reducing Commotio Cordis Risk

NOCSAE funded groundbreaking research to develop the world’s first performance standard to protect against commotio cordis, one of the leading causes of sudden cardiac death in young athletes. NOCSAE’s role in athlete safety is to develop performance standards for athletic equipment. Some sports equipment manufacturers design their products to perform to these standards. NOCSAE developed a method for testing protective equipment against the conditions that cause the commotio cordis injury. NOCSAE’s performance standard applies to baseball and lacrosse.

What is commotio cordis?

Commotio cordis is a heart rhythm disruption caused by a blow to the chest. Although infrequent, it is one of the leading causes of sudden cardiac death in athletes. The condition is an episode of ventricular fibrillation induced by a direct blow to the chest over the heart during a specific portion of the heart’s electrical cycle. It can be caused by a direct hit from an object such as a baseball or lacrosse ball, a lacrosse stick or even a collision with another player. The impact doesn’t have to be hard or high velocity. It’s estimated that approximately 15 to 25 athletes died each year from this event. Most of those deaths were youth under the age of 18, many of whom were wearing a non-certified form of chest protection that wasn’t designed to address this risk.

Injury risk

Even the best protective equipment cannot prevent all such injuries, so it is important for coaches, parents, players and bystanders to be able to recognize the danger if an athlete is struck in the chest and collapses. Without immediate efforts to resuscitate the victim with an automated external defibrillator (AED), death can occur within just a few minutes. Commotio cordis can be fatal, and it is not related to an existing heart condition. Younger athletes, typically under the age of 18, are more vulnerable to commotio cordis. Coaches, parents and athletes who have access to an AED and training in CPR will help prevent tragic outcomes from commotio cordis. When an AED is used within three minutes of a collapse, survival rates are as high as 89%.

Commotio cordis protectors made to the NOCSAE standard

Today, USA Lacrosse, the National Federation of State High School Associations (NFHS) and NCAA require all goalies in girls’ and boys’ lacrosse to wear protectors that meet the NOCSAE standard. USA Lacrosse, NFHS and NCAA extended this requirement to all field players in boys’ lacrosse in 2022. For baseball, NFHS and NCAA require all catchers to wear protectors that meet the standard.

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