Thursday, September 06, 2012
Blows to the chest in sports By Anthony Policastro, M.D. Commotio cordis is not one of the terms in our everyday vocabulary. However, I recently saw a TV news show talking about it. The problem with the news show was that they did not call it that. It was a story about a child who was hit in the chest with a baseball and had cardiac arrest. He now has brain damage from the cardiac arrest. The news story was about the parents suing the metal bat manufacturer. The bat was likely an innocent bystander. Commotio cordis in English means agitation of the heart. It is a stopping of the heart under certain circumstances. It occurs after some kind of blow to the chest. We have long known about blows to the chest affecting heart rhythm. That is why a blow to the chest is one of the first things to do in an observed cardiac arrest situation. Sometimes, it might start the heart to beat again. The circumstances include the location of the blow. There is only a small area of the chest in which the potential is there for the heart to stop. There is a certain angle that the blow must take when it hits the chest. There is a certain amount of energy that the blow must provide. It has to occur at a precise millisecond (1/1000 of a second) during the normal heartbeat cycle. The likelihood of all these things happening in the exactly right way at the exactly right time is low. That is why this is such a rare occurrence. The severity of it (causing heart stoppage and sudden death) is what makes it newsworthy. During the 11 year period between 1996 and 2007, there were 188 cases recorded nationwide. Half occurred during organized sports and 96% of the victims were male. In addition to the right circumstances, there are certain situations that make this more likely to occur. One of those is related to the less developed thorax in an adolescent. This makes the adolescent more susceptible to this kind of injury. A more rapid heart rate due to the exercise associated with sports results in extra heartbeats per minute. Someone's heart rate may double from 65 to 130 during exercise which means that they have twice as many chances every minute for the event to occur. The lowered oxygen levels from doing exercise seem to make the heart muscle more vulnerable. Thus a blow might not cause this issue in a well oxygenated heart. However, it might do so if the heart muscle is receiving less oxygen due to the exercise. Baseball events seem to be the ones most publicized. However, other sports can also result in blows to the chest. These include football, ice hockey, polo, rugby, fencing, lacrosse, boxing and martial arts. There are some things that can be done to reduce the risk of injury of this type. Chest protectors are not one of those things. About 20% of the victims were wearing chest protectors at the time of the injury. One of the things that can be done is related to coaching techniques. Defensive players in lacrosse are taught to avoid using their chest to block the ball or puck. Baseball batters can be taught to turn away from the ball when the pitch is off target. Another important preventive action is to have an automated external defibrillator at sporting events. Since the heart stoppage can be kicked started with a defibrillator, rapid use of one is important. The death rate from cardiac arrest of this type is about 65%. That means that from the time the individual goes down to damage from the lack of oxygen is about 3 to 4 minutes. Thus if an event like this is witnessed, the defibrillator needs to be obtained and used almost immediately. Time spent over an athlete lying on the ground after a chest blow is not productive. It is important for the promoters of organized sports to have a plan for these unusual events. It is important for many spectators at such events to know how to use an external defibrillator. If your children participate in sporting events and you attend them, then you need to learn how to use one. You might be the first person to arrive. You might be the one to save a child's life. That is the only way to bring down the high mortality rate. Commotio cordis might not be a familiar term. However, the techniques that we can use to prevent or treat it are something that sporting event organizers and attendees should be familiar with.

DHSS public hearings The Delaware Department of Health and Social Services will hold public hearings in all three counties as part of Gov. Jack Markell's effort to improve Delaware's regulatory climate and to streamline or eliminate unnecessary regulations. A hearing will be held on Monday, Sept. 24 at 6 p.m. at Sussex Central High School, 26026 Patriots Way, Georgetown (for all Department of Health and Social Services regulations except the Division of Public Health) and Tuesday, Sept. 25 at 6 p.m. at Sussex Central High School, 26026 Patriots Way, Georgetown (Division of Public Health regulations). In addition to participating in the public hearings, members of the public are also encouraged to submit comments in writing. Comments may be submitted via an online submission form through Dec. 1. For more information or to comment on DHSS regulations, go to

Plan for aging population By some accounts, Sussex County is the Florida of the mid-Atlantic region, attracting thousands of retirees as new residents each year with a low cost of living, temperate weather and easy access to major metropolitan areas. With an expected 44 percent increase in the senior population between 2010 and 2020, that growth will prompt new or expanded programs and services. Denise L. Weeks-Tappan, planning supervisor for the Delaware Division of Services for Aging and Adults with Physical Disabilities, will be the featured guest speaker at the September meeting of the Sussex County Advisory Committee on Aging and Adults with Physical Disabilities. Weeks-Tappan will present "The Delaware State Plan on Aging, 2012-2015," focusing on how the state plans to meet the needs of a growing population in the years ahead. The meeting begins at 10 a.m. Monday, Sept. 17, at the County Administrative Offices West Complex, 22215 N. DuPont Blvd., Georgetown. The Sussex County Advisory Committee on Aging and Adults with Physical Disabilities is an 11-member panel established by the Sussex County Council to be an advocate for programs and policies that benefit older and disabled residents. All meetings are open to the public. For more information, visit the committee's page at

Pedal Away Prostate Cancer September is Prostate Cancer Awareness Month and local bicycling enthusiasts will help raise funding for prostate cancer screenings during Pedal Away Prostate Cancer, a 25-mile bicycle race which begins at 7:30 a.m. on Saturday, Sept. 8, at Eden Hill Medical Center, 200 Banning St., Dover. Pedal Away Prostate Cancer is open to both competitive and non-competitive cyclists with trophies awarded to top finishers in various categories. After the race, everybody is invited to attend a Men's Health Fair at Eden Hill from 8:30 to 10:30 a.m. Proceeds will be utilized for prostate screenings on Sept. 22 at Bayhealth. According to the American Urological Association, men age 50 and over should have a prostate screening at least once per year. African-American men and men with a family history of prostate cancer have a higher risk, and should begin annual screenings at the age of 40. To find out more and to register for the race, visit, then type "pedal away prostate cancer" in the Search Events box.

Choptank Transport joins initiative Choptank Transport is proud to announce its new membership with "Healthiest Maryland Businesses." This initiative is a statewide social marketing campaign to create a culture of wellness at the workplace and is headed by the Maryland Department of Health and Mental Hygiene. "As an employer aiming to achieve and maintain a healthy workforce," comments Pam Hutchinson, human resources director at Choptank Transport, "this initiative is a perfect fit for what we are trying to accomplish at Choptank Transport. We currently offer a smoke-free workplace, free blood-pressure screenings, employee massage days, biggest loser contests and a health and fitness center on the premises." Choptank Transport is a third-party logistics provider headquartered in Preston, Md.

Bayhealth names new vice president Bayhealth announces the addition of Shana D. Ross, MSHR, MBA, to vice president, human resources. In this role, Ross joins the Bayhealth executive team, providing leadership in recruiting, developing, engaging, rewarding and retaining a highly qualified, patient-focused workforce. She will also focus on processes and programs to enhance employee commitment and engagement and promote a strong work/life balance and a culture of safety. In addition to human resources, Ross is responsible for Bayhealth's Early Learning & Child Care Center. Ross joins Bayhealth from Adventist Midwest Health in Hinsdale, Ill., where she served as the director, human resources & talent management since 2007. She received her MBA and her MS in human resources management from the University of Maryland, and her BS in political science from Virginia State University.

First human case of West Nile Virus The Delaware Division of Public Health (DPH) has confirmed the state's first human West Nile virus case. DPH epidemiologists have concluded that, although the 34-year-old man who tested positive is a Wilmington resident, the disease was likely contracted out of state. The man is hospitalized. DPH reminds community members to protect themselves against West Nile virus. Although a number of cases have been seen in the U.S. recently, Delaware has only this single human case this year and only one in 2011. West Nile virus is transmitted by mosquitoes when they bite, generally from spring to fall. Nearly 80 percent of people infected with West Nile virus will not become ill. The CDC estimates that only 20 percent of those infected will develop West Nile fever, with mild symptoms including fever, headache, body aches, a skin rash on the chest or back and swollen lymph glands. Many cases likely go unreported. To report intolerable numbers of biting mosquitoes or other concerns, contact the Department of Natural Resources and Environmental Control (DNREC) Mosquito Control Section field offices in Sussex at 422-1512. For more general information on West Nile Virus, go to

Delmarva Radiation joins NCCS Nanticoke Cancer Care Services is proud to welcome Delmarva Radiation Services to provide patient centered radiation oncology care in a compassionate, warm, and supportive environment - right at Nanticoke.

Delmarva Radiation Services, PA, under the direction of Dr. Brian Costleigh, has a history of providing excellent cancer care for patients. Jennifer Hung, MD, Andrejs Strauss, MD, and Owen Thomas, MD are providing services allowing patients to once again receive the care they need close to home. Nanticoke Cancer Care Services is affiliated with Beebe Medical Center's Tunnell Cancer Center. This affiliation allows medical and radiation oncology physicians to continue to treat patients at Nanticoke Cancer Care Services in Seaford on a full-time basis. In addition to access to high quality physicians who are affiliated with and have access to all the resources of the Tunnell Cancer Center, this affiliation expands support services for patients, makes clinical trials available in Seaford, and provides a $1.2 million upgrade to technology available at Nanticoke.

Entertainment sale at Look-In Glass The Look In-Glass Shoppe at Nanticoke Memorial Hospital is holding an "Infinite Entertainment Sale" on Thursday, Sept. 13 from 7 a.m. to 3 p.m. and Friday, Sept. 14 from 7 a.m. to 4 p.m. Stop by the lobby at Nanticoke and shop for tablets, televisions, laptops, cameras, GPS, gaming consoles and other consumer electronics. Payroll deductions are available for eligible NHS employees. All proceeds go to Nanticoke Health Services to support patient care services.

Foundation golf tournament The 2012 Bayhealth Foundation Charitable Golf Tournament, co-sponsored by Dover MotorSports, Inc., will be held Thursday, Sept. 27 at Wild Quail Golf and Country Club in Wyoming. Since 1986, DoverMotorsports, Inc., and the Bayhealth Foundation have worked together to host this annual, charitable golf tournament that coincides with race weekend, with all proceeds benefiting Bayhealth. Since its inception, the tournament has raised more than $1,000,000 to benefit patient care at Bayhealth. Registration opens at 10:30 a.m., and lunch follows at 11 a.m. Shotgun start is at 12:30 p.m. An awards dinner will be held at the end of the tournament. Emceeing this year's tournament banquet will be NASCAR play-by-play ESPN announcer Allen Bestwick. Individual golfers are $250 and two golfers may sign up for $325. To register, visit E10970 Allen Bestwick

Milford Memorial Garage Sale A public garage sale will be held at Bayhealth Milford Memorial on Saturday, Sept. 15 from 7:30 to 11:30 a.m. to support fundraising efforts for the American Heart Association Heart Walk. The garage sale will be held at 301 Jefferson Ave., Milford, in the parking lot between Kings Highway and Jefferson Avenue. Bayhealth employees have formed teams for the October Heart Walk, and items for sale at the garage sale will raise more proceeds to benefit the American Heart Association. For more information, contact Jessica Palladino at 430-5701.

Go Red luncheon and fashion show Most people might be surprised to learn that the leading killer of women is heart disease. More than 200,000 women die each year from a heart attack - five times more than those who die from breast cancer, reports the National Coalition of Women with Heart Disease. To raise awareness about heart disease in women, the American Heart Association in 2004 kicked off the Go Red for Women social and educational initiative, which includes an annual fundraising luncheon bringing women together to learn more about the disease so that they can empower themselves. Beebe Medical Center will sponsor the 6th Annual Go Red for Women Luncheon and Fashion Show Wednesday, Sept. 19, at the Clubhouse at Baywood Greens in Long Neck. Doors will open at 11 a.m. and lunch will be served at noon. The cost is $25 a person. Heather A. Raff, MD, a cardiologist in Lewes with Cardiovascular Consultants of Southern Delaware, will be the keynote speaker. Dr. Raff, who is a member of the Beebe Medical staff, moved to the community more than a year ago following her fellowship in cardiovascular disease at the University of Colorado School Of Medicine. As an extra addition to the luncheon event, community health nurses from the Beebe Medical Center's Population Health Department will be providing blood pressure screenings for those attending the luncheon from 11 a.m. until noon. For tickets, contact Pat Sandy at 226-7732 or Muriel Pfeiffer at 947-2640.

Bayhealth recruits veterans Discipline. A strong work ethic. A team attitude. Those are just a few of the attributes which make military veterans outstanding employees when they return to civilian life. And those are just a few of the reasons why Bayhealth is renewing its efforts to recruit veterans. The August 13th event, sponsored by Delaware's congressional delegation, gave vets the opportunity to meet and mingle with Bayhealth and other employers representing banking, law enforcement, and a wide range of other industries. "The veterans job fair not only helped make a connection between employer and prospective employee, but it also helped raise public awareness of why veterans are so valuable to our workforce," said Hayward, who noted that the vets attending the recent event represented a diverse range of professions including mechanics, engineers, security, clerks, radiology technicians and nurses.

Golf group donates proceeds The Seaford Ladies Nine Hole Golf Association recently held a "Pretty In Pink" cancer fundraiser which included a dinner, fashion show, Live/Silent/Chinese auctions, and golf tournament. Proceeds totaled $17,000 and were donated to Nanticoke Cancer Care Services to assist patients with transportation costs. Patients often find it difficult to travel to and from appointments. Some live alone, do not have family in the surrounding area, or are not able to operate a vehicle and cannot afford public transportation. Proceeds from "Pretty In Pink" will help offset these costs for these patients. Nanticoke Cancer Care Services recently affiliated with the Tunnell Cancer Center to provide comprehensive medical and radiation oncology services in Western Sussex County. In addition, the affiliation will expand support services to patients and provide access to clinical trials in Seaford. With this affiliation the number of cancer patients treated at Nanticoke is expected to grow which also means an increase in the financial need of patients.

Prostate screenings offered September is Prostate Cancer Awareness Month. The Cancer Care staff at Nanticoke Memorial Hospital will once again provide prostate screenings (D.R.E. & blood test) on Friday, Sept. 7 from 8 a.m. to 5 p.m. at the Cancer Care Center (located at 701 Middleford Rd., Seaford). There is a $10 screening fee and pre-registration and fasting are not required. Nanticoke Memorial Hospital encourages men over the age of 50 to take advantage of this service. Also men age 40 and at high risk of developing prostate cancer are encouraged to participate. African-American men and men who have a family history of the disease have a higher risk for developing prostate cancer. For more information, call Melinda Huffman, nurse navigator, at 629-6611, ext. 3765.

NMH offers CPR classes Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child, or infant who is choking and use of the AED. This classroom-based, video, and instructor-led CPR course offers families, friends, and community members the opportunity to learn CPR and need a course completion card. Classes are open to participants ages 12 and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. The target audience is those who have a duty to respond to a cardiac emergency. Cost is $40. Payment and registration is required by no later than five business days prior to the class. Late registrations may be accepted if seating is available. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

HIV/AIDS Support Group A new support group for HIV/AIDS will meet every other Wednesday, at 7 p.m., in the Branford Lounge at Epworth United Methodist Church at 19285 Holland Glade Rd., Rehoboth Beach. The group is sponsored by Epworth UMC, CAMP Rehoboth, the AIDs Delaware and Delaware HIV Consortium. For more information, contact David at

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. To learn more, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

ALA hosts skydiving fundraiser Take a leap to make the air cleaner and healthier. The American Lung Association in Delaware is sponsoring the Third Annual "Fighting for Air at All Extremes," a skydiving fundraiser. The event will take place from 8 a.m. to 8 p.m. Friday, Sept. 7 and Saturday, Sept. 8 at Skydive Delmarva on 32524 Aero Dr., Rt. 24 West, Laurel. Lung disease is the third leading cause of death in the U.S. According to the Lung Association's State of the Air 2012, more than 140,000 Delawareans suffer from asthma, chronic bronchitis and emphysema - all forms of lung disease. The ALA-DE hopes to raise $40,000 to support lung health research, education and advocacy efforts. Participants of Fighting for Air at All Extremes can join the jump as an individual, team, volunteer or sponsor. There is a registration fee of $25 per participant. All skydivers must be 18 or older. A fundraising minimum of $300 is required to receive a tandem jump. All fundraisers will receive gift bags and t-shirts. The top fundraiser will take home a special prize and all participants who raise $500 or more will be entered into a raffle for some great prizes. To register, contact Kelli Burris at 302-737-6414, ext. 14 or at or visit