saw this on yahoo.. need you thoughts..

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Infinity

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"As reported by Indiana Fox affiliate WXIN, Dylan Williams was practicing with his Union City (Ind.) Little League team when he was struck in the neck with a line drive. The boy immediately fell to the ground and never got up, sending both coaches and teammates into utter confusion.
"He just fell to the ground," Erick Williams, Dylan’s father, told WXIN. "I even yelled at him to get up."
There was a reason for Erick Williams to be in shock; while it was clear that Dylan was hurt by the line drive, there was no sense that it should have been life threatening. Usually, fatal heart conditions are brought on by chest impacts and other similar strikes, not those to the neck.....
Doctors apparently agreed, as did CAT scans of the area of Williams injuries, concluding that Dylan Williams died from a heart attack, but couldn’t explain to his parents or Little League officials why he had suffered cardiac arrest.
"They’re at a loss," said Georgiana Williams, Dylan’s mother. "They didn’t know how to explain it to us. They didn’t know. They did CAT scans on where the ball hit him. Nothing. No injuries."
While there may be no medical answers as yet, ..... "

why is this? did it shoot a clot or are they saying he had a pervious unknown heart condition or is this totally random.. how would you respond to this? would you treat or just call DOA?
 
I would guess that the ball stimulated the vagus nerve and cause him to Brady down to asystole.

Alternatively, he could have been struck just right at just the right spot in the cardiac cycle to cause v-fib.

Yes I definitely would have worked him, likely the response time would have been well under 10 minutes and someone probably was doing CPR prior to EMS arrival.
 
I can't explain it anymore than the doctors could, well they are far far more educated than I, but you bet I would have worked it.
I had learned that cases like that if CPR is started ( I hope it was) immediately , those have a higher success rate than those with diseased hearts.
 
abckidsmom said:
I would guess that the ball stimulated the vagus nerve and cause him to Brady down to asystole.

Alternatively, he could have been struck just right at just the right spot in the cardiac cycle to cause v-fib.

Yes I definitely would have worked him, likely the response time would have been well under 10 minutes and someone probably was doing CPR prior to EMS arrival.
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Same answers as above. I've heard of it happening to kids when hit in the chest. I haven't heard anything about the throat.

Witnessed arrest of a pediatric patient = work them and transport to the hospital.
 
What about epiglottitis?

Or would the inflammation remained after death?
 
EMDispatch said:
What about epiglottitis?

Or would the inflammation remained after death?
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It doesn't really sound like epiglottitis. The OP says that right after the kid was struck by the ball he went down and never got up. Someone please correct me if I'm wrong but with epiglottitis the child would develop difficulty breathing or not be able to breath and then go down and not get back up once his oxygen levels get low.
 
DesertEMT66 said:
It doesn't really sound like epiglottitis. The OP says that right after the kid was struck by the ball he went down and never got up. Someone please correct me if I'm wrong but with epiglottitis the child would develop difficulty breathing or not be able to breath and then go down and not get back up once his oxygen levels get low.
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Usually fever, inability to swallow.

He wouldn't be playing ball that day
 
I'd like to know where he got hit in the neck. I wonder if it was at the very bottom of the neck where it would be more likely that the impact could have transmitted energy into the rib cage than, say, right under the jaw.
 
Is it just eyewitness accounts saying the ball hit him in the neck? Knowing that witnesses suck most of the time, particularly during traumatic events, the simplest explanation would still be the ball hit the patient in the upper chest and caused Commotio Cordis.
 
DesertEMT66 said:
It doesn't really sound like epiglottitis. The OP says that right after the kid was struck by the ball he went down and never got up. Someone please correct me if I'm wrong but with epiglottitis the child would develop difficulty breathing or not be able to breath and then go down and not get back up once his oxygen levels get low.
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We were taught back in my EMT class that it can result relatively quickly from neck trauma in children. It was actually the basis for a question on my state exam.
 
EMDispatch said:
We were taught back in my EMT class that it can result relatively quickly from neck trauma in children. It was actually the basis for a question on my state exam.
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Preexisting epiglottitis (as an infection) can develop rapidly worsening inflammation secondary to trauma. I would imagine that's what you're thinking of, where they warn you not to bother the child, keep them calm, and not to shove anything in their mouth. I guess the news article mentioned a "heart attack" (read as: layperson term for SCA) was the COD anyway, which wouldn't be the diagnosis in airway obstruction from swelling.
 
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EMDispatch said:
We were taught back in my EMT class that it can result relatively quickly from neck trauma in children. It was actually the basis for a question on my state exam.
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Um, epiglottitis is caused by an infection, most often Haemophilus influenzae. It's not a trauma related illness.
 
JPINFV said:
Um, epiglottitis is caused by an infection, most often Haemophilus influenzae. It's not a trauma related illness.
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Right. Only thing I can think dispatch is thinking is the trauma caused by putting things in the mouth etc.

Someone with epiglottis would be really sick. And not playing ball
 
chaz90 said:
Is it just eyewitness accounts saying the ball hit him in the neck? Knowing that witnesses suck most of the time, particularly during traumatic events, the simplest explanation would still be the ball hit the patient in the upper chest and caused Commotio Cordis.
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This is me assuming they also did a rapid trauma assesment and a full work up(including xrays) at the hospital wouldnt they have found bruising peri/ postmortem?
 
Infinity said:
This is me assuming they also did a rapid trauma assesment and a full work up(including xrays) at the hospital wouldnt they have found bruising peri/ postmortem?
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Have you ever had time for a rapid trauma assessment while doing CPR?
 
EMDispatch said:
We were taught back in my EMT class that it can result relatively quickly from neck trauma in children. It was actually the basis for a question on my state exam.
Click to expand...

It is quick. Generally in a couple hours though, not seconds.

I agree with Chaz on Commotio Cordis. A vagal response into asystole is definitely possible as well.

Other thought was a dissected internal carotid secondary to blunt trauma causing a massive CVA resulting in cardiac arrest but the article said CTs were negative for injury.

The only reason I believe it hit him in the neck is I bet it left one helluva mark. Ever been hit by a line drive? It doesn't feel good.
 
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