Prevention of commotio cordis in baseball: An evaluation of chest protectors

Background: In a recent study of fatal chest impacts by baseballs, 28% of t he children were wearing a chest protector. This study evaluates the effect iveness of chest protectors in reducing the risk of commotio cordis. Methods: Five commercially available chest protectors were placed on a thre e-rib structure simulating the chest and impacted at 40, 50, 60, and 70 mil es per hour by a standard baseball. Ten repeated tests were conducted on ea ch vest In random order, and on the control (un-protected chest). The visco us response (or viscous criterion [VC]) was used to assess differences in f atality risk. Results: One vest had a statistically lower VC (average, 50,6%, p < 0.05) f or all impact speeds. Three averaged 18.7% to 27.7% lower VC, but were sign ificantly different only at higher speeds. One vest had an average 34.2% hi gher VC, and was significantly higher at 40 to 50 miles per hour (p < 0.05) , A method was proposed linking laboratory test results to real-world incid ents of ventricular fibrillation. Conclusions: The majority of commercially available chest protectors fail t o provide consistent reductions in commotio cordis risk. Nonetheless, there are benefits from their use in baseball until improved safety equipment is developed and standard tests are established to assess sport equipment eff ectiveness.