Sudden Cardiac Arrest and Lindsay’s Law

Information for the Youth Athlete and Parent/Guardian

• Lindsay’s Law is about Sudden Cardiac Arrest (SCA) in youth athletes. This law went into effect in 2017. SCA is the leading cause of death in student athletes 19 years of age or younger. SCA occurs when the heart suddenly and unexpectedly stops beating. This cuts off blood flow to the brain and other vital organs. SCA is fatal if not treated immediately.

• “Youth” covered under Lindsay’s Law are all athletes 19 years of age or younger that wish to practice for or compete in athletic activities organized by a school or youth sports organization.

• Lindsay’s Law applies to all public and private schools and all youth sports organizations for athletes aged 19 years or younger whether or not they pay a fee to participate or are sponsored by a business or nonprofit. This includes:
1) All athletic activities including interscholastic athletics, any athletic contest or competition sponsored by or associated with a school
2) All cheerleading, club sports and school affiliated organizations including noncompetitive cheerleading
3) All practices, interschool practices and scrimmages

• Any of these things may cause SCA:
1) Structural heart disease. This may or may not be present from birth
2) Electrical heart disease. This is a problem with the heart’s electrical system that controls the heartbeat
3) Situational causes. These may be people with completely normal hearts who are either are hit in the chest or develop a heart infection

• Warning signs in your family that you or your youth athlete may be at high risk of SCA:
- A blood relative who suddenly and unexpectedly dies before age 50
- Any of the following conditions: cardiomyopathy, long QT syndrome, Marfan syndrome, or other rhythm problems of the heart

• Warning signs of SCA. If any of these things happen with exercise, see your health care professional:
- Chest pain/discomfort
- Unexplained fainting/near fainting or dizziness
- Unexplained tiredness, shortness of breath or difficulty breathing
- Unusually fast or racing heart beats

The youth athlete who faints or passes out before, during, or after an athletic activity MUST be removed from the activity. Before returning to the activity, the youth athlete must be seen by a health care professional and cleared in writing.

• If the youth athlete’s biological parent, sibling or child has had a SCA, then the youth athlete must be removed from activity. Before returning to the activity, the youth athlete must be seen by a health care professional and cleared in writing.

• Any young athlete with any of these warning signs cannot participate in practices, interschool practices, scrimmages or competition until cleared by a health care professional.

• Other reasons to be seen by a healthcare professional would be a heart murmur, high blood pressure, or prior heart evaluation by a physician.

• Lindsay’s Law lists the health care professionals who may evaluate and clear youth athletes. They are a physician (MD or DO), a certified nurse practitioner, a clinical nurse specialist or certified nurse midwife. For school athletes, a physician assistant or licensed athletic trainer may also clear a student. That person may refer the youth and family to another health care provider for further evaluation. Clearance must be provided in writing to the school or sports official before the athlete can return to the activity.

• Despite everyone’s best efforts, sometimes a young athlete will experience SCA. If you have had CPR training, you may know the term “Chain of Survival.” The Chain of Survival helps anyone survive SCA.

• Using an Automated External Defibrillator (AED) can save the life of a child with SCA. Depending on where a young athlete is during an activity, there may or may not be an AED close by. Many, but not all, schools have AEDs. The AEDs may be near the athletic facilities, or they may be close to the school office. Look around at a sporting event to see if you see one. If you are involved in community sports, look around to see if there is an AED nearby.

• If you witness a person experiencing a SCA: First, remain calm. Follow the links in the Chain of Survival:
Link 1: Early recognition
• Assess child for responsiveness. Does the child answer if you call his/her name?
• If no, then attempt to assess pulse. If no pulse is felt or if you are unsure, call for help “someone dial 911”

Link 2: Early CPR
• Begin CPR immediately

Link 3: Early defibrillation (which is the use of an AED)
• If an AED is available, send someone to get it immediately. Turn it on, attach it to the child and follow the instructions
• If an AED is not available, continue CPR until EMS arrives

Link 4: Early advanced life support and cardiovascular care
• Continue CPR until EMS arrives
• Lindsay’s Law requires both the youth athlete and parent/guardian to acknowledge receipt of information about Sudden Cardiac Arrest by signing a form.


Required video: Lindsay's Law Parent Info (Video)


Summary: Sudden Cardiac Arrest and Lindsay’s Law

What is Lindsay’s Law? Lindsay’s Law is about Sudden Cardiac Arrest (SCA) in youth athletes. It covers all athletes 19 years or younger who practice for or compete in athletic activities. Activities may be organized by a school or youth sports organization.

Which youth athletic activities are included in Lindsay’s law?
• Athletics at all schools in Ohio (public and non-public)
• Any athletic contest or competition sponsored by or associated with a school
• All interscholastic athletics, including all practices, interschool practices and scrimmages
• All youth sports organizations
• All cheerleading and club sports, including noncompetitive cheerleading

What is SCA? SCA is when the heart stops beating suddenly and unexpectedly. This cuts off blood flow to the brain and other vital organs. People with SCA will die if not treated immediately. SCA can be caused by 1) a structural issue with the heart, OR 2) an heart electrical problem which controls the heartbeat, OR 3) a situation such as a person who is hit in the chest or a gets a heart infection.

What is a warning sign for SCA? If a family member died suddenly before age 50, or a family member has cardiomyopathy, long QT syndrome, Marfan syndrome or other rhythm problems of the heart.

What symptoms are a warning sign of SCA? A young athlete may have these things with exercise:
• Chest pain/discomfort
• Unexplained fainting/near fainting or dizziness
• Unexplained tiredness, shortness of breath or difficulty breathing
• Unusually fast or racing heart beats

What happens if an athlete experiences syncope or fainting before, during or after a practice, scrimmage, or competitive play? The coach MUST remove the youth athlete from activity immediately. The youth athlete MUST be seen and cleared by a health care provider before returning to activity. This written clearance must be shared with a school or sports official.

What happens if an athlete experiences any other warning signs of SCA? The youth athlete should be seen by a health care professional.

Who can evaluate and clear youth athletes? A physician (MD or DO), a certified nurse practitioner, a clinical nurse specialist, certified nurse midwife. For school athletes, a physician assistant or licensed athletic trainer may also clear a student. That person may refer the youth to another health care provider for further evaluation.

What is needed for the youth athlete to return to the activity? There must be clearance from the health care provider in writing. This must be given to the coach and school or sports official before return to activity.