Letter from the Director from David H. Janda, Director:

Homeland Security starts in everyone’s backyard, neighborhood and school district. This is evident throughout the body of this update. All of us at The Institute continue to focus our efforts on the roll of injury prevention within our society. Unfortunately, injury is an equal opportunity event that transcends age, gender, race, nationality, state borders, national borders and continental shelves. In fact injury, in its own right, is one of the most fearsome terrorists that any of us can face. Its end result is unnecessary lifelong disability, potential fatality, and unending medical costs. This year 12 million students aged 5-22 in our country will sustain a sport or recreation related injury, the vast majority of which are completely preventable. Unfortunately, we continue to focus on being reactive and waiting for injuries to happen. What I have tried to do at The Institute is educate the public on a worldwide basis of how we can all be proactive rather than reactive. That has been the focus of The Institute’s efforts since its inception in 1989. It is also the focus of the book, The Awakening of a Surgeon, and the soon to be released national public television special, The Power of Prevention: Making Your Family Safer. Homeland Security does not start and stop in some cave thousands of miles away. In fact, it is my contention that Homeland Security starts in every person’s backyard, neighborhood and school district.

The same proactive skills that we have developed in sports medicine through The Institute I believe can be implemented to combat cancer, heart disease, and for that matter terrorism. The principles transcend all of these issues, which are taking a devastating toll on our fellow citizens as well as our fellow men, women and children throughout the world. As The Institute has grown and progressed over the years, there have been several hallmark events that have catapulted us to a higher level. I believe we are at one of these times in our existence. The involvement of public television is extremely important in informing the masses of how to implement prevention into everyones’ daily lives. As we say at The Institute, “When it comes to prevention, caring is the first step, but for it to be more than empty rhetoric, action must follow.” The operative word is action. Through our show, The Power of Prevention Making Your Family Safer, preventive action will become the end result. With the information that we supply in the show and in conjunction with the book, The Awakening of a Surgeon, we give every American Family weapons of mass instruction of how to become safer and healthier. We cannot idly sit by and wait for a multi-trillion dollar industry, a multi-billion dollar corporation or the Federal or State Governments to take control of this issue, control must come from every member of our society in order to become safer and healthier.

The show, The Power of Prevention: Making Your Family Safer, is a one hour show on the Institute’s work, as well as information supplied in the book, The Awakening of a Surgeon, of how families, communities, school districts can all become safer and healthier and prevent the catastrophic issue of injury. In addition, we discuss how these same principals can be applied to the other issues I mentioned above. In addition to the one-hour show another half hour show was created through public television, which is part of a tape that will be distributed by public television. In this show, we introduce ten action steps on how every family and community can become safer and healthier.

One of the steps that I discuss in the show is the need for pre-participation physicals for every student athlete, no matter what the age. Pre-participation physicals can drastically reduce the number of sudden cardiac deaths that are occurring in the athletic population. It is extremely important that every individual, no matter what the age, have a pre-participation physical examination. Six to twenty percent of all athletes will require further evaluation due to this examination due to concerns related to the cardiovascular system. In fact, two percent of athletes will be disqualified from participation based on the pre-participation physical. Needless to say, none of us are trying to dissuade individuals from participating in sports. However, the most catastrophic consequence is death. These sudden deaths can be drastically reduced with implementation of this one simple step- the pre-participation physical.

What we are trying to prevent with a pre-participation physical is sudden cardiac death. The symptoms we watch out for consists of a history of passing out or light headedness with activities, chest pain, palpitations, a heart murmur or a family history consistent with light-headedness with activities or passing out with activities. The American Heart Association has developed guidelines consisting of a history and a physical examination before high school and every two years thereafter. In addition, an interim history be performed every year for episodes of chest pain light-headedness, shortness of breath, murmur or a positive family history. We would also suggest that the physical examination be performed if any student athlete is involved in sport at a middle school or elementary level and for as long as that individual is involved in sporting activities through the senior level. It should be noted that when a history form is being filled out on a student it be filled out with the parent and not solely by the student. When a parent accompanies a student to the physical examination we believe it is important that pulses be checked, blood pressure be checked, and the heart and lungs be listened to with a stethoscope. Yes, it is a hassle and expensive for us to take our students to be evaluated but a very careful, thorough physical examination is needed to prevent this catastrophic problem. Pre-participation physical exams will not completely prevent sudden cardiac death, but can drastically reduce its occurrence. As the months go on, I will highlight the other nine steps as we continue our journey of preventing sports and recreation injuries.

As you are aware, The Institute has been one of the leading organizations in the world focusing on the chest impact fatality scenario in sports. The number one reason for children dying in sports is getting hit in the chest with a baseball, hockey puck, or a lacrosse ball. As we have shown, the most effective way of reducing these deaths is with an Automatic External Defibrillator. (AED). Over the months, there has been significant misinformation delivered to the publics doorstep by manufactures as well as some other organizations as it relates to these Automatic External Defibrillators (AED’s). As you are also aware, The Institute does not take financial contributions from any organization that has a product related to any of the research we do. It is important to realize that just as there are different types of breakaway bases, one of which works – many of which don’t, there are a number of Automatic External Defibrillators.

What we have concluded at The Institute is the Heartstream/Heartstart AED is the most effective AED device. We make this recommendation based on the fact that it is the only AED approved by the FDA to be placed on a conscious victim, the only AED with a pediatric capability, the only AED that takes 12 seconds to analyze before and after shock delivery, the only AED studied safe in water and metal surfaces, the only AED with non-invasive 3 lead monitoring, the only AED with live training options, the only AED that detects artifact, noise, motion, environment and radio. It is with these facts that we believe that if an AED is purchased it should be the Heartstream/Heartstart variety. An AED should be in every gymnasium, be available for every field, and every hockey arena in our country. AED’s save lives. I believe that an AED is so important that I made it a central core of the show The Power of Prevention: Making Your family Safer.

As we start 2003 we continue to “Dream Big and Dare to Fail”. I hope you will continue to do the same. It is my hope that the show The Power of Prevention: Making Your Family Safer will help millions of Americans and in conjunction with the book, The Awakening of a Surgeon, Our goal is to make families, neighborhoods and communities safer and healthier for many years to come.