TO: District Superintendents of BOCES Superintendents of Public School Districts, Administrators of Public, Charter, and Nonpublic Schools
FROM: Kathleen R. DeCataldo
DATE: June 15, 2022
SUBJECT: Dominic Murray Sudden Cardiac Arrest Prevention Act
The Dominic Murray Sudden Cardiac Arrest Prevention Act, Chapter 500 of the Laws of 2021, and Commissioner’s regulation §136.9 are effective July 1, 2022. The Act was written to ensure that schools, students, and parents are provided with critical, lifesaving information on sudden cardiac arrest (SCA) risks, signs and symptoms, to ensure students at risk are evaluated prior to participation in athletics, and that SCA is immediately recognized and treated to prevent death. The Act requires:
• The Commissioner of Health to develop information, in conjunction with the
Commissioner of Education, relating to pupils exhibiting signs or symptoms of
pending or increased risk of sudden cardiac arrest;
• Directs the Commissioner of Education to post the information on the
• All schools must include such information1 in any permission form, consent form, or similar document that may be required for a student’s participation in
interscholastic athletics or reference how to obtain such information from the
Department and Department of Health’s websites, or on the school’s website, if one exists;
• The Commissioner of Education to promulgate regulations requiring that any
student displaying signs or symptoms of pending or increased risk of sudden
cardiac arrest shall be immediately removed from athletic activities, and shall not resume athletic activity until he or she has been evaluated by and received
written and signed authorization from a licensed physician; and retain the
authorization on file in the student’s permanent health record.
Sudden cardiac arrest (SCA) is defined as the abrupt and unexpected loss of heart function. SCA can be fatal if not treated within minutes, and even with treatment death may occur. Immediate treatment is cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED). Public schools, BOCES and charter schools are reminded that they are required, pursuant to Education Law Article 19 §917, to have at least one staff person who has undergone the training mandated in Public Health Law for CPR and AED use, assure that AED equipment is provided in an instructional facility where students are present and during any school-sponsored athletic contest or school-sponsored competitive athletic event held at any location. Schools are encouraged to plan for these emergencies and develop protocols and communication plans recommended in Managing Emergency Health Care and Communicable Diseases in the School Setting 2019 (nysed.gov).
Although SCA is rare2 — the incidence of sudden cardiac death (SCD) on the playing field is 0.61 in 100,000 — there are steps parents/guardians and school personnel can take to identify students who may be at risk and help to identify students exhibiting signs or symptoms. These signs or symptoms may be misinterpreted or disregarded by the student or others, but are an important indication that a student should be seen by a healthcare provider for an evaluation. Additionally, a student may have personal risk factors or family
history risk factors that indicate they are potentially at increased risk for SCA and should be evaluated by a healthcare provider prior to participating in athletics.
Preventing SCA before it happens is the best way to save a life.3 The Interval Health History for Athletics must be completed prior to each sports season unless a physical examination has been conducted within 30 days before the start of the season. The updated form contains questions to elicit potential risk for cardiac conditions and to identify students who need to see a healthcare provider for further evaluation. A sample letter for parents/guardians is available on the NYSED Health Services webpage to explain the purpose of completing the form. Schools and directors of school health services (a.k.a. medical directors) are strongly encouraged to require the parent/guardian to return this form with the signed consent. See School Health Examination Guidelines (nysed.gov) for more information on requirements for participation in interscholastic athletics.
The lists of signs and symptoms, and risk factors listed below, developed in collaboration with the Department of Health and pediatric cardiologists, indicate when a student may be at risk for SCA4.
1. Signs or symptoms
• Fainting or seizure, especially during or right after exercise or with excitement or startle
• Racing heart, palpitations, or irregular heartbeat
• Dizziness, lightheadedness, or extreme fatigue with exercise
• Chest pain or discomfort with exercise
• Excessive shortness of breath during exercise
• Excessive, unexpected fatigue during or after exercise
2. Risk Factors
• Personal Risk Factors:
o Use of diet pills, performance-enhancing supplements, energy drinks, or
drugs such as cocaine, inhalants, or “recreational” drugs.
o Elevated blood pressure or cholesterol
o History of health care provider ordered test(s) for heart related issues
• Family History Risk Factors:
o Family history of known heart abnormalities or sudden death before 50
years of age
o Family members with unexplained fainting, seizures, drowning, near
drowning or car accidents before 50 years of age
o Structural heart abnormality, repaired or unrepaired
o Any relative diagnosed with the following conditions:
Enlarged Heart/ Hypertrophic Cardiomyopathy/Dilated
Arrhythmogenic Right Ventricular Cardiomyopathy
Heart rhythm problems, long or short QT interval
Catecholaminergic Ventricular Tachycardia
Marfan Syndrome- aortic rupture
Heart attack at 50 years or younger
Pacemaker or implanted cardiac defibrillator (ICD)
Any student with such signs or symptoms, family history or personal risk factors should be evaluated by a healthcare provider before participating in athletics. This is important since SCA can be triggered by athletic activities in students at risk.
It is imperative that students are educated on the risks and symptoms of SCA and encouraged to report any of the signs or symptoms to their coach or athletic trainer, and parent/guardian. Administration, coaches, and athletic trainers will want to foster a culture of acceptance, where the health and safety of the athletes is foremost as early identification and treatment of a student at risk for SCA may save their life.
Any student displaying signs or symptoms of pending SCA must be immediately removed from athletic activities and not resume athletic activities until they have been evaluated by and received written signed authorization to do so from a licensed physician. This authorization must be kept on file in the student’s cumulative health record maintained by the school.
Finally, the law requires that coaches of extra class athletic activities7 in both public and nonpublic schools complete a course in first aid knowledge and skills from a nationally recognized organization, as defined in paragraph (D) of section 3000-B of Public Health Law. Such course must include instruction in recognizing signs and symptoms of cardiac arrest or sudden cardiac arrest. The first aid Courses Accepted as Meeting the Coaches First Aid and CPR/AED Requirement (nysed.gov) for coaches include this mandatory
For questions, please contact the Office of Student Support Services at
email@example.com or 518-486-6090.