Will Orndorff sprinted across the outfield intent on gloving the fly ball. As it arrived, so did diving teammate, Sheldon Stickley. The punishing head-to-chest collision knocked Sheldon unconscious.

Will fell heavily, too, and didn’t move. Inside, his heart quivered. Then it died.

It was March 31. Will and Sheldon, members of the Strasburg High School baseball team, were practicing at their home field in sunny, 60 degree weather.

The devastating collision left Sheldon with a concussion. The blow to Will’s chest triggered a condition called commotio cordis – literally commotion of the heart – where the organ’s electrical rhythms are grossly disturbed. The pumping process turns spastic, and then shuts down. As the flow of blood and oxygen ceases, life ends . . . unless precise interventions occur without delay.

In an instant, the field went silent. Jeff Smoot, the Rams’ coach for over 25 years, rushed to the boys. Recognizing Will’s dire circumstance he began chest compressions and mouth-to-mouth resuscitation.

Joe Loving, a firefighter/paramedic with Shenandoah County Fire & Rescue, was a mile away at his home station when he got the 911 dispatch. In two minutes he was beside the boy, defibrillator in hand. After affixing the pads and getting an okay from the machine, he ordered “clear,” and fired. For anxious seconds they waited . . . and then there was a beat, and another. Will had a pulse and was breathing.

Loving inserted a breathing tube and placed an IV line and when AirCare 4 arrived, they placed him in the helicopter and flew him to Winchester Medical Center, a level II trauma center.

Judy Orndorff was at work when she got the frightening call about her son. She hurried to the hospital and saw Will as they rolled him in. “I touched his hand and he opened his eyes but it wasn’t anything I considered a response. He wasn’t acting right.”

Jack Orndorff was in Woodstock having his truck serviced when Strasburg Town Manager, Kevin Fauber, called. “He told me there’s been an accident. ‘It’s William. They started CPR and have him back.’”

With Jack’s truck still perched on the lift, the garage owner handed him the keys to a loaner. “Take this and go!”

Commotio cordis is rare. Between 1996 and 2007, the National Commotio Cordis Registry documented 188 cases. 96 percent of the victims were male with an average age under 15. Ominously, less than one in five survived.

Blunt trauma to the chest doesn’t always trigger commotio cordis. Research by cardiologist Steven Yabek, MD, found that blows to the chest set off ventricular fibrillation only during a narrow window in the cardiac cycle, a 15-30 millisecond span representing about three percent of a complete cardiac cycle. Blows outside that time could inflict damage but the heart doesn’t typically stop.

Winchester cardiologist James Warner, MD, evaluated Will. “His heart was probably going to be fine. Our concern was brain function. He was completely unresponsive. How much damage would he have for lack of oxygen?”

Consulting with neurologist Neil Crowe, MD, Warner wanted to “pull out every stop for someone that young to make sure he had the best chance of coming out of this well.”

They focused on the hypothermia protocol – a technique that can preserve brain function for someone who has undergone cardiac arrest. Dr. Crowe has been involved in about a dozen hypothermia cases. The patient is sedated and given drugs to induce paralysis. Then the body is chilled to about 90 degrees by applying ice to the body and covering it with a cooling blanket. Then you wait 24 hours for a result.

Dr. Crowe knew they were “getting to the outer time limit to consider cooling, but he wasn’t coming around the way we would have liked.” Dr. Crowe conducted a quick literature search to affirm their approach and the Orndorffs consented.

The goal is to spare brain damage. Deprived of oxygen, neurons receive a signal to self-destruct. The signal comes in the form of a chemical reaction that triggers the release of enzymes that are fatal to neurons. As the neurons die, swelling occurs in the brain, and disability and death can follow.

Hypothermia short-circuits this downward spiral by stalling the chemical processes triggering cell death. With oxygen restored, and bodily functions reduced to a state of suspended animation, the neurons have time to shake off the insult and return to work.

Wednesday evening staff began warming Will, one degree an hour. At 4:30 Thursday morning Judy and Jack were with their son when he stirred. As Mom moved around the bed he followed her with his eyes.

“I asked him if he could respond and he squeezed my hand. That’s when the party began!”

Dr. Crowe conducted a brain test. “He came running out hollering and almost jumping up and down,” said Jack.”’He’s going to be good.” Later, as the Orndorffs met with friends in the waiting room, the 17-year old came walking down the hall triggering cheers.

For Dr. Warner the coach who started CPR and the EMT with the defibrillator “were the keys to success.”

This was Joe Loving’s first encounter with commotio cordis. “I am happy I was in the right place at the right time, and had 14 years of training to call on.”

Loving knows CPR is often delayed because observers underestimate the trauma. When CPR is delayed longer than three minutes, survival plunges to less than five percent.

Jack Orndorff appreciates what happened. “It’s a miracle Will came from where he was to where he is now. I read up on it and it says he had a 15% chance of making it if everything was done right – from A to Z. I’ve known Coach Smoot all my life, so this really makes it special.”

Will and Sheldon rejoined the team after a few weeks. First game back Coach Smoot put one in right and one in left. “He’s using the centerfielder as a cushion,” jokes the happy dad.