Christopher DiPasquale, PhD, PT, OCS, SCS, CHT
Performance Physical Therapy & Sports Medicine
Offices in Hebron and Colchester, CT
(This is an adaptation of an article published in 2019)
The single biggest catastrophic threat to your student-athlete is Sudden Cardiac Death. When the heart stops suddenly, it's critically important to get it going again as soon as possible
The 2 common causes of sudden cardiac death are:
The heart stops from a mild to moderate blow to the chest - by a ball or collision with another athlete - called Commotio Cordis
The heart stops from a cause the athlete is born with - called Congenital Condition
Both of these cause the heat to stop suddenly.
When the heart stops, it's important to get it going again as soon as possible.
The Best Way to do that is:
THE immediate use of an Automated External Defibrillator - called an AED. AN AED gives a shock to the heart to restart it.
AND to start Cardiopulmonary Resuscitation - call CPR. The important thing with CPR is the compression of the heart to move blood to maintain life.
The good news is that all public school coaches in Connecticut are required to be trained in using an AED and performing CPR.
AED machines talk you though the set-up. The machine does the rest. The AED gives a shock to the heart to restart it.
Schools Have Options - Optimal, Practical-Optimal, and What We Have Now.
1. Optimal but Not Practical - an Athletic Trainer and an AED with Every Team Every Time
It would be optimal if every team had a trainer with an AED at every practice and every game. That solution would minimize any delay to get the AED on and CPR started. It would provide the maximum chance for student survival.
>>>But that's not practical. It would add a few $100,000 to the school athletic budget every year.
2. Optimal & Practical - Coach plus AED with Every Team Every Time
The state requires coaches to be trained in using an AED and performing CPR. If there was an AED present with a coach at every practice and every game, the time to get the AED on and CPR started would be minimized.
>>>This would provide the maximum chance for survival. It's a reasonable solution. A one time minimal cost to purchase AEDs for each team.
3. RHAM High School Example - 1 Trainer and 1 AED
I will use RHAM as an example. From personal experience, I know RHAM has one athletic trainer who is usually several minutes away from most teams...most of the time...on the RHAM campus. Other times the trainer is not at RHAM. While there are several AEDs on campus, there is one with trainer when the trainer is there. When the buildings were locked to improve security, the AEDs were locked in the building.
Survival rate will likely decrease by 30% under the best circumstances with the current set-up at RHAM. For every minute it takes to get an AED on there is a 10% decrease in survival. If the trainer is on campus it will take about 3 minutes for the trainer to be notified and then get the AED to the athlete. Sometimes there are athletic events at RHAM and no trainer. This happens when the trainer is traveling with another RHAM team.
Survival rate will likely decrease by 50% if an athlete goes down without an athletic trainer present and we have a locked school. Under the best of circumstances it would take 5 minutes - someone to get into the school and get an AED off the wall and get back to the field to apply the AED.
RHAM Emergency Action Plan
The emergency action plan we put in place at RHAM asked coaches to assign team members roles and to practice or perform drills for this type of emergency.
We had no success getting the teams to practice or drill this emergency plan.
Where Will the Money for AEDs for Each Team Come From?
For several years at RHAM I have recommended the funding for the athletic trainer be removed from the budget and AEDs purchased for each team instead.
The reality is the funds for an athletic trainer could be better spent on things such as an AED to save the lives of student-athletes in an emergency situation.
The emergency evaluation and treatment of severe injuries can be well handled through our robust local emergency medical services and with the first responder training the state requires of our public school coaches.
Follow-up care and treatment would best be handled by the student-athletes' families in collaboration with their primary healthcare providers.
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Chris DiPasquale, PhD, PT is a physical therapist special board certified in sports medicine. He is the supervisor of the Sports Medicine Program at Performance Physical Therapy & Sports medicine with extensive experience in providing sports medicine services at the high school and college levels in Connecticut. Locally this has included RHAM High School in Hebron, Bacon Academy High School in Colchester, and Lyman Memorial High school in Lebanon. Following a 2019 RFP process the organization will no longer be providing coverage at RHAM.