When you see a cardiac arrest, your brain fights you - "No, this isn't really happening" - and the circumstances fight you - "Dang! in CPR class the manikin didn't weigh very much and wasn't sitting in a deep chair. This blog deals with practical details and presents reports of "saves." Let me have your questions and comments - they will steer the course of this blog.
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It's not that far away -- in miles or time passed. Perhaps you remember but if you don't, Fennville, Mich., is just 120 miles from here, a two hour ride, tracing the southeastern shore of Lake Michigan.
On March 3, it will be a year since the small town became big news. Back then, just like Munster and Bishop Noll had done the week before, Fennville High School secured an undefeated regular season in boys basketball.
The team managed it on the strength of their best player, Wes Leonard, who hit the game-winning shot with 25 seconds left to break a 55-55 deadlock.
After the buzzer, the two teams shook hands. Leonard's teammates then hoisted him on their shoulders, but when they set him down, he suddenly dropped to the floor unconscious.
Now two national publications stir memories of the incident, one by intent and one by pure chance. Both are required reading for every athletic administrator, athletic trainer, coach and parent.
Last year, I reported that Fennville High School had an automated external defibrillator (AED) in the building, but that it wasn't used promptly on Leonard. This week's Sports Illustrated reveals why.
Meanwhile, the current issue of the Journal of Athletic Training happens to include the National Athletic Trainers' Association's newest position statement: Preventing Sudden Death in Sports.
According to the statement, "Sudden cardiac death (SCD) is the leading cause of death in exercising young athletes." Men's college basketball is where it is most likely to happen.
"Access to early defibrillation is essential," the statement asserts. [Amen]
Fennville's AED was in an office mere feet from the gym. According to SI, the school's principal would eventually run to get it. [This is nuts - a trained person would immediately determine that the scene was safe, check for responsiveness, check for normal breathing, begin Bystander CPR, and either call 911 or have someone else call.]
Early on in the NATA document, before specific conditions are addressed, the authors write, "A sports organization that does not have (an athletic trainer) present at practices and games and as part of the medical infrastructure runs the risk of legal liability." [This is really simple from a medical perspective: Any game / match / contest / practice session of any sport that involves exertion ought to have a properly maintained AED and a person who knows how to use it. Screening for Long QT, Short QT, and HCM has to be mandatory for any high school athlete.]
Fennville High School did not have an athletic trainer. [Not relevant - don't need an athletic trainer to have some one who knows what to do on scene at every practice and contest.]
Prior to promoting the presence of an athletic trainer, though, the NATA statement said, "we urgently advocate training coaches in first aid, cardiopulmonary resuscitation (CPR), and (AED) use, so that they can provide treatment until a medical professional arrives."
SI reports that well-meaning individuals from the crowd thought Leonard had heat exhaustion and started treating him for that. Meanwhile, Fennville's head coach helped clear the gym. Finally, a bystander summoned his wife, an emergency room nurse, from the concession stand. [What more convincing evidence do we need that more people need to learn Bystander CPR?]
She determined Leonard was pulseless, called for the AED, and started CPR.[That's super - the right move!]
The NATA position statement reports, "Survival rates have been reported at 41 percent - 74 percent if bystander CPR is provided and defibrillation occurs within 3 to 5 minutes of collapse."
Soon, the Fennville principal returned with the AED. SI's Thomas Lake tells us the ER nurse immediately attached the pads to Leonard's chest and then hit the power button. However, the machine did not come to life. [AN AED HAS TO BE MAINTAINED!!!!!!!]
"The battery was dead," writes Lake. [If you have an AED available for public access, you need to maintain it in accordance with the manfacturers's published requirements.]
Consequently, so was Wes Leonard.
John Doherty is a certified athletic trainer and licensed physical therapist. This column reflects solely his opinion. Reach him at firstname.lastname@example.org.