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JOHN DOHERTY: Remembering an anniversary we can't afford to forget
By John Doherty Times Sports Correspondent | Posted: Monday, February 20, 2012 10:00 pm | No Comments Posted

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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 ptatcsport@sbcglobal.net.

Read more: http://www.nwitimes.com/sports/columnists/john-doherty/john-doherty-remembering-an-anniversary-we-can-t-afford-to/article_ac1c7625-d556-5ca0-b757-f44d439401e6.html#ixzz1n4ksrznt

Mr. Ryks, to answer your question at the end, the odds are more than 90% that she would have stayed dead.

Automated external defibrillator helps revive woman at Duluth airport

Bystanders used an automated external defibrillator and CPR to revive a woman who collapsed at Duluth International Airport on Sunday afternoon.

By: Steve Kuchera, Duluth News Tribune

The woman was waiting to go through security when she collapsed. Bystanders, including a nurse, couldn’t find a pulse or sign of breathing. A Transportation Security Administration supervisor ran to get one of the terminal’s automated external defibrillators.

AEDs are portable devices that, when attached to a patient, automatically

detect whether the person’s heart is beating irregularly. If so, the device instructs the user to administer an electric shock, which can spur an irregularly beating heart back into a normal, effective beat.

The nurse administered at least one shock and performed CPR until the woman became responsive.

When members of the full-time 148th Air National Guard Fire Department arrived on the scene, the victim was suffering a small seizure. The firefighters established an airway, gave her oxygen and stabilized her. After a few minutes, Duluth Fire Department personnel arrived to help until Gold Cross Ambulance came to transport the woman to Essentia Health St. Mary’s Medical Center.

None of the agencies interviewed had recorded the patient’s name, so her condition could not be determined.

“I heard last night that she was doing fine,” Wade Boyat, the 148th’s assistant fire chief, said. “She had a stent put in her chest, and she was doing very well.” A stent is an artificial tube commonly inserted in coronary arteries to increase the flow of blood around the heart.

The response to the medical emergency was a great combination of work between Air National Guard Fire, Duluth Fire, Gold Cross and the TSA, he said.

He also praised the response of bystanders and the presence of AEDs in the terminal.

“The community is aware that AEDs are all over now,” Boyat said. “And they have become so user-friendly, people are comfortable using them. And when somebody feels comfortable using a machine like that, they are more secure in themselves to actually work on someone who might need help.”

The Duluth International Airport installed AEDs several years ago. As far as airport executive director Brian Ryks knows, Sunday was the first time one was used.

“Obviously it was a good thing we had one there,” he said, “because who knows what the outcome would have been if we didn’t have it.”

Can you spot the only thing that could have been done better?

Teamwork helped fallen 8th-grade Jessie Clark player after he collapsed

By Jim Warren — jwarren@herald-leader.com

Posted: 12:12pm on Feb 7, 2012; Modified: 2:20pm on Feb 7, 2012

Read more here: http://www.kentucky.com/2012/02/07/2059144/teamwork-helped-fallen-8th-grade.html#storylink=cpy

Fayette County school district officials said Tuesday fast action by an athletic trainer, safety procedures that worked according to plan and some good fortune came into play after eighth-grader collapsed at a baseball conditioning drill Monday afternoon.

The Jessie Clark Middle School student, identified as Benjamin Highland, was reported in critical condition Tuesday morning at University of Kentucky Chandler Hospital. The incident occurred about 5:30 p.m. on the baseball field at Lafayette High School.

School district officials said Tuesday that athletic personnel on the scene Monday afternoon quickly recognized what was happening when the boy fell, and they summoned veteran trainer Jenni Williams. She told a coach to call 911, then used an automatic external defibrillator to treat the boy and administered CPR until emergency ambulance crews arrived.

A nurse who lived nearby and was out walking her dog saw what was happening and pitched in to help provide CPR, said Mike McKenzie, the district's high schools director.

McKenzie said everyone involved worked together, crediting Williams in particular.

"With the adrenalin and emotion after such an event, she was pretty shook for a while last night," McKenzie said. "She's fine, but in the moments after such a situation where you've just helped a young person survive ... .

"In talking with her last night ... we thanked her and told her job well done. Her first response was, 'It was a team effort.'"

McKenzie also credited others who helped in the crisis: coaches on the scene, the nurse who was walking nearby and an off-duty police officer who offered assistance. He said school officials were trying to find the nurse's name.

Williams, who is employed by the University of Kentucky, was declining comment Tuesday, UK officials said.

"It really was a team effort by a lot of people on the sidelines who jumped in and helped out," McKenzie said.

According to Fayette school district officials, the boy was participating in drills with Lafayette High School baseball players, and apparently was trying out for the team.

They said the players had finished one drill and were transitioning to another when he collapsed.

"One of the kids yelled 'Coach;' they look over and saw a young man start to go down," McKenzie said. "They immediately went to the young man, determined immediately that they needed the trainer and called the trainer who was just inside the gym. She came out, immediately turned to one assistant coach who called 911, turned to the other coach and he immediately went and got the AED. She began CPR."

McKenzie said he didn't know how long the drills had been going on before the boy collapsed.

_________________________

So we can hope for a CPC1 or CPC2 recovery for Benjamin. The only thing that could have been done better and that could have increased the probability of Benjamin's getting out of the hospital with major brain functions intact would have been having someone start CPR immediately after Benjamin went down, rather than having called for the trainer. Please get trained, all of you.

Read more here: http://www.kentucky.com/2012/02/07/2059144/teamwork-helped-fallen-8th-grade.html#storylink=cpy

Please tell me why...

...when most people you talk with say that learning CPR is a good idea, only about one third of sudden cardiac arrests are treated with Bystander CPR.

Here's a "save" story - it happens every day, but lots of people needlessly die or become severely disabled when they suffer a sudden cardiac arrest.

Tell me why you think that happens.

Bob
___________

Lafayette General honored a Lafayette woman with the Making a Difference award for going above and beyond, giving life saving CPR to a jogger who had collapsed.


Monday, January 9th started as any other day for Gary Dodson. He went to work and then around 11:30 went home for lunch and was planning on continuing his normal routine.

"I was going to go to Girard Park and run my normal three laps and go from there," said Gary Dodson.

Dodson exercises regularly and says he doesn't remember much from that day or even hitting the track.

"I do not remember changing into my running clothes, I don't remember driving to the park, parking or plugging in my iPod and running. I do not remember any of that."

Dodson's heart stopped beating and he collapsed on the track. Bystanders called 911, and that's when Deedra Harrington who works in the College of Nursing at UL was passing by and says something in her mind told her to turn around and see if he needed help.

"When I approached and got out of my vehicle, I noticed that he was unresponsive and initiated CPR at that point," said Harrington.

Within minutes medics arrived and used a defibrillator to revive Dodson. They rushed him to Lafayette General where doctors realized he had a massive heart attack.

"I did make an attempt to see how he was doing. I didn't want to know his name or anything, but I did want to see if he survived," said Harrington.

The next day Dodson woke up and repeatedly asked what happened and he wanted to meet the woman that saved his life.

"When I was able to talk to Deedra, she was able to fill in part of the blanks as far as what happened and what she did and what happened after."

"I said, you look so much better than when I saw you yesterday. It is a great feeling to know that it only takes one individual to make a difference."

Since that day, Dodson has slowed down and says he appreciates life a lot more.

"I'm not going to let things stress me out like they did before. Life is precious, I realize that now. I just try to look for the good things in life and that's how I look at it now."

A life that was changed forever and a gift that Dodson says he is eternally thankful for.

Since Dodson's heart attack, he plans on attending the annual heart starter mass training this spring.

Chris Welty

cwelty@katctv.com

Skip getting trained & maybe your psychiatrist will be able to buy that new car.

BY MARSHA SILLS Acadiana bureau February 04, 2012

“I’m a living example: This is what knowing CPR can do.” Gary Dodson, who received CPR after a heart attack while jogging.

LAFAYETTE — For years, Gary Dodson put off attending free bystander CPR training held annually at the Cajundome.

But that changed this year, he told a crowd gathered in the lobby of Lafayette General Medical Center.

“You can make a difference. … Everyone needs to know it,” he said.

And no one knows that better than Dodson, who suffered a sudden cardiac arrest Jan. 9 while jogging in Girard Park.

“My heart stopped,” Dodson said.

Though onlookers called 911, no one started CPR — until Deedra Harrington arrived. Harrington, a nurse practitioner at Lafayette General, was driving around the park on her way back to the University of Louisiana at Lafayette’s campus, where she teaches in the nursing department, when she saw a small crowd gathered around Dodson. Harrington continued driving, assuming the man had the assistance he needed, but then instinct kicked in.

“I don’t know what made me turn around,” she said. “There were four people around him. Someone had called 911, but no one had started CPR.”

She continued the chest compressions until the ambulance arrived.

“This is truly miraculous,” said Dr. Christopher Daniels, Dodson’s cardiologist, of Harrington’s intervention.

The story for patients who suffer sudden cardiac arrest like Dodson rarely ends in success, Daniels said.

Dodson had a 99 percent blockage of his right coronary artery, Daniels said.

During a short recognition ceremony Friday afternoon, LGMC President and Chief Executive Officer David Callecod presented Harrington with the hospital’s “Making a Difference” award for her “actions above and beyond” on Jan. 9.

Dodson and Harrington both used the event as an opportunity to stress the importance of learning bystander CPR.

“I’m a living example: This is what knowing CPR can do,” Dodson said before the recognition ceremony.

This year’s “Be a Heartstarter” bystander CPR training will be on April 14 with sessions at 8 a.m. and 10:30 a.m., Callecod said. The free event is now in its 12th year and sponsored by the local medical community and businesses. About 12,000 people have received the training in the past decade, according to the event website.

Though she has specialized training as a medical professional, “advanced skills” aren’t needed to learn and perform bystander CPR, Harrington stressed.

“It’s the individuals in the community that make the difference,” she said.

Dodson will celebrate just how much on his on 66th birthday Feb. 23.

The study needs to be done.

The NIH has launched two multicenter clinical trials that will evaluate treatments for sudden cardiac arrest that occurs out of the hospital.

The CCC trial will compare survival with hospital discharge rates for two CPR approaches — continuous chest compressions combined with pause-free rescue breathing vs. standard CPR — delivered by paramedics and firefighters to those experiencing cardiac arrest. Trained emergency personnel will give all participants in the CCC trial three cycles of CPR followed by heart rhythm analysis and, if needed, defibrillation.

There have been two trials in Scandanavia that showed 30%-40% improvements in outcome with compression-only CPR. There was a study in Japan that showed that, for a specific class of heart disease, compression-only CPR was not as good as 30 & 2 CPR.

What will really be interesting is to see whether the promotion of compression-only CPR will persuade more people to take action at the scene of a cardiac arrest. If compression-only CPR increases the number of bystanders who take action, it the CCC trial will conclude that continuous-compression CPR is a really good thing.

A related, recent study showed that cardiac arrest victims who were intubated - the traditional gold standard for control of the airway - fared far worst than victims who were not intubated. Apparently, it's all about minimizing interruptions during chest compressions, at least in the first 5-10 minutes.

It's easy to read the paper without realizing what needs to be fixed.

Tragically, a 64 y/o gentleman died in San Antonio yesterday. The cause of death has not been announced, but it's likely that it was either a sudden cardiac arrest, a ruptured aortic anurism, or asphyxia via drowning, with the most likely being a sudden cardiac arrest.

It is apparent from the article that there are a number of problems with the way public pools are staffed and managed that make it unlikely that someone could survive in the situation this gentleman encountered. Even more sadly, most of these factors are to some degree controllable by the management of the pool.

THE SHORT FORM:
My mission is not to criticize anyone. My Mission is to point out that the odds of surviving were not good for several structural reasons and to rally public support for changing the environment.

THE DETAILS:
KSAT.com published the news, and their story included the following.

• "Annett told KSAT that she and her husband were swimming on Friday when she noticed him at the bottom of the pool.
• "She called for help and three lifeguards pulled him out and administered CPR, but Earl did not survive."
• There was no mention of an AED's having been used.

OK. Let's stop there and think about what we just read.

• A quick check on the internet reveals that there are two pools at the Blossom Center in San Antonio: a 25 meter long pool, 7-13 feet deep and a 50 meter long pool, 3-12 feet deep.
• These pools are in adjacent buildings.
• The 'three lifeguard' reference suggests that two were assigned in the building that houses the larger pool, and one was assigned in the building that houses the smaller pool.
• The story states that it was the three lifeguards that pulled the victim from the pool.
• The story also clearly states that it was the wife who spotted the victim on the bottom and called for help.

The victim's chances of surviving the incident depends upon the cause of death and the timing of the steps taken subsequent to the victim's sinking to the bottom.

Let's first estimate how much time elapsed between the time of the incident and the time that CPR was initiated. I've included my estimate of the "shortest" (the minimum time possible) and "more likely" (the more likely value for that timing). These "more likely" values are by no means maximums. I am a swimmer and a paramedic and have had to respond in emergency situations.

1. Discovery: the time between the event and the time the body was noticed on the bottom;
2. LG's know: the time between the the body's being noticed and the cries for help were heard and understood by the lifeguards.
3. Response to victim: the time between the cries for help were understood by the lifeguards and the time enough lifeguards were on the bottom at the victim's side to begin getting the victim out of the water.
4. Extrication: the time between the start of the extrication and the time the victim was on his back out of the pool on a hard flat surface.
5. To begin CPR: the time between the victim's being on his back on a hard, flat surface and the time CPR compressions were begun.

Item	Shortest	More Likely	Comments
1.Discovery	2 sec	180 sec	Which pool, how crowded
2. LG's know	3 sec	15 sec	Try yelling something to a LG in an enclosed pool.
3. Response to victim	15 sec	50 sec	Try it before you scoff. If you can swim 50 meters in 50 seconds, the local swimming coach wants to meet you. When you are in rescue mode you can run to a closer point, but on the average - if you are the only LG at a 25 meter pool or one of two LG's at a 50 meter pool, it's going to take you the better part of a minute to get into the water and get alongside the victim on the bottom, sometimes more, sometime's less.
4. Extrication	90 sec	120 sec	If you haven't had to do this, please try it before you complain about my estimates.
5. To begin CPR	1 sec	15 sec	Lifeguards are taught certificated CPR. That's necessary to make sure that management can be reasonably assured that the LG's actually attended class and passed.
Totals	1:51	6:20	If it took 6:20 to begin CPR, his odds of surviving with major brain functions intact had rapidly dwindled to about 1 in 20 by the time CPR began. (10% per minute)

OPPORTUNITIES:

1. There need to be enough life guards on duty so that they have a high likelihood of being the first to notice the problem. One easy way of sizing up the life guard staffing, quality, and management is to walk up to a lifeguard, positioning yourself, if possible, to make sure he or she cannot see the pool, and ask how many people are in the pool. If the LG can't tell you instantly - and without looking at the pool - there is a problem. If there is only one on duty, there is a problem.
2. There have to be enough life guards on duty to get any given swimmer from the bottom to the surrounding deck. After I saw the article this morning, I headed over to a local community pool, saw the lifeguard - a strong, fit person - intently watching the pool. I then took a look at the swimmers and made the assessment that about a quarter of the swimmers were people that the strong, fit LG on duty could not have single-handedly gotten out of the pool. (Yes, the LG answered without hesitation that there were nine people in the pool.)
3. The LG has to have access to other help and an AED. If he or she are in a "one LG, one swimmer" situation, the LG needs a way of activating the emergency network (calling 911) and of getting an AED and a helper to his or her side quickly.
4. There has to be an AED at the facility for the helper, when notified, can bring.
5. The LG's have to drill. How many LG's regularly have had to get 200 pounds of limp victim off the bottom and onto the deck in a position ready for chest compressions?

None of these changes will happen without public pressure. Bob