Somebody do Something … just don’t ask me to perform CPR
For nine years I was the Public Access Defibrillation (PAD)
Program Co-ordinator for a municipality with a population of just under
500,000. It was an exciting time on the frontier of AED placement in Canadian
communities. In five years the number of cardiac arrest survivors in the
community more than quadrupled, from 7 in 2005 to 31 in 2010, with many of
those additional lives being saved by members of the public performing
effective CPR and deploying an AED within minutes of patient collapse.
One life that was not saved was that of a hockey referee. He
collapsed during a game that was well attended in an arena equipped with an
AED. No one that witnessed the collapse knew where the AED was located or how
to use it. No one was able to locate any of the arena staff that were trained
to use the AED. CPR was performed but by the time Paramedics arrived it was too
late for a defibrillator to be effective. In this earlier blog I share my
thoughts on why this should have never happened.
A few weeks after the event the EMS Chief and me met with Executives
from the Hockey and the Referee’s Associations. There were lots of emotions and
lots of suggestions coming from all sides. The consensus was to move forward in
a positive manner that would help ensure that the next time resuscitation needed
to be performed the hockey community would be better prepared.
I lobbied hard with management to be allowed to offer “free”
certification level CPR/AED training to any adult associated with the local
minor hockey association – coaches, trainers, referees, officials and parents.
In the end I was given the go ahead to offer six free sessions for up to 20
people per session over six consecutive Wednesday evenings in February and
March. I would provide the training but the hockey association had to provide
the people. The marketing and promotion, the filling of the seats, was entirely
their responsibility, a condition which they readily agreed to. The first week five adults with two teenagers
in tow showed up – I had prepared 20 manikins and brought in another trainer to
assist. I called the association and they promised more people the next week,
four is not more than five. After three
people showed up in week three I spoke to the association and we mutually
agreed to end the program. Out of the 120 seats that we had made available to
the association 12 were filled.
The following winter good friends of mine that had lost a child
on the ice to cardiac arrest (the AED was deployed but could not convert the heart
back into a blood pumping rhythm) partnered with a local charity to donate an AED to an arena in their
community. After a very nice on ice presentation ceremony that included a long
and heartfelt standing ovation in memory of their beautiful son we announced
that the following morning in the arena’s community room we would be offering
free CPR/AED training to any and all interested parties, the session
was also promoted through other means. Three people, plus the three of us attended.
The next time a coach, referee or player collapses to the
ice and no one in attendance knows what to do where will the blame lie? In a public
sports venue equipped with an AED it is the responsibility of every adult that
regularly attends that venue as a coach, trainer, official or spectator, paid
or volunteer, to acquire basic resuscitation skills. It is not the sole responsibility
of the Zamboni driver to safeguard everyone’s life or to be highly visible
whenever someone collapses.
Again this week a child collapsed after taking a puck in the
chest (a phenomenon called “commotio cordis”
that claims the lives of about twenty young teens each year in North America)
at an arena in Toronto. Thankfully arena staff and trained spectators were able
to resuscitate the child. Nice job by Doug Jamieson and team. According to the CBC News story no hockey people –
coaches, trainers, referees - helped with the resuscitation effort; if this is
not true please let me know.
The CBC interviewed several parents that witnessed the event
and they put forward suggestions on how cardiac emergency response could be
improved at Toronto arenas. The suggestions ranged from somewhat plausible to
downright silly. However not one parent stepped up and suggested that they themselves
and in general more people from the minor hockey community should be trained in
CPR and AED use. There was lots of half-baked, buck-passing, ill-informed
recommendations but not one person stepping up to take a little personal
ownership for resuscitating friends or family members in cardiac arrest.
In a related CBC story from June 2014 a senior executive
from Hockey Canada explained that despite at least 8 on ice deaths in 9 years Hockey
Canada is satisfied with its cardiac emergency response protocols which do not require CPR/AED training for
coaches and trainers. In fact the recommendation is that if a coach or trainer
suspects a player is in cardiac arrest they should seek out someone in the
arena that is trained to manage the situation. This is the stated policy of the governing body of the sport that our entire nation loves so much.
Long before the hockey referee died and every day since (it
has been more than 6 years now) I have shouted from the
mountaintops the importance of universal user group CPR/AED training. I believe
that both minor and adult sport organizations should not be allowed to rent municipal
sports venues unless the majority of their members are trained in CPR/AED and
in general anyone that lives, works or plays in a building equipped with an AED
should be trained.
My final two thoughts on this story:
- When interviewed by CBC Ali's sister used the word lucky. A lot of forethought, planning and training on the part of The City of Toronto and the arena staff went into 13 year old Ali being "lucky" that day.
- When you buy a Ford Escape everywhere you go you see Ford Escapes. When you take AED training everywhere you go you will notice the AED hanging on the wall. Take the training.
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