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The Collapsed Athlete: Preparation Is Essential

By Steve Mann, 04/05/23, 8:30AM MDT


Recognize, React, Rescue

Few things are scarier than the sight of a young athlete, having collapsed on their field of play, lying motionless and/or unresponsive. The shocking incident several months ago involving Buffalo Bills’ defensive back Damar Hamlin left players and fans at the stadium and millions of football fans watching on TV in disbelief and hopeful for a positive outcome.

Thankfully, Hamlin was saved by an alert and prepared medical team both on the field and later at the hospital. But what about when something like this happens at one of our local hockey rinks? Are we prepared to jump into action if necessary to help our kids?

While it is certainly rare for an 8- or 10- or 12-year-old skater to collapse on the ice, it has happened. And many recall Chris Pronger of the St. Louis Blues crumpling to the ice after being hit in the chest with a puck in 1998. So, having an emergency action plan is critical. It can be the difference between life and death.

Kevin Margarucci, USA Hockey manager of player safety, and Dr. Michael Stuart, USA Hockey’s chief medical officer, discuss this important and timely topic.

USA Hockey: How big of an issue is hockey players collapsing on the ice?

Stuart: Cardiac emergencies are very uncommon. But preparation is key, including having an emergency action plan (EAP) and an automated external defibrillator (AED) in every rink. 

USA Hockey: Is this a recent phenomenon or is just getting more attention now due to social media, political landscape, COVID controversies, what happened with the Buffalo Bills, etc.?

Margarucci: Cardiac arrest in sports is not new. But the recent televised scenario in an NFL game certainly heightened awareness.

USA Hockey: Is this a bigger problem in hockey than in other sports?

Margarucci: Emergencies can occur in all sports and school activities, including ice hockey practices and games.

USA Hockey: How important is it to have an emergency plan in place before the season starts?

Stuart: Sudden cardiac arrest is a leading cause of death in both adults and student athletes. An emergency action plan is essential to save lives by immediately responding to life-threatening emergencies with a basic, straightforward protocol.

USA Hockey: What can/should our local associations do to be ready if this happens at the rink?

Stuart: Preparation is essential. Every association should have an emergency action plan in place. This simple procedure includes: 1. calling 911 to alert the Emergency Medical System, 2. cardiopulmonary resuscitation (CPR), 3. immediate use of an automated external defibrillator (AED) and 4. prompt transfer to hospital emergency department.

Margarucci: Everyone should be familiar with the Emergency Action Plan and the location of the AED so this life-saving protocol can be activated without delay. Successful resuscitation requires a team effort with defined roles, including calling EMS, starting chest compressions, procuring the AED, and guiding the emergency responders to the site of collapse.

USA Hockey: Should associations require coaches and/or officials to have CPR training? Even if not required, would you recommend it?

Stuart: It is strongly recommended that all individuals, including coaches and officials are able to recognize cardiac arrest, call 911, perform chest compressions, locate and apply the AED. 

USA Hockey: It seems as though most youth hockey games (most youth sports really) are played without medical personnel on site. Does this concern you? Is this something we need to change?

Stuart: Yes, the process begins with education and establishment of a cardiac emergency response plan. USA Hockey’s Safety and Protective Equipment Committee is working to pass a proposal that requires medical coverage at all sanctioned tournaments throughout the season. Certified Athletic Trainers are highly qualified medical professionals that can provide care at an event, help create emergency actions plans for your teams, educate all stakeholders (coaches, athletes, parents, administrators) and respond immediately to these emergency situations.

USA Hockey: What should coaches, officials, players and parents each do if a player collapses on the ice, and/or may be showing signs of cardiac arrest? What can they each do to help?

Margarucci: Recognize, React, Rescue.