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.

http12/cancel-one-game.html://leadingcause.blogspot.ca/2012/

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.  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.

http://www.cbc.ca/news/canada/toronto/aed-defibrillator-helps-save-teen-hockey-player-s-life-1.2837497

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.
http://www.cbc.ca/news/canada/nova-scotia/cardiac-arrests-kill-8-young-hockey-players-in-9-years-1.2669393

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.