'Anyone Can Save a Life' Aims to Prepare

July 28, 2015

By Rob Kaminski
MHSAA benchmarks editor

It was 2008 when Jody Redman and staff at the Minnesota State High School League developed an emergency action plan to provide guidance and procedure in the event of sudden cardiac arrest during scholastic athletic competition.

The desired response from schools upon receipt of the plan was, well, less than enthusiastic.

“Only about 40 percent of our schools used the information and implemented the program,” said Redman, associate director for the MSHSL. “Our focus was completely on sudden cardiac arrest, that being the worst-case scenario regarding athletic-related health issues.”

The MSHSL asked the University of Minnesota to survey its member schools, and results showed that the majority of schools not on board simply felt a sudden cardiac arrest “would never happen at their school.” Naive or not on the schools’ parts, that was the reality – so Redman went back to revise the playbook.

“We expanded the plan to deal with all emergencies, rather than specific incidents,” Redman said. “Now it’s evolved so that we are prepared to deal with a variety of situations which put participants at risk. We shifted gears and got more schools to participate.”

Did they ever. And not just in Minnesota.

This summer, the “Anyone Can Save a Life” program, authored by the MSHSL and the Medtronic Foundation, is being disseminated to high schools nationwide with the financial support of the NFHS Foundation. The program will reach schools in time for the 2015-16 school year.

Once received, schools will find that there are two options for implementation, via in-person training or online.

“The in-person method is facilitated by the athletic administrator with the assistance of a training DVD” Redman said. “The important element is the follow through, ensuring coaches return their completed Emergency Action Plan (EAP). With the e-learning module on anyonecansavealife.org, individuals will complete an e-learning module that will walk them through the details of their specific plan, and as they answer questions, the information will automatically generate a PDF of the Emergency Action Plan (EAP) which they can edit at a later date as information changes.”

Schools will find five major components of the program to be received this summer: the first is an implementation checklist for the AD, explaining their role. Next are sections for in-person training, online training and event staff training. The last item contains a variety of resources that will ensure the successful implementation of a comprehensive emergency response to all emergencies. 

Generally speaking, the program prompts schools to assemble preparedness teams, broken into four categories: a 911 team, a CPR team, an AED team and a HEAT STROKE team. The groups are made up of coaches and their students who will be in close proximity to all after-school activities.

“The reality about school sports is, at 3:30 every day the office closes and any type of medical support ceases to exist,” Redman said. “We then send thousands of students out to gyms, courts, fields and rinks to participate without systemic support for emergencies. This program puts into place that systemic support.”

Another stark reality is that the majority of schools in any state do not have full-time athletic trainers. Even for those fortunate enough to employ such personnel, it’s most likely the training “staff” consists of one person. That one body can only be in one place at one time, and on widespread school campuses the time it takes to get from one venue to another could be the difference between life and death.

“Athletic trainers can champion the program, but someone needs to oversee that every coach has a completed EAP in place,” Redman said. “For every minute that goes by when a cardiac arrest occurs, chance for survival decreases by 10 percent.”

Thus, it’s imperative to train and grant responsibility to as many people as possible, including student-athletes. In fact, students are a vital component to having a successful EAP. Students will be put in position to call 911, to meet the ambulance at a pre-determined access point, to locate the nearest AED, to make sure emersion tubs are filled for hot-weather practices, and for those who are trained, to assist with CPR.  Coaches will identify students at the beginning of the season and prior to an emergency taking place.  They will provide them with the details of the job they are assigned so they will be ready to assist in the event of an emergency. 

“We have game plans for every sport, and for every opponent on our schedule,” Redman said. “But we don’t have a plan to save the life of a member of our team or someone attending a game at our school.

“This is about developing a quick and coordinated response to every emergency so we give someone in trouble a chance at survival, and then practicing it once or twice a season. We have ‘drop the dummy’ drills where we drop a dummy and evaluate how it went, and how everyone performed. In one scenario, it’s the coach that goes down, and then you have a group of 15- or 16-year-olds standing there. That’s why students have to take ownership of this, too.”

The key to an effective emergency action plan is to utilize and empower students in every sport and at every level to be a part of the response team. Following are brief descriptions of the teams.

The 911 Team 

  • Two students will call 911 from a pre-determined phone and provide the dispatcher with the location and details of the emergency.

  • Two students will meet the ambulance at a pre-determined access point and take them to the victim.

  • Two students will call the athletic trainer, if one is available, and the athletic administrator and alert them to the emergency.

The CPR Team

  • The coach is the lead responder on this team and is responsible for attending to the victim and administering CPR, if necessary, until trained medical personnel arrive.

  • One person is capable of providing effective CPR for approximately two minutes before the quality begins to diminish. Having several students trained and ready to administer CPR will save lives.

The AED Team

  • Two students will retrieve the AED and take it to the victim.

  • Two students will physically locate the athletic trainer, if one is available, and take him or her to the victim.

The Heat Stroke Team

  • Two students identify locations of emersion tub, water source, ice source and ice towels.

  • Two students prepare tub daily for practices and events.

For more information, visit anyonecansavealife.org or contact the MSHSL.

Next Play: Heart of the Matter

June 25, 2015

By Rob Kaminski
MHSAA benchmarks editor

From the retirement of NFL players in their mid-20s fearing long-term disability, to NASCAR drivers suffering injuries against concrete walls when alternative substances are available, to MLB outfielders running into barriers which place aesthetics and tradition over safety, the focus of highlight shows, apps and old-fashioned sports pages is shifting from action inside the lines to the sidelines.

As the reality of human vulnerability continues to invade our favorite escape from reality – athletics – protecting those in the spotlight needs to be Job 1.

While the quest for risk management protocols and health and safety provisions is a never-ending loop, the MHSAA bolted from the starting blocks with a 4H plan (Health Histories, Heads, Heat and Hearts) in the fall of 2009, a mission that enters the fourth turn for the 2015-16 school year.

And, as pulse quickens for the “Heart” stage in the fall, the MHSAA will continue to step up initiatives involving the other three initiatives during the next lap.Think of it as a continuous relay, where the baton is never dropped and fresh runners continue the race.

While organizations at other levels might be asking, “What to do,” the MHSAA is focusing on “What’s next?” 

In this playbook the next plays are critical in allowing student-athletes to continue providing their communities with inexpensive and entertaining breaks from reality.

The Heart of the Matter

The 2015-16 school year brings with it an ambitious but paramount stage in the MHSAA’s mission to protect and promote the well being of student-athletes across the state.

Beginning in the fall, all high school varsity coaches will need to have Cardiopulmonary Resuscitation (CPR) certification by established deadlines which correspond to rules meetings.

The requirement is new, and the volume of personnel affected is vast. Yet, plans have been in place during the past few years, and schools in many communities are ahead of the curve.

“We’ve fielded some questions regarding the requirement, but I think that many of our schools  already have similar protocols in place,” said MHSAA assistant director Kathy Vruggink Westdorp. “Increasingly, schools have become more prudent with regards to health and safety, and programs which emphasize these initiatives have been well received.”

Pete Ryan, MHSAA Representative Council member and athletic director for Saginaw Township Community Schools, concurs.

“The CPR requirement will not be a change for Heritage, as we have required CPR for eight years,” Ryan said. “We offer certification through our district nurse at no charge to the coaches and train about 20-30 coaches per year.”

The training vehicle might vary from district to district, but so long as the end result is certification, the coaches are free to take course by any means possible, whether online or in person.

“I think we’ll see a blend of online and classroom delivery,” Westdorp said. “And, I don’t think it will be just the coaches. At the MIAAA Conference (in March), school leaders were proactive in terms of certification for athletic directors, too.”

Mike Bakker, President of the Michigan Interscholastic Athletic Administrators Association and athletic director at Fenton High School, says CPR certification is a must in the risk management plans for all school settings.

“As an educator who has been a CPR and first aid instructor for the American Heart Association for a number of years, I am excited that the MHSAA will require CPR training for varsity coaches,” Bakker said. 

“I certainly hope that in the future we will see that all coaches are trained in CPR. There might be a bit of a challenge at first to get our coaches trained, as schools look for the most economical as well as timely way to accomplish this mandate. The biggest hurdle that I can foresee is trying to find qualified trainers in all areas of the state that have multiple training dates available to fit the needs of such diverse coaching staffs.”  

Ryan believes there is no substitute for the personal touch.

“We are doing in-person training which I feel is better because the individuals have to perform the procedure on the practice dummy," he said. "It’s simply more hands-on training.”

School nurses and trainers will play a substantial role in the certification process, as will community health organizations in many locales.

“In many of our schools, the health educators are certified to conduct CPR courses,” Westdorp said. “We’ve also had numerous calls from non-school entities alerting us to their availability to provide training, such as fire departments and local medical centers.”

Fenton is one such school with the luxury of on-site personnel to train its staff.

“We are fortunate in Fenton that our athletic trainer and athletic director are certified trainers so we can accomplish our training in-house, but I know that not all schools are as fortunate,” Bakker said.

Which is exactly why it’s necessary for coaches to become certified, and ideally not just the head coaches.

“It should be encouraged that all coaching staff become CPR certified so that they are able to take action, especially for schools which do not have an athletic trainer on staff and if the head coach is unavailable or present, in the unfortunate event that a potential cardiac emergency and/or sudden-death incident occurs,” said certified athletic trainer Gretchen Mohney, the Clinical Coordinator and Instructor for Western Michigan University Undergraduate Athletic Training Program.

Mark Mattson, athletic director at Traverse City Central, indicated that while not previously a requirement, the district has been proactive in prepping the coaches.

“From the moment the requirement was announced, we've been out in front of it,” Mattson said. “What’s great is, even though it hasn’t been a requirement for Traverse City Area Public Schools, many coaches are indeed already certified. The district also offers training sessions once a month and those dates are passed on to our coaches. Jason Carmien (AD at Traverse City West) and I have also had conversations about providing training at our preseason coaches meeting for those still in need prior to the start of the fall season.”

Coaches can also count on a familiar training source to come through for certification: the MHSAA Coaches Advancement Program. Westdorp, who heads up the expansive continuing education program for the state’s coaches, envisions coursework at select sites which will build CPR training into the session, giving attendees more added incentive and training opportunities.

CAP has also served as a siren to inform and remind the MHSAA’s constituents about the upcoming regulation.

“In all CAP courses this school year, we’ve been educating the coaches about the CPR requirement,” Westdorp said. “We also can format the courses to include a two-hour block for CPR certification within the CAP training. We could even do it with a league and conference group where we set up rotations, and the CPR aspect would be one of the rotations.”

Westdorp added that many athletic directors currently schedule coaches meetings and additional coursework around CAP training. It’s a perfect fit to deliver pertinent messages while all parties are in one location.

Such gatherings could also provide the opportunity for athletic leaders to share emergency action plans.

Along with the CPR component of the MHSAA’s health mission for the coming school year, schools will be asked to have in place and rehearse emergency action plans involving cardiac and other health-related emergencies.

To assist, schools will receive this summer the “Anyone Can Save a Life” program developed by the Minnesota State High School League and endorsed and delivered nationally by the National Federation of State High School Associations (check back for more on this program later this week).

“The ‘Anyone Can Save A Life’ initiative promotes the need to have and to practice planning for different kinds of emergencies; it involves students as well as adults; and it invites schools to include their previously existing  plans,” said MHSAA Executive Director Jack Roberts.

“The result can be a fresh, comprehensive emphasis on preparing for emergencies well before they occur and then responding with more confidence when those emergencies inevitably happen. It is the perfect link between the last two years when we focused on heat illness and the next two years when we focus on sudden cardiac arrest,” Roberts added.

It will also be of primary concern to place automated external defibrillators (AEDs) in all schools and provide training for use of the devices.

The reasoning behind such a full-court press can be backed by simple facts. 

  • At any one time, an estimated 20 percent of the U.S. population congregates on school grounds, increasing the likelihood of school-based cardiac emergencies.
  • Victims of SCA can be brought back to life by providing chest compressions and early defibrillation with an AED.
  • Every second counts. When SCA occurs, chest compressions and the use of an AED need to start immediately.
  • The AED can only help and will only deliver a shock if it is needed.
  • The AED is very easy to use. Just turn it on and follow the voice prompts.

The best way to combat such situations is to create an atmosphere of preparedness; making sure all people in close proximity to potential victims can respond with quickness, confidence and precision to help reduce fatalities.

“In order for best practices to be achieved, it will require coordinated efforts to establish a quality emergency action plan among the entire athletic department staff, which should be practiced annually. This should be viewed as the first line of preparedness and defense in sports safety,” said James Lioy, an adjunct professor in athletic training at WMU who was named Michigan High School Athletic Trainer of the year in 2000-01.

That’s the goal of action plans such as those included in MHSAA CAP Levels and the Anyone Can Save A Life program.

“We've taken the ‘know-how’ out of it. You don't have to know how to perform the medical procedures to be trained and prepared as part of an effective emergency response team,” said Jody Redman, associate director of the Minnesota State High School League and one of the authors of the Anyone Can Save a Life program.

A common refrain in athletics to assign perspective on sport in society is, “It’s just a game; it’s not life or death.”

However, in the most dire of circumstances, participants indeed can be faced with life or death. Knowing how to respond can make all the difference.