CPR Training, CAP Add to Preparedness

By Geoff Kimmerly
MHSAA.com senior editor

October 12, 2015

A recent graduate from Ovid-Elsie High School named Chris Fowler started classes this fall at Michigan State University, his days representing the Marauders on the basketball court, football field and golf course now memories as he starts the next chapter of his young adult life.

But his story also will remain a reminder as his high school’s athletic department prepares each year to keep its athletes as safe as possible.

Three years ago next month, Fowler collapsed on the football practice field in cardiac arrest. The then-sophomore was brought back to life by two of his coaches, who revived him with CPR and an AED machine.

There’s no need for athletic director Soni Latz to recount the events of that day when explaining the importance of being ready to respond to a medical crisis – her coaches are well aware of why Fowler survived and understand completely why they too must be prepared.

“Everyone is very aware of what happened and the importance of being trained and knowing what to do, and actually feeling comfortable to step in and administer CPR when needed,” Latz said. “You can feel it’s never going to happen to you, but once it has, it makes you more aware and conscientious to be prepared.”

But Fowler’s story is worth noting on a larger level as varsity coaches at all MHSAA member schools are required this year for the first time to become certified in CPR, and as the largest classes in Coaches Advancement Program history begin course work that includes up to four modules designed to make them aware of health and safety situations that may arise at their schools as well.

The CPR requirement is the most recent addition to an MHSAA thrust toward raising expectations for coaches’ preparedness. The first action of this effort required all assistant and subvarsity coaches at the high school level to complete the same rules and risk minimization meeting requirement as high school varsity head coaches beginning with the 2014-15 school year.

The next action, following the CPR mandate, will require all persons hired as a high school varsity head coach for the first time at an MHSAA member school after July 31, 2016, to have completed the MHSAA’s Coaches Advancement Program Level 1 or Level 2. 

In addition, MHSAA member schools this summer received the “Anyone can Save a Life” program, an emergency action plan curriculum designed by the Minnesota State High School League to help teams – guided by their coaches – create procedures for working together during medical emergencies.

“Coaches get asked to do a lot, and even if a school has an athletic trainer or some other health care professional, that person can’t be everywhere all the time. Coaches often are called upon to be prepared for (medical) situations,” said Gayle Thompson, an adjunct assistant professor at Albion College who formerly directed the athletic training program at Western Michigan University and continues to teach CAP sports medicine modules.

“The more (coaches) can learn to handle the situations that can inevitably arise, the better off they’re going to feel in those situations and the better care they’ll be able to offer their athletes. It’s proven that the faster athletes are able to get care, the quicker they’re able to come back to play.”

Pontiac Notre Dame Prep – which has sent a number of coaches through the CAP program – began a focus on heart safety about five years ago after a student-athlete was diagnosed with a heart issue that allowed her to continue to play volleyball and softball, but not basketball. Athletic director Betty Wroubel said that prior to the student’s diagnosis, the school did provide training in CPR, AED use and artificial respiration; however, that situation put coaches and administrators further on the alert.

Her school offers CPR training also to subvarsity and middle school coaches, using a combination of video instruction from the American Red Cross and in-person guidance by members of the school community who are certified to teach those skills. Students at the school also have received training – and it paid off a few years ago when one of them gave CPR to a baby who had stopped breathing at a local shopping mall.

Portage Central scheduled two sessions this fall for its coaches to receive not only CPR certification, but AED training as well. Central was fortunate to have an American Red Cross first-aid trainer in house, teacher Rachel Flachs, who also is close to the athletic side as the girls swimming and diving coach at Mattawan High School.

Central athletic director Joe Wallace said the training was offered not just to varsity head coaches, but every head coach on every level of the program so that “at least we know that at every given practice, every game, we’d have someone recently trained,” he said.

And he was proud of how his coaches immersed themselves in the subject matter.

“They were putting themselves in scenarios to see how it related to their own sports and asking really great questions,” Wallace said. “It was thought provoking.”

The CAP sports medicine modules are designed to do the same as coaches consider the medical situations they could face. They aren’t designed as “medical training,” said Tony Moreno, a professor of kinesiology at Eastern Michigan University and teacher of all four CAP sports medicine modules. Rather, attendees receive an awareness and basic education on common injuries, injury mechanisms and prevention, and how to create an action plan in the event of an injury incident.

The CAP program touches on a variety of safety topics in several of the available seven levels of coach education.

CAP 1 – which is part of the mandate for new coaches beginning next school year – includes “Sports Medicine and First Aid.” Cap 4 has modules titled “Understanding Athlete Development” and “Strength and Conditioning: Designing Your Program.” CAP 5 includes the session, “Peak Health and Performance.” Attendees also have the option of receiving CPR and AED training as an addition to some courses.  

With a quick Internet search, coaches have no trouble finding a variety of resources on sports medicine, performance enhancement, nutrition and healthy living regarding young athletes. “However, some of these sources are more credible and scientifically-based in comparison to others,” Moreno said. “CAP strives on an annual basis to continue to update and improve the quality and credibility of this information and in a face-to-face manner where coaches have the opportunity to ask questions about their experiences and specific programs.”

“Having the CAP requirement will only make them better informed. Many have had this kind of information before, but there’s always something new coming,” Thompson added. “I think we do a good job, not of trying to tell them they were wrong, but maybe taking what they’ve known a step further and making them better prepared – empowering them to do their best.”

Wroubel may understand more than most athletic directors the growing list of tasks coaches are asked to accomplish; she’s also one of the winningest volleyball and softball coaches in MHSAA history and continues to guide both Fighting Irish programs.

But she and Wallace both said the CPR mandate isn’t considered another box to check on a to-do list; there’s enthusiasm because of its importance and the opportunity to carry those skills into other areas of community life as well.

Wroubel has served as a coach since 1975 and said this renewed emphasis on coaches having knowledge of sports medicine actually is a return to how things were when she started. Back then, coaches were responsible for being that first line of medical know-how, from taping ankles to providing ice and evaluating when their athletes should make a trip to the doctor’s office.

“When I first started coaching, we didn’t have sports medicine people, trainers, or team doctors other than for football. You did everything yourself,” Wroubel said. “I think everybody got away from that, but I think it’s coming back because a trainer can’t be everywhere.

“It’s healthy and it’s good for kids. … The more of us with emergency skills, the better we’re able to serve our community.”

PHOTOS: (Top) Portage Central coaches receive CPR training earlier this fall. (Middle) Pontiac Notre Dame Prep coaches practice during AED training. (Photos courtesy of school athletic departments.)

'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.