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.)
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.