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.)

Taking a Healthy Approach to Sports

November 8, 2013

By Rob Kaminski
MHSAA benchmarks editor

During election years, it’s a familiar rallying cry: “Four more years! Four more years!”

It’s become commonplace following the third quarter of football games around the country for members of the leading team to march down the gridiron with four fingers raised on one outstretched hand as teams switch ends of the field to signify, “Fourth quarter is ours; finish the job.”

The number four also is significant in education with school terms identified as freshman, sophomore, junior and senior years.  

To that end, the MHSAA is imploring everyone involved in educational athletics to go back to school in 2013-14 with a four-year mission in mind: “Four Thrusts for Four Years.”

The goal is to attain and maintain advanced degrees in sports safety, positioning Michigan schools in the center of best practices for ensuring the health of our product and students, today and beyond.

“Just a brief look around all levels of today’s athletic landscape reveals heightened awareness of health and safety issues,” said MHSAA Executive Director Jack Roberts. “Interscholastic sports as a whole – and particularly school sports in Michigan – has long led the charge to employ the safest contest rules and provide the healthiest environments for our games and participants.

“But, to put it in athletic terms, we can’t sit on the lead,” Roberts added. “We can, and must, improve our games in order to guarantee their existence for future generations. That is our goal, our thrust in the coming years.”

Following are the focal points for this four-year plan:

  • Implement heat and humidity management policies at all schools for all sports.
  • Require more initial and ongoing sports safety training for more coaches.
  • Revise practice policies generally, but especially for early in the fall season.
  • Modify game rules to reduce the frequency of the most dangerous play situations, and to reduce head trauma.

The directive actually kicked off last March, when the Representative Council approved a heat management policy for MHSAA tournaments and a detailed model policy for schools. While not setting requirements for member schools during the regular season, it suggests actions based on heat index – the degree of felt discomfort derived by combining temperature and humidity measurements – that are designed to minimize the risk of heat-related illness during interscholastic participation. 

The policy is mandatory for all MHSAA tournaments beginning this school year, and the MHSAA plans to monitor schools’ adoption of the plan throughout the year to determine best policies moving forward.

Laminated cards containing the policy and heat index chart were printed and mailed to schools in June and continue to be disseminated at statewide meetings this fall. Two publications, Heat Ways and Safety Blitz, were published, mailed and posted to MHSAA.com, heightening awareness of healthy practice regimens, and schools have been offered discounted psychrometer prices through the MHSAA to assist in their efforts to properly monitor weather conditions. 

“This action was significant; but it’s just the next step in a continuous series of actions being taken to make school sports as healthy as possible for students,” said Roberts.

The MHSAA’s proactive movements toward a safer tomorrow are taking place concurrently, rather than sequentially. While the heat and humidity plan is the most developed of the four “thrusts,” other initiatives are underway. Today’s climate prompts such action.

From the NCAA’s new “targeting fouls” to the NFL’s “crown” rule, and of course Major League Baseball’s Biogenesis/PED debacle, the headlines off the field in August centered on protecting the games rather than simply playing them.  Like it or not, it’s the type of news  fans need to get used to as their favorite sports audible to option plays in order to steer clear of the endangered species list.

The situation can’t be overstated. Athletics at all levels has been approaching a crossroads for years, and the time to heed the signals has come.

“Let’s make one thing abundantly clear: The people in charge of football at all levels are wise to craft rules that make the game safer, even if those rules will be controversial,” wrote Andy Staples for SI.com College Football on July 23.

The story continued: “As more information arrives about the long-term dangers of the headshots football players absorb at the high school, college and pro levels, something has to change. The next few years will be messy. The game needs saving, because if it continues as it has, it will get decimated by lawsuits and by parents of young children who decide the potential adverse effects aren't worth the risk.”

When kids stop playing, numbers at the high school level and beyond are bound to diminish as well. To trumpet the vast benefits of interscholastic football while easing parents’ minds on safety concerns, the MHSAA formed a Football Task Force in the spring of 2013. The task force is the first of several to be convened during the next four school years, and the objectives of each are to promote the sports involved as safe, low-risk, competitive athletics through the  development of  better practice policies and modification of playing rules. 

“These task forces will be central to the overarching mission of preserving sports for years to come,” said Roberts. “We believe the MHSAA Football Task Force has set a foundation on which to build. Our discussions involving revised practice policies have reached the draft stage, and we intend to have formal proposals ready to present to the Representative Council in March 2014.”

The work of the 13-member task force – made up of football coaches and school administrators from around the state – will be reviewed by the Michigan High School Football Coaches Association, the MHSAA Football Committee and at the MHSAA League Leadership meeting for fine-tuning prior to reaching the Council.

“It is important that we provide opportunities for children to participate in interscholastic athletics and crucial that we do all we can to ensure they will be safe when they do,” said Football Task Force member Tammy Jackson, principal at East Jordan High School, who has a sports medicine background. “The MHSAA has taken an active role in promoting safety by convening the Task Force to examine current rules and consider modifications to further protect children.”

With so much publicity concerning football safety, the football group was a natural to become the first of several task forces to be assembled.

“We must educate the public on the benefits of all school sports,” said task force member Bill Chilman, superintendent of Beal City Schools. “In the case of football, it must be impressed upon people that it is statistically a very safe game when taught and played properly. The Football Task Force being proactive rather than reactive to this safety movement is key to promoting the lifelong values of football and all school sports.”

And within that public is a group which has the most vested concerns: the parents.

“There is more information available to the general public regarding sport and sport injuries, and unfortunately parents and kids all too often hear about the negative side of sport,” suggests Mike Bakker, athletic director at Fenton High School, and another member of the MHSAA Football Task Force. “It is imperative for the integrity of the sport of football to have coaches and administrators provide information about the safety of the game and the steps we take to keep kids safe. We must educate parents about the proper way to play the game and the signs to look for if problems arise.”

Without getting into the minutia of the new NCAA and NFL playing rules regarding use of the helmet, suffice it to say this will be an interesting fall during which to monitor penalties and their effects on injury numbers, particularly when it comes to concussions.

The rules changes have been reported and debated at the national level ad nauseam, and the mood seems to inexplicably tilt toward skepticism and criticism from the very group that would stage a revolt of epic proportions if football ever became extinct: the fans.

Case in point: six targeting fouls were called in 75 games during the opening weekend of college football over Labor Day Weekend (one ejection was overturned by replay), and the outcry began. Analysts and fans are afforded frame-by-frame replays which onfield officials do not have the luxury of seeing before throwing the flag.

Like it or not, the rules are in place. And, they have been implemented to protect the future of the game. The impetus now falls to the caretakers of the game – the officials – who no doubt will bear the brunt of disapproving masses in the stadiums. Yet, football is their livelihood too; both players and officials are expected to make adjustments. 

At Officiate Michigan Day and the ensuing National Association of Sports Officials Summit this past July in Grand Rapids, the theme was clear: “The game has changed, and the officiating has to change with it.”

From NFL Referee Jeff Triplette to SEC Coordinator of Officials Scott Shaw to Big Ten Referee Alex Kemp and Fox Sports NFL Rules Analyst Mike Pereira – people who have been around the block – the message delivered was that the changes are necessary for the health and growth of football.

“We’re talking about taking out a specific type of play that, quite honestly, you didn’t see that much of before about 10 years ago,” Triplette said during a player safety panel at the NASO Summit. “They still played defense, there were still great hits. But somehow, these violent types of tackles began to get notoriety – whether it was all the ESPN highlights, YouTube, and maybe a combination of all of that stuff – and players started to celebrate those hits, and that became the goal.”

Not only can the game become safer; it might even become better by going retro. In recent comments on The Sports XChange, NFL analyst and former coach John Madden said, “You are always concerned how any change will impact the game. In this case, players are not going for the head shot, that big hit. They are keeping their heads up.  Better tackling has become the unintended consequence. That's a good thing. Good for football. Good for kids watching. Players are tackling the way they are supposed to, with their shoulders and wrapping up. The big hit, the big replay had become so popular that tackling suffered.”

In high school, the most notable rule change involving helmets involves penalties for players who lose their helmets during a play. However, illegal helmet contact continues to be a point of emphasis and carries a minimum of a 15-yeard penalty as it has for many years. In the NCAA the mantra on helmet-to-helmet blows is, “When in doubt throw them out,” as the foul now carries with it a player ejection.

That is not the high school rule—yet—but officials at all levels need to be on the lookout. Kemp was quick to warn a roomful of prep football officials during Officiate Michigan Day, “We’ve been told to err on the side of safety, and these plays will result in ejection,” while also adding that such plays will be reviewed by replay officials. “That portion of the rule isn’t there in high school yet, but be ready for it; it’s coming, so when it happens in your games take notice and determine the severity.”

Which brings us to contest rules for safer play. During the next few years, various sport groups will be assembled to follow the MHSAA football task force’s lead in scrutinizing rules and developing proposals for revisions or additions to be submitted to the National Federation of State High School Associations. Initial football discussions receiving some traction involve changing the enforcement spot on post-interception penalties and limiting the number of yards teams can run up on free kicks. Before any submissions are made to the NFHS Football Committee, the task force will conduct research and present findings to Michigan committees.

“We can make changes ourselves – through MHSAA sport committees – for the subvarsity level, but our committees can only make recommendations to national rules committees for varsity level play,” explained Roberts. “Over the next four years, we will be asking our sport committees to give more time to the most dangerous plays in their sport – identifying what they are and proposing how to reduce that danger.”

While the football task force here at home is finalizing practice policy proposals targeted for implementation in the fall of 2014, Texas and Illinois are two states which launched restrictions with the opening of football this season.  Spokespersons from both states indicate that coaches and school administrators have been pleased with the new formats.

Coaches no doubt will need to adjust practice itineraries and budget time wisely.  Administrators need to remind staffs that the new era is dawning in the name of player safety, which is paramount to all parties.

“In game situations, coaches want our officials to throw the flag on late hits, low hits and other illegal contact,” Roberts said. “These are incidents that they have no control over. They do have control over practice time and teaching fundamentals; so let’s encourage safety measures that we can control, and employ those tactics to help the game prosper.”

Education will key the efforts to align coaches of all sports – and all levels – in the movement toward a healthy future.  School will be in session during the next four years as the MHSAA implements effective and practical means for raising coaches’ preparedness. Three avenues are on the map:

First, the Representative Council mandated that beginning with the 2014-15 school year, all assistant and subvarsity coaches at the high school level must complete the same MHSAA rules meetings currently only required of varsity head coaches or, alternatively, one of the free online sports safety courses posted on or linked from the MHSAA Website that is designated as fulfilling this requirement.

Second, it is proposed that by 2015-16, MHSAA member high schools will be required to certify that all of their varsity head coaches have a valid CPR certification.

Third, it is proposed that by 2016-17, any person who is hired for the first time to be the varsity head coach of a high school team, to begin after July 31, 2016, must have completed either Level 1 or Level 2 of the MHSAA Coaches Advancement Program. The MHSAA is preparing to subsidize some of the course cost for every coach who completes Level 1 or 2.

Together, these changes will move Michigan from one of the states of fewest coaching requirements to a position consistent with the “best practices” for minimizing risk in school sports and providing students a healthy experience.

At stake in these four thrusts – whether for an administrator, coach, official, student-athlete, parent or fan – are the environments that offer so many lessons and the games for which we root.