Rich Peverley came frightfully close to death Monday night. Thanks to quick action by the Dallas Stars medical staff, the 31-year-old forward survived.
Six minutes, 23 seconds into the first period in a game against the Columbus Blue Jackets, Peverley collapsed on the Stars bench. Players immediately started banging their sticks on the ice and boards to attract the attention of the officials and to seek medical help.
According to Dr. Gil Salazar of UT Southwestern Hospitals, the medical staff responded quickly. They started chest compressions, placed an IV, provided oxygen, and utilized a defibrillator. Peverley, who underwent a procedure at the beginning of the season for an irregular heartbeat, regained consciousness in the stadium and was quickly taken to a hospital.
Despite Peverley’s improvement, the Stars and Blue Jackets chose to postpone the contest.
The Dallas Stars were prepared. If a similar cardiac event had occurred at a youth hockey game, or during an adult recreation league soccer game, would the athlete have survived?
Teams of every sport, age and skill level should remember four points from Peverley’s collapse to avoid tragedy.
Sports facilities should have a defibrillator on site. While sudden death in sports is not common, it can occur. Estimates of the incidence of sudden cardiac death during sports range from 1 in 25,000 to 1 in 200,000 athletes.
Early use of a defibrillator is thought to be the best determinant of survival after out-of-hospital cardiac arrest. Survival rates drop 7 to 10% with every minute that defibrillation is delayed. The 15 or 20 minutes spent waiting for paramedics to arrive might prove to be too long.
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Have athletic trainers present. Professional and college sports usually have doctors on site for games. Physicians rarely cover games at other levels in sports other than football.
Athletic trainers are qualified medical professionals critical to the care of athletes. They are trained in the evaluation and management of injuries and medical illnesses. In an emergency, they can start resuscitation and stabilize the athlete until paramedics arrive to transport the athlete to a nearby hospital. All schools and teams should work to have athletic trainer coverage.
Develop an emergency action plan. Before a serious injury or medical event occurs, outline a plan for coaches, athletic trainers and others to quickly and effectively react. Ensure that the ability to communicate with emergency medical services and hospitals is available, and know who will initiate that contact. Know where the defibrillator and other medical supplies are. Determine the quickest way that an ambulance can get onto the field. These details should be worked out before the season starts, and everyone involved with the team should know the plan.
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Every athlete should get a pre-participation physical exam. High school and college athletes are required to get physicals. A young adult who plays men’s league baseball might not have seen a doctor for years. He might not know that he has a risky heart condition.
For instance, hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in athletes. Some people have symptoms like shortness of breath, chest pain or feelings of a racing heart. Often, though, sudden death is the first manifestation of an athlete’s heart condition. While the detection of many conditions requires more advanced testing, a routine physical exam is at least a start and probably worthwhile for all athletes.
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After Peverley’s collapse, Stars coach Lindy Ruff admitted to reporters that he was scared. “If it wasn’t for our doctors and all the members (of the training staff) reacting so quickly, I could be standing here with a different story. They were there ASAP. It’s an absolute marvel after what he went through.” Peverley will undergo ex testing this week to determine if and when he can return to the ice.
In an instant, Rich Peverley’s life was at stake, and the Dallas Stars were ready. Hopefully this event will serve as a reminder that all teams need to prepare now for a medical emergency.
Should emergency personnel be mandatory at all football games? In the Zone segment from Episode 18 of The Dr. David Geier Show
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Note: A modified version of this post appears as my sports medicine column in the March 13, 2014 issue of The Post and Courier.