Dec 21, 2016
Emergency Response: Part 1
Timothy Neal

There are significant dates in any athletic training career. For some athletic trainers, those might be the dates they passed their BOC exam or when they started their first job.

For those of us who have faced life and death emergencies, those dates remain with us and remind us to continuously improve and prepare. Some of those dates for me are Nov. 7, 1981 (fractured larynx in a wrestling student-athlete), April 12, 1984 (subdural hematoma in a football student-athlete), Jan. 26, 1998 (hemothorax in a men’s lacrosse student-athlete), Sept. 29, 2001 (sudden cardiac arrest and use of an AED on a football official during a game), and many others that include anaphylaxis, seizures, torsion testicles, fractured skulls, pulmonary embolisms, sickle cell crises, and major joint dislocations.

This three-part article will tell the story of another emergency date in my career: Aug. 14, 2004. It was during my time as Assistant Director of Athletics for Sports Medicine at Syracuse University. It is a story of a heat stroke emergency in a Syracuse football student-athlete, Ryan Durand, who has granted permission to tell his story for this article. I hope that his story and the key moments of that emergency can help the reader better prepare for the next significant moment in their career. It is a story of preparation, anticipating and setting up the next several steps in the emergency action plan (EAP), and the seamless teamwork of the athletic training staff and team physician — all of which combined to save Ryan’s life.

The take-home points of this article are:

• The importance of an EAP

• Early recognition and action to meet the detected emergency

• Thinking ahead and adjusting the emergency care in anticipation of potential consequences of the emergency as it evolves

• The teamwork that is so valuable between the certified athletic trainer and team physician

Ryan was a freshman football student-athlete at Syracuse on Aug. 14, 2004. It was the end of a relatively cool day for August in Syracuse, and the football team was in the midst of its acclimatization practices. The players had plenty of access to water and Gatorade, and a break was taken midway through a relatively short practice. The players ran five 110-yard sprints for their conditioning for the day.

When the team left the field, Ryan stood still and appeared winded and mildly confused. Brad, Troy, and I approached him and started our assessment… We immediately recognized this situation as an emergency and started to act on our [emergency action plan].

As the team broke from the post-practice huddle, then-Associate Athletic Trainer (now Assistant Athletic Director for Sports Medicine) Brad Pike, ATC, PT, and Assistant Athletic Trainer Troy Gerlt, MS, ATC, and I remained on the field. The four graduate assistant athletic trainers had already broken down the field and were on their way into the football complex at Manley Field House, with the lead graduate assistant athletic trainer already at the point of the team column heading into the field house, approximately 200 yards away.

When the team left the field, Ryan stood still and appeared winded and mildly confused. Brad, Troy, and I approached him and started our assessment. Very quickly, we established that Ryan was not responding to any of our questions and was not sweating. Since that day’s session was only a shorts and T-shirt acclimatization practice, there was no contact, and Ryan couldn’t have been concussed. We immediately recognized this situation as an emergency and started to act on our EAP as Brad and Troy placed Ryan on the field cart. Troy started driving the cart to Manley. It was better to get Ryan to immediate help rather than staying on the field waiting for help to come to us.

Running alongside the cart, I immediately called our Medical Team Physician, James Tucker, MD, who was due any moment at Manley Field House for an evening medical clinic. He picked up on the first ring. I quickly informed him of Ryan’s status and that Brad — who was riding on the cart with Ryan and monitoring his vital signs — was calling for an ambulance per our EAP. Dr. Tucker was only two blocks away and sped to Manley.

While still running next to the cart, I then called the lead graduate assistant athletic trainer in Manley and instructed him to bring as many IV sets as he and the other graduate assistant athletic trainers could carry, along with the portable oxygen unit, the AED, ice, towels, ice bags, and the physician emergency crash kit, to the curb in front of the football complex at Manley. I did this for three reasons:

1. I wanted to be able to start immediate care when Dr. Tucker arrived. I had been in several emergencies during my time at Syracuse, and the response time for paramedics was not consistent. I did not want to lose time waiting for advanced care — the athletic training staff and Dr. Tucker were going to perform the advanced care right there on the curb.

2. The ambulance could easily find us on the curb when they arrived at Manley instead of finding the right door or meeting someone to direct them to the athletic training room, saving precious time.

3. I was anticipating that Ryan’s condition could worsen and wanted the necessary equipment at the scene ready for use.

Check back next week for part 2 of “Emergency Response.”

Photo by Lance Cpl. Edward C. deBree.

Timothy Neal, MS, ATC, is Assistant Professor and Clinical Education Coordinator of the Athletic Training Education Program at Concordia University Ann Arbor. Previously, he spent more than 30 years at Syracuse University, serving in a variety of sports medicine roles. He can be reached at: [email protected].

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