Dec 21, 2016
Emergency Response: Part 3
Timothy Neal

In the previous two installments of “Emergency Response,” Timothy Neal described the harrowing treatment of heat stroke in a football player. Learn about the outcome in this final article.


While en route to the hospital, Ryan started to regain his sensorium and vital signs and started talking more with me in the ambulance. Upon arrival to the hospital, I gave the emergency room physician Ryan’s history and immediate care. Dr. Tucker arrived within minutes and took over Ryan’s treatment. Once Ryan was determined to be stable, Dr. Tucker and I called his parents in Massachusetts, informing them of Ryan’s situation and letting Ryan speak with them. The parents then started toward Syracuse, meeting Dr. Tucker and I a few hours later at the hospital.

I also called Coach Pasqualoni and the Athletic Director at the time, Jake Crouthamel, as well as the university risk manager to inform them of the emergency per our EAP. Coach Pasqualoni arrived at the hospital shortly afterward to visit Ryan before he was admitted for observation, and Coach was relieved to see Ryan in a better condition than just an hour previously.

Ryan spent several days in the hospital. The physicians monitored his CK levels and other electrolytes and tested his vital organs for any damage, of which there was none. Ryan was eventually released and spent the rest of the preseason indoors. Then, he started a very gradual return to activity, returning fully by mid-September.

Ryan suffered no long-term damage to any vital organs and never again experienced any heat-related problems during practice, games, or conditioning sessions during his playing time at Syracuse University. He went on to have a great career at Syracuse, becoming an All Big East Conference Player and a four-year All Big East Conference Academic First-Team Member. After graduating from Syracuse, Ryan went on to a five-year NFL career.

This situation serves as a reminder for the reader that even if athletes aren’t “at risk,” an emergency can still occur that the athletic trainer must be prepared for.

Examining this emergency in hindsight, I believe it was an aberration or a “one-off.” Ryan wasn’t ill, had no reported history of heat-related problems, and was weighing himself pre- and post-practice per team rules. His practice hadn’t been that strenuous, and the climate was in the high 70s, with minimal humidity.

This situation serves as a reminder for the reader that even if athletes aren’t “at risk,” an emergency can still occur that the athletic trainer must be prepared for. Athletic trainers are vigilant for athletes with pre-disposing conditions or in situations where emergencies can occur. However, all athletes are at risk during participation, and being prepared with an effective and practiced EAP, anticipating and acting on evolving events, having experienced athletic training staff on-scene rendering care, and having a close relationship with the team physician are all valuable elements in quickly recognizing and managing a medical emergency.

I encourage all athletic training students and athletic trainers to read the NATA Position Statement: Emergency Planning in Athletics. I also highly recommend attending talks or reading articles on emergency care by two particular athletic training professionals: Ron Courson, ATC, PT, NREMT-I, CSCS, Director of Sports Medicine at the University of Georgia, and Darryl Conway, MA, ATC, Associate Athletic Director for Student-Athlete Health and Welfare at the University of Michigan. These two professionals are the top athletic training resources in managing medical emergencies in athletics. I hope Ryan’s story has been helpful in assisting you in meeting the next significant moment in your athletic training career.

Timothy Neal, MS, ATC, is Program Director of Athletic Training Education 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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