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Monday, October 6, 2014

The NHL Learned a Lesson by @ChicksDigHockey

Jiří Fischer played his entire career as a defenseman with the Detroit Red Wings. The wings were playing the Predators on November 21, 2005 when Fischer, then 25 years old, went into cardiac arrest on the bench. The team physician, who was also an emergency-room physician, had a seat behind the bench and had an Automated External Defibrillator (AED) nearby because he knew Fischer had a heart condition. He reached Fischer in seconds. Over the course of six minutes and with the assistance of an external automatic defibulator Fischer was successfully resuscitated and transported to a hospital. 

On March 10 2014, the Dallas Stars hosted the Columbus Blue Jackets. Dallas' Rich Peverley collapsed on the bench with a "cardiac event" during the first period after finishing a shift. He was resuscitated (including a defibrillator shock) and underwent a successful heart surgery nine days later. 
The NHL strengthened its emergency medical standards after the Fischer incident. Each team needed two doctors near the benches at each home game, and at least one needed current training in hockey-specific trauma management or Advanced Trauma Life Support (ATLS). Each team needed one AED at the home bench and another on an ambulance dedicated to the players.

Pay attention because this is an incidence of the NHL getting it right. 

After the Rich Peverley incident last season, the NHL has strengthened its standards further. Each team needs three doctors near the benches at each home game – an orthopedist, a primary care physician and an ER physician – and at least one, if not all, must have current training in ATLS and Advanced Cardiac Life Support.

That’s a preemptive strike. That’s the NHL saying to its players, “We’ve got your six”.

If and when there is another life-threatening emergency – a cardiac event, a severe laceration, an obstructed airway – there will be an extra layer of expertise and experience to ensure the best possible outcome. In the past, team physicians were often internists who did not specialize in trauma medicine. Also, many teams treated their team Docs to seats in luxury suites located high above the ice and far from the bench. Now, they are required to be in close proximity to the bench. 

The Stars had an ER physician at the game in which Peverly collapsed in addition to their team physician. According to an account published on Yahoo Sports:
 "They removed Peverley’s sweater and shoulder pads. They did chest compressions, gave him oxygen, started an IV and defibrillated him. They needed to shock him only once before he regained consciousness. It all happened in less than three minutes."

This new mandate makes sense. Hockey is the fastest of professional sports. Skate edges are razor sharp, pucks are frozen hard and propelled by sticks. Players collide with boards as well as each other but neither of the players discussed here needed help as a result of injury. Proof that the NHL team approach to emergency preparedness is what’s best for player safety. 

Jiří Fischer never played in the NHL again although he has played in the occasional alumni game. He’s 34 now, a father of two and the Wings’ director of player development. Peverley, now 32, is cleared to work out with the team but not to skate with them. His future as an NHL player remains uncertain.

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