Rich Peverley came frightfully close to death Monday night. Thanks to quick action by the Dallas Stars medical staff, the 31-year-old NHL player survived.
Six minutes, 23 seconds into the first period in a game against the Columbus Blue Jackets, Peverley collapsed on the Stars bench. The former South Carolina Stingrays player went into full cardiac arrest.
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.
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 incident 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 percent with every minute that defibrillation is delayed. The 15 or 20 minutes spent waiting for paramedics to arrive might prove to be too long.
South Carolina Stingrays president Rob Concannon said the ECHL requires all teams to have defibrillators on site for every game. Cocannon said the league has been in contact with teams to make sure they have a protocol in place for emergencies situations like the one that happened with Peverley.
"I think it was a wake-up call for all the leagues around the country, NHL, AHL, ECHL, the college level and for USA Hockey," Concannon said. "We have great doctors at the North Charleston Coliseum who have a plan in place."
Athletic trainers should be present. Professional and college sports usually have doctors on site for games, but 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.
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.
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.
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 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.
Dr. David Geier is an orthopaedic surgeon and sports medicine specialist in Charleston. For more information about medical emergencies and other topics, go to his blog at drdavidgeier.com.
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