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Emergency Action Plans Save Lives. Here’s How.

Advance With MUSC Health
April 10, 2023
Grassy playing field painted for football at the fifty-yard line.

When emergency strikes, time is of the essence. Here, MUSC Health Sports Medicine Athletic Trainer Michelle Bolton, MS, ATC, SCAT, discusses what happened to NFL player Damar Hamlin and how immediate action — and a well-defined Emergency Action Plan — likely saved his life. 

The collapse of Damar Hamlin during the NFL matchup between the Buffalo Bills and Cincinnati Bengals has brought lots of attention to athletic trainers and what we do as health care professionals. 

What Happened to Damar Hamlin?

The Bills reported that Damar Hamlin went into cardiac arrest after a hit to the chest during the game. When athletes take a direct hit to the chest that results in cardiac arrest, this is a syndrome called commotio cordis. The direct force must occur during the precise time in the cardiac cycle and in the right area of the chest, usually over the lower portion of the heart.

About Commotio Cordis

This syndrome is usually seen in younger athletes, but it can happen to anyone, and the risk increases with participation in contact sports. Time is of the essence: Early recognition and early intervention are key to surviving these types of events.

Athletic trainers spend years learning about the risk associated with sports and spend just as much time preparing to handle emergencies. Injuries can’t be predicted, but skills and knowledge can decrease the risk.

When To Implement an Emergency Action Plan

Should an emergency arise, the Emergency Action Plan (EAP) begins immediately. An EAP is a well-defined plan that illustrates how athletic trainers and other support staff should respond to an emergency and communicate with responding EMS personnel. Some schools have EMS and doctors present at games, so they may have assigned roles as well.

Support staff includes coaches, school administrators, school resource officers, athletic directors and athletic training students. Each individual’s role is clearly defined, and everyone included in the plan should be familiar with their role.

The EAP also shows the location of emergency equipment (AEDs, first aid kits, splints, etc.) and where EMS will report. It may include a map of the facility. A chain of command is established, and the point person delegates when each person should carry out their duties.

The EAP Chain of Command

Examples of duties include who will call 911, who will meet EMS and tell them where to go, who will be on crowd control, who will retrieve emergency equipment and who will communicate with the athlete’s parents. The EAP also outlines what information is to be relayed to dispatch when 911 is called, contact information for the sports medicine staff and directions to the location of the emergency.

Separate EAPs are developed for each field and/or facility used for practices and games. The EAP also includes procedures for response to inclement weather. The staff must know what steps are necessary to ensure the safety of the athletes and spectators. Someone should be assigned to monitor the weather and decide when it is safe to resume activities.

Like fire escape routes, some schools have their EAP posted at each field, gym or other facility used. The EAP should be readily assessable (or accessible) and easy to read. The best practice would be to review and update EAPs at least once a year and meet with local EMS to review any changes and/or introduce the athletic trainer to new staff and ensure they know the role of the athletic trainer.

The primary goal of the EAP is to save a life. Everyone included in the plan should be prepared to respond to any injury or life-threatening situation at any given time. The key is identifying the issues and how to respond. Time is of the essence, and someone’s life depends on identification and proper intervention.

Michelle Bolton, MS, ATC, SCAT, is the outreach Athletic Trainer for MUSC Health Kershaw Medical Center at North Central High School. Schedule an appointment with MUSC Health Sports Medicine.