Article reposted from The Columbus Dispatch
In any one of the 60 minutes of a regulation hockey game, a variety of bad things can happen on the ice. So, as the NHL season approaches, Blue Jackets players aren’t the only ones in Columbus training.
On Monday, the team’s medical and athletic-training staff joined more than 30 Columbus Division of Fire paramedics and six emergency physicians from OhioHealth on the rink at Nationwide Arena to prepare for the worst.
“This is a very dangerous sport,” said Mike Vogt, lead athletic trainer for the team. “Guys are flying around at 20 miles per hour with sharp blades on their feet, carrying sharp sticks and hitting a hard puck around. There are a lot of brutal possibilities.”
There are common hockey injuries, such as knocked-out teeth and broken, bloody noses, which are handled by trainers. And then there are non-traditional hockey emergencies, such as the March 2014 heart attack suffered by Dallas Stars player Rich Peverley while he was sitting on the bench during a game. The Blue Jackets were the visiting team that night, and Vogt had an upclose view of the response.
But in-game emergencies are rare: Paramedics are called to help in Columbus about once a season.
Even otherwise-ordinary emergency situations play out differently on ice, possibly in the confines of a penalty box, in front of tens of thousands of fans, with victims covered in layers of bulky padding. That’s why the NHL requires that paramedics attending games have on-ice training.
This year, the preseason training session had a new layer of realism, with high-tech dummies provided by OhioHealth’s medical-simulation program.
Dr. Brad Gable, associate director of the program, has used simulation techniques to train paramedics for special situations such as bariatric patients and obstructed airways. Firefighters were so impressed that they asked for the dummies to be included in this year’s Blue Jackets training.
Unlike with live volunteers, responders can give a dummy electric shocks, monitor its heart rhythms and see the results of their resuscitation efforts.
Using the simulators “elevated the whole experience,” said Blue Jackets medical director Dr. Joseph Ruane. “It’s easy to do a walk-through, to say, ‘Yeah, we’ll go here and do this,’” he said. Resuscitating a “patient” whose heart isn’t beating is another matter. “We wanted to intentionally add a little anxiety.”
The result, Ruane said, was that this year’s ice training was “clearly better than any in the past.”
One simulator dummy was set up to have a heart attack while on the bench, as happened in Dallas. The other suffered a cardiac event on the ice.
The on-ice scenario led to discoveries: Even though shocking the patient while he’s lying directly on the ice could allow the current to travel to the responders, that painful (but nonlethal) possibility doesn’t necessarily justify delaying the shock until the patient can be put on a board.
And once the patient is on a gurney, slippery footing makes it better for paramedics not to raise the gurney to its full height. Instead, the gurney is more stable if left low. A paramedic can straddle the patient, kneeling, and continue CPR while the others use the straps that normally belt patients to the gurney to pull it like a sled across the ice.
“Every situation, you learn from,” Vogt said.
Once, when Vogt was checking out a player lying in the goal net with neck pain, a paramedic who was trying to help moved the net — on which Vogt was leaning. “I almost fell over,” he said. “So, the lesson there is, communicate.”
In the simulations, the actual mock-run treatments are only part of the lesson, said Karla Short, EMS education manager for the Fire Division. “There’s the experience, but the real learning comes in the debriefing,” she said.
Dr. Ryan Squier is one of six physicians with Mid-Ohio Emergency Services, which contracts with OhioHealth to staff emergency rooms. He and the five colleagues who take turns working the Blue Jackets games “are huge hockey fans,” he said. That doesn’t just make for a nice side gig for the docs; it also helps them more closely follow the action and understand what constitutes a serious emergency as opposed to garden-variety hockey mayhem.
He’s glad he’s never been called onto the ice.
“Our purpose there is if something extremely bad happens,” he said. “For a potentially life-threatening event. If we’re there at the games and we never get called down, that’s a good thing.”
That’s the whole point of medical simulation, Gable said. “It’s a chance to practice the low-frequency, high-risk events. You may only be likely to see it a few times, but you have a chance to practice it, so if it comes up, you know what to do.”