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Team-Based Emergency Planning: Why it is a Necessity

On Day Two of the 7th Annual Injury Prevention Symposium, West Virginia University professor Samantha Scarneo-Miller details the need for schools and sports organizations to prepare a specific and detailed action plan for medical emergencies on their fields of play 

VAIL/COLORADO SPRINGS, COLO. – The need for emergency action plans and life-saving procedures to be in place at athletic events were never more visible than this past Jan. 2nd when Buffalo Bills’ defensive back Damar Hamlin suffered cardiac arrest after making a tackle against the Cincinnati Bengals in a “Monday Night Football” NFL game in Cincinnati. A large television audience—plus millions more people alerted to the catastrophic event via social media—watched as team athletic trainers, doctors and emergency personnel feverishly worked to stabilize Hamlin and get him transported to the nearest trauma center.

Hamlin has made a complete recovery and is back at full strength with his Buffalo teammates in the team’s minicamp this spring. The emergency action plan set forth by the NFL and followed by the Bills, Bengals and the staff of Paycor Stadium was executed properly and received much praise after its execution helped save Hamlin’s life.

This was indeed a high-profile example of an emergency situation, with national television cameras airing it live and millions of fans watching the event play out. Yet, it is something that is not all that uncommon in the world of competitive athletics. Not all schools or sports organizations have the resources of an NFL franchise, but all need to make similar emergency action plans and be prepared for the extraordinary circumstances that surround a life-threatening injury on the field of play.

Samantha Scarneo-Miller, Ph.D., ATC, an assistant professor and MSAT program director at West Virginia University School of Medicine, spoke about the benefits and the necessary components of an emergency action plan during the afternoon session of Day Two of the 7th Annual Injury Prevention Symposium, virtually presented by Steadman Philippon Research Institution (SPRI) and United States Olympic and Paralympic Committee (USOPC) on June 8, 2023.

Dr. Scarneo-Miller, self-described as a “driven and relentless catastrophic sport injury researcher with a focus on promoting written policy adoption and legal aspects of sport injury,” delved into the specifics of developing an emergency action plan and the need to incorporate a wide scale of medical, administrative and athletic staff personnel to put the plan into use.

While the most frightening emergency situations involve life-threatening events such as the Hamlin incident and spinal cord-related injuries, all traumatic injuries—including concussions, severe fractures and leg injuries—require the same type of prepared action plan to follow at the time of the injury.

“Data collected from the National Center for Catastrophic Sport Injury Research published in 2021 is showing that cardiac arrest remains the top cause of sudden death in sport, followed by traumatic head injuries and exertional heat stroke,” said Scarneo-Miller. “While we're still seeing cardiac arrest leading the pack, we do see about 20% of catastrophic, non-fatal injuries are related to spinal cord injuries. So, this gives us some information about where we can be providing some better services as far as athletic training services or developing policies and procedures.”

Thankfully, not all emergency situations are as severe and life-threatening as what happened in Cincinnati in January, but all situations still need the proper focus of those called upon to deal with them.

“When it comes to emergency planning, we must remember that stressful situations often activate our body's sympathetic nervous system and results in an increased heart rate and increased blood pressure,” added Scarneo-Miller. “It dilates our pupils, and then we see rapid release of adrenaline. Once these hormones reach certain levels, this is when panic can ensue. And when we're responding to an emergency situation, we need to not be panicked. We need to be as calm as possible.

“So, my question for everybody watching this is, ‘are you ready?’ Are you ready to respond to a catastrophic injury?” asks Scarneo-Miller. “Have you developed these proactive, comprehensive policies and procedures and emergency action plans to make sure that you and your organization are ready to respond to these types of injuries? Because again, with sport participation continuing to rise, our risk is still there. And while we know that having access to an athletic trainer is one of the best things that an organization can do to try to mitigate this risk, we also know that the development of comprehensive policies and procedures and emergency action plans can be—in some cases—life or death decisions for our patients.”

Much of Dr. Scarneo-Miller’s presentation was directed toward encouraging healthcare providers to include managers and directors at the small college, high school and club levels into the emergency planning team. These are the places where the majority of athletes compete and where the facilities and resources are more limited than at the major universities and professional sports levels. While all levels need to implement similar emergency action plans, not all have the same power and resources behind them to execute the required activities.

For the managers, directors and athletic trainers at these lower levels, Dr. Scarneo-Miller suggests that team-building is a necessary skill to get their needed action plans in place. It’s not just team doctors, athletic trainers and coaches that need to be part of the action plan.

“It's very important to identify who should be involved in the development of these new documents and plans,” said Scarneo-Miller. “Most places do not include their principal and superintendent and maybe those are people you should be considering. It is also helpful to include local emergency medical service providers in your planning. Running your emergency action plan and policies and procedures by them may trigger some things that they can either help you tweak or make the language more understandable.”

Involving the whole school or club’s personnel and leadership can lead to some positive long-term benefits.

“Bringing together these stakeholders into the same room and really facilitating a positive conversation to get buy-in and support from these individuals will help you in the long run,” continued Scarneo-Miller. “I want to remind you that just because a state may or may not require a certain policy or emergency action plan, specifically in athletics, does not mean that you cannot go and advance your own clinical practice, especially at the high school level. It is imperative that we are always putting policies, procedures and emergency action plans into place regardless of the directives and requirements of our state and government leaders.”

For further information, contact Lynda Sampson, VP External Affairs (lsampson@sprivail.org, 970-479-1563)

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