The horror that gripped the NFL when Buffalo Bills defensive end Damar Hamlin collapsed and went into cardiac arrest during a game this week in Cincinnati was all too familiar to members of the hockey community.
Five players in the NHL in the last 25 years who have collapsed during a game – terrifying scenes that stopped play as people scrambled to help – have been diagnosed with some kind of heart-related issue.
Big defenseman Chris Pronger went down after taking a puck in the chest. Jiri Fischer, Rich Peverley and Jay Bouwmeester all fell to the bench. Ondrej Pavelec went down on the ice.
All recovered – a couple of them continued to play for years – and the incidents prompted the NHL to adjust procedures to prepare for and manage cardiac events, as rare as possible.
“It allows you to make sure your protocols are working,” said Pronger, who suffered from the condition commotio cordis when he was hit in the chest during a playoff game in Detroit in 1998. “You’re able to kind of see where things went right, where things went wrong and you’re able to really dig in and improve or say, ‘No, this is exactly what we planned for, this is exactly what happened and that’s how we supposed to manage and take care of these situations.”‘
Hockey has had enough of these situations for doctors and trainers to be ready to handle the next one.
The NHL’s emergency action plan requires at least three doctors, two ambulances and automated external defibrillators (AEDs) in all arenas, which now have benches that can be removed to clear space for medical attention.
It’s a plan that has evolved: electrocardiogram (EKG) tests first became mandatory for players in 1998, and in 2005 a doctor was simply required to be within 50 feet of the benches and nearby AEDs .
After Peverley collapsed during a game in Dallas in March 2014, the NHL required that the on-call physician be an active, trained emergency management specialist. In the years since, there have been improvements in cardiac life support capabilities and additional provisions for CPR and cardiopulmonary trials involving paramedics and arena staff.
“The most important thing is that everyone involved in either practice or competition is aware of an emergency action plan, and that includes the ability to recognize cardiac arrest, to start CPR as soon as possible quickly and to have access to an AED. as soon as possible,” said Dr. Ben Levine, a professor of internal medicine and cardiology at the University of Texas Southwestern Medical Center who treated Peverley. “The sooner you can start that cascade of events, the more likely there will be a successful outcome.”
University of Alberta Dr. Terry DeFreitas said 2 minutes is the ideal response time to start CPR and the use of an AED. She said she believes it will help the medical staff to know the arena and for the ambulances to be close to the ice.
“That doesn’t give you much time at all,” DeFreitas said.
Quick work by trainers like the Blues’ Ray Barile with Pronger and again with Bouwmeester in February 2020 and Detroit’s Anthony Colucci with Fischer could have saved the players’ lives. Now there is a plan on how to respond in seconds.
Retired defender Mathieu Schneider, who was by Fischer’s side when his teammate collapsed in 2005, said the medical staff deserve a lot of credit.
“I really think we’re at a place, a point in time now, where we’re ready for almost anything that can happen in a game situation,” said Schneider, who serves as special assistant to the NHLPA’s executive director.
The Russian-based Kontinental Hockey League in 2008 saw 19-year-old New York Rangers prospect Alexei Cherepanov die of heart failure during a game. At the time, there was no ambulance on the scene and no working defibrillator. Afterwards, the league took steps to mandate not only those changes but require comprehensive physicals for players and more.
“The KHL certainly learned their lessons there, especially if they were going to get players at that time to come there,” said John Davidson, who spent nearly five decades in hockey and is now president of hockey operations for -Columbus Blue. Jackets.
Davidson took a lot of pucks to the chest and neck as an NHL goaltender from 1973-82 and was broadcasting in the game when Pronger was hit. Davidson has grown to appreciate the amount of work that goes into protecting players.
“It’s a big part of what we do,” Davidson said. “We don’t just show up, drop the puck, play the game and go home. There’s a lot going on behind the scenes, and I feel very comfortable with the standard of safety we have with the NHL.”
The NFL will now look at how Hamlin’s cardiac arrest was handled, like the NHL studied its cases to see what could be improved.
“That’s the key to doing something well,” Levine said. “See what happened at your event or another event, ask, “What do we do, and can we do this better?”‘