Death of New York Rangers Star Prospect Sparks Attention to Adequacy of Emergency Medical Presence at Sporting Events

When New York Rangers prospect Alexei Cherepanov suddenly collapsed on the bench during a Kontinental Hockey League (KHL) hockey game at a Moscow region arena on October 13, 2008, the lack of preparedness for such an occurrence was startling.  The player was carried from the bench area without a stretcher, and no ambulance or working defibrillator was available.  The absence of a rink-side stretcher, on-duty ambulance and working defibrillator, as well as a 15-minute wait for the arrival of a hospital ambulance, have been cited as evidence of an exceedingly poor level of organization that may have cost the young player whatever chance at survival he may have had.

Cherepanov apparently had chronic ischemia — a medical condition when not enough blood gets to the heart or other organs.  He probably should not have been allowed to play in a game in which he collapsed and died, a regional investigator suggested. In contrast, the National Hockey League requires that medical staff on hand must be certified in advanced trauma life support. There is also a requirement for ambulance service on site.

In response to the tragic death, the Russian KHL announced that two fully equipped ambulances must be present at all league games under a new set of regulations governing emergency medical response. The Eastern Collegiate Hockey Association, a professional minor ice hockey league, requires that each home team provide a certified athletic trainer or emergency medical technician, a fully stocked first aid kit, and access to immediate ambulance/emergency medical services.

The National Athletic Trainers’ Association has issued recommendations concerning emergency preparedness.  The National Athletic Trainers’ Association warns that an organization or institution and its personnel can be placed at risk by the lack of an emergency plan, which may be the foundation of a legal claim. More specifically, the National Athletic Trainers’ Association recommends that each organization or institution that sponsors athletic activities or events develop and implement a written emergency plan.

Emergency plans should be developed by organizational or institutional personnel in consultation with the local emergency medical services. Components of the emergency plan include identification of the personnel involved, specification of the equipment needed to respond to the emergency, and establishment of a communication system to summon emergency care. Additional components of the emergency plan are identification of the mode of emergency transport, specification of the venue or activity location, and incorporation of emergency service personnel into the development and implementation process.

Emergency plans should be reviewed and rehearsed annually, with written documentation of any modifications. The plan should identify responsibility for documentation of actions taken during the emergency, evaluation of the emergency response, institutional personnel training, and equipment maintenance. Further, training of the involved personnel should include automatic external defibrillation, cardiopulmonary resuscitation, first aid, and prevention of disease transmission.

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