iOn January 2, 2023, during a National Football League game involving the Buffalo Bills and Cincinnati Bengals, Bills’ safety Damar Hamlin collapsed from an apparent cardiac arrest. Thankfully, numerous medical personnel were able to respond and render care to Mr. Hamlin. The incident was frightening—fellow players and spectators prayed for his survival while medical personnel worked feverously to keep his heart beating. The collateral impact of this incident on the reputations of the NFL, the Bengals and Bills, their coaches, their players, and the referees are also significant. Prompt decision-making and appropriate response have been critical to preserving the confidence in these organizations and people.
No Wisconsin School District is immune from such a tragic situation.
According to the Wisconsin Interscholastic Athletic Association (WIAA), sudden cardiac arrest is the leading cause of death in young athletes while training or participating in sport competition. Even athletes who appear healthy and have a normal preparticipation screening may have underlying heart abnormalities that can be life threatening.1
As recently as January 2021, a varsity basketball player from Wisconsin Lutheran High School collapsed during a game at Menomonee Falls High School. Thanks to spectators in the crowd, several of whom worked as emergency room nurses, the student-athlete was revived on the floor and immediately transported to a hospital. The nurses were able to quickly access the school’s automated external defibrillator (AED).2
Wisconsin School Districts need to be ready to deal with similar incidents with our student-athletes. Now is a critical time to brush up on the School District’s health and safety requirements.
Wisconsin School Safety Law
Every school board and the governing body of a private school must meet terms set forth in Wisconsin State Statute sec. 118.07, “Health and safety requirements.” The statute requires a “school safety plan”:
A school safety plan shall be created with the active participation of appropriate parties, as specified by the school board or governing body of the private school. Before creating or updating a school safety plan, a school board or governing body of a private school shall, in consultation with a local law enforcement agency, conduct an on-site safety assessment of each school building, site, and facility that is regularly occupied by pupils. The on-site assessment shall include playgrounds, athletic facilities or fields, and any other property that is occupied by pupils on a regular basis.
A school safety plan shall include all of the following:
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An individualized safety plan for each school building and facility that is regularly occupied by pupils. The individualized safety plan shall include any real property related to the school building or facility that is regularly occupied by pupils.
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General guidelines specifying procedures for emergency prevention and mitigation, preparedness, response, and recovery.
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Guidelines and procedures to address school violence and attacks, threats of school violence and attacks, bomb threats, fire, weather-related emergencies, intruders, parent-student reunification, and threats to non-classroom events, including recess, concerts and other performances, athletic events, and any other extracurricular activity or event.
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The process for reviewing the methods for conducting drills required to comply with the plan.
On March 30, 2022, Wisconsin Act 210 was signed into law. The Act amended Wisconsin Statute section 118.2935, which requires the operator of a youth athletic activity to inform coaches, athletes, and their parents about the nature and risk of sudden cardiac arrest during youth athletic activities. This notice is similar to the notice that must be provided related to the risk of concussions. It is important to note that Act 210 does not require that schools take any further action besides providing notice, nor does Act 210 create any liability to school districts.
School Safety Plan Applied to Sudden Cardiac Arrest
While a school safety plan developed pursuant to Wisconsin State Statute sec. 118.07 is largely associated with, and in response to, external threats to students related to school security and facilities, many of the elements of the school safety plan can be applied to addressing cardiac arrest in student-athletes. Incorporating a cardiac arrest response into a school safety plan, or as a separate plan, can be done (and should be done) with minimal cost and disruption relative to the potential value for the student-athlete and for the interests of the school district.
What Can School Districts Do Right Now?
Update the Safety Plan. The WIAA provides a model Emergency Action Plan.3 But any model must be tailored to the specific School District. Furthermore, the model only goes so far, and nuances of the District including specific action items, crisis communication protocols, and other important notification and decision processes must be analyzed and considered when developing a plan.
Practically Analyze and Test your Response Protocols. Required notices, safety plans and policies are critical, but they don’t respond to emergency situations; people do. Not every gym or athletic field will have multiple emergency room nurses able to respond within seconds of a cardiac arrest. To that end, what are you doing to ensure that your coaches and administrators are able to respond to emergency situations?
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Do all of your coaches have access to a phone?
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Can emergency personnel quickly reach your location?
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Do you have a CPR-certified person nearby?
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Where is your AED?
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Does your staff know where the AED is located?
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Does your school safety plan address cardiac arrest?
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Has your school conducted any drills?
It is also best practice for coaches to always have a roster of the participants of the activity and any known medical condition of a participant. This information can be shared with emergency personnel.
Completion of Student Physicals. One of the first steps that is required for student safety is completion of student physicals. All Wisconsin high school athletes that participate in WIAA activities must have a physical on file prior to participation. Ensuring this process is completed, and working with local health care providers to increase access for students, should be a priority for schools.
Conclusion
Providing enrichment activities such as youth athletics to students, in a safe manner, is an important role for school officials. While sudden cardiac arrest or other significant medical events involving adolescents are rare, the School District must be prepared to respond to emergencies quickly, particularly when the consequences are life or death.
FOOTNOTES
1 https://www.wiaawi.org/Portals/0/PDF/Publications/medicalproceduresguide.pdf
