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The First 5 to 7 Minutes – Are You Prepared?

Dr. Steven Horwitz
Jul 11, 2016
4 min read

Issue #1: Response Time

If your child goes down, how long will it take for emergency responders to arrive at the scene?

“6 minutes to live or die – The price of just a few seconds lost: People die,” says USA Today.

The article continues, “There is no nationwide standard for measuring emergency response times. A USA TODAY study of the 50 biggest U.S. cities found that most report only the slice of the response that looks most favorable: the time it takes for the emergency crew to drive to the scene. On many emergency runs, that is just a fraction of the time that passes between the call for help and the arrival of rescuers.”

“More than 1,000 "saveable" lives are lost needlessly each year in the nation's biggest cities because of inefficiencies in the cities' emergency medical systems, USA TODAY's investigation found….”

More recent analysis says this. According to NEDARC (National EMSC Data Analysis Resource Center), the average EMS Response Time meaning the time from when the unit is dispatched to the arrival on the scene is a little more than 9 minutes.

According to the National Athletic Trainers Association, “the average estimated time to arrival of EMS when not prestationed onsite was 7.8 min.”

What We Learned: Emergency response time is at best 7 minutes.

Issue 2: Response Time and Survival Rates

"The single greatest factor affecting survival from SCA is the time interval from cardiac arrest to defibrillation.1" NATA

CPR performed before the arrival of emergency services doubled the survival rate as compared to no CPR before the arrival of emergency services. And, “the sooner defibrillation can be performed, the better the chance of survival.”

"Our results are consistent with previous literature showing that 911 response time measured from the time of the 911 call to arrival of the response vehicle on scene, is a significant predictor of patient survival"

What We Learned: Survival rates are dependent on how quickly care is provided to the victim.

Issue #3: Relationship of Training to Outcomes

“One of the major determinants of variability in patient outcomes within systems has been shown to be the quality of CPR performed during resuscitation1,7 with poor performance associated with worse outcomes.” JAHA

"the odds of survival were higher for patients treated by paramedics" who had more experience performing CPR out of the hospital. And, “Even with training, rescuers often perform poorly on each of these components, specifically CCF [chest compression fraction], compression depth, and ventilation rates” CIrculation

The National Athletic Trainers Association says coaches "do not have the proper medical education to treat injuries or recognize the common causes of life-threatening medical conditions, which puts the lives of athletes in jeopardy."

“Each year, cardiopulmonary resuscitation (CPR) is provided for thousands of children in North America.1,2 The quality of CPR directly affects hemodynamics, survival, and neurological outcomes following cardiopulmonary arrest (CPA).3- 9 Unfortunately, health care professionals struggle to retain effective chest compression (CC) skills after basic life support or advanced cardiac life support training.10- 12 Even well-trained health care professionals fail to consistently perform CPR within established American Heart Association (AHA) guidelines during CPA.” JAMA

What We Learned: The quality of the response (CPR) is pivotal as to whether the victim survives. Even highly trained medical personnel “fail to consistently perform CPR within established American Heart Association (AHA) guidelines.” And most sports coaches do not have the proper education or training.

Issue #4: Importance of Preparation and Planning (Emergency Action Plan) and Access to Trained Medical Personnel

A study of marathon related cardiac arrest showed that “The strongest predictors of survival were initiation of cardiopulmonary resuscitation by bystanders”

63% of high schools do not have even 1 full-time Athletic Trainer and 30% have no access whatsoever to an Athletic Trainer. NATA

“Only 45% of schools reviewed and practiced their emergency response to SCA at least once annually and only 20% of schools posted their emergency action plan at athletic venues.” NATA

Yet, most high school athletic directors “believed the secondary school coach had sufficient knowledge and training to address the medical needs of student-athletes without an AT." NATA

What We Learned: Most high schools do not have trained medical personnel and there are virtually no trained medical personal in the youth league sports world. More than 50% of schools do not review an emergency plan even once per year and 80% do not post their plan. There is a huge disconnect between what athletic directors believe and the realty of the lack of training and preparation of their coaches. Youth league sports are woefully unprepared for medical emergencies.

Summary

Emergency response time is at best 7 minutes.
Survival rates are dependent on how quickly care is provided to the victim.
The quality of the response (CPR) is pivotal as to whether the victim survives. Even highly trained medical personnel “fail to consistently perform CPR within established American Heart Association (AHA) guidelines.” And most sports coaches do not have the proper education or training.
Most high schools do not have trained medical personnel and there are virtually no trained medical personal in the youth league sports world.
More than 50% of schools do not review an emergency plan even once per year and 80% do not post their plan.
There is a huge disconnect between what athletic directors believe and the realty of the lack of training and preparation of their coaches.
Youth league sports are woefully unprepared for medical emergencies.