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Tuesday, 11 March 2014

Former Bruin Rich Peverley suffers near lethal cardiac event during game: How this brings to focus the improvements of the NHL's medical responce

Posted on 18:01 by RAJA BABU


All aspects of NHL competition seem trivial when a combatant collapses in a near lifeless heap. That was proven Monday night in Dallas when former Bruin forward and current Stars center man, Rich Peverley collapsed while on the bench. The event was ruled a complication of cardiac arrhythmia 

As shown by a chilling clip of the event, within seconds of Peverley's collapse the Stars bench was overcome with panic as players frantically pounded their sticks and some vaulted onto the ice all in a desperate attempt to catch the referee's attention. For at the very least 5 seconds that all seemed like hours, play went on all before the whistle went and both benches emptied racing in a confused mob towards the Stars bench. To credit the Stars personnel, Peverley had been carried back into the open hallway within 10 seconds of the first of 4 distinct whistle blasts by the referee where he was administered CPR and shocked with an electronic defibrillator in a desperate attempt to regulate his slowing heartbeat.  

Amidst the chaos of this all, those charged with the job of responding to medical emergencies like this remained cool. As implied by Dallas coach Lindy Ruff in his emotional post-game press conference, their actions and the timeliness that they were executed might have saved Rich Peverley's life. 

"There wasn't any concern [regarding Peverley's return to the lineup]," Ruff said "Our doctors have done a fabulous job monitoring the situation." After a long pause, the NHL's most experience coach admitted "I was scared,"

"If it wasn't for our doctors and all the members (of the training staff) reacting so quickly, I could be standing here with a different story," Ruff said. "They were there ASAP. It's an absolute marvel after what he went through."

"When he dropped, it was red alert," Ruff said. "Don't worry about the game. It was about getting the doctors.

"As soon as he came off the ice, I started screaming into the crowd for a doctor. The players don't want to play, and I don't want to coach the team right now." 

The NHL later released a statement saying that the game had been postponed due to the shock and distraction felt by the percipients of the game. 

Obviously, those simply watching the incident could not even pretend to understand what it felt like for these players to see their friend their teammate teetering on the edge of death. But at the same time, watching this incident revived a tale of an incident similar to this in principle that took place almost a decade ago. The only difference is how that incident actually played out. 

On November 21st 2005, then 24 year old Detroit Redwings defenceman Jiri Fischer collapsed due to a bout of ventricular tachycardia that knocked him unconscious and stopped his heart in a similar way that was true with Peverley. Only while Peverley's heart was restarted within seconds of his collapse mainly because of a preparedness and familiarity with protocol on the part of his coaches, there was even more confusion and chaos when Fischer went down that resulted in Fischer's prolonged passage of time without a heartbeat. 

As shown by a similar segment of game film, it took almost 30 seconds for anyone who could help Fischer to actually get to him. This truth was such due to a confusion and ineptness at dealing with situations like this on the part of the Detroit coaches and a lack of doctors who can respond without being summoned by coaches among other things. In this case, he had to wait for trainers stationed by the zamboni doors on the opposite end of the ice to be escorted to the bench, weave their way through the crowd of players gathered by it and actually set up around Fischer's body. Even then, those attending to Jiri did not really know what was happening and did not understand that they needed to get him back to the locker room where the only defibrillators in the building were. 

Though he was finally resuscitated, Jiri Fischer never played hockey again and by doing so left a deep scar in the league's reputation as a safe one. But while that scar would never vanish, the league has since worked to keep additional ones from forming. 

Right now, most all NHL arena's have been modified so that they have "tunnels" that provide direct access to the locker room, in those tunnels it is also mandatory to station at least 1 advanced paramedic in addition to the teams trainer on the bench. Finally, in conjunction with the great strides made in relation to the ease with which a defibrillator can be used on a person, there are now defibrillators stationed in locker rooms, hallways and benches. Finally, all arenas now have ambulances parked nearby full time. 

Jiri Fischer is proud of what the league has done in reaction to his cardiac arrest.

"I think my incident was a big eye-opener in terms of the limitations in the resuscitation protocol and what should be implemented in all the arenas, from the local rink to the biggest light there is -- the NHL," said Fischer. "My cardiac arrest wasn't the first one, but it was certainly the first live one [on TV] in hockey, and that attracted a lot of attention. So the whole protocol has changed since then. [Wings doctor] Tony Colucci, who saved my life along with the rest of our medical staff, he was really pushing every meeting that they had with NHL doctors, they talked about the accessibility of an ambulance, they talked about how doctors need to be close, they talked about how a defibrillator needs to be part of the standard equipment for every locker room in every rink, they talked about how the whole protocol of resuscitation should go before somebody gets into the hospital. That's not just for the players but for anybody in the stands.

"Unfortunately, I volunteered for that," Fischer said, chuckling, "but a lot of good things came out of it."


When asked about the Peverley incident, Fischer said: "It was very impressive. I watched it again on TV this morning," said Fischer. "I'm impressed how well the staff did, how well everybody responded. They saved his life."


They saved his life just as they saved Fischer's life but with the speed and order with which they did so, these medics and other personal may have saved what they could not save with Fischer - his career.



 ~ As a footnote, good luck to Rich Peverley in his recovery and hopeful return to hockey.
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