Administration and Leadership, Cardiac & Resuscitation, News, Patient Care, Training

Preparing to Protect Student Athletes

Issue 11 and Volume 38.

Dr. Jim Kyle facilitates a "Medical Time Out" at a school in West Virginia

Every Friday night at nearly 20 high schools in West Virginia, EMS staffers, athletic trainers, injury experts and other medical personal go into a time out.

No, they’re not being punished. They’re getting a “Medical Time Out.”

In what Jim Kyle, MD, FACSM, FAAFP, hopes becomes as routine as the referee’s coin toss to start a game, those folks are meeting to plan how they’ll attack any emergency issues that may happen on or off the field during the contest.

“I’ve always made it a priority before any athletic event to meet with the EMS staff covering the game or event,” Kyle says. “We talk about whether an AED was on the sidelines. Who has the facemask removal tools? Things like that are pretty routine and obvious, but sometimes in a hectic moment nobody knows where the equipment might be.”

But what Kyle considered routine, he found out, wasn’t the case at many college or high school events. So, rather than leave things to chance, he’s developed the “Medical Time Out” to get all the medical professionals in sync before they need to work together on a real emergency.

Participating agencies go over key issues that could impact an emergency response, such as suggested hand signals that can tell EMS personnel they’re needed on the field.

“They go through a checklist very similar to a checklist you’d go through before surgery, a ‘Surgery Time Out,’ or like a pilot would before a flight,” Kyle says.

The idea for the time out stems from Kyle’s history working at sporting events. He’s been an emergency room physician for more than 30 years and currently serves as the emergency room director at Beckley Appalachian Regional Healthcare Hospital and the EMS medical director for region 1 in West Virginia. He was also the team physician for the track and field competitions at the 1996 Olympics in Atlanta.

Kyle first introduced the program at Concord University, where he’s the medical director for the athletic training program. The university made the concept part of its football programs, and this season it has been rolled out on the high school level in West Virginia.

There’s a need for such a program, says Kyle. In some cases in the past, there was little coordination between the EMS teams and the athletic trainers and coaches working on the field. For example, Kyle says there are specific tools required to remove the facemask of a football helmet. Identifying the location of the tool and who will grab it heading onto the field can eliminate a scramble at the height of an emergency.

They also discuss the potential for helicopter landing zones and how they’ll respond to an emergency in the stands.

“We want this to be very visible,” says Kyle. “Instead of the home and visiting team going behind the gates, we’ve asked our EMS personnel to take the cot out onto the track with gear and the clipboard so spectators, coaches and players can see them 30 minutes prior to the game.”

Response to the program has been good, says Alicia Suka Besenyei, executive director of The Kyle Group.

“We’ve heard from parents of kids in ‘pee-wee’ [football] leagues that they’re looking for ways they might get added to the program,” Besenyei says.

Since the program began, Kyle says the EMS participation has grown as well. When only one ambulance is needed at a sporting event, he’s finding times where two or three show up just to participate in the medical time out aspect.

Kyle says the next step is rolling out the program to high school soccer, where concussion rates among student athletes are very high. Cheerleading is another sport that could benefit from the use of a medical time out, Kyle says, because of the increased physicality.

Also in the works is an educational video that could expand the reach of the medical time out concept beyond West Virginia. Production is underway on the video, which could be ready to go by the end of the year.

“Parents have really gotten behind this, particularly in our area,” Kyle says. “They really like the idea of taking a step to being