NHL adds requirement for ER doc at game (near bench)

[LadyStanley]

https://ca.sports.yahoo.com/news/nh...peverley-cardiac-incidents-221633710-nhl.html

Especially after cardiac incidents with Jiri Fischer and Rich Peverley.

The NHL strengthened its emergency medical standards after the Fischer incident. Each team needed two doctors near the benches at each home game, and at least one needed current training in hockey-specific trauma management or Advanced Trauma Life Support (ATLS). Each team needed one AED at the home bench and another on an ambulance dedicated to the players.

Now, after the Rich Peverley incident last season, the NHL has strengthened its standards further. Each team needs three doctors near the benches at each home game – an orthopedist, a primary care physician and an ER physician – and at least one, if not all, must have current training in ATLS and Advanced Cardiac Life Support.

And prior to this, sometimes the doc was in the rafters, not anywhere near the ice.

Seems ludicrous to not have (emergency/first aid) doc "right there".

Definitely will help with critical injuries to have the doctors just off the ice.

 

[Fugu]

A little more on how the league manages the medical issues/standards:

Adding an ER physician at every game isn’t easy. There is added cost. There are chemistry concerns. You have to find the right people in every city – physicians with the appropriate skill set, who understand NHL dressing room dynamics, who fit with already well-trained, cohesive medical teams.

This had to pass through two medical committees and an executive board, and then it was presented at the annual NHL team physician society meeting in June. There was a group discussion and Q&A session. “Some doctors don’t like it because they feel they can administer that care,” Zeis said.

But it’s not that team physicians are incapable. It’s that ER physicians deal with life-threatening emergencies every day. It’s about being prepared for worst-case scenarios and having everything and everyone in place to handle them.

The NHL is giving teams a grace period. “There are exceptions and exemptions that we have to make to be able to facilitate this and get to as close to 100-percent compliance as we can,” Colucci said.

It's a good mix of specialties due to the types of injuries players might sustain during a game. Orthopedists would be able to quickly assess spinal and neck injuries, or life threatening fat emboli that could result when a thigh bone is broken, for example. The ER docs are well-suited for the lacerations, cardiac and obstruction of breathing incidents.

It's a very good move, I think.

 

[Tyler Biggs*]

Good call by the NHL and the players association. The guys need the best help they can get as soon as possible.

I don't care what team they play for, I do not like seeing anyone get hurt. Keep all the boys safe.

 

[LadyStanley]

I believe there's also a neurologist "on call" (in arena) to be able to diagnose any concussions in the 15 minute "quiet time" after suspected hits.


(Recall one time waiting for warmups, that the ambulance crew and a handful of others "walked through" handling cases on/near bench. That was at least a year ago.)

 

[FLYLine27*]

The real question is, what took so long?

 

[LadyStanley]

The real question is, what took so long?

Are you a prophet? Have you perfect predictions of anything and everything that can/would happen?

 

[Inkling]

"three doctors near the benches at each home game – an orthopedist, a primary care physician and an ER physician"

Three doctors seems a bit over the top. Agree with having one near the benches who can handle any cardiac arrest issues…but three MD's at every game? There are probably some small hospitals who don't have that many doctors on hand at any one time.

 

[Desert Ice 11]

"three doctors near the benches at each home game – an orthopedist, a primary care physician and an ER physician"

Three doctors seems a bit over the top. Agree with having one near the benches who can handle any cardiac arrest issues…but three MD's at every game? There are probably some small hospitals who don't have that many doctors on hand at any one time.

Yeah, I don't see why the would need a primary care doctor. Maybe he travels with team and is like the family doctor for all the players. This would come in handy so the other doctors wouldn't have to go over medical history and waste time and visa versa. Primary care doctor would be up to date on any medical issues that came about during that game.

The other two are specialized so I completely understand having the ER doctor there and the orthopedic doctor. So three seems appropriate to me.

 

[LadyStanley]

"Primary care" physician could handle the little things like stitching up (so could the trainer, or maybe the trainer IS the PCP?).

He/she my also be the doctor that knows each player's allergic reactions or other (ongoing/chronic, acute) medical issues.


Unlike 100+ years ago, few doctors are general practitioners. It's specialization now. The Orthopedist specializes in bones and limbs. The ER doc is taught and prepared to handle life threatening issues.


I'll be happier knowing that the players are under the best care possible on the ice.

 

[Fugu]

Aren't the team doctors considered their primary care physicians, of a sort? We may be getting hung up on the nomenclature.

 

[enarwpg]

The real question is, what took so long?

It's a stratagem so that at the concussion lawsuit hearings they can say they've always been proactive with the players health, etc. Makes them look real good.

 

[discordant concord]

any ideas on the approx. cost, or do they just give the docs tickets?

 

[LadyStanley]

any ideas on the approx. cost, or do they just give the docs tickets?

May be negotiated into the group insurance coverage the team/parent organization has for it's employees (including players and their families).



When you find an audited statement of expenses, we'll know.

 

[powerstuck]

"three doctors near the benches at each home game – an orthopedist, a primary care physician and an ER physician"

Three doctors seems a bit over the top. Agree with having one near the benches who can handle any cardiac arrest issues…but three MD's at every game? There are probably some small hospitals who don't have that many doctors on hand at any one time.

I agree. Heck with the newest technology and studies, how hard is it to form the guy/girl that goes onto ice when player seems hurt to perform a basic life saving maneuvers ?

 

[Lonewolfe2015]

I wonder if they have shifts for this kind of thing. While there's only ~41 games they end up attending, these are generally people with very busy lives/schedules and being at 41 games takes them away from what is generally going to be a more important (the ER).

I also wonder how many roles can be overlapped, perhaps limiting this to 2 overall despite 3 roles required. I can see why they might want 3 people though, imagine your team doctor/physician is in the lockers stitching up a player when someone goes down. An ER doctor would also be better suited for situations pertaining to someone like Zednik, Hall or O'Byrne when you get severe skate cuts/gashes.

 

[LadyStanley]

It may not be the same doctor for each role at each game. It may be a shift "rotation" from a team of doctors.

You can be assured that the NHL do not **plan** to take away doctors from the ER just to staff the game.

 

[Riptide]

Just one more thing driving up teams costs while cutting into their bottom line (or into their debt). I'd love to see the actual books published for one NHL team (more recent than Columbus's from 10-15 yrs ago).

That said this is a good move.

 

[Riptide]

Yeah, I don't see why the would need a primary care doctor. Maybe he travels with team and is like the family doctor for all the players. This would come in handy so the other doctors wouldn't have to go over medical history and waste time and visa versa. Primary care doctor would be up to date on any medical issues that came about during that game.

The other two are specialized so I completely understand having the ER doctor there and the orthopedic doctor. So three seems appropriate to me.

As well as knowing exactly what the player may have been taking, and if they have any allergies and whatnot. But isn't that just the team doctor that many (most?, all?) teams have that travel with the teams now?

 

[LadyStanley]

As well as knowing exactly what the player may have been taking, and if they have any allergies and whatnot. But isn't that just the team doctor that many (most?, all?) teams have that travel with the teams now?

I'm not aware of how many team doctors travel with the team (during the regular season). It's often the training staff that handle the sniffles and little stuff on the road, AIUI.


Now, during the playoffs, there are additional staff, including "the" team doctor, who are included in the entourage.

 

[Riptide]

I'm not aware of how many team doctors travel with the team (during the regular season). It's often the training staff that handle the sniffles and little stuff on the road, AIUI.


Now, during the playoffs, there are additional staff, including "the" team doctor, who are included in the entourage.

I remember reading something that Pittsburgh is going to have a doctor travel with the team (starting last season?) as a full time gig. Previously it had been someone else (trainer?). I just assumed it was one of those things that teams were trying to do to differentiate themselves from the rest of the league. The cap is the cap, but stuff on the management side (or how nice/modern the dressing room, facilities, etc are) are things the teams can do to stand out.