Empowering Lay Responders in High School Athletic Events:

Lessons From 30,000 Feet

September 30, 2024

Ray Castle, PhD, LAT, ATC, NREMT

Clinician, Speaker, and Consultant - Sports Medicine and Emergency Medicine

Ladies and gentlemen, this is your captain speaking. We have reached cruising altitude, and we’re expecting a smooth ride ahead—unless there’s a medical emergency. In that case, if you are a healthcare provider and willing to assist in a medical emergency, please press your call button above so our flight attendants can identify you in advance.

Sound familiar?

If you've flown in the last few decades, you've likely heard a version of this announcement. What if we could borrow a page from the aviation industry and apply it to high school athletic events? Imagine this: "This is your athletic trainer speaking. If you are a healthcare provider attending today’s game, we’d like to recognize you as a lay responder. Please see an event staff member next to the concession stand for a quick orientation and your official shirt (or badge).”

Here’s the thing—Emergencies at athletic events don’t always happen on the field. Spectators can collapse, suffer cardiac arrest, or experience other health crises. And when these emergencies strike, the nearest help might just be someone with medical training sitting in the bleachers, eating nachos. Oftentimes, athletic trainers and other professionals are called from the field to assist when their focus (and scope of practice) is limited to the field of play.

The problem? These would-be Good Samaritans often jump in without a formal connection to the event staff, creating chaos instead of calm. In the confusion, they might not know the Emergency Action Plan (EAP) or how to coordinate with the on-site athletic trainers, leading to missed opportunities for effective care. Or even worse, they come onto the court or field of play and interfere with the chain of care already in place with the onsite medical staff. The lay responder strategy can also significantly codify the event administrators/staff roles in providing an efficient and effective response.

So, what can we do about it? Let's take a cue from the airline industry and develop a formal process for identifying and integrating lay responders. Just as airlines ask for help with a friendly announcement, we can equip our events with strategies to recognize and prepare these helpers. Depending on your event resources, consider inviting them to participate in your pre-event Medical Timeout Meeting. Special badges, lanyards, “team shirt”, or even a radio could be the ticket to identifying those who are ready to assist. A quick, on-site tutorial could ensure they know the drill, making them valuable extensions of the event’s medical team. And, they can be called upon to assist on the field if needed.

Need proof this can work? Research has shown the importance of lay responders in emergency scenarios. For example, the role of lay responders in providing initial care before the arrival of EMS has been highlighted in various articles, including a 2023 article published in Clinical Cardiology that underscores the importance of increasing bystander initiation in CPR/AED during athletic events. Furthermore, the "Best Practices for Emergency Action Planning and Implementation in Athletic Settings" 2024 article in the Journal of EMS outlines the importance of integrating lay responders into your EAP and venue-specific response is not just an opportunity - it is a best practice in EAP development and implementation.

By formalizing the role of lay responders, you can make your high school athletic events safer for everyone. After all, the more people prepared to help in an emergency, the better. Wouldn’t it be nice to know you can focus on your primary job of providing care for athletes, and not have to wonder if you will get called into the stands during games?

ADDTIONAL READINGS:

  1. Malik A, Hanson J, Han J, Dolezal B, Bradfield JS, Boyle NG, Hsu JJ. Sudden cardiac arrest in athletes and strategies to optimize preparedness. Clin Cardiol. 2023;46(9):1059-1071.

  2. Ryan P, Twomey G, Falvey É. Assessment of layperson knowledge of AED use in sports clubs.

  3. Castle R, Courson R, Csillan D, et al. Best Practices for Emergency Action Planning and Implementation in Athletic Settings. JEMS. Published online July 23, 2024. Accessed August 1, 2024. https://www.jems.com/ems-operations/best-practices-for-emergency-action-planning-and-implementation-in-athletic-settings-introduction/

  4. Scarneo-Miller SE, Hosokawa Y, Drezner JA, et al. National Athletic Trainers’ Association Position Statement: Emergency Action Plan Development and Implementation in Sport. J Athl Train. 2024;59(6):570-583.

Action Medicine Consultants, LLC
Ray Castle, PhD, LAT, ATC, NREMT - Owner & CEO - Action Medicine Consultants, LLC

“Dr. Ray Castle is a seasoned professional with over three decades of experience in athletic training and emergency medicine. As the owner and Chief Medical Officer of Action Medicine Consultants, LLC, Ray has dedicated his career to enhancing emergency care knowledge and skills, particularly in sports settings. He is a BOC Certified Athletic Trainer and a nationally registered EMT, known for his expertise in large-scale event medical coordination and planning. Ray is also a distinguished educator and speaker, having delivered over 200 presentations at various levels. His passion lies in advancing emergency action planning and response, making significant contributions to the field of sports emergency care.”

Owner & CEO - Action Medicine Consultants, LLC