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NHL emergency standards applauded for saving life of Stars' Rich Peverley

Dallas Stars center Rich Peverly lines up for a face-off in the first period of an NHL Hockey game against the Columbus Blue Jackets Monday, March 10, 2014, in Dallas. He was taken to the hospital after medical emergency with 13:37 left in the first period. (AP Photo/Sharon Ellman)

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Dallas Stars center Rich Peverly lines up for a face-off in the first period of an NHL Hockey game against the Columbus Blue Jackets Monday, March 10, 2014, in Dallas. He was taken to the hospital after medical emergency with 13:37 left in the first period. (AP Photo/Sharon Ellman)

BOCA RATON, Fla. - The clock was ticking on Rich Peverley's life.

When the Dallas Stars forward, stricken with an irregular heartbeat, collapsed on the bench Monday night, medical personnel had him down the tunnel and receiving attention immediately. Peverley had experienced what the team called a "cardiac event," and every second counted.

Before the rest of the game between the Stars and Columbus Blue Jackets was officially called off, coach Lindy Ruff reported back that Peverley was going to be OK. That positive ending to a potentially deadly incident had a lot to do with quick reactions and implementation of the NHL's procedures for emergency medical care.

"Luckily, the doctors acted incredibly swiftly and competently and averted what could have been a tough situation," NHL deputy commissioner Bill Daly said. "Everything played out and transpired exactly as you would draw it up."

While Peverley was kept alive over a matter of minutes, the process could date all the way back to 2005 when Detroit Red Wings doctor Tony Colucci and others saved defenceman Jiri Fischer when he went into cardiac arrest. Red Wings general manager Ken Holland said more uniform standards were put in place after that happened, ones that played a role for Peverley.

"Last night was an example. A life was saved," Holland said Tuesday at the NHL general managers meeting. "When I became manager in '97, we didn't even do EKGs in training camp. I think in about '02-03, we started doing EKGs.

"Our league has done a lot more. I think you're always evolving, and I think we do a much better job at being prepared and identifying risks."

There are still plenty of unknowns about those risks, and why these young, fit hockey players seem to be experiencing more of these health irregularities, such as Pittsburgh Penguins defenceman Kris Letang suffering a stroke. But Peverley's situation showed people around the league that protocols in place can work well in the most crucial of situations.

"Every building has a plan in place like that," Calgary Flames president of hockey operations Brian Burke said. "There's doctors in attendance—mandatory doctors in attendance, paramedics in attendance, ambulance on-site. The NHL is very thorough about that."

That's by design after a handful of terrifying incidents over the years, including in 1998 when Chris Pronger's heart stopped after taking a slapshot to the chest.

The NHL has four pages of emergency medical standards that spell out in specific detail that at least two doctors must be in attendance for every game and one must be within 50 feet of the bench. A defibrillator, which was used on Fischer nine years ago, triage room and ambulances must be available, too.

"I think we're much more prepared now than ever to handle serious incidents like that," Ottawa Senators general manager Bryan Murray said.

That's due in large part to what went into Fischer's second-by-second medical care.

Brendan Shanahan, now the NHL's director of player safety, who was sitting down the bench from Fischer at Joe Louis Arena on Nov. 21, 2005, didn't know much during the commotion other than that Colucci sprung into action.

"Before I even knew which one of my teammates was down on the bench, Tony was already on top of him giving him chest compressions," Shanahan said. "There was a lot of yelling and screaming and the one guy that wasn't confused was our team doctor, who was on top of him performing CPR."

Mathieu Schneider was sitting right next to Fischer, who collapsed on him. As soon as Peverley collapsed Monday night at American Airlines Center, Schneider got text messages about it and experienced flashbacks to what happened with Fischer.

"That was one of the scariest moments of my career," said Schneider, the NHLPA's special assistant to the executive director. "At first, you had no idea what was happening, but then he started convulsing. It was real scary, scary for everyone. Tony Colluci was right behind our bench and was on top of him before anyone knew. It was a great effort to save him."

Fischer never played again, and it's too early to tell what will happen to Peverley, a Stanley Cup-winner with the Boston Bruins and a veteran of 442 career games.

Dallas released a statement Tuesday indicating that the 31-year-old Kingston, Ont., native was resting comfortably at UT Southwestern St. Paul hospital and was undergoing tests to determine the cause and a long-term solution to what triggered the cardiac episode.

"Rich has been communicating with his teammates and friends," general manager Jim Nill said in the statement. "He is extremely grateful for all of the prayers and support that he's received from fans and friends alike."

If Peverley returns, or even if he doesn't, this situation and Fischer's had better endings than two tragic incidents in Europe that cost the lives of Sergei Zholtok and Alexei Cherepanov.

Zholtok, who had a history of cardiac arrhythmia, died of heart failure in 2004 when playing in his native Latvia. Cherepanov, a 19-year-old New York Rangers prospect, died of heart failure in 2008 while playing in Russia's Kontinental Hockey League.

Russian investigators found that Cherpanov had a heart condition known as myocarditis and shouldn't have been playing pro hockey but also that his club, Avangard Omsk, was negligent in not having the necessary life-saving tools available.

"A row of gross violations was committed by the medical brigade helping A. Cherepanov,'' Russia's federal Investigative Committee said in a statement that pointed out doctors didn't arrive until 12 minutes after Cherepanov collapsed and the defibrillator battery was drained.

In addition to mandating two doctors be present, including at least one who has completed "hockey-specific trauma management training," the NHL requires an Automatic External Defibrillator be on the home bench and on the waiting ambulance. Each arena is also expected to have a second ambulance ready if the first is used, or the game is held up until one is available.

Though it was reported and assumed, Daly would not reveal whether a defibrillator was used on Peverley, citing player privacy. He was taken in an ambulance to the hospital, though the game was cancelled.

After his experience with Fischer, Schneider understood exactly why the Stars and Blue Jackets could not continue, despite assurances Peverley would be OK.

"Being close to your teammates, it's too taxing to go back and play," Schneider said. "I would think you would be playing half-heartedly in a situation like that, and I would say probably both teams. Even though your opponents may not be as close to that player, it's a brother."

Why it seems like heart problems have been all-too prevalent in professional and amateur sports in recent years is somewhat of a trend that's hard to explain. Burke thinks hockey players make up a normal cross section of the population, which figures to have a similar percentage of people affected by such problems.

Burke saw one of them first-hand when he was Toronto Maple Leafs general manager as goaltender Jonas Gustavsson battled a heart condition that required three minor surgeries.

"In Jonas' case he had atrial defibrillation and they zapped his heart—it works 80 per cent of the time and he was one of the 20 per cent where it didn't work so they had to do it again," Burke said. "But he's had no lasting effects. That put his electrical rhythms in his heart back into sync and he's had no issues since."

Burke can only hope that's the case for Peverley, but, absent knowing that, believes the best approach is to just continue giving players thorough medical attention and the best care possible.

Even after what he went through with Fischer, Holland is no expert on the topic, either. He's just glad others connected to the NHL are.

"I'm not a doctor. I'm a hockey person," Holland said. "That's why you try to hire the best people that you can. The league makes sure that we've got the best procedures in place."

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