You know the drill: prior preparation prevents poor performance. And it really does count on the golf course
If you picked up a copy of our newly launched Australian Golf Digest Women for yourself or your partner, you may well have read my article “Heart to heart” on sudden cardiac arrest and the fact that women are more than twice as likely to die from it than men.
I have a particular interest in this topic because I’d experienced two occurrences of arrhythmia in one day and ended being taken to the local hospital emergency department by the wonderful ambulance paramedics. In the end, I was diagnosed with supraventricular tachycardia, a condition that I now live with and one that, in serious circumstances, can lead to sudden cardiac arrest.
So, what does this have to do with golf? Well, Mike Covey, director of Shield Training and Consulting – a company that specialises in providing first-aid training and critical incident planning for golf clubs – says survival rates of sudden cardiac arrest are low (between 5 and 9 percent, depending on which study you read).
“On a golf course, or in any remote area, your survival rate will drop even lower because of difficulties faced in response time and extrication,” he explains. “We know that early CPR and time to defibrillation is the key. The faster we start CPR on a patient in cardiac arrest, and the faster we apply the defibrillator, the higher the chance that the patient will survive.”
Golf is high-risk
“The incidents we often see on golf courses include dehydration, hyperthermia, chest pain, ball strikes and sudden cardiac arrest. Most clubs are well versed in managing the low-acuity injuries. It is the life-threatening issues faced in golf that are of concern, Covey explains. He adds that golf is a notoriously tricky sport from an emergency-management perspective and is high-risk for several reasons. These include:
- Potential for trauma from snake/spider bites, ball strikes, cart accidents, etc.
- Dehydration and electrolyte imbalance
- The higher average age of members compared to other sports
- Difficulty accessing and extricating patients due to large land mass and difficult ingress/egress from golf courses
- Emergency service vehicles are heavy and get bogged – they will often not drive on grass
- Delay in time to defibrillation due to the size of the course.
“All these factors mean that without proper planning and training of golf club staff, a collapse on the course will often portend a bad outcome,” Covey says.
Would you know what to do?
Picture this: you’re out on the back nine, headed up the fairway on the 15th hole and one of your fellow golfers collapses. What do you do? Would you even know what has happened? Hopefully, one of you will have some idea of what is going on and call for an ambulance, start CPR and try to find the nearest defibrillator (AED). However, this is when the trouble can start.
According to Covey, a great deal can go wrong when ambulances are called to an incident on a golf course. “Paramedics often get sent to the wrong location,” he says. “They will often arrive at the clubhouse, only to realise that the best access point is via a gate on the other
side of the course. This creates a delay that can mean the difference between life and death.
“As an intensive care paramedic, I have had to manage quite a few cardiac arrests on golf courses, and they are always difficult. We generally face a set of problems that is very specific to golf. The call normally comes from somewhere on the course, which means there is often a disconnect between course staff and the bystanders at the scene. Often, the course staff are unaware that an ambulance has been called until we arrive. Golf clubs also have multiple access points, with several gates spread across the perimeter fence. All these things result in a delayed response time.”
It is through proper training, preparation and planning that golf clubs can focus on preventing these issues. “Most courses have had their fair share of emergencies occur, and anyone who has been involved in a cardiac arrest will know how stressful and difficult they are to manage on the course,” Covey adds.
What do golf clubs need to do to be prepared?
Preparation and planning are the key to saving lives in a sudden cardiac arrest scenario. Aside from providing high-quality first aid and CPR training to staff, and installing first-aid kits and AEDs, it is essential for golf club managers to sit down with a specialist organisation and meticulously plan in case of an emergency and to ensure ambulance access is expedited. This includes studying the access points, course-specific issues, defibrillator locations, course AED coverage and current first-aid capabilities with the aim of developing a critical incident response plan for their course.
“These plans include custom digital renderings of the course, with an overlay of AED locations and access points. By mapping out the course and pre-determining the access points, when an ambulance is called, course staff can prevent the ambulance from being sent to the wrong spot,” Covey explains.
The next step is educating golfers about what to do in the case of an emergency. Organisations such as Shield Training run information sessions, often in the evening, on what to do when phoning 000 for an ambulance, the importance of advising golf club staff, how to do CPR, how to use an AED and key elements of first aid.
“In an emergency, it always falls back on staff to know what to do. Once they have been advised by the golfer on the course that an ambulance has been called, the staff member can call 000 so the paramedics can be advised that it may be better to go to, say, a particular gate on a particular street rather than directly to the clubhouse,” Covey says. “This is not a perfect process, but the best clubs can do considering all of the circumstances involved.”
It would be a welcome relief for me to know that the staff at the golf course where I play know exactly what to do in the case of an emergency – as it would be for others.
What can golf club managers do?
Developing a good culture in a club is incredibly important, says Mike Covey, the director of Shield Training and Consulting, because when something goes wrong, the team will need to work together to provide first aid. Here are his key considerations for golf club managers:
- Defibrillators are the key to increasing survival rates. Think about your AEDs. Are your staff confident in using them? Do they know where they are? Do you have good coverage or is there only one AED for the entire course?
- About half the AEDs that Covey checks when his company engages with a golf club are out of date or have flat batteries
- Make sure you have a system that supports regular inspection and maintenance of your AEDs
- Develop an emergency plan and emergency protocols, including making sure your team knows what to do in an emergency
- Think about your worst-case scenario. Discuss with the team how you would extricate a patient from the most difficult section of your course in heavy rain
- Discuss your gates. Are they accessible by emergency services? How would you get paramedics to the right spot? Who has the keys?
- Run a member information evening. Do your members know how to do CPR or use an AED? Would they know how to find your club’s AEDs?
• Visit shieldtraining.com.au for more information.
