Hockey Canada records show there have been at least eight deaths of minor and major junior league hockey players over the last nine years from cardiac arrests suffered on the ice or at the rink, CBC News has learned.
The organization, which oversees more than 500,000 players, does not mandate first aid or CPR training in its minor leagues.
"We've created a user-friendly program that we can work with at the minor hockey level, and we've by no means said that CPR and first aid are not important. We very much encourage it," said Todd Jackson, head of Hockey Canada's safety program.
Hockey Canada asks teams to develop an emergency plan that identifies the responsibilities of select team volunteers, such as who tends to a player who is down and who calls 911. It also requires teams to identify any parents or volunteers associated with the team who know first aid.
It encourages volunteers registered with teams to get CPR and first aid training, but does not mandate that there must always be someone who is trained to be present at the rink.
One responsibility under the emergency plan states: "Responsibilities include … seeking highly trained medical personnel in the arena facility if the charge person believes the injury is serious and cannot wait for emergency assistance to arrive. This can be accomplished by using the loudspeaker or having arena staff ask throughout the facility."
'You are racing against time'
"The moment a person loses a heartbeat and circulation stops, every minute is critical," said Dr. Tatiana Jevremovic. "You are racing against time."
Jevremovic, who works in London, Ont., leads a sideline emergency medical course for the Canadian Association of Sport and Exercise Medicine. She said having to seek out someone with first aid training can waste precious time in a cardiac arrest situation.
"If you're witnessing someone collapse for no reason … no identified collision — as you're running towards them you should keep in mind that an unexplained collapse could very well be a cardiac arrest," she said.
"You get on that chest and you start compressions, get that AED [automated external defibrillator]. If there's a heart rate, there's a pulse, the AED will advise you not to do anything."
But Jevremovic warns that before someone is able to effectively assess a player quickly, they need some level of first aid training.
"I want to stress the importance that the response of emergency services is still so, so important as well and that's where we have to be organized and be able to get that [911] call in as quickly as we can when we know there is an emergency situation," said Todd Jackson.
'Discussion too easily dismissed'
Steve Boyd's son Jordan collapsed following a cardiac arrest last August at a Quebec Major Junior Hockey League training camp for the Acadie-Bathurst Titan. The 16-year-old hockey player from Nova Scotia was pronounced dead at hospital.
Boyd said knowing — in all likelihood — another player is going to go into cardiac arrest again next season, Hockey Canada's program is short-sighted.
"Encouraging hockey associations to do this is completely different from mandating it. Like I said, they mandate Speak Out courses. They mandate basic coaching training. For the cost of first aid, I don't know why they wouldn't also mandate that," said the grieving dad.
"I think the discussion gets too easily dismissed because it doesn't happen very often and people feel, well, we can't prepare for every event like this when it might happen. I'm not sure that's true. I think there are things you can do to raise the level of preparedness and the level of response."
When Jordan collapsed, despite the presence of trained staff, more than 10 minutes passed before he was shocked with a defibrillator. It's not clear how many of the young players who have died in the last decade had early CPR or AED intervention. Hockey Canada says it is comfortable with its current program.
"We are at a point where we are delivering something we are very comfortable with," said Jackson.
"We're delivering something that gives that safety person the initial tools they need to build a plan within their team environment and we'll continue to do that."
The safety program training includes a two-minute module on sudden cardiac death awareness and advises volunteers to look for the warning signs of underlying cardiac conditions, such as fainting during exercise.
It concludes by encouraging program participants to get first aid and CPR training in order to effectively handle emergencies.
'We can't change what's happened'
Jackson said Hockey Canada is constantly reviewing its safety program, but when asked about considering making CPR and AED training mandatory, he was non-committal.
"That's not a question I can answer right now. As I say, we sit down with a group, a network of people that are paramedics, that are therapists, that are doctors and we look at it on an ongoing basis," he said.
Hockey Canada does not review a team's response to a cardiac arrest — something Boyd said should change.
"I'm not sure what their reasons are for not wanting to dig into the details of those situations. I think anytime that you don't, that there's an opportunity that's been missed to learn and try and improve the system," he said.
The Boyd family wants Hockey Canada to step up the preparedness of volunteers before the next cardiac arrest happens.
"From our perspective, we can't change what's happened in the past, but moving forward there has been a discussion and some awareness about our son," said Boyd.
"I think it would be a shame if Hockey Canada and other hockey organizations, in fact, other sports organizations, don't at least have a discussion, a dialogue about how we can keep our players safer and how we respond to incidents like this, because I think there are some gaps."
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