I Think Korey Would Be Proud
(But There Is Much Work Still To Do)
By: Douglas J. Casa, PhD, ATC, FACSM, FNATA ,
Chief Operating Officer: Korey Stringer Institute

On August 1, 2001 Korey Stringer passed away due to exertional heat stroke suffered while practicing for the Minnesota Vikings. August 1, 2011 marks the 10-year anniversary of his passing. Obviously, the years that followed his passing were filled with heartache, legal struggles, and setbacks. But, in the past few years, as a result of the efforts of Korey’s widow Kelci Stringer, NFL Commissioner Roger Goodell, and Korey’s agent James Gould, and those affiliated with the NFL (Jeff Pash, Gary Gertzog, Elliott Pellman), NFLPA (DeMaurice Smith, Jason Belser, Scottie Graham, Thom Mayer), Gatorade (Scott Paddock, John Shea, Karen May), Timex (Herbie Calves and Team), and University of Connecticut (UConn; Carl Maresh, Tom DeFranco, Peter Nicholls, Colin Poitras, Becca Stearns, Julie DeMartini, Kelly Pagnotta, and many others), we find ourselves presented with an enormous opportunity to make a positive impact on the health and safety of athletes at all levels of competition. The founding of the Korey Stringer Institute (KSI) at UConn was a momentous occasion in that the two opposing sides of the legal battle came together to make an honest effort to find some genuine and worthy legacy in the name of Korey Stringer. (The concept of KSI was announced in January 2009 as part of the settlement between the NFL and Kelci Stringer, and there was a formal opening at the NFL Draft Press Conference in Radio Music Hall in NYC on April 23, 2010.) We could not have anticipated how much KSI was needed before we opened our doors, but we have come to quickly realize that the concept of preventing sudden death in sport and physical activity is an issue that is a concern for a wide range of vested parties, including medical staff, parents, coaches, athletes, administrators, media, lawyers, and researchers. We have worked diligently to provide resources at KSI that our namesake would be proud of, and we are extremely thankful that Kelci has entrusted this enormous responsibility on my UConn colleagues, board members from around the country, and me. While August 1, 2011 marks the 10-year anniversary of Korey’s death, for us it is another milestone to pay tribute to the progress we have made and the Herculean tasks that lie ahead. In particular, the problems with conditioning sessions at the collegiate level and the lack of oversight and nearly complete dearth of appropriate polices and regulations at the high-school sport level provides fuel for our continued diligence to try and prevent needless deaths associated with sport participation. We trudge on, proudly. In one of our KSI offices hangs a framed former jersey of Korey from his playing days with the Vikings; a few feet away is my framed jersey from when I had a heat stroke as a high-school track athlete. Together they serve as reminders of the life that was tragically and  needlessly lost 10 years ago and the opportunity to serve that was provided when I survived my heat stroke 26 years ago. We do not take the responsibility lightly. We will never back down from our aggressive efforts to make positive changes. The outcomes of our efforts are lifesaving, and that is our fuel. The ultimate motivation for me is knowing that at hundreds of dinner tables across the country, parents, spouses, children, siblings, and friends are blessed with the presence of someone that we helped save. We cherish our chance to do this, and look forward to doing this long into the future.

P.S. We are going to have an event to honor the 10-year anniversary of Korey’s passing. More news to soon follow.

ksi@uconn.edu

A coach’s primary duty is to push your child to the point of peak physical ability through challenging and exhausting workouts. They are not medical professionals. If your child exhibits signs of exertional heat stroke, or other potentially fatal episodes during play or practice, in most schools and organizations today, it is the coach who is in charge of saving your child’s life. 

The situation has a strange twist of irony.  In the heat of the moment, the person whose focus is on pushing and prodding for more effort, must decide if the signs and symptoms being exhibited by your child are normal or warning signs in need of the following attention:

A) Rest and hydration;

B) Medical attention;

C) A 911 call. 

While all emergency situations will eventually end up at the hospital, the recognition and treatment delivered in the first 15-20 minutes is the biggest predictor of a healthy or fatal outcome. 

Coaches should not be asked or expected to take on this responsibility.  It’s a recipe for disaster. The right person for the job is an athletic trainer. An athletic trainer is a seasoned sports-medicine professional who possesses the training, experience and tools to assess the condition causing the on-field emergency and immediately implement the appropriate care for the specific condition. 

The next time you speak to your child’s coach ask whether they are assisted by an athletic trainer on site. If not, ask the coach if he or she can explain the key differential clinical indicators for exertional heat stroke, concussion, exertional sickling (can occur when children with sickle cell trait exercise very intensely without proper recovery), a cardiac condition, hyponatremia (a sodium deficiency), or asthma — which are some of the most common causes of sudden death for athletes — and how to treat each problem. Unfortunately, the presenting signs and symptoms can often be quite similar and difficult to recognize by untrained personnel.

Your athletic team must have professionals nearby who can recognize the differences and treat them appropriately. Before an ambulance ever arrives, the most important decisions and care must be implemented.  Whether it is an AED (automated external defibrillator) for a cardiac condition, cold-water immersion for exertional heat stroke, immediate cessation of activity and transportation for an exertional sickling case, or a myriad of other emergent conditions and responses, the common denominator is that the first few minutes are critical. 

Think very carefully – who do you want making life and death decisions about your child?   Approximately 50% of the high schools in America have an athletic trainer, but for the remaining half, the first line of medical care is the coach.  Check with your school system to make sure your child’s safety is in trained, experienced hands.

Can you imagine that with all the advancements in research, education, awareness, knowledge, improvements of state/NCAA policies, presence of athletic trainers at more high schools, and other advancements that we still had more heat stroke deaths in the past five years than in any other five-year block over the past 35 years. This is a staggering testament to the long journey ahead for the prevention of exertional heat stroke within the confines of organized American sport.

On the broader landscape of all causes of sudden death in sport, the data is also not encouraging., which is why we are happy to say that The Korey Stringer Institute is well-positioned to help states, towns, schools and sports-related organizations and professions update or instate the policies and procedures for the prevention of sudden death during sport and physical activity. To that end we announce the official opening of the KSI on April 23, and are ready to roll up our sleeves and start doing the important work that is needed to make change.

Our first offering is the new KSI Web site, which was designed as a tool that you can use as a daily resource for information you need to make decisions. I’d love to hear your comments and thoughts on how we continue to make it a useful tool. I also welcome your comments on KSI blog posts. This is a great way to let us know what you are thinking and what you need from us.

Thanks. See you on the road ahead.   
Doug