By Kate Vander Wiede

PPT Athletic Trainer Sal Palermo helped save a referee’s life when his heart stopped during a game

Salvatore Palermo, right, received several awards for his life-saving actions at a Ponaganset Girls Basketball game.

He was sitting on the bench with his school’s JV Girls Basketball team when it happened: Across the court, he watched as the referee went down. The crowd gasped and fell quiet.

His team had been running toward their scoring hoop, Performance Physical Therapy Athletic Trainer Sal Palermo recalled, and on the way back down the court, the referee blew the whistle just as a player accidentally hit him in the chest with her shoulder. “I saw him just standing there,” Sal said, “and the next thing I knew, he was down.”

Immediately, his training and education kicked in, and Sal jumped into action, sprinting across the court.

He’d thought the referee might have fainted of dehydration, since it often gets warm in the gym. But once he got to the referee, Sal and a parent who had also run down to help realized that the referee didn’t have a pulse.

“He was turning blue,” Sal recalled of the referee. “He wasn’t breathing.”

Sal and the parent – who it turned out was an EMT – started CPR at once. Asked if he was scared at this point, Sal said that adrenaline just took over. “You know, you know what you’re doing, and you do it. It just happens like that,” he said with a snap of his fingers. After two sets of chest compressions, as Sal and the parent prepared to switch places, the referee came to.

Sal was relieved, but also nervous that the referee might have something seriously wrong with him, so he and the EMT parent kept the referee on the ground and asked him questions while they waited for the ambulance.

At the hospital, they diagnosed what had happened: commotio cordis. Commotio cordis is when the heart stops after a relatively low-impact blunt trauma to the chest at a specific moment in the heart’s rhythm. According to research published in the Archive of Trauma Research, “commotio cordis has been reported as the second most common cause of sudden death in athletes, especially in baseball and hockey players and football players.” When the athlete’s shoulder had hit the referee’s chest, it did so at precisely the wrong time, causing the heart to stop. Without immediate CPR, commotio cordis is often fatal. But because of Sal and the parent EMT’s quick action, the referee was released from the hospital the next day, and he’s been doing well since.

Over the last few months, Sal and the EMT parent have been honored with awards for their quick response, including a Certificate of Life-Saving Achievement and a Varsity Letter Certificate from the Ponaganset School Committee. Both also received a Distinguished Service Award from the International Association of Approved Basketball Officials organization, which the referee is a part of. The referee was the one to present the award.


Be Prepared by Knowing CPR

Sal said athletic trainers get CPR and First Aid training as a part of their certification, which gave him the expertise he needed to respond to the emergency. Certified athletic trainers like have expertise in several essential domains: injury and illness prevention and wellness promotion, assessment and diagnosis of injuries and immediate and emergency care. He suggested that any person could better prepare for health emergencies like this by getting their CPR certification. Even without a CPT certification, Sal said that if you see someone go down, you should check for a pulse. If they don’t have one, you should do good, deep compressions at a steady pace (don’t worry about the breath) while someone else calls 911. You should continue compressions, switching off with another person when needed, until emergency help arrives or the person’s pulse returns.


Call to Action

In addition to being able to provide quick emergency care like Sal did at Ponaganset, the National Athletic Trainer’s Association reports that schools with athletic trainers have fewer student athletes injuries than schools without athletic trainers. They also help improve the detection and prevention of dehydration, head injuries and other sports-related health issues. This year there is legislation in the State House (H7703) that, if passed, would make athletic trainers a more common sight in schools. Call your representative and urge them to pass the house bill and ensure trained people are always on the sidelines at youth sporting events to help with emergencies.