BETHLEHEM, Pa. — Some Lehigh Valley school districts are reviewing their safety protocols for responding to injuries at area football games after a professional player's recent collapse brought renewed attention to the dangers of the sport.
At least one doctor recently told Bethlehem Area School Board members that some football games in the Lehigh Valley were going without ambulance coverage.
Some ambulance providers say that because of worker shortages exacerbated by the COVID-19 pandemic, they have to put more of their focus on covering their 911 service areas than staffing school activities.
- Some EMS providers say worker shortages make it difficult to cover school football games and staff 911 calls
- COVID-19 exacerbated labor shortages
- Some agencies have cut back on the school sporting events they cover because of a lack of resources
Buffalo Bills player Damar Hamlin suffered a cardiac arrest this month during a game. He collapsed on the field after tackling a player on the opposing team.
Medical personnel administered CPR for several minutes and used a defibrillator to jumpstart his heart before transporting him by ambulance to a hospital.
He since has been released from the hospital to continue his recovery from home.
Medical experts have speculated Hamlin experienced commotio cordis, a blow to the chest during the cardiac cycle that causes cardiac arrest.
Warnings of shortages
John Hauth, senior director of sports medicine relations for St. Luke’s University Health Network, recently told the Bethlehem Area School Board the district was fully staffed with athletic trainers, who are trained to practice sports medicine, and equipment.
But he warned that some football games outside the city and Bethlehem Township had gaps in the availability of emergency personnel.
He also said there was a nationwide shortage of athletic trainers, including in the Lehigh Valley.
The Governor’s Council on Physical Fitness and Sports and the Pennsylvania Interscholastic Athletic Association say ambulances should be on site at games or be able to respond within five minutes of being called.
School districts contract with ambulance providers to staff games and other events and activities.
“The safety of our student athletes is first and foremost,” PIAA Assistant Executive Director Melissa Mertz said. “That’s why we make sure they have AEDs [automated external defibrillators], that they have some training."
"So in those instances when an EMS might be on call versus physically sitting at the end of the end zone, we help with the people and the equipment to do CPR, somebody to connect the AED until an EMS can arrive within a couple of minutes.”
Robert Mateff, chief executive officer of Cetronia Ambulance Corps, said the company used to staff varsity and sub-varsity sporting events throughout the Lehigh Valley before the COVID-19 pandemic, but that is no longer the case.
“We covered Allentown [high schools], we covered Central Catholic [High School], we did sub-varsity games in the city of Bethlehem,” he said. “We went as far as Palisades” [High School in Upper Bucks County].
Pandemic left shortages
Bryan Wilson, board president of the Eastern PA EMS Council, said many paramedics work multiple jobs to make ends meet. But he said because of the pandemic, some first responders decided to spend time with their families rather than work that extra shift.
The Eastern EMS Council is a nonprofit that acts as a regional advocate for a six-county region which covers Berks, Carbon, Lehigh, Monroe, Northampton and Schuylkill counties.
“It’s trying to find that balance between serving the community in the emergency capacity as well as in this preparedness capacity.”Bryan Wilson, board president of the Eastern PA EMS Council and ER physician
“They might work for Cetronia for Bob and one other place part-time and Bob puts out a stand-by and they’re just like, ‘Nah, I’m going to play with my kids today,’” Wilson said.
Wilson, who also is an emergency medicine physician with St. Luke’s, said he’s been told that some EMS agencies are mandating overtime shifts to make sure 911 calls are serviced.
“It’s not something we take lightly, like, ‘Nope sorry, you’re not going to get an ambulance for the football game,’” he said. “It’s not what we want to do. It’s trying to find that balance between serving the community in the emergency capacity as well as in this preparedness capacity.”
A lack of resources forced Cetronia to pull back its coverage to districts within its 911 coverage area, which includes Parkland and Whitehall, Mateff said.
He said his agency used to provide ambulance support at games for Allentown School District’s two high schools, which at times could mean up to five events on a Saturday. Cetronia notified the district in January 2022 that starting in September it wouldn’t have the means to continue providing coverage.
“So Allentown partnered with the city and they’re helping out and others,” he said. “But I just know that it’s a constant struggle.”
'Investing in our communities'
Allentown EMS Chief Mehmet Barzev said the city took over providing ambulances for varsity and junior varsity games for William Allen, Dieruff and Allentown Central Catholic high schools, along with Executive Education Academy Charter School. They also provide coverage for many of the cross-country meets. The city’s EMS bureau charges $160 an hour for stand-by services.
“While no one can deny the shortage of EMS workers across the nation, we took on this responsibility because it is important to invest in our community and provide this necessary function as a safety net for the athletes competing,” Barzev said in an email.
“If we learned one thing from Buffalo Bills’ Damar Hamlin, it’s that fast access to EMS will make a difference during an emergency that can arise during competition.”
The city of Bethlehem is staffing ambulances for high school varsity football games and other Bethlehem Area School District activities at $138.54 an hour.
A Bethlehem Area School Board agenda item dated May 23, 2022, noted that the athletic directors were unable to get quotes from Bethlehem Township, Cetronia and other EMS providers.
Providing 'top-level care'
Donald DeReamus, quality assurance manager and government relations liaison for Suburban EMS, said labor shortages among paramedics are a problem nationwide, with turnover reaching 30%. Suburban EMS covers 19 municipalities in Northampton and Monroe counties.
“It’s not a very high-paying field,” he said. “And COVID made it worse because people didn’t want to infect their families. So we have people leaving from that and then there’s just not a lot of people coming into this field anymore because of the pay.”
DeReamus, whose agency covers several school districts, disputes that high school football is going without having an ambulance on site.
“Most of the places we deal with we're physically on site or they won’t play the game,” he said.
Wilson said Hamlin’s kind of injury is extremely rare. He and Hauth said athletic trainers and coaches are taught how to handle that type of situation.
“Emergency activation of the 911 system and early chest compressions — those are the two things we know are going to make the biggest impact,” Wilson said.
Mateff said despite any strains on the emergency response system, the area partnerships among EMS, police and firefighters, and two large hospital networks, St. Luke’s and Lehigh Valley Health Network, mean that students can get the emergency care they need.
“In the Lehigh Valley, I have no doubt any incident would be covered as quickly, with the same level of professionalism and competence,” he said. “Again, we are resource rich with our hospital networks. We are able to provide top-level care.”
