A 16-year-old Nova Scotia hockey player who had an undiagnosed heart condition may not have had every opportunity to survive a fatal cardiac arrest on the ice last August at a training camp in northern New Brunswick, CBC News has learned.
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Jordan Boyd was just beginning one of the most exciting days of his life when he collapsed, about 10 minutes into the tryout for the Acadie-Bathurst Titan of the Quebec Major Junior Hockey League (QMJHL).
He had passed a full medical exam leading up to the camp, but the QMJHL does not require cardiac exams as part of its medical exam. The autopsy revealed Boyd had an underlying heart condition known as arrhythmogenic right ventricular cardiomyopathy.
Following Boyd's collapse, no one used an automated external defibrillator (AED) prior to the arrival of paramedics, despite a league requirement that one be in the rink.
Based on initial information provided to the dispatcher, the emergency was treated as an unresponsive/fainting incident, according to Ambulance New Brunswick.
Three minutes into the call, it was changed to cardiac arrest, after the dispatcher asked if Jordan was breathing and the caller said the team’s athletic therapist was starting CPR.
The dispatcher was then told the team’s athletic therapist was fully trained in CPR. The dispatcher asked if there was an AED. According to Ambulance New Brunswick, the dispatcher could hear the caller asking a bystander to get the AED.
Paramedics who arrived at Jordan’s side at 10:40 a.m. reported not seeing an AED being used or readied for use.
Ambulance New Brunswick says when paramedics arrived more than five minutes after he dropped, they assessed the team's administration of CPR as ineffective. Boyd was pronounced dead in hospital a short time later.
Now Jordan’s parents, Steve and Debbie Boyd of Bedford, N.S. — who shared the details of Ambulance New Brunswick's reports with CBC News — are calling for better emergency response training for sports leagues and teams across Canada.
"How do we make the outcome different so that this doesn’t happen to another family, another young athlete? Or if it does, that you know with certainty that everything was done ... that could be done to try and save that athlete," Steve Boyd says.
On Aug. 12, 2013, Jordan was waiting in line for a drill when he fell face first to the ice, bloodying his nose and face. The 911 call from the rink came in at 10:34 a.m., according to an ambulance report.
Timing of AED use is crucial
I held his hand. I looked in his eyes and I said 'Jordie, Dad's here. Dad's here.' - Steve Boyd
Steve and Debbie Boyd were in the stands at the opposite end of the rink. When Jordan dropped, Steve Boyd made his way to his son on the ice.
"My first instinct was just to, I held his hand. I looked in his eyes and I said, 'Jordie, dad’s here. dad’s here,'" Steve Boyd says. "And he didn’t answer me back or anything. I could tell he… I don’t even think he heard me. He was just, his eyes didn't move. They were open but they just, they didn’t move."
The paramedics reported they found Jordan still wearing his jersey and chest protector, so they were concerned effective CPR had not been performed by team staff.
Paramedics cut through the gear and performed another two minutes of chest compressions before using their defibrillator, delivering the first shock at 10:45 a.m.
In all, more than 10 minutes passed before Jordan received a shock — about six minutes too late for the AED’s best chances of saving a life.
There is no guarantee an AED will always save a person's life. However, Halifax cardiologist Dr. Martin Gardner says studies show the first five minutes offer the best chances of success.
"What the data showed is that if the defibrillator had been applied within the first five minutes, you get that 70 per cent effective rate," Gardner says.
"I believe up until 10 minutes, the effectiveness is still in the 50 per cent rate area and then it falls off quite quickly after that. So the earlier it’s applied, the higher the degree that this would be effective."
The loss of Jordan has been difficult for the Boyds. Debbie Boyd had watched her son train for months, getting ready for the big day.
She says their six-foot-one, 190-pound son was in top shape, and no one in the family saw any sign of an underlying heart condition. Debbie Boyd says she spent every day of his summer break with him, supporting his training goals.
Jordan was drafted 66th overall to the QMJHL in the spring of 2013. Debbie brought him to hockey practices and training sessions five days a week in preparation for training camp.
She watched him run sprints up and down Halifax’s Citadel Hill in the blazing heat. She says they attended a talk with a nutritionist together, and that Jordan took it "for gospel."
"He went to the organics section of the health-food store and got granola," Debbie Boyd says. "He was just healthy, healthy, healthy. Chicken breast, I don’t know how many chicken breasts I went through this summer you know, and pasta and salad, and that’s how he ate."
Parents trusted team
When Jordan started training camp, his parents say they trusted in the team's ability to provide medical care — something they now believe was a mistake.
"I think the people that initially attended to Jordan weren’t expecting this and they probably did the best that they could in the situation they were in," Steve Boyd says.
"Having said that, I think there needs to be more training and more awareness around the potential of this event occurring. And team trainers, therapists, staff, should be given more advanced training to anticipate these types of situations."
Debbie Boyd adds: "When you collapse, there’s only a certain amount of time that when you get the defibrillator on you, that you have a chance of having it work."
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The Acadie-Bathurst team has had emergency response training sessions since Jordan's death. When asked for an interview by CBC, the team deferred comment to the QMJHL. The league refused requests for an interview.
"League rules stipulate a defibrillator must be present in every QMJHL rink," spokesman Photi Sotiropoulos says in an email to CBC News. "Moreover, the majority of our teams also have a portable defibrillator that they bring with them during road games.
"Athletic therapists are trained to do CPR and are also present during training and game days. The safety and well-being of our players is paramount and we take this aspect of our work very seriously."
CBC News asked the league why team staff didn’t use a defibrillator. Sotiropoulos says events happened quickly that day. He says the league reviewed its policies and procedures, including the actions of team staff, and didn’t feel any changes were necessary. He adds that protocol was followed "to the letter."
When asked about the paramedics’ assessment of the CPR performed by the team, the league said it had nothing further to add.