Finding the Right Treatment

Emergency medical devices, such as defibrillators, are reassuring to clubs and their members.

When selecting a tennis club, potential members expect to size up tennis courts, ball machines, locker rooms, and other amenities. However, there is additional equipment to consider: automated external defibrillators (AEDs) and other medical gear.

“Just by the nature of the sport — where people can go from complete rest to full-out activity, with some not exercising any other way — there are going to be some [cardiac] problems on a tennis court,” says Stephen Tharrett, a former senior vice president at Dallas-based ClubCorp and currently an editor of the American College of Sports Medicine’s Health/Fitness Facility Standards and Guidelines.

When the publication’s third edition is published in April 2006, according to Tharrett, it will recommend the inclusion of AEDs in all fitness centers, with the intended effect of transforming what has been a growing trend into an industry standard. By 2010, he predicts installing AEDs in sports facilities will be legislated beyond the current states of Illinois, Rhode Island, New York, Maryland, and Louisiana. An AED is a computerized medical device that can recognize whether a person’s heart rhythm requires an electric shock, and uses voice prompts, lights, and text messages to tell the rescuer how to deliver one.

“It’s a natural part of a facility’s duty of care to its members,” says Tharrett, noting that AEDs are joining traditional safety measures such as first aid kits, CPR-trained personnel, and even oxygen masks for members experiencing difficulty breathing. “As long as you provide appropriate training on modern equipment that is serviced regularly, these devices are absolutely in members’ best interest.”

As the national tennis director and regional manager of two Tennis Corp. of America (TCA)-owned tennis clubs in the Kansas City area, Ajay Pant says he sets an example for his staff by participating in emergency training offered to all TCA employees.

“There’s a certain way you have to push down on the abdomen when doing CPR, and it took me a while to get it,” Pant admits. “I’m the guy in charge and it would have been easy for me to let it go, but I held up all proceedings until I got it right. I wanted to send the message that there can be no shortcuts when safety is involved.”

HeartStart Onsite Defibrillator
Philips Electronics

ZOLL AED Plus
ZOLL Medical Corporation

PowerHeart AED G3
Cardiac Science

In addition to CPR, according to Pant, TCA clubs also train staff on AEDs, first aid and infant CPR at facilities with nurseries. Tennis pros who work with members outdoors during the summer are taught to look for heat illness symptoms such as hot, dry skin, change in skin color, hyperventilation, and confusion. If a teaching pro suspects heat exhaustion or sunstroke, for example, Pant says the lesson is immediately ended (with the fee waived) so the member can be taken inside for treatment.

“We train our staff on what to look for because even when you ask a member how they’re feeling, they may say they’re fine,” says Pant. “We adhere to strict policies, but we believe our members appreciate it.”

Ed Brune, general manager and tennis director of the Indianapolis Racquet Clubs, says the company’s two facilities both have first aid kits, with an employee in charge of keeping each one fully stocked. He also recently purchased an AED for each site.

“I’ve been studying defibrillators for two or three years, waiting for something to come along that’s easy to use and cost-effective,” says Brune, noting that the local fire department conducted the training for his key employees. With increasing publicity surrounding AEDs — not to mention about one-quarter of the Indianapolis Racquet Clubs’ 3,000 members over 50 years of age — Brune says it was simply time to make the devices part of the clubs’ standard equipment.

Ville Jansson, sports club manager at Mission Hills Country Club in Rancho Mirage, Calif., says his ClubCorp-owned property is equipped with an AED, oxygen, and first-aid kits containing antiseptics, sports injury-related bandages, and “everything imaginable” at both the tennis and golf portions of the property. The company strives for 100 percent employee training in safety procedures including AED usage, he says.

“It’s peace of mind for our members,” says Jansson, a former ATP touring pro with 10 professional tournament wins. “AEDs are coming down in cost so these days, you see them in a lot of places. It makes sense for us to have them, too.”

Ron Woolard, the national director for Athletics & Tennis at Dallas-based ClubCorp, says Mission Hills Country Club is one of 79 ClubCorp sites that were equipped with AEDs in 2002.

The investment of purchasing the devices, servicing them, and dedicating employee hours to repeated certifications can be significant, Woolard says. AEDs can range in price from about $2,000 to $3,000, he notes, and companies may opt to pay an additional monthly fee of approximately $200 per site for an outside vendor to keep AEDs in working order with fresh pads and batteries, and alert them to staff whose certifications are set to expire.

“Though presently it is not legislated that clubs be equipped with AEDs, ClubCorp felt because of the potential of saving a life, that this initiative was worth the investment for the company,” says Woolard.

Helen Durkin, director of public policy for the Boston-based International Health, Racquet and Sportsclub Association (IHRSA), cautions clubs and members alike from believing that AEDs will save every life since they are most beneficial in cases of sudden cardiac arrest, where the heart actually stops beating. Liability is another common concern for clubs, she says, since Good Samaritan laws for businesses have not yet been enacted in all states.

“IHRSA is working hard to ensure that all states that require AEDs provide adequate coverage so these businesses aren’t subject to liability by using these devices or not using them,” says Durkin, noting that 25 percent of IHRSA member clubs surveyed in 2000-01 already had AEDs in their facilities.

Durkin also notes that studies have indicated that 85 percent of sudden cardiac arrest cases occur in the home or hospital, with only the remaining 15 percent spread out across airports, businesses, jails, dialysis centers, gaming establishments, golf courses, homeless shelters, large industrial sites, nursing homes, physician offices, shopping malls, sports complexes, streets and highways, trains and ferries, urgent care centers, and utility trucks.

“There are plenty of club owners who have gotten AEDs and tell stories of how they’ve been used to save lives, but in the case of an emergency, clubs should still call 911 and follow their first-aid protocol in case it’s not sudden cardiac arrest,” Durkin says. For their part, she adds, members shouldn’t panic and cease exercising because they’re afraid their heart will give out on the tennis court.

“AEDs can be useful devices to have on hand,” Durkin says, “but I’m concerned that all this legislation is going to perpetuate the idea that exercise is more dangerous than it is.”

Where to Get AEDs

A prescription was once required to purchase an AED, but now the devices are offered over the counter. Royal Philips Electronics offers two over-the-counter models: the HeartStart OnSite Defibrillator and the HeartStart Home Defibrillator.

For more information about AEDs, contact manufacturers such as the following:

Training is provided by manufacturers as well as by the American Red Cross and American Heart Association. Neither organization recommends one device over another. For training information, contact your local American Red Cross chapter or the American Heart Association’s Heartsaver AED program at 877-AHA-4CPR (1-877-242-4277).

See all articles by Cynthia Cantrell

About the Author

Cynthia Cantrell is a contributing editor of RSI magazine.

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