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Baseball death prompts ambulance director to review athletic policy
WAYNESVILLE, Mo. (April 24, 2009) — The death of Waynesville High School baseball player Patrick Clegg, 16, has prompted Pulaski County Ambulance Director Gary Carmack to review how his paramedics handle athletic events.

Clegg, who was a close friend of Carmack’s grandson and was also a friend of the son of a Pulaski County emergency medical technician in the ambulance district, was struck in the back of his head Tuesday by a pitch while playing at Lebanon High School and was taken off life support later in the week. Since the game was outside the county, Pulaski County Ambulance District paramedics wouldn’t have been present at that game and Carmack said from what he knows, Laclede County first responders “did an excellent job.”

Baseball games don’t usually have paramedics present even in Pulaski County, but Carmack said that may need to change.

“I’ve been a paramedic in this community for over 30 years and I don’t ever recall being asked to cover a baseball game,” Carmack said. “With this very sad, tragic case with the baseball player, in a sport, anything can happen. How many of us think in baseball somebody can really get hurt, but it can happen.”

State law requires an ambulance crew to be present at all varsity football games in Missouri, but Carmack said the ambulance district routinely staffs many other sports events.

“In my opinion, it’s good to have the paramedics there regardless of whether it’s required by the law,” Carmack said. “Anytime you have a large gathering of citizens you have the potential. We have had people in the stands, someone falls, someone has a heart attack, so anytime you have a large crowd of people it’s good to have EMS there.”

The most common examples include lower-level football games, basketball games, soccer games, and wrestling matches, all of which can result in serious injuries.

“The last couple of years, the (Waynesville) school has actually asked us to cover all football games, even ninth-graders, seventh- and eighth-graders,” Carmack said. “(For) the varsity football games they paid us $500 a year to cover them, but we covered the seventh grade, eighth grade, ninth grade, just because we felt like it was the thing to do, but here’s the difference: we didn’t commit a unit to it. In other words, if we got really busy and there were cardiacs and car wrecks, the ambulance would actually pull out, while at a varsity game they’re committed to that game. That unit is actually (on) its mission right there.”

The Waynesville R-VI School District is the only one in Pulaski County to offer a football program, and it’s also the best-funded. Carmack said the school district asked ambulance personnel to upgrade its level of coverage of non-varsity football games and he was happy to accommodate that request.

“In the last couple of years, the school asked us if we would commit an ambulance to be there for all football games, and they wanted me to come up with a budget to do that, as we did, which is a very reasonable budget … we didn’t feel that we should do it to make a profit,” Carmack said. ‘We started covering basketball games and soccer games a long time ago on our own without being asked by the school.”

The Waynesville school district has also asked to have ambulance crews cover wrestling matches, he said.

“We don’t get paid for that; we just go down there if we can,” Carmack said. “We started going down to basketball games because we would get called a lot since on the basketball court it’s pretty common for a kid to fall and hurt their ankle or whatever … that was done for a public service and mostly for the kids.”

For sports such as soccer and baseball, the location of many Waynesville athletic fields right across from the main Waynesville ambulance base helps, Carmack said, but it’s not a perfect solution. If both ambulances stationed at the Waynesville base were out on other emergency calls, ambulance crews might have to respond from as far away as Laquey, Richland or Crocker with delays that could be up to 20 to 30 minutes.

For the smaller districts that don’t have football, providing ambulance crews to cover athletic events can be just as important.

“Some of our worst injuries actually have been in soccer,” said Deputy Ambulance Chief Mike McCart. “We’ve had some pretty bad broken legs and stuff.”

Now that the Pulaski County Ambulance District has a new ambulance base off Exit 150 near Laquey, the Laquey R-V School District has asked the ambulance crews to come to major soccer games and the Frisco League basketball tournaments which are usually held at Laquey, though it continues to be an unpaid service and the Laquey ambulance will sometimes leave for medical emergencies elsewhere in the district.

Less formal arrangements exist with the Crocker R-II School District and Richland R-IV School District, both of which have had ambulance bases in their towns for many years.

“The Laquey school seems to really appreciate that because that’s a slower moving base so we’re usually there for most games,” Carmack said. “Crocker usually doesn’t ask us for anything, but a lot of times we’ll just drive over there and park because it’s good to have our presence there at the school to let the people know that we are there, and the same thing with Richland.”

Football, soccer, wrestling and basketball are well-known as sports that can cause injuries, and the Pulaski County Ambulance District has also sometimes been asked to cover volleyball games as well. However, Carmack said high-speed projectiles such as baseballs could easily cause injuries as well, even though it’s considered a safer sport.

“I was watching a St. Louis Cardinals game when one of the players was standing in the batter’s box and a foul ball came up and hit him in the eye socket,” Carmack said. “If you start looking up the statistics for the last 75 years, there’ve been more people hurt in baseball than you would think ... I’ve been sitting down at Busch Stadium and foul balls would come back and I would think, ‘If you weren’t paying attention and one of those hit you, it could kill you, because that is a projectile coming at 100 mph.’”

A related problem is broken bats hurting players or potentially flying into the stands and hurting spectators, Carmack said.

Carmack said one option may be to have a paramedic or a medically-trained person in the stands at athletic events, even if a full ambulance crew is not present.

“We enjoy covering the sports, being at the schools, doing that for the kids and the families,” Carmack said. “We feel like that is part of our commitment for the community.”

Commitment to covering athletic events has included purchasing a Gator vehicle so paramedics won’t have to bring an ambulance onto the new artificial turf of the Waynesville High School football field.

“They spend a lot of money on their football turf, and they don’t want us bringing the ambulance on their turf unless we absolutely have to, and that’s understandable,” Carmack said.

The Gator vehicle is similar to what people see at NFL games when medical personnel use lightweight wheeled vehicles to come to the aid of players and ferry them to a waiting ambulance off the field, Carmack said.

“We can roll there with a spineboard and get that kid off the field without having to drive the ambulance on there,” Carmack said. “We did receive some criticism once ... it was some teachers (who) didn’t know my paramedics were there sitting watching the game. And what they didn’t know is it was their school’s policy not allowing our ambulance closer.”

That doesn’t mean taking care of the turf takes precedence over taking care of people.

“If a kid gets hurt bad, we’ll do whatever it takes. If we have to, we’ll land a helicopter right in the middle of the football field,” Carmack said. “We have not and I hope and pray we never do, but we will do whatever it takes to take care of our citizens’ kids.”

Incidents like that would be limited to life-threatening situations such as a head injury resulting in a coma or severe spinal injury, Carmack said.

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