Find the cause In last week’s edition of The Wright View, I mentioned two aspects of ‘children at play’ that needed urgent attention. The first dealt with the initiation of a ‘concussion protocol’ for athletes involved in Rugby Sevens where the possibility of high speed impact affects those learning the game, the so-called ‘non-elite’ players, school children. The other aspect of ‘children at play’ that I want to discuss this week is the response and care of children/athletes who collapse during games. We do remember the half-hearted and restricted response to the death of a child representing Jamaica in a cross-country event in Tobago some years ago. A pre-participation-evaluation (PPE) questionnaire and examination were developed to identify athletes at risk for sudden cardiac death while engaged in sports. The PPE not only identified and initiated referral to cardiac specialists those with abnormal findings, but it also identified previously unknown physical and mental inadequacies that could be improved with treatment. The initial fervour dissipated until the unfortunate collapse and demise of a Manning Cup footballer at a game at the Stadium East field in 2016. Again, a flurry of activity that resulted in an increasing number of people, young and old, athletes and non-athletes who recognised the importance of a PPE before entering any exercise programme for the well-documented benefits of movement. An excellent spin-off of this important evaluation came when the SportsMax Elite League for Under 18 footballers started. All players in the league had to have been evaluated by way of a PPE before being eligible to play. Automatic external defibrillators were donated and distributed to some schools and the use and care of the machine was taught by experts from abroad and locally. One aspect of the death of that footballer at the Stadium East field was the fact that even though there were medical personnel on site, and they tended to the fallen player in reasonable time, there was no effort made to identify the cause of his collapse by the simple use of a stethoscope, a must-have instrument used by any medical person tasked with the care of the injured at an athletic event. In the USA on March 26 this year, 26-year-old Zeke Upshaw, a G League player in the NBA, collapsed in a game. The designated medical team arrived within 90 seconds of his collapse and they stayed by his side for four minutes while a stretcher was arranged to take the fallen athlete to the nearby, designated hospital. Zeke Upshaw never recovered and his cause of death at autopsy was Sudden cardiac death! During the four minutes that he was on the floor, surrounded by three medics, no one listened to his heart! No one checked if his heart was beating! There is, as can be expected, a lawsuit involved, brought against the authorities at the game by the parent of Zeke Upshaw. How is it possible that in 2018, with all the exposure and attention given to the treatment of collapsed athletes during games, a simple stethoscope was not brought into play? What is needed, therefore, is mandatory training and certification in basic life support for coaches, medical personnel, referees, umpires, and grounds administrators. It is now well established that more than 90 per cent of sporting activities under the auspices of local authorities will not start unless the necessary security arrangements are in place. Let us add medical personnel to that list of mandatory presence before the start of the game. A proper, well-equipped medical kit should be present at all competitive games. This request/idea is not expensive when compared to the value of the life of an athlete that may be saved. Let us use the unfortunate demise of a basketballer in the USA to galvanise our local sport administrators to do the right thing and not wait for another tragedy; for yet another round/flurry of activity would be definitely too late for the collapsed athlete. The time to act is NOW.