As a certified personal trainer, let me ask you a question. What will you do, if― God forbid ―one of your clients dies right in front of you or is seriously injured while working out? What would you do if ANY member of the gym you worked at died or was injured? This question often comes as a complete surprise to most new personal trainers, and even those who have been working for a while. Sadly, the idea of people dying or being injured while exercising is hardly is ever addressed by the gym management to employees. As such, when it happens ―and it will one day― the gym becomes utter chaos because often, nobody knows what to do.
In this review, I want to give you an idea of what to do if you ever come face-to-face with what will be your worst day ever as a personal trainer…
Gym Emergency: Typical Scenario
After speaking with many personal trainers over the years who have witnessed what happens during an emergency, (like a heart attack), this is the basic picture of what often occurs:
- Fitness staff does not know what to do. Most people panic.
- Front desk person calls 911 (or the police).
- The gym manager performs CPR/AED.
- Club members are afraid to help or don't want to get involved.
While there is much to shake our heads at in disbelieve with this scenario, it's the part about the personal trainers not knowing what to do that is the most disturbing.
One reason for this is that the fitness staff usually doesn't know the health club's emergency procedures. Even if they did know those procedures, how many of the fitness staff are even CRP/AED certified?
At some health clubs, not all of the staff are CPR/AED certified. This is a huge red flag because it reduces the speed at which help can be rendered. ALL staff should be CPR /AED certified. This includes front desk staff, child care staff, janitorial staff etc.
Another thing I've been told is that CPR/AED certifications sometimes become mandatory for personal trainers AFTER the incident occurs. Not before ―but after! What's up with that?
It is true that some health clubs require ALL fitness staff (personal trainers, group fitness instructors, front desk staff etc.) to be CPR /AED certified. On the other hand, some facilities only require the manager or manager on duty (MOD) to know CPR/AED. This regulation seems to vary from club to club.
Speaking of the AED, in New York, courts there have ruled that health clubs in New York do not have to use their AED. In other words, the gym may have an AED, but if somebody has a heart attack, they don't have to use it! I find this very disturbing! Different states will have different AED regulations.
All personal trainers should understand the AED regulations of the health club they are employed at.
Let me be clear. What I'm discussing here is not something limited to smaller, local gyms. I know for a fact ―because the employees have told me this ―that larger, more well known health club chains can be guilty of this too. The only way for consumers/ staff to know, is to directly ask the management about this issue.
Why Don't Trainers Know This?
Why don't health club managers /owners teach personal trainers and front desk staff what to do if a medical emergency occurs? I don't know the answer? I hope somebody will ask this question and let me know what the reason is.
If I had to guess, I'd speculate that managers don't bring it up because:
1. They assume trainers who are CPR/AED certified already know what to do.
2. They don't want to scare new personal trainers away.
3. The gym has no official emergency procedures (other than “call 911”).
4. It never occurred to the manager / owner that people could have heart attacks etc. in the gym.
I'd also point out that there is a paucity of articles written about this issue in personal trainer/fitness publications. As such, I don't want to lay blame only at the feet of those who operate health clubs.
As for point #1, just because a personal trainer is certified in CPR/AED does not mean he/she would react swiftly and effectively if an emergency occurred. Knowing CPR alone isn't enough. CPR/AED certifications are best used as part of a comprehensive emergency plan that all staff know about.
The point about the health club having no emergency plan, I feel, is a bigger possibility than many realize. I've asked A LOT of personal trainers working in very well known health clubs, if they were aware of the gym's emergency plans ―almost all of them have told me they did not know if any existed.
If this is the norm in health clubs, then either:
1. The gym has no emergency plan.
2. The owners/managers are not teaching the staff what those emergency plans are.
Either is inexcusable.
Based on my observations and interactions with personal trainers over the years, I feel most gyms in the US are woefully ill prepared for medical emergencies.
The Members Won't Help You
In emergency situations, most people become sheep, too afraid to get involved ―or even acknowledge that an emergency is occurring. As an example of this, in 2012, a man was pushed in front of a NYC subway in plain view of many people. Even though somebody took the time to snap a cell phone picture as the subway was approaching, nobody helped this man as he tried to escape. He was killed.
One personal trainer told me the story of how a gym member, who was having a cell phone conversation, literally stepped over somebody who was laying on the floor having a heart attack. Fortunately, this personal trainer ―a former US Marine ―took the cell phone from the member and called 911 himself.
In short, the fitness staff will likely be on their own (until paramedics arrive) if an emergency occurs.
What To Do In an Emergency
Let's assume that you work in a gym that has no emergency procedures or you are not aware of them.
If you ever hear an announcement over the PA system asking: “Is there a doctor or nurse in the building?” that's usually an indication that something really bad just happened. You may – or may not – hear these words over the PA system. Every club is different.
Once, while teaching a class, I heard this announced over the PA system of a YMCA: “Code E to the Zumba Room. Code E to the Zumba Room.” I knew “Code E” could only mean one thing – Emergency.
If you suspect that an emergency is occurring, no matter what you are doing, go to the location of the emergency and assess the situation. Don’t assume somebody else will do it. If you are training someone, excuse yourself and go.
Move quickly to the location but do not run fast/sprint as this can lead to accidents (staff, tripping or knocking over members) which exacerbates the situation.
After you arrive, follow these basic steps:
If CPR is Needed
- Remain calm
- Perform CPR /use the AED (if you are CPR/AED certified)
- Instruct a staff member to call 911 and notify the gym manager/owner of the incident
- Perform CPR ( or AED) until paramedics arrive
- Instruct someone to obtain the member's health club file and give it to paramedics when they arrive (this file will contain emergency contact info, medications the person takes etc. The paramedics will need this).
- Designate a staff member to wait outside the gym, to escort the paramedics t o the emergency when they arrive. This improves chances of help arriving quickly.
- File an incident report
If CPR is Not Needed
- Remain calm
- Help the person if you are able
- Determine if calling 911 is needed (when in doubt, call 911)
- Notify the manager / owner of the gym
- File an incident report
Obviously not every emergency will be this cut and dry.
The book, Health Fitness Management is also a good resource that covers health club risk and safety issues.
When emergencies occur in the opposite gender locker room:
- Men ARE allowed to go into the ladies locker room.
- Women ARE allowed to go into the men's locker room.
During medical emergencies, I have personally entered women's locker rooms. Even if I was specifically told not to, I would do it it because its the right thing to do.
I say this for a reason. When a young women died at a Planet Fitness in 2012, the front desk person said he wasn't allowed to to go in the lady's bathroom.
All health clubs should have incident reporting forms. These forms―often labeled “Incident Report” ―are usually located at the front desk or in the manager or owners office or at the personal trainer desk/office.
Incident reports should be completed any time something out of the ordinary happens. Ideally the incident report should be completed immediately after the event occurred because that's when your memory is best. In this report, write down what exactly happened, as accurately as you can, and be sure to include:
- The date and time of the incident.
- The location of incident (location inside the gym it happened).
- Names of everyone involved (the gym member, staff, members, etc.).
- What happened during the incident (treatments, if any that were administered).
- The outcome of the incident (went to hospital etc.).
- Include the names of any witnesses that were present.
The ACE Fitness and Business Forms Handbook is a good resource for incident reports and other paperwork items that show up in gyms.
Where To Get a CPR Cert
I feel very strongly that every personal trainer should be CPR and AED certified. Finding a CPR /AED cert in your area is easy. Here is the page of the American Heart Association website where you can see all the classes in your area. Just enter your state or zip code and all the classes in your area will show up. Hospitals, fire stations and YMCA's also conduct CRP/AED classes regularly.
People sometimes stress out over tests but you don't have to with CPR/AED certifications. The class & test usually only lasts a couple of hours. The test is usually not difficult.
Can You Be Sued?
A common thought I hear from people, when we discuss this topic is that they would be afraid to do CPR on another person because of the fear of being sued if anything went wrong. I'm not a lawyer (Any lawyers reading this, I'd welcome your impute ) but its my understanding that the Good Samaritan Law protects the general public who are trying to help another person who is injured.
As I understand this, if the person is unconscious, it is assumed that they would want your help. If they are conscious, its always good to ask if they want your assistance, before rendering help.
While I feel helping is a good thing to do, as I understand it, a health club manager /owner cannot force you do CPR on another person if you don't want to do it. Again, I'd welcome legal minds to weigh in on this issue.
Legal stuff aside, at the end of the day, I think we all have to do what is right. I feel we have moral obligation do what is right for those who travel through life with us. In my world, I have to be able to look at myself in the mirror and like the person who looks back. I know others might not feel the same but isn't a career as a personal trainer, a career of service to others?
One more thing, whether you work in a gym or are self employed, you should have personal trainer insurance.
Basic Emergency Plan
All gyms are different, but my experiences tell me that many health clubs in the US are very unprepared for medical emergencies. But it doesn't have to be this way. Here is a basic emergency plan that can be implemented ―today― by any health club. My hope is that health club managers / owners will look at this and modify it to best suit their needs. The basic points of being prepared include:
1. All front desk staff and fitness staff should be CPR/AED certified
2. There should be a code word, which, when spoken over the front desk loudspeaker, alerts all staff that a medical emergency has occurred. For example, at a facility I worked at years ago, the code name was “Coach Redman.” When this name was announced, ALL staff converged on the area where the emergency was occurring. For example, announcing “Coach Redman to the tennis area” told everybody that an emergency was happening in the tennis area.
3. When an emergency occurs, the front desk person calls 911 and announces the code word over the PA System.
4. The first person to arrive at the location performs CRP (and AED if needed) until paramedics arrive.
5. That person also directs staff member to obtain the gym member's health history form to give to the paramedics
6. A staff member should wait outside of the gym for paramedics, so as to help the paramedics get to the emergency as fast as possible.
7. Immediately after the emergency, an incident report is completed and given to manager or owner of the facility.
The Gyms Responsibility
It should be mandatory for all staff to understand the the gym's emergency plan when they are hired. All staff should have a copy of it too.
Mock emergencies drills should be planned from time to time to keep the staff prepared. The staff should not know when these mock emergency drills will occur. Ideally these drills should be performed in conjunction with paramedics who can supervise and provide valuable feedback.
After The Emergency
It's very possible that people are reading this who never considered the idea that club members could die or be injured in the gym while working out. That's OK. It's best you learn it here first, than when you are experiencing it for the first time when it's happening. Seeing someone having a heart attack ―or dying ―can be a scary experience for anyone. I know because I've seen it myself.
After it happens, it's possible that some members of the gym staff may suffer from a post traumatic stress disorder (PTSD) ―and even be afraid of returning to the gym, for fear that another medical emergency might occur.
What I can say is that it's very normal to feel this way. I also want people to remember that medical emergencies are not something that happen every day. It's possible that health clubs might go for years without a serious issue occurring.
After an emergency has occurred, I think the key to reducing the anxiety and fear of returning to work, is to acknowledge what happened, think about how you reacted ―and how you can improve if it happens again ―and remember that emergencies, while serious, don't happen very often. It might even be a good idea for the gym staff to have a meeting to assess as a group what they did right – and what might need improving – if this happens again.
How Likely Is A Medical Emergency In Gyms?
Studies show that the risk of dying during exercise is very low. That said, it does happen and if you belong to a gym or are a fitness trainer you should be aware of it. Here are just a few incidents I found doing a quick online search
These are just a few of the incidents I located. Many more are out there. Whether you work in a gym or are self employed, you should be always be on guard and ready to act.
Why I Wrote This
I know my words have probably angered some who may feel I am writing a “hit piece” on gyms, but this was not my intent. I decided to express my thoughts on this issue based on what I've been told by trainers over the years, coupled with my own personal experiences.
I also want consumers reading this to be able to judge whether a gym might be safe for them as well. Based on what people have told me, it doesn't appear personal trainers (and other staff) are being adequately prepared for how to handle emergency situations by their employers.
I know there are health clubs that take safety very seriously and If you work at (or own) such a facility, I hope you will comment below so that others can learn from you and your experiences.
I also wrote this because I want people to know its OK to be afraid when something like this happens. Fear is natural. It's only when it prevents action does it become a problem.
I also want to say that I know mistakes will probably be made as well because, when you think about it, most people are never asked to stand up and become “BatMan” for about 20 minutes or so, during life and death situations. We are all human. I think the key is, help if you are able to, and not fear making mistakes.
If you work at a health club and have witnessed medical emergencies in the gym, I hope you will share your experiences below. My hope is that we can create a dialog and learn from each other to help our fellow personal trainers who may not have previously considered this very neglected topic of discussion.
What do you think?