When Vic Rhodes, a diabetic student, went into insulin shock during her vinyasa class at Triangle Yoga in Chapel Hill, North Carolina, teacher Rebecca Drake activated her support network. A student alerted the desk attendant, who called 911. The studio director, Tracy Bogart, helped Rhodes eat one of the sugar tablets from the container he always kept next to his mat, and soon the ambulance crew arrived and administered more sugar. Rhodes has recovered and is back in classes.
Despite every studio's and teacher's efforts to create a safe environment, such medical emergencies do happen in yoga classes, as a result of either an acute injury or an underlying condition. Knowing the symptoms that indicate the need for medical attention and thinking through how to react during an emergency will help keep your students safer.
What to Watch
In teacher trainings she conducts with her husband, Erich Schiffmann, former nurse Leslie Bogart regularly tells the cautionary tale she calls "The Red Man." An older male student, new to yoga, appeared very red and was sweating profusely a few minutes into a class. When Bogart approached him, he reported feeling dizzy. They agreed he should discontinue the day's class and talk to his doctor about his symptoms, which he did the next day.
"The day after that he went in for a heart-valve replacement and coronary bypass surgery," Bogart remembers. "I was flabbergasted. You can imagine what could have happened had I been in a 'try it again' mood. I was and am so thankful that my medical training, and something else, caused me to see what I saw in Red Man that day and to realize that his leaving the class was the best solution." She recommends that teachers should have "no fear about suggesting that a student see a health care [professional] if there is any question about the situation."
As a medical doctor and yoga teacher based in Northern California, Baxter Bell is especially attuned to his students' health. When he notices a student who "just doesn't look right," he will check in. "Every once in a while, they'll say, 'I'm feeling really nauseous' or 'I'm feeling really dizzy right now.'" In those situations, he offers a modified practice, suggests that the student stop entirely, or recommends visiting a doctor.
Bell describes what to look for: "If someone's sweating profusely but you aren't doing anything particularly strenuous in the practice—that's a real classic thing for heart problems, a sweating episode with difficulty breathing. If you see someone laboring beyond what you would expect, go over and check out what's going on."
Other conditions may not be so obvious; trust your intuition and be conservative when a student's health is in question.
Handling Emergencies During Class
When you see something in class that raises concern about a student's health, quietly confer with the student. Ask what he or she is experiencing, and whether the symptoms might be related to any known medical conditions.
Determine with the student whether it's safe to continue practicing. If so, offer a modified sequence of poses.
Perhaps the student is ready to end the practice and go home; decide whether it's safe for the student to be alone. You may want to send a friend or another classmate along, or call the student's spouse, a parent, or a friend.
If the situation appears more questionable, you'll need to decide whether to summon emergency medical technicians (EMTs) by calling 911. Always err on the side of caution.
In an obvious emergency—if a student loses consciousness or is badly hurt—delegate responsibility. If CPR is in order, begin resuscitation. Assign a student to call 911, and be sure that student knows how to direct the emergency crew to your exact location. Ask another student to collect the belongings of the person who is in distress, so they will be ready for the EMTs. Look for an emergency contact name and number, either in a wallet or on a studio waiver.
Steps for Preparation
Learn CPR and first aid. Seek training through your local Red Cross (redcross.org) to gain hands-on experience. If no local classes are available, take an online course. Keep your certification current by retraining every two years.
If your studio has an automated external defibrillator (AED), you should be trained in how to use it. These devices can greatly improve survival rates in cases of cardiac arrest.
Know your students' medical histories. Learn students' medical backgrounds—medical waivers are a good idea—and regularly update your knowledge. Periodically remind students to keep you informed if their medical conditions have changed. Be sure to make yourself available for them to approach you privately with any sensitive information.
Carry a phone. Carry a charged cell phone with you, and also know where to find the nearest landline phone.
Know where you are. Post the physical address of your studio by the phone, so that you—or the student designated to call the EMTs—can tell the 911 operator where to find you.
Consider the logistics of emergency response abroad. On retreat or in an unfamiliar place, be sure to know where to locate a working phone and how to summon an ambulance. Remember that other countries use different emergency-response numbers. Stay abreast of students' medical conditions, especially those that may be exacerbated by travel, food, or altitude.
Breathe. Use strengths gained through your own practice to keep yourself calm. When her student went into shock, Drake remembers, "I focused on keeping my breath smooth and even. Amid the chaos of the situation and how scary it was, I felt really calm and centered. I was able to stay focused and peacefully make difficult decisions." Breathe deeply and focus on doing what you can in the present moment.
Sage Rountree, author of The Athlete's Guide to Yoga, teaches yoga and coaches triathletes in Chapel Hill, North Carolina. Visit her website at sagerountree.com.