Hope for the best. Prepare for the worst.

That is the collective philosophy of the 17 local athletic administrators whose high school either sanctions a football team or participates in a co-op team with a neighbor.

The worst is usually out-of-sight, out-of-mind, like the automobile or fire insurance we purchase and hope never to use. Within the past week, however, a near-tragedy close to home prompted all area gridiron stakeholders to re-evaluate injury protocols.

Adam Smith of Leavitt Area High School continues to recover from his injuries suffered in a game at Greely High School in Cumberland. Smith was rushed to Maine Medical Center in Portland, his body in shock and his blood pressure plummeting, after a blow to the abdomen shattered his spleen.

“It’s a one-in-a-million thing,” Joel Stoneton, athletic director and assistant football coach at Winthrop, said. “You just don’t think it’s ever going to happen to you or to your school. It’s always going to be someone or somewhere else.”

And every school is unique in the structure of its athletic department, the size of its budget, the level of community participation, urban or rural location, and proximity of the nearest major medical facility.

Greely, a Class B school located 20 minutes from Maine Med, had both an ambulance and a physician, Dr. Kate Quinn, on site.

Lewiston AD Jason Fuller will have only half that scenario in place for Friday night’s game against Massabesic at Don Roux Field, but the former player and coach still is confident in the ability to tackle an emergency.

“For football, we have one doctor and one fellow, so technically you could say we have two doctors on the sideline,” Fuller said. “No, we do not have an ambulance at the field. I expected to get that question this week. One good thing with our situation is that (United Ambulance) is right down the street. The response time is always 5 to 10 minutes, and the hospitals (Central Maine Medical Center and St. Mary’s) are a mile away.”

Fuller’s counterpart at Edward Little, Dan Deshaies, said the news of Smith’s injury inspired him to forward the newspaper articles to Superintendent Katy Grondin, with a request to examine the possibility of more consistent coverage from Auburn fire and rescue.

Cost has been the prohibitive factor to date. The service is $450 per game, Deshaies said, regardless of whether an athlete is transported to the hospital. EL varsity, junior varsity and freshman football teams each host at least four football games each autumn.

“The way we work it is, we have a trainer on the field and I’m in the stands. We have a signal. If she gives me that signal, I know to call 911,” Deshaies said. “So right now you’re looking at five minutes for the trainer to assess the injury and for me to make that call, and another two or three minutes, at least, for the ambulance to get there. That’s five to seven or eight minutes that could make the difference between somebody living or dying.”

Deshaies’ first athletic administration post was at Dirigo High School in Dixfield.

The school dropped its football program during Deshaies’ tenure, but he said that parents with EMT certification or a connection to the ambulance service made certain that local rescue was represented at every sporting event.

“I’m hoping we can come up with an arrangement like that here, where someone offers to do it out of the goodness of their heart or enjoys the games and wouldn’t mind being there and watching them for free,” Deshaies said.

Oxford Hills AD Jeff Benson, a 25-year veteran who has performed the same duties at Lisbon, Gray-New Gloucester and Edward Little, is comfortable that his current safety situation is the best yet.

PACE Paramedic Service provides an ambulance at every Vikings’ football game.

“They will sit there, and if we don’t need them at all, then that was a good night,” Benson said. “They do get called away sometimes. That can happen. But we can call for another one and the ambulance barn is two minutes away, and Stephens Memorial Hospital is two minutes away.”

There are uniform safety precautions in place for local football programs.

All have at least one certified athletic trainer at each game. Maine Principals’ Association rules require every coach, including volunteers, to complete CPR, first aid and concussion management training.

“A lot has changed in my years. It’s a 180-degree difference, if that’s the proper term,” Benson said. “The equipment has changed. That has a lot to do with it. I’m sitting here in my office looking at the helmet I used in 1973 at Hall-Dale, and it’s nothing like we have now. As equipment improves, you also have to improve safety along with it. That’s just how it goes. They parallel each other.”

Each school also has access to an automated external fibrillator, or AED, which can shock the heart and potentially restore a normal heartbeat if a player, official, coach or spectator goes into cardiac arrest.

Most models are built for beginners, with talking instructions to ensure that the device can be connected to the patient quickly and used properly.

“Our boosters bought us two of them,” Deshaies said. “We keep one in my office, and any coach can take it with them on the road if they want.”

Even though most of the official training never gets used in a real-life situation, Stoneton said that shouldn’t diminish the value of it. He uses his own off-field experience as an example.

When his daughter, Kelsey, collapsed at home from a pulmonary embolism in August 2014, it was her father’s rapid response that gave doctors extra time to attempt life-saving measures. She passed away the following day.

“Instinct just takes over. I was just able to do what I had to do, almost with a sense of detachment,” Stoneton said. “It showed me that all the training you do, even though sometimes you don’t think about it, it pays off when you need it. It just kind of kicks in for you.”

Benson said that the closest call of his career also crossed over into his duties as a parent.

His son, Josh, was struck in the throat by an opposing player during a hockey playoff game. Jeff Benson, EL’s athletic director at the time, rushed onto the ice behind the trainer and found the Red Eddies’ star unable to breathe.

“He couldn’t even cough,” Benson said. “Finally he did. He coughed up blood right at the last second before she was going to have to (give him a tracheotomy). Now, tell me, at that moment, am I down there as the AD or as a parent?”

Fuller, whose children play sports in the Oak Hill system, said that no Lewiston parents contacted him this week with concerns about the Leavitt episode.

“I’ve had them call me about the (Southern Maine) viral meningitis outbreak,” he said. “It goes to show you never know. It’s always something different you have to deal with.”

In his Lewiston tenure, Fuller has tried to promote safety by putting all home games within a golf cart ride of campus. Past Blue Devils’ teams practiced and played games at the middle school and the Randall Road complex. Safety coverage and response time were Fuller’s reasons for ending the arrangement.

The worst injuries he has witnessed have been broken bones, concussions and neck injuries, all were situations in which the athlete was treated and released. The most recent football ambulance call was in Week 1 of this season, when Windham running back Dylan Koza fractured his leg at the end of a touchdown run.

“It’s one of those things where you can never really be sure you’re prepared to handle the situation until it happens. You can do all the training you want, but until you have to deal with it, you don’t know,” Fuller said. “I’m amazed by how quickly (Quinn) was able to diagnose that Greely situation. That is impressive. If she doesn’t make that call, we are probably here talking about a different story and a different outcome.”

The saving of Adam Smith’s life was a tribute to the value of awareness and its ability to overcome the limits of geography and time.

Administrators in the diverse, far-flung, tri-county region strive to create that awareness each day, so that it is ready at the unforeseen moment when somebody’s son or daughter requires it.

“I’m very confident with what we have in place,” Benson said.

“I feel like our kids are in a safe place,” Stoneton added. “I remember one year we had like five doctors whose kids were playing on one of our teams. It’s one of those things were I think we’re fortunate in Winthrop. We’re in a great area with a central location.”

koakes@sunjournal.com