Objectives Prepare you to act so the athletes can receive appropriate care and treatment in the case of an emergency The secondary purpose is for the overall event management Clinical Competence ID: 1014821
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1. Sports ManagementAcute Management of Sports Injuries, and event administration
2. ObjectivesPrepare you to act so the athletes can receive appropriate care and treatment in the case of an emergency. The secondary purpose is for the overall event management.
3. Clinical Competence
4. Before anything else, preparation is the key to successAlexander Graham BellUnderstand the Risk
5. Athletes of All Shapes and Sizes~ 8 million athletes in secondary schools ~ 31 million age 6 to 14 play ≥ 1 sport~ 39% of life-threatening injuries to ER were sport related Adverse events are under reportedSudden Cardiac Death (SCD) – Leading cause of death – High School athletes = 1 in 50,000 – 80,000
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7. Prepare YourselfKnow your responsibilitiesKnow the resources availableKnow where to goKnow how to communicateKnow the sportKnow the potential for injury
8. In preparing for battle I have always found that plans are useless, but planning is indispensableDwight D. EisenhowerEvent Management
9. Scope of ServicesMemorandum of UnderstandingShepherd Administration and SFD enter into a mutually understood MOUCoverage AspectsPlayersCoaches and OfficialsEvent SpectatorsParking LotsMedical ServicesAthletic TrainersEMSMedical Doctor(s)
10. Event Management ConsiderationsDevelop standard operating proceduresDevelop emergency action plans and treatment protocolsEducatingAthletes and CoachesSpectators and ParentsOther Medical staffStaffing Needs10% Treatment within 10 minutes (FEMA)10% of 6,000 is 600 – How many EMS crews?
11. Event Management ConsiderationsInform Applicable Personnel of details (time, location, access)Closest Emergency FacilityWhere? What can they handle?Shelter in PlaceWhere? What can they handle?Other Fire and EMS How far away is mutual aid?Police ConsultationWho’s in charge, when?
12. Event Management ConsiderationsChain of CommandUnified CommandLocationIdentify Key PersonnelWho responds to Unified Command PostOrganization Should Begin EarlyFailing to plan, is planning to fail.
13. VenueLocation of venue(s)Access to venue(s)Coverage needs at venue(s)Create IAP for each venueSpecific needs or concerns?
14. Venue ConsiderationsContained, offer privacy, and protection from the environmentMedical tentTables/chairsCotsPowerHeating/coolingAdequate Medical supplies
15. Venue ConsiderationsCommunication:Radio ChannelWho’s Listening?Cell phonesWiFiDevelop a communications plan to direct emergency careConnecting family members to ill or injured participantsFamily waiting area?
16. Incident Action PlanWritten, Reviewed, Practiced!!Action Plan Should IncludeDirections to each venueContact person at venueDetailed map of aid station/first aid locationsNote any barriers to responseRoad closures, locked gatesNotification and timing of closuresHospital travel routesSecondary EMS/Fire Support
17. Incident Action Plan: Plan B?
18. Injuries is a part of a sportsmans life; you have to live with it.Randy JohnsonSports Injuries
19. Where is the injury?
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21. First ResponseYour priority is to ensure the is athlete safe and stable. Do not immediately move the athleteAssume the worst – every injured player should be approached as having a serious injury until proven otherwise Determine if the athlete in consciousAVPUCheck their ABC’s (Airway, Breathing, Circulation)
22. First ResponseTake control of the situation – remember spectators!Assess what care the injury may requireBe efficient and effectiveSend somebody for equipment, if necessaryIf required, start CPR immediately
23. Professional Response
24. Levels of Injury PriorityFirst PriorityInjuries that pose an immediate threat to life:Airway obstructionCardiac arrestUncontrolled bleeding Second PriorityUrgent injuries that are potential threats to life or limb:Head injurySpinal injury Serious limb injuriesBlood vessel / nerve injury Third PriorityMild limb injuries:Sprain / Strain Small bone fxCuts and Bruises
25. Take Control, and Calm the SituationAs the Sports Responder, it is your responsibility to calm down the injured athleteWays to help calm an athlete down:Let the athlete know they are going to be alright and you are going to take care of themTalk slowly, calmly, and at eye levelTouch is an effective method to calm an anxious athleteEncourage them to take slow deep breathsRemove unnecessary personnel (i.e. teammates, opponents, or onlookers)Remove them from the field of play, safely and quickly
26. Kindness goes a long way. And a sense of humor. It’s like medicine – very healing. Max IronsTreatment of Common Sports Injuries
27. Bleeding ControlApply DIRECT PRESSURE to the wound using a dressingIf dressing becomes soaked with blood, DO NOT remove the dressing. Simply apply a new dressing and keep placing pressure on the woundReference WVOEMS Protocol 6101
28. ShockShock is always a possibility, but becomes a major concern with severe injuriesShock is an acute medical condition due to insufficient blood through the circulatory systemSigns:Moist, pale, cool and clammy skinWeak and rapid pulseFast and shallow breathing (hyperventilating)
29. Managing ShockMaintain body temperature (blankets)Elevate feet 8-12 inches in most situations“If the face is red, raise the head; If the face is pale, raise the tail”Monitor Vitals (pulse and breathing)Shock can set in with the realization of a serious injury. This is why it is important to keep the athlete calm.
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31. ConcussionA brief period of unconsciousness followed by complete recovery Brain is “shaken” in skull All head injuries are potentially serious Injuries may be associated with damage to the brain tissue or blood vessels inside the skull Player should be regularly assessed for signs of deterioration worsening headache, drowsiness, blurred vision West Virginia 2013 legislation on sports concussion return to play requires mandatory removal from contest in all cases of suspected head injury identified by sideline physician, athletic trainer or coach. Return to play guidelines require a 5 day progression after symptom resolution and neuropsychological testing with physician involvement.
32. Cervical Spine InjuryResults from extreme bending of neck with or without compression Every downed player should be treated as having a cervical spine injury until proven otherwise Head and neck stabilization techniques should be employed if a player is unconscious or suspected of having a neck injury (e.g midline neck pain) WVOEMS Protocol 6102
33. C-Spinal ImmobilizationLeave helmet in place until enough personnel to safely manage the removal. Hold head steady and straightRest arms on legs to stabilizeKeep player’s airway open – remove any blood / teeth Do not move player’s neck Player must be transferred ASAP to hospital under controlled circumstancesFull spinal immobilization
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35. WVOEMS Protocol 6106Treat all painful, swollen, or deformed areas as fractures.
36. Fractured Clavicle (Collar Bone)Caused by blow to shoulder or a fall on the outstretched hand Most commonly broken bone in body. Check PMS.Sling arm, and avoid contact.Check PMS.
37. Fractures of Extremities/Hands/FingersRemove JewelrySplint Support Injury SiteCold PacksTransport
38. Ankle FracturesType of ankle fracture depends on the foot position at time of injury and the direction of force exerted Injury can result from Falling to one side (“going over on ankle”) Twisting injuries Player will complain of Tenderness, swelling and bruising over ankle Deformity of affected ankle
39. Foot Fractures“Turf Toe” Dislocation (± fracture) of big toe Caused by forced dorsiflexion of joint e.g. player kicked ground / landed on big toe Pain and swelling big toe “Jones Fracture” / Avulsion Fracture Fracture of a small bone on the outside of the middle of the foot Caused by a pivot in the opposite direction of the planted foot Pain, swelling, bruising, tenderness over area
40. Dislocated ShoulderTwo TypesAnterior (forward) - most common (96%) Posterior (backward) Player may have fallen onto his outstretched hand or received a direct blow to shoulder Player will complain of Limited shoulder motion Pain with movement of arm Player may have a history of shoulder dislocation EMS DOES NOT REDUCE, we SLING
41. Ligament InjuriesCommon Sports Injury. Many ligaments in the knee Cruciate – Anterior (ACL) and Posterior (PCL) Collateral – Medial (MCL) and Lateral (LCL)Injured by either hyperextension of knee or blow from side of knee Can also be injured by pivoting on a planted foot / twisting (often a non-contact injury) Player will often hear or feel a “pop” Player will be unable to continue Wrap and Ice
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43. NOT all Sports Injuries are Orthopedics.
44. EnvironmentalHeat ExposureRemove patient from hot environment and place in cool environment.Loosen or remove clothing.Norm Consciousness, encourage oral fluid intakeCool by fanningCold ExposureMove to warm environmentRemove wet/cold clothing, use blanketsActively warm with heating packs
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46. Other MedicalSeizuresProtect AirwayRequest ALS, don’t delay transportAltered Mental StatusPossible causes of unconsciousness or altered mental status (AEIOU-TIPS)Glucose Level?
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48. Other MedicalNausea/VomitingPosition of Comfort12 leadZofranHypoglycemiaOral Glucose
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50. Hands OnGroup 1Retrieve the dummy with the shoulder pads.Learn the components of pads.Roll onto the backboardPad the VoidsSafely move your patientGroup 2Retrieve the dummy with the football helmetLearn to assess neck for JVD, Trach. Dev., and any signs.Learn to remove helmet safely and efficiently.Learn the components of the helmet.When all in group have achieved the objectives, switch groups.