Emergency Action Plan Part 2

As a continuation from last week we will continue with Emergency Action Plans to continue showing the importance of why all teams, clubs and organizations need to have an effective EAP.  I would like to thank Dr. David Geier, Mike Hopper, ATC and Stop Sports Injuries blog for their posts on EAPs as well in the last couple of weeks as some of the basis for this post will come from them.

Last week we discussed the three major roles that are needed to have an effective EAP, these make up the personnel portion based on Dr. Geier's components.  The second component is communication, both with each member of the EAP, parents, other teams and administrators.  We covered communication within the EAP last week so we will discuss communicating with parents and administrators.

Parent communication is so critical prior to competition, once an injury occurs and after an injury occurs.
Prior to the season starting or competitions inform your parents that you have an EAP, they do not need to know the details, just make them aware that if an injury does occur you have a detailed plan.  It is very important to let them know that the plan includes injury care and contacting EMS as it will help avoid multiple calls to dispatch.  During injury care, it becomes the job of the control person or additional members of the team staff to help calm the parents of the athlete.  Inform them of the degree of the injury, that they are being cared for and that EMS is on route.  This would be the same if you are travelling and the parents are not there, you need to contact them as soon as possible to advise them of the situation.  Post injury stay in contact with the parents to ensure that everyone is on the same page as to severity and rehabilitation of the injury.

When acting as the host for events, you should let the other team know of your EAP as there may be differences as to activating EMS and access to the facility compared to their home venue. When visiting ask the other team or facility these questions, you can not always be reliant on them having an EAP and there maybe the same differences as if they were the visiting team.

Whenever a major injury occurs especially in a school based setting, letting the administrators know can be vital.  In school settings the athletic director, principal and at times the school board must be made aware of the situation.  For minor sports, the club or organizing body will need to know the details of the incident.  In both cases it primarily will be about liability and insurance.  Depending on the insurance plan, there can be time frames for starting a claim and retrieving the information needed.  Usually it will involve paper work from the hospital which can take time to receive and insurance companies usually don't budge on their deadlines.

The third component is ensuring you have proper equipment to deal with emergency situations.  That equipment will vary depending on whether you are a coach, parent, or Athletic Therapist.  The most basic things that everyone in sport should have on the sidelines are:

• Up to date medical information on all participants in your care including coaches
• Face mask removal tool - football 
• Rescue shears for removal of equipment
• CPR mask & other Personal Protective Equipment such as gloves
• Wound supplies - gauze and towels to stop flow of blood
• ICE 
• Triangle bandages
• Splints 
• AED - you may not have a portable one but knowing where it is located at the venue is extremely important

An AED can mean the difference between life and death in emergent situations involving the heart.  The rate of survival increases by 75% when and AED is used.  For every minute that an AED is not used the rate of survival drops by 7-10% and by 12 minutes without defibrillation the rate of survival is only 5%.  Having one on site during any sporting event is a major step towards proper injury management.

You never know what each day at the rink, field or gym will bring.  Hopefully everything goes off fine and no injuries occur, but at some point an injury will happen.  Emergent situations can range from a spinal injury, head injury or an open fracture.  You may have a medical situations such as heat stroke, allergic reactions or an athlete with diabetes who is either hypo or hypoglycemic.  Be it in a school setting, a club or team sport having a detailed documented EAP that fully defines the roles and actions of everyone involved is the critical step in ensuring athlete safety.  Having someone on hand as a first responder, be it a coach with first aid and CPR, an Athletic Therapist or an EMT, without the prior planning of what to do in that emergent situation, no matter what their skills are, the athlete's well being and safety has been put in jeopardy.

For more information on EAP's please contact us at info@eliteinjury.com or visit our website at www.eliteinjury.com.

Resources used

Dr. David Geier - Why are Emergency Action Plans Critical for sports teams?
Mike Hopper, ATC - Sports Emergencies
Heart and Stroke Foundation - Public access to AEDs
Stop Sports Injuries - Why all sports teams should have an Emergency Action Plan

Emergency Action Plan

An athlete goes down, they are hurt and not getting back up.  What do you do?

Well no matter if you are an Athletic Therapist/Trainer or coach the most important thing that you have already done is have your Emergency Action Plan (EAP).  The EAP is simply the plan that you as an association, club or team have set out in case an emergent situation may occur.  It is important to remember that not all emergent situations may be an injury.  An athlete may have a medical episode as well as someone in the stands.

It is really simple to think that if an emergency does occur everything will fall into place and there will be no complications.  However during an emergent situation, there is chaos.  No matter the level, no matter the expertise of the medical staff or coaching staff, everything going on is chaos.  If you check back to any of the videos from the post Athletic Therapists/Trainers in Action  even though all the ATs are working in the professional ranks, what goes on around them is chaos.  The biggest thing to notice is that it is organized chaos.  Each person knew their role and that by completing their role, that was what would guarantee the athlete getting the best, quickest care possible.

It is very important to note that if as a coach you are unable to have an Athletic Therapist on staff you still need to have an EAP and may find it more important as you will be taking control and charge of the situation.  You as a coach need to have this written plan that you share with your coaching staff and inform your parent group that you have one.  This will help with efficiency in care and will ease any concerns that your parent group will have in case something were to happen to their child.

So what makes up a good EAP.  There are three major roles.  Charge Person, Call Person, Control Person.  The focus will be on if you do not have an AT on staff and will be managing the emergency as a member of the coaching staff.  Time is of the essence during an emergency, so making sure that everyone knows what to do is very important.

The Charge Person's only concern is the care of the injured athlete.  They are to decide whether or not further care is needed beyond what they are trained to do.  This can include finding someone more qualified in the stands and activating EMS.  It is recommended that this person does possess some level of first aid and CPR training that way they have the knowledge base to know if more care is needed and can do some basic interventions.

The Call Person has at times the most simple job, they need to discuss with the charge person what the extent of the players injury is and if they want EMS contacted.  Never rely on a cell phone during this time as depending on the location service may be intermittent.  The call person should know the location of a land line or pay phone at the venue and have the address for each.  They should also know the best location for the ambulance to come to to ensure adequate access, the closer the ambulance can get to the playing field can at times be critical.

The Control Person can be likened to the bouncer.  They must ensure only the people needed to help with the emergency have access to the athlete.  As much as spectators and parents feel they will be of assistance, the more bodies in the way can impede the care of the injured athlete.

So how does all this start.  Once the charge person enters either the competitive surface, both the call and control person need to be at the ready.  A simple set of easily identifiable signals can get the ball rolling.  You can choose which signals work best for you and your EAP team, but some standard rules should apply.  The signal for activating EMS should be one handed, as your other hand could be stabilizing the head and neck.  All signals should be large ie. arm straight up in the air, hand on the head ect.  That way someone on the sidelines or stands can easily distinguish what is going on.  You can have a signal not only to activate EMS, but to ask for assistance from the sidelines.

Depending on the EAP sample you look at, it can be either the call person or control persons job to talk to the facility staff.  The facility staff are a huge asset during this time.  They know the layout of the venue and will assist in ensuring the ambulance can get to the athlete quickly and uninhibited.  You can also decide who will retrieve the Automated External Defibrillator (AED), it can be the call or control person or you can designate someone who's job is solely to do that.  As soon as the charge person shows the need to activate EMS the AED needs to be retrieved.

Use the officials of the game or event, they can help greatly in dealing with crowd control including the other team.  Once they charge person has decided that EMS needs to be activated they can assist the control person and facility staff in ensuring quick access to the athlete.

Time is of the essence during an emergency, be it your athlete or a spectator or even an athlete from another team, you want to ensure they get the quickest access to advanced medical care.  In rural areas your average time for an ambulance to arrive can be upwards of half an hour, even in the city you may be looking at a wait of ten minutes or more.  The sooner that you as the charge person decide that is what is needed, the sooner that ambulance is on its way.  Never assume that someone else more qualified will be there to make that determination and know that unlike professional sports Paramedics are not waiting in the wings to take over.  A well organized EAP runs smoothly like a well choreographed dance, each person moves independently of each other but all working towards the same goal.  This goal is the safety of the athletes and having an EAP is one of the first steps in ensuring that for them.

Please follow us on Twitter @EliteInjuryMgmt and check out our website at www.eliteinjury.com

Athletic Therapists/Trainers in Action

With the events of Monday March 10, this post will show either Athletic Therapists or Athletic Trainers at work.

Richard Zednik, throat laceration on February 10, 2008.  Assistant Athletic Trainer Dave Zenobi

Rich Peverley suffers a cardiac event on March 10, 2014.  Athletic Trainers Dave Zeis and Craig Lowry.  This article form Bleacher Report describes the emergency treatment he received.

Freddy Meyer collapses at centre ice on February 3, 2011.  Athletic Trainer Tommy Alva was first on the ice.

Alex Cobb, pitcher for the Tampa Bay Rays is hit by a pitch.  Head Athletic Trainer Ron Porterfield does an amazing job of dealing with Cobb and keeping the scene clear.  Shout out to the Kansas City staff for assisting on the field.

As you can see having an Athletic Therapist or Athletic Trainer on your bench or sidelines can save a life.  ATs are not just for professional athletes.  To ensure the safety of all athletes please push your organizations, leagues and teams to have Athletic Therapists and Athletic Trainers there.  Not all teams can have team physicians and as you have seen the physicians are not the first on site.  It does not matter the sport or the level injuries happen and someone needs to be prepared and trained to deal with minor muscle injuries to severe ones such as a spinal cord injuries.

For more information on Athletic Therapists please visit www.athletictherapy.org and for Athletic Trainers www.nata.org

Please follow us on Twitter @EliteInjuryMgmt and for more information on Elite Injury Management and the services we offer including on site coverage at www.eliteinjury.com