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Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
Kin 188  Emergency Plans And Equipment
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Kin 188 Emergency Plans And Equipment

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  • 1. KIN 188 – Prevention and Care of Athletic Injuries Emergency Plans and Equipment
  • 2. Introduction <ul><li>Coverage considerations </li></ul><ul><li>Emergency response personnel </li></ul><ul><li>Emergency plan components </li></ul><ul><li>Emergency care equipment and supplies </li></ul>
  • 3. Coverage Considerations <ul><li>During practices, ATC is typically the only health care professional in attendance </li></ul><ul><li>During games, often team physicians present in addition to ATC </li></ul><ul><li>During games for contact sports, often have on-site ambulance coverage per contract arrangement – set up before season starts </li></ul>
  • 4. Emergency Response Personnel <ul><li>Certified athletic trainer (ATC) </li></ul><ul><li>Team physician </li></ul><ul><li>EMS personnel </li></ul><ul><ul><li>EMT and/or paramedic </li></ul></ul><ul><ul><li>Fire department vs. ambulance </li></ul></ul><ul><li>Coaches and administrators </li></ul><ul><li>Others </li></ul>
  • 5. Certified Athletic Trainer (ATC) <ul><li>Typically responsible for set up of emergency equipment and method of communication for events </li></ul><ul><ul><li>Requires perspective on type of equipment necessary, accessibility of the equipment and knowledge of use </li></ul></ul><ul><li>Typically the first responder to emergency conditions </li></ul><ul><ul><li>May direct care on own or summon additional personnel for assistance </li></ul></ul><ul><li>Manages situation in absence of team physician </li></ul><ul><ul><li>Requires trust, communication amongst emergency response team members </li></ul></ul>
  • 6. Team Physician <ul><li>Ultimately responsible for directing care in emergency conditions, even if not present at site </li></ul><ul><ul><li>Pre-season planning and communication are key elements to having viable emergency response </li></ul></ul><ul><li>If on-site, often not initial evaluator but typically summoned for assistance once circumstances of situation are identified </li></ul><ul><ul><li>May be able to administer some forms of emergency care ATC is unable to do while EMS is activated (IV, advanced airways, etc.) </li></ul></ul>
  • 7. EMS Personnel <ul><li>Variability across country regarding initial response when EMS activated – critical to know specifics in your area </li></ul><ul><ul><li>Initial response may be from fire department with or without paramedics </li></ul></ul><ul><ul><li>Initial response may be from local ambulance service, again with or without paramedics </li></ul></ul><ul><ul><li>Regardless of personnel, they work under protocols from hospital or county medical director – communication key to minimizing “turf wars” </li></ul></ul><ul><li>EMT </li></ul><ul><ul><li>Trained primarily to stabilize patient and prepare for transportation (BLS) – role growing with technology (AED, etc.) </li></ul></ul><ul><li>Paramedic </li></ul><ul><ul><li>Has advanced training in pre-hospital care (ALS) </li></ul></ul><ul><ul><li>Able to administer IVs and medications as well as cardiac monitoring, advanced airway management and intubation, defibrillation </li></ul></ul>
  • 8. Coaches and Administrators <ul><li>Primary responsibility is to follow instructions of ATC/team physician/ EMS personnel to assist in providing care when necessary </li></ul><ul><li>Administrators often present at games and can have vital role in emergency plan from a facility accessibility and/or communication standpoint </li></ul><ul><li>Ideal if all coaches and administrators required to have first aid and CPR certification </li></ul>
  • 9. Other <ul><li>Other personnel that may be present or nearby and called upon for assistance in emergency situation </li></ul><ul><ul><li>School nurse </li></ul></ul><ul><ul><li>Teacher </li></ul></ul><ul><ul><li>Parent (ideally not of injured individual) </li></ul></ul><ul><ul><li>Police officer (often present at games for security concerns) </li></ul></ul>
  • 10. Emergency Plan Components <ul><li>Steps to be taken in emergency situation </li></ul><ul><li>Communication considerations </li></ul><ul><li>Equipment considerations </li></ul><ul><li>Transportation – emergency care facilities </li></ul><ul><li>Record keeping </li></ul><ul><li>Training of personnel </li></ul>
  • 11. Emergency Plan Steps <ul><li>Prior to emergency situation occurring </li></ul><ul><ul><li>Proper certification of personnel (CPR, etc.) </li></ul></ul><ul><ul><li>Proper clearance for participation for all individuals – via PPE </li></ul></ul><ul><ul><li>Emergency contact information current for all individuals (insurance, phone numbers, pertinent medical history, etc.) </li></ul></ul><ul><ul><li>Personnel perspective on location and accessibility of emergency equipment </li></ul></ul><ul><ul><li>Communication methods and location/accessibility – for activation of EMS as well as for summoning personnel and/or equipment to emergency site (hand signals vs. walkie-talkie) </li></ul></ul>
  • 12. Emergency Plan Steps <ul><li>Prior to emergency situation occurring </li></ul><ul><ul><li>Personnel (including local EMS) familiar with accessible routes to all facilities (directions, gates/keys, etc.) </li></ul></ul><ul><ul><li>Different emergency plans for each facility </li></ul></ul><ul><ul><li>Will team physician and/or EMS be present – if so, where located and how summoned </li></ul></ul><ul><ul><li>Communication of emergency procedures to visiting team personnel </li></ul></ul>
  • 13. Emergency Plan Steps <ul><li>In the event of an emergency situation, all personnel must have understanding of roles and responsibilities </li></ul><ul><ul><li>Who is initial evaluator? </li></ul></ul><ul><ul><li>Who will activate EMS? How/where done? </li></ul></ul><ul><ul><li>Who will bring necessary equipment to site? </li></ul></ul><ul><ul><li>Who has access to locked gates/doors? </li></ul></ul><ul><ul><li>Who will direct EMS once they arrive on scene? </li></ul></ul><ul><ul><li>Who makes decisions about transportation of injured individual? </li></ul></ul>
  • 14. Emergency Plan Steps <ul><li>After an emergency occurrence </li></ul><ul><ul><li>Who will contact parents/guardians and/or administrators? </li></ul></ul><ul><ul><li>Completion of medical records for documentation of event </li></ul></ul><ul><li>Information provided to EMS at time of activation </li></ul><ul><ul><li>Type of emergency </li></ul></ul><ul><ul><li>Possible injury/condition of injured person </li></ul></ul><ul><ul><li>Assistance being given to injured person </li></ul></ul><ul><ul><li>Exact location of facility and injured person – including point of entry to facility </li></ul></ul><ul><ul><li>Name/phone number of person calling – always wait for EMS operator to hang up first </li></ul></ul>
  • 15. Communication Considerations <ul><li>EMS activated via 911 system </li></ul><ul><li>Must have access to reliable telephone </li></ul><ul><ul><li>Direct land line – most reliable, access issues </li></ul></ul><ul><ul><li>Nearby pay phone – free for 911 calls, operable/reliable </li></ul></ul><ul><ul><li>Cellular phones – signal strength, battery life, where does call go </li></ul></ul><ul><li>When multiple facilities used at once, often use walkie-talkies to communicate need for EMS to central location </li></ul><ul><li>When circumstances allow, should contact parents and/or administrators </li></ul>
  • 16. Equipment Considerations <ul><li>Must consider all possibilities and have appropriate equipment for facility on hand </li></ul><ul><ul><li>Budgetary and/or personnel limitations often dictate what is needed and appropriate to have </li></ul></ul><ul><li>Must know when and how to utilize equipment – must be accessible </li></ul><ul><li>Communication with local EMS regarding area protocols is advised </li></ul><ul><ul><li>Issues can arise relative to helmet removal, spine board strapping techniques, splinting devices, etc. </li></ul></ul>
  • 17. Transportation <ul><li>Must be able to differentiate significant but not limb- or life-threatening conditions that can be transported via personal car, school vehicle or parents </li></ul><ul><ul><li>Liability issues and concerns </li></ul></ul><ul><li>Must recognize limb- or life-threatening conditions and utilize EMS personnel for transportation to nearest appropriate facility for definitive care </li></ul>
  • 18. Record Keeping <ul><li>As with any injury/illness, emergency care rendered must be documented for individual’s medical file </li></ul><ul><li>Careful and detailed documentation of all components of care provided from initial presentation through transfer of care to EMS personnel is critical </li></ul><ul><ul><li>Best done ASAP after emergency event to enhance recall </li></ul></ul><ul><ul><li>Can provide protection in case individual/family sues against care providers </li></ul></ul>
  • 19. Training of Personnel <ul><li>Good for all potential members of emergency care team to have solid grasp of emergency plan </li></ul><ul><li>Optimal for all members to practice elements of plan via scenarios to identify and address weaknesses </li></ul><ul><ul><li>Must be done regularly, once yearly not enough </li></ul></ul><ul><ul><li>Enhances likelihood of reactionary response to address needs of situation vs. emotional response where actions may be less than ideal due to stress of situation </li></ul></ul>
  • 20. Emergency Equipment and Supplies <ul><li>Airway management </li></ul><ul><li>Cardiac equipment </li></ul><ul><li>Spine injury considerations </li></ul><ul><li>Musculoskeletal injury considerations </li></ul>
  • 21. Airway Management <ul><li>Pocket masks </li></ul><ul><ul><li>Used during rescue breathing/CPR to minimize contact between patient and rescuer </li></ul></ul><ul><li>Bag-valve-masks (BVM) </li></ul><ul><ul><li>Uses bag for ventilation vs. rescuers breaths </li></ul></ul><ul><li>Oropharyngeal airways </li></ul><ul><ul><li>Allows for establishment and maintenance of patent oral airway </li></ul></ul><ul><li>Supplemental oxygen </li></ul><ul><ul><li>Used when injured individual is ventilating but not perfusing (transfering oxygen) well in tissues </li></ul></ul>
  • 22. Cardiac Equipment <ul><li>Development of automatic external defibrillators (AED) to address need for early defibrillation of abnormal heart rhythms to increase survival rate </li></ul><ul><ul><li>Previously limited to paramedics and hospital personnel – now commonly available (aircraft, airports, schools, malls, etc.) </li></ul></ul><ul><li>AEDs able to provide basic cardiac monitoring, instructions for electrode placement and delivery of cardiac conversion techniques (shocks) </li></ul><ul><ul><li>“ Idiot proof” – do require specific training for perspective (typically done with in conjunction with CPR/first aid) </li></ul></ul><ul><ul><li>Must ensure that batteries are charged at all times </li></ul></ul>
  • 23. Spine Injury Considerations <ul><li>Equipment </li></ul><ul><ul><li>Spine board – various sizes, materials </li></ul></ul><ul><ul><li>Cervical immobilization devices/collars </li></ul></ul><ul><ul><li>Strapping devices (“seat belts”, 9-point straps, “spider” straps) </li></ul></ul><ul><li>Protocols </li></ul><ul><ul><li>Different approaches to strapping techniques, removal of equipment (helmets, shoulder pads) in different areas </li></ul></ul><ul><ul><li>Must have understanding of approach to maximize delivery of care and minimize conflict regarding procedures </li></ul></ul>
  • 24. Musculoskeletal Injury Considerations <ul><li>Equipment needed to immobilize fractures, dislocations and/or joint sprains </li></ul><ul><ul><li>Vacuum splints – usually today’s standard </li></ul></ul><ul><ul><li>Air splints – not common today </li></ul></ul><ul><ul><li>Cardboard gutters – typically adhered with ace bandage </li></ul></ul><ul><ul><li>Sam splints /Ladder splints – flexible, conform to body part </li></ul></ul>

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