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