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Kin 188 Emergency Plans And Equipment

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Kin 188 Emergency Plans And Equipment

  1. 1. KIN 188 – Prevention and Care of Athletic Injuries Emergency Plans and Equipment
  2. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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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