Appendix C - Medical Documents.doc

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Appendix C - Medical Documents.doc

  1. 1. APPENDIX C – MEDICAL DOCUMENTS Section 1 – Medical Requirements Section 2 – Medical Protocol for Hosting a National Level Competition (ie, CACST) Section 3 – Medical Protocol for Hosting a Provincial Level Short Track Speed Skating Event Section 4 – Forms Section 1 – Medical Requirements Organizers shall provide emergency medical services for all participants at the competition and practice sites. Details of the personnel and the facilities are outlined below. The Speed Skating Canada Medical Information Package (found at the end of this document), must be completed and returned to the National Office within 30 days of the competition. These forms will be forwarded on to Risk Management where analysis of the injuries can occur. 1. Personnel The following recommendations regarding medical personnel are for the safety and treatment of skaters. 1. A qualified medical doctor (namely the Chief Medical Officer) with experience in trauma, musculo-skeletal injuries must be present during the scheduled practice sessions and competitions and must be available all other times at the arena or at the hotel. Ideally, this physician should be a CASM-Certified sports medicine doctor (G or Physiatrist or Orthopedist or Urgentologist). 2. Emergency medical personnel (for example paramedics, emergency medical technicians, emergency first responders, emergency physicians or surgeons etc.) must be present at rink side during all schedules practice sessions and competitions. They must be able to respond quickly and with enough staff and equipment to assess and safely remove the injured skater from the ice pad and to deal with any emergency resuscitation and treatment necessary. This includes cardiovascular collapse, respiratory compromise, lacerations (minor or major), upper and lower limb, spinal and head trauma. In order to have quick interventions by qualified professionals and adequate assessments without unnecessary staff and equipment going on/off the ice everytime an athlete goes down (therefore reducing the need for unnecessary floods), the ideal medical team would be the following: BY RINK SIDE: NUMBER PROFESSIONALS LOCATIONS CATA-Certified athletic therapists 4 OR 2 per risky corner SPC Level 3-Certified sports physiotherapists Both at entrance for 2 EMTs (paramedics) stretcher to the ice surface (zamboni corner) 1 CASM –Certified sports At opposite corner to EMTs
  2. 2. medicine doctor (ideally GP or urgentologist) The emergency response protocol should be as follows: Unless there is a multi-athletes trauma scene or an obvious urgent life threatening situation (such as major bleeding, etc.) for which cases all staff would be jumping on the ice, the first responders to go on the ice (equipped with fanny packs and a trauma bag for major bleeding) would normally be the 2 certified athletic therapists located at the corner where the injury occurred (the staff at the opposite corner automatically become helpers and equipment people). Their role is to quickly but thoroughly assess the injury, classify the urgency of the case, and determine if the athlete can safely get off the ice on his skates. If so, the 2 ATs will manage the necessary e-care and help the athlete to get off the ice. However, if the injury requires transport to the hospital by ambulance, only then are the doctor and/or EMTs (depending on the signals given by the 2 ATs) going on the ice for assistance (EMTs always going on with the immobilization and transport equipment such as stretcher, scoop and spinal board, head and neck immobilizer, fracture splints and pump, trauma and medical bags, ambubag, oxygen tank, etc…). Note that, ultimately, the two first responders to go on the ice should be those professionals who are most familiar or have the greatest experience with the emergency care of short-track speed skating injuries specifically!!! Obviously, the doctor could be part of the two first responders and substitute for one of the ATs in the above protocol if his experience with short track is more exhaustive. Otherwise, this will rarely result in a more efficient intervention, especially if the athletic therapists are used to working together. However, EMTs should not be made the first two responders because, unlike medical conditions encountered in daily life or on scenes of car accidents which they are highly qualified to assess and treat (epilepsy, bleeding, cardio-respiratory problem, diabetes, heat stroke etc…), they have little training in the assessment of orthopedic injuries and their mechanism of injury (such as ligamentous sprains, muscle strains, contusions, etc… that are very coming in sports). Therefore, for such cases, they will make decisions solely based on the intensity of complaints, which very often leads to unnecessary splinting, boarding, and transport (with the associated downsides such as time loss for the intervention, unnecessary withdraw of the athlete from his competition, time loss while waiting for back-up ambulance, extra floods, increase in costs and insurance claims, etc…). IN THE MEDICAL ROOM AND THERAPY ROOM: NUMBER PROFESSIONALS LOCATIONS CASM –Certified sports medicine doctor (ideally 1 In medical room GP OR physiatrist OR orthopedist) CATA-Certified athletic therapists 1 OR In therapy room SPC Level 3-Certified sports physiotherapists 1 Emergency nurse In medical room
  3. 3. 3. Only medical staff with emergency skills is allowed at the designated medical areas at rink side. These areas must be enclosed within some type of physical boundaries such as cables or fences in order to restrict any skater, journalist, photographer or spectator from invading the working space of the emergency response personnel and thus their visibility and quick interventions. 4. An ambulance must be present on site for all Short Track practice and competitions. 5. There must always be a back up ambulance available. There must always be enough emergency staff available to provide care at the ice surface if others are busy taking care of injured athletes in the medical room or are required in transport to the hospital. 6. Medical personnel must always be present in the first aid room and at the rink side (at alternate corners of the ice surface), while competitors are on the ice. At rink side the medical personnel must have easy access to the ice surface (I.E. two sections of windows should be removed from the boards in the appropriate corners) and be able to communicate with the technical delegates and medical staff at all times. Through walkie-talkies that are powerful enough to avoid interferences with other wavelengths. Furthermore, one channel should be reserved to the medical team only (must be different thank organizing committee for ethics reasons and for the sake of clarity in the transmission of potentially vital information). In total, 5 walkie-talkies are needed (one per corner), one in the medical room, one for the CMO and one for the doping control delegate. 7. Medical personnel are expected to be on site 30 minutes before and 30 minutes after practice and competition. Specific short track emergency mock-up situations/run through must be practiced during the days prior to the event with all the staff will be present during the competition. The first responder dedicated to the rink side should already be paired up and assigned to a specific corner to ensure cohesion and better communication when real incidents occur (clarifying everyone’s role and responsibilities, know each other’s training and experience, discussing protocols, ensuring proper functioning or equipment, etc.). If this could not be done before hand, there must be a similar session planned on the first morning of the event and for every time there is a switch of staff during the event (at lunch breaks, at end of day). In such circumstances, medical personnel would be expected at least 60 minutes before warm-ups and competition. 8. There must be a Medical Technical Advisor appointed by the medical team who is responsible for prearranging liaison with the local EMT services, clinics, hospitals and appropriate specialists for the care of the competitors during the competition. Similarly, there must be an “Anti-Doping Technical Advisor” appointed by the medical team who is responsible to plan, prepare, and organize anti-doping tests with the Canadian Centre for Ethics in Sports (CCES) in accordance with the ISU rules and regulations. The necessary number of chaperones (male and female) must also be available and prepared by the Technical Advisor. 9. It is the responsibility of the Medical and Anti-Doping Technical Advisor that all medical encounters and all doping tests are recorded. 10. All personnel must be made aware of the disaster plan and location of emergency exits for the facility and their responsibilities for the athletes in their care. 11. All medical personnel must be easily identified with specific clothing. 12. Racing will not resume unless medical personnel are present rink side and at their assigned posts. 2. Facilities Communication 1. A telephone and clock must be present in the medical room.
  4. 4. 2. There must be a means of communication between the emergency medical personnel at alternate corners of the ice surface and medical treatment room. 3. There must be communication to the physician at all times. 4. The Medical and Anti-Doping Technical Advisor and the Chief Medical Officer must be provided with a means of communication. Medical Room This room should be well signed and easily identified. It should be close to the ice and have clear access to the ice surface. There must be an unobstructed and secure passage from the medical room and the ice surface to the ambulance. The ambulance entrance must be within 100 metres of the ice surface exit. The Medical Room must: 1. Be open at all times during practice and competition. 2. Be large enough to deal with expected medical encounters. 3. Have beds, blankets, table, chairs, garbage can, clock etc. 4. Have washing facilities i.e. sink and toilet 5. Have medical equipment and pharmacological agents necessary for the examination and treatment of respiratory illness (for example Asthma), cardiovascular stabilization (for example, blood loss, sever lacerations or collapse), neurological complications (for example concussions, seizures), musculo-skeletal problems (for example fractures and soft tissue injury), Gastrointestinal illness (for example dehydration due to vomiting and diarrhea) and minor skin care (for example lacerations and abrasions). Please refer to Section 5: Equipment List. 6. Cooler with ice bags must be available in the room and/or at rink side. 7. Have an area for medical record keeping and all records must be secure. 8. A room must be made available for the physician to examine and treat patients in privacy. This room should have at least one bed, one table, chairs and access to running water. Therapy Room Although not compulsory, a Therapy Room should be set-up to accommodate any athlete who would like to stretch or take care of an injury (i.e. by doing the RICE principle of Rest Ice Compression Elevation for example) and for any therapists who would like to treat their athlete before or during competition. This room should be separate from the medical room and minimally have 2-3 treatment tables available to use, and an ice cooler with ice bags. In its more exhaustive forms, it would also have electrical therapeutic modalities such as an ultrasounds, a portable muscle stimulator, and a multi-current unit, together with massage oils and creams and taping material. There should always be a Certified Athletic Therapist available to assess and treat in this room. Doping Control Room A Doping Control Room must be secured and also separate from the medical room (with a waiting area, a test area, and paperwork area all connecting but separated from one another). Also required are: 2 tables, 6 chairs, 2 big garbage cans, a phone, and refreshments for athletes coming for tests. Athlete Area Refreshments: individual portion cold drinks must be provided at the ice rink at competition and practice sites. 3. Spectator Medical Care If spectator medical services are available (i.e. St-John Ambulance for instance), these services must be provided in a room separate from the Medical Room and Therapy Room for security and safety reasons. It would ideally be located in the stands area as well.
  5. 5. 4. Information Information on access to medical care must be made available to competitors, officials, spectators, coaches and support staff in advance of the competition. The Chief Medical Officer should go over telephone numbers, locations of treatment room and physician room and the emergency exit plan of the venue. 5. Equipment List The following list of supplies and equipment should be used as a guide Near the rink (respiratory tract – advanced management) 1. Oxygen cylinder and non-rebreather masks 2. Suction devise with catheter or 60 cc syringe 3. Oro-pharyngeal/nasopharyngeal airways, all sizes 4. Stethoscope 5. Ambu-ventilator bag 6. Endo-tracheal tubes 7. Laryngoscope and assorted blades (McIntosh and Miller) 8. Tracheotomy and crycotomy set (medical bag) 9. Chest tube 10. Spinal board and fast clips for mobilization 11. Vacuum restricting mattress and Scoop (stretcher) 12. Vacuum splint of various sizes 13. Adjustable stifneck cervical collars 14. Wool blankets 15. Nitrile gloves 16. Pressure pads (large) military type 17. Sterile gauze (4x4) 18. Kling gauze, 3 and 6 inches 19. Multipurpose scissors 20. Artery forceps 21. Tourniquet At the Clinic 1. Examination table 2. Chairs 3. Wheelchairs 4. Portable stretcher 5. Crutches 6. Blankets and towels 7. Sphygmomanometer 8. Stethoscope 9. Glucometer 10. Disposable thermometers and hypothermia rectal thermometer 11. Cardiac monitors (international competition – Lifepack) 12. Various Shapes and Sized Bandages - Adhesive, Sterile gauze, Sterile Kling, Tensor, Retelast or Surgifix (elastic tubular net) 13. Solutions for intravenous administration (NACL 9% 1000 ml) 14. Stitch set – Sutures, Steristrips, Antiseptic solution, Local anaesthetic, 15. Eye and ear kit 16. For Immobilization - Plaster, rolls of 4 and 6 inches, Roll of woollen fabric, Athletic tape, Physio derm, Tuf-skin, Pro-wrap, Tensor bandages, Carton splint, Triangular bandages
  6. 6. 17. Miscellaneous - Insta-glucose, Flamazine, Vaseline, Tongue depressors, Zip-lock bag used for ice (zamboni snow), Scissors Pharmaceuticals Found in the Clinic Please also include a current list of allowed substances and a copy of the I.O.C. prohibited substances. Medications:  Antipyrexials  Analgesics  Anti-inflammatories  Anti-nausiants  Bronchiodilators  Antidiarrheals  Antibiotics oral/topical/ophthalmic  Antihisimines/decongestants  Muscle relaxants  Antiolytics Suppositories:  Antinausiants/vomiting/antimetics  Analgesics Injectables:  Local anaesthetics  Analgesics  Antiemetics  Anti-epileptics  Steroids  Syringes/needles 6. Emergency medical response action plan Each venue where a competition or practice occurs should be equipped with their own Emergency Action Plan for evacuating the building. Ensure you are familiar with this plan prior to the start of the competition and share this plan with all other organizers, officials, coaches, support staff and athletes. Where an Injury Occurs The First Responders (Athletic Therapists and/or Chief Medical Officer) should: a) Assess the case b) Keep away bystanders (done by referees) c) Assess the wound d) Treat the wound e) Immobilize the injured person f) Arrange for ambulance if needed (cell phone) Where Transport by Ambulance is Required: The Chief Medical Officer, with assistance from the Athletic Therapists and EMTs on the Medical team should: a) Describe the type (degree) of emergency b) Indicate if patient is conscious, breathing, hemorrhaging…etc. c) Indicate as the case may be, that there is a Doctor with your staff d) Indicate the exact location of the place e) Provide the phone # of your cell phone f) Ask when the ambulance is expected to arrive
  7. 7. g) Confirm all of the above to the First-Aid people h) Assign someone to wait for the ambulance outside the premises so as to help the paramedics bring in the equipment Note: You should always have with you the Hospital’s emergency phone number and that of the paramedics. 7. Doping requirements The Doping Control Officer (DCO) is selected by the Canadian Centre for Ethics in Sport. Please contact Yanna Moncion to determine who the DCO is for your competition. (ymoncion@speedskating.ca) Please ensure that the event technical delegate contacts the DCO at least one week prior to the event, so that the following information can be reviewed and/or confirmed: Qualified volunteers required to effectively conduct doping control Set-up of the Doping Control Station and its location vis a vis the field of play Sealed beverages for the athletes Exact location the event is being held and necessary directions Time DCO should arrive on-site Individuals recruited as volunteers (Chaperones) in doping control will be responsible for athlete notification, as directed by the Doping Control Officer, and could also be asked to witness the passing of athlete urine samples. Generally one Chaperone will be required for every athlete being tested. All individuals should meet the following criteria: a. Minimum age of 18 years b. Ability to communicate effectively (verbally and in writing) in English and/or French, as required to be able to carry out Chaperone duties at the specific doping control sessions c. Must not be involved in the administration of the sport for which testing is being conducted; must also not be involved with the personal affairs of or be related to an athlete that may be required to provide a sample at the session d. Must have the following characteristics: i. Ability to follow directions or instructions ii. Ability to work in stressful situations iii.Ability to solve problems iv.Respectful and professional behavior v.Ability to maintain confidential information A Chaperone who will be witnessing an athlete providing a sample must be the same gender as the athlete. The Doping Control Station should be in accordance with the criteria specified in Section 5 of the Canadian Doping Control Regulations however the Doping Control Station may permit modifications, as long as security and chain of custody requirements for the sample collection session can be maintained: For announced testing, the Doping Control Station should be located in close proximity to the competition or training site. However, the Station should be located away from heavy traffic areas in order to increase security. The Doping Control Station shall be clearly marked with signs. Wherever possible, the Doping Control Station shall be divided into three separate, but interconnected areas (preferably, but not necessarily, three rooms). These areas are:
  8. 8. a) Waiting Room/Area This room or area should be large enough to accommodate Athletes, representatives accompanying Athletes, representatives of the CCES, doping control personnel, and security personnel. The room should have chairs or benches and tables and an adequate supply of sealed, non-alcoholic, non-caffeinated beverages. Security personnel should be located at the door to control access to the room. b) Doping Control Processing Room/Area Only doping control personnel, the Athlete being tested and the representative of the Athlete being tested and, if required, an interpreter shall be allowed access to this room or area. This room should contain a table, some chairs, a wash basin, collection vessels, pre-packaged kits, suitable material for sealing the containers, doping control documentation and writing supplies and materials, and a lockable cupboard, cooler, refrigerator, freezer or secure area for the storage of samples. This room/area is used for: i. Securely storing the doping control supplies and documentation; ii. Selection of collection vessels and pre-packaged kits by Athletes; iii.Processing and sealing of containers; iv.Packaging and storing of samples; and v.Completing and processing doping control documentation. c) Lavatory Wherever possible, this room or area shall contain a sink and toilet and shall be connected to the doping control processing room/area. It shall be large enough for the Athlete and Chaperone to move freely. The organizing committee is responsible for providing suitable individually sealed beverages (non-alcoholic and non-caffeinated), as approved by the Doping Control Officer, for the athletes who are being tested (a minimum of three beverages per athlete being tested is required). For more information about the CCES, Doping Control and Doping Control Procedures please consult our web site www.cces.ca or contact the CCES 1-800-672-7775.
  9. 9. Section 2 – Medical Protocol for Hosting a National Level Competition (ie. CACST) Introduction This document has been prepared to assist organizers of the various events at the development, competition and elite levels in Quebec. It is a compilation of the following: 1. Information needed to contact Quebec Speed Skating Federation (FPVQ) officers. 2. Names of Quebec Speed Skating Federation medical advisory committee members. 3. All procedures and documents required to prepare for an event. 4. Several annexes to assist the organizing committee and therefore lessen preparation of the documents required for hosting an event. This document will be reviewed annually by members of the Federation’s medical advisory committee and will be adapted to needs and new scientific knowledge in order to ensure that every event takes place safely. Important addresses and names of officers (EXAMPLE) 1. Address of the Quebec Speed Skating Federation 930 Roland-Beaudin Avenue Sainte-Foy, Quebec G1V 4H8 2. FPVQ Safety Committee Officer Stéphane Bronsard, Short Track Speed Skating Coordinator Phone: (514) 255-2254 #1 Cell phone: (514) 779-7489 Email: sbronsard@fpvq.org 3. Quebec Speed Skating Federation Safety Committee members René Fortin, Chairperson, Rivière-du-Loup Alain Turcotte, physician, Laval Procedures for hosting a competition The document entitled "Medical Protocol for Hosting an Event" must be completed and returned to the Quebec Speed Skating Federation four weeks before an event takes place. A – Personnel The following recommendations have been prepared for the safety and treatment of skaters. 1. A qualified physician or paramedic must be present at all times during the competition. 2. A nurse or a sports therapy professional (certified athletic therapist or sports physiotherapist, SPC-1) must complete the team. One of these professionals must have experience applying immobilization techniques according to standards of practice in traumatology. 3. The medical team must include at least one member with experience in sports medicine. 4. For competitions at the development-level circuit, the presence of a physician or paramedic is not mandatory, but it is strongly recommended. Should a physician or paramedic not be present, the medical team must consist of two sports therapy professionals (certified athletic therapist or sports physiotherapist, SPC-1).
  10. 10. 5. An ambulance must be able to respond quickly whenever on-ice evacuation or ambulance transportation is required. Ambulance response time must be under eight minutes. A second ambulance must be available to take over when the first is already transporting an injured person. 6. The medical team, which includes at the very least a physician and one other professional, must be always be located at rink side near a door giving direct access to the ice surface, in the central area of the rink. (If the medical team is associated with a team of skaters, plan to place these skaters nearby.) 7. Only the designated medical team and the medical officer for the event may remain in the designated medical area. 8. All short track speed skating events at the hopeful and elite levels must be held near (within 20 minutes of) a level II trauma centre. However, events at the development level can be held near a stabilization centre. 9. A communications system must be available to provide a link between the medical team and the organizing officer. This system must also enable medical team members to communicate with each other. 10. The local organizing committee must designate a medical officer; this person does not need to be a health practitioner and cannot be the medical specialist designated to intervene. The medical officer will make prearrangements with the local trauma centre and will make sure that all medical aspects of the competition are in place. 11. The medical officer for the event must ensure that all traumatic medical events are recorded and that a copy of the record is sent to the FPVQ. The medical officer fills out section A of the Injury Report. 12. The medical officer for the event is responsible for the medical kit loaned by the FPVQ. He or she must take an inventory of its contents before and after the competition, indicate any missing items, and see to the transfer of the kit in cooperation with Federation employees. It should be noted that the organizing committee will be billed for first aid kit items used during the competition. 13. All medical team members must be advised of emergency exit locations in order to ensure athletes’ safety in emergency situations. 14. An evacuation plan must be developed for emergency procedures such as evacuating a skater on the ice. All medical team members must be very familiar with their duties in these situations. 15. Before the competition begins, medical team members must make sure that all equipment is in working order and that all team members know how to use it and are capable of carrying out all emergency procedures. 16. All medical team members must be easily recognizable by their uniform. 17. A Federation medical advisor is available at any time to assist with hosting an event. This advisor can verify medical protocol and produce a medical report on the event. This report is submitted to the FPVQ medical committee. Definitions 1. PHYSICIAN Emergency doctor, internist or physician with emergency room experience. 2. EMERGENCY MEDICAL TECHNICIAN – PRIMARY CARE PARAMEDIC
  11. 11. Has a paramedic degree from a institution recognized by the Paramedic Association of Canada and is a member in good standing of the Association professionnelle des paramédics du Québec. 3. NURSE Registered nurse and member in good standing of the Ordre des infirmières et infirmiers du Québec. 4. CERTIFIED ATHLETIC THERAPIST Has a university degree (BSc.) in sports therapy from an institution recognized by the Canadian Athletic Therapists’ Association and is nationally certified. 5. SPORTS PHYSIOTHERAPIST Has a university degree (BSc.) in physiotherapy and is certified in sports physiotherapy (SPC-1). 6. LEVEL II TRAUMA CENTRE Institution offering general surgery, orthopedics, multidisciplinary critical care and early rehabilitation. Certain level II regional trauma centres are responsible for providing specialized neurotrauma services. 7. STABILIZATION CENTRE Offers ongoing medical services, usually provided by general practitioners. These centres have the diagnostic and therapeutic resources necessary to stabilize or manage some ailments that are more complex than those treated by front-line medical services. 8. NB: Under no circumstances can a member of St. John Ambulance or a similar organization serve as medical personnel for a competition. B – Facilities Communication A telephone must be available to the medical team near the rink so that they can call for ambulance services. The telephone number for the ambulance must be indicated on the skater evacuation plan. Arena medical clinic  The arena’s medical clinic must be near the ice and easily accessible (unrestricted access at all times).  There must be a predetermined, unobstructed passage between the medical room (examination and treatment) and the ambulance.  The medical clinic must be well identified.  It must be available at all times (during warm-up, practice and competition).  It must be large enough to accommodate two injured people.  It must contain an examining table, blankets, chairs and a table.  The medical section of the Medical Report serves as a medical record. A copy of this report is sent with injured athletes who are transported to a hospital centre. A copy of the Medical Report is therefore automatically put on record in a hospital centre for the most significant events. A copy of the Medical Report is also transmitted to the Federation, where it is stored securely for five years.  Medical documents must be secured at all times during the competition. Medical Equipment
  12. 12. Necessary medical equipment must be available near the ice and in the treatment room at all times and in the manner specified in the document on the subject. Note: If the organizing committee for the event is not able to meet the standards set out in this document, the medical officer for the event must contact a member of the medical advisory committee through the FPVQ in order to discuss the issues encountered.
  13. 13. MEDICAL PROTOCOL FOR HOSTING AN EVENT NAME OF THE EVENT: ________________________________________________________________ This document has been prepared to help organizers of an event respond to medical needs and to ensure that preparation is complete. This document must be returned four weeks before an event takes place. Requirements YES NO Will the medical team be easily recognizable by its uniform? Will a medical examination room be identified to evaluate and treat people with injuries or skaters who are ill? Will the medical room be large enough to accommodate two medical staff and two skaters at the same time? Will an evacuation plan be prepared for skaters on the ice, and will the medical staff be familiar with it? Will you have sufficient equipment to deal with the following:  bleeding (minor or major)  fractures, including vertebral and cervical fractures  head trauma Will your medical team be able to deal with bleeding, spinal cord Fractures, and head trauma? Will you have sufficient medical personnel to meet the needs?  Physicians  Other (nurse, sports therapist, emergency medical technician) Will the closest trauma centre be informed that the event is being held? What is the distance, in minutes, from the competition site to the nearest trauma centre? _____ minutes In addition to general surgery, does the trauma centre identified have The following specialties?  neurosurgery  orthopedics  vascular surgery Please indicate the name of the trauma centre identified: __________________ Has an agreement been reached with an ambulance service for the rapid transport of skaters? Is the response time for an ambulance to the site less than eight minutes? If the ambulance response time is greater than eight minutes, please indicate the approximate time. Time: ________ Will a physician with knowledge of traumatology and/or emergency Medicine be present during the competition? Will an effective means of communication be available for medical officers? Will a telephone be available near the rink and in the medical treatment room? Will the medical team be located near the rink in order to be able to intervene quickly?
  14. 14. Name of Medical Officer for the Event: _____________________________________ Address: ______________________________________________________________ Telephone No.: Home Office _____________________________ _____________________________ Email: ____________________________ Fax: ______________________________ Signature of Medical Officer for the Event: __________________________________
  15. 15. List of equipment for hosting an event Equipment at the rink side Basic Equipment  Stethoscope Evacuation equipment  Material available immediately at rink side.  Back board (local)  Vacuum immobilization mattress (when available, local)  “One Fit Stifneck” cervical collars  Foil and wool blankets (local)  Stretcher at the skating rink (local) Equipment for the immediate treatment of major hemorrhagic situations  Material available immediately at rink side.  Latex gloves  Abdominal dressings  Compression bandages (4 and 6 inches)  Sterile gauze (4 x 4)  Kling gauze, 3 and 6 inches  Universal scissors  Straight haemostatic forceps  Velcro tourniquet  Vaseline Equipment for respiratory tract attack  Material available immediately at rink side. These items are in a travel bag.  Laerdal pocket mask  Oro-pharyngeal airways  Nasopharyngeal airways, 2 adult size plus children’s Equipment at the medical clinic Basic Equipment  Blankets (local)  Sphygmomanometer  Stethoscope  Thermometer with disposable tip  Hypafix  Standard tape, 1 inch  Mini flashlight  Baggies for ice (when ice is available)  Non-sterile gloves  Disinfectant  Cold Pack compress
  16. 16. Various dressings  Adhesive bandages of various shapes and sizes  Sterile gauze (4X4)  Sterile Kling of various sizes (3 and 6 inches)  Compression dressings of various sizes  Elastic bandages of various widths  Various tapes (transparent and white)  Adaptic or unitule  Hypafix Immobilization  Velpeau  Triangle bandage  Attelle Ambufix (2–3) Miscellaneous  Tissue glue  Tongue depressors  Ice (local)  Adhesive bandage  Kit Documents available Notification of a traumatic event document  Medical evacuation plan (to be completed by the local committee)  Prescription pads (by the physician at the competition) Note: Local - to be provided by the local organizing committee All other equipment is provided by the Federation. Protocol for On-Ice intervention and evacuation of an injured skater IN ACCORDANCE WITH 2003 QUEBEC SPEED SKATING FEDERATION REQUIREMENTS, THE MEDICAL TEAM IS LOCATED AT RINK SIDE, IN THE CENTRAL AREA, AT ALL TIMES An effective means of communication must allow team members to communicate among themselves. Moreover, they must be able to communicate with one of the organizing officers, who will ensure, among other things, that an ambulance is called at the physician’s request. On-Ice Intervention  The medical team is ready to intervene at all times.  They intervene at the specific request of the referee.  Only personnel who are members of the medical team are authorized to intervene. However, the physician or sports therapy professional may request assistance in certain circumstances.  When the surface is wet, they are assisted by skaters.
  17. 17.  In most circumstances, the physician or another member of the team proceeds alone to the site of the accident and asks the other team member to meet him or her, if needed, and to bring any equipment that might be necessary.  If the injury appears to be major, the two team members proceed to the site of the accident with all the equipment necessary.  The attending physician becomes the “trauma leader.”  On-ice intervention is as brief as possible. Appropriate medical stabilization measures must be applied.  An adequate immobilization must be performed to avoid any complications Evacuating the injured person The physician or sports therapy professional decides if the injured person can be taken to the arena’s medical clinic or if the person must be transported immediately to a hospital centre. Transport to the medical clinic The injured person is taken by the most direct route over the ice toward the arena’s medical clinic. During the acute phase, the injured person continues to be under the responsibility of the attending medical team. However, when a skater is accompanied by a parent or a health professional, they are consulted to establish the course of events to follow. They can then take over the injured person’s care as soon as the situation allows. When the injured person is transported from the arena’s medical clinic to an emergency service, the evacuation route must minimize exposure to the public. If the physician or sports therapy professional must leave the premises to accompany an injured person, another physician or sports therapy professional must take over; otherwise, the competition will be delayed until the physician returns. Immediate transport to emergency service In some circumstances, the injured person must be transported directly to an emergency service. An ambulance must be readily available and an exit route from the arena will have been determined previously. The physician decides on the need to accompany the injured person. If the physician leaves to escort the injured person, another physician must take over. Failure to do this will result in the competition being temporarily suspended.
  18. 18. Section 3 - Medical Protocol for Hosting a Provincial Level Short Track Speed Skating Event A – Personnel 1. A qualified physician, paramedic or certified athletic therapist must be present at all times during the competition. 2. It is recommended that one of these professionals have experience applying immobilization techniques according to standards of practice in traumatology. 3. Arrangements must be set in place for and ambulance to be able to respond quickly whenever on ice and evacuation or ambulance transportation is required. Ambulance response time should be under eight minutes. 4. At least one medical personnel must always be located at ringside near a door giving direct access to the ice surface, in the central area of the rank. 5. A communication system must be available to provide a link between the medical personnel in the organizing officer. The system must also enable medical personnel to communicate with each other as required. 6. The medical personnel must ensure that all traumatic medical events are recorded and that a copy of the record is given to the event coordinator. 7. The medical personnel is responsible for the medical kit that is available for use during the event. This may be a medical kit that is owned by the host speed skating organization. 8. The medical personnel must be aware of emergency exit locations in order to ensure athletes’ safety and emergency situations. 9. And evacuation plan must be developed for emergency procedures such as evacuating a skater on the ice. The medical personnel and event coordinator must be very familiar with their duties in these situations. 10. Before the competition begins, medical personnel must make sure that all equipment is in working order and that all volunteers and aides know how to use it and are capable of carrying out emergency procedures. 11. All medical personnel should be easily recognizable by a uniform, specific piece of clothing or identifiable area of location. B – Facilities Communication A telephone must be available to the medical personnel or event coordinator near the rink so that they can call for ambulance services. The telephone number for the ambulance must be indicated on the skater of actuation plan. Arena Medical Clinic A designated area should be made available in a convenient location in the arena with unrestricted access at all times.  The medical clinic must be near the ice and easily accessible  There must be a predetermined, unobstructed passage between the medical room and ambulance location.  The medical clinic must be well identified.
  19. 19.  The medical clinic must be available at all times, including warm-ups, practice and competition.  The clinic must be large enough to accommodate two injured people.  The clinic must contain an examining table, blankets and chairs.  Medical documents must be maintained and kept secure at all times during the competition. Medical Equipment Necessary medical equipment must be available near the ice and in the medical room at all times and in the manner specified as below. C – Medical Equipment Rink side Equipment Basic Equipment  Stethoscope Evacuation Equipment  This material must be available immediately at rinkside.  Backboard  Wool Blankets  Stretcher Equipment for Hemorrhagic Situations  Latex Gloves  6 Inch Compression Bandages  4x4 Sterile Gauze  Kling Gauze  Universal Scissors Equipment for Respiratory Emergencies  Laerdal Pocket Mask  Oropharyngeal Airways Medical Clinic Equipment Basic Equipment  Blankets  Standard Tape  Mini Flashlight  Bags for Ice  Non-Sterile Gloves  Disinfectant Dressings  Adhesive Bandages of Various Sizes  Sterile 4x4 Gauze  Sterile Kling Gauze  Compression Dressings Immobilization
  20. 20.  Triangular Bandage Miscellaneous  Tongue Depressors  Ice  Medical Kit Documents  Medical Evaluation Plan  Athlete Injury Report Form *** Appendix 19Cis appropriate for provincial speed skating meets as it is written ***
  21. 21. Section 4 - Forms The Chief Medical Officer of the Organizing Committee is in charge of all aspects of the medical and anti-doping arrangements for the practices and competitions. The Chief Medical Officer must request from the National Office six (6) weeks prior to the competition The Medical Information Package. It consists of: 1. Speed Skating Canada Injury Report Form* 2. Medical Record Form 3. Consent Form 4. Data Form for Emergency Phone Calls 5. Emergency Response Report Form * Must be completed for each injury occurred at practice and competition.
  22. 22. INJURY REPORT FORM To be completed by the Chief Medical Officer Please return to Speed Skating Canada within 30 days of injury Name: _______________________________ Age: ______ Sex: F □ M □ Address: _____________________________________________________________________ Phone:_______________________________ E-mail: _______________________________ Name of Competition: __________________ Date of Competition: ___________________ Date/time of injury: ___________ Club:__________________ Facility: ________________ Activity type: Learn to skate □ Short track □ Long track □ Accident/injury occurred in: Training □ Competition □ Accident/injury occurred during: off-ice □ on-ice □ activity □ Skater’s ability level: beginner □ developmental □ high performance □ Number of years in speed skating: __________ SSC recommended Padding: yes □ no □ Ice conditions: Good □ Average □ Poor □ What on site medical attention was required? ______________________________________ Ambulance transportation required: yes □ no □ Description of injury/diagnosis:
  23. 23. Description of accident/how the injury was sustained: (Please indicate point of impact and protective padding on above drawing) Please include description of clothing which athlete was wearing: Signature: _________________________________________ Date: ____________________ Address: _____________________________________________________________________ E-mail: ___________________________________ Please return this form to the meet coordinator.
  24. 24. MEDICAL RECORD FORM Date: _____________________________________________ Last Name: _______________________________ First Name: _______________________________ Date of Birth: ______________________________ Category: _________________________________ Health Insurance No.: ________________________________ Address: ______________________________________________________________________________ Phone No. (Home): _________________________ Other: ____________________________________ Emergency Phone No.: __________________________________________________ First Name: ______________________ Last Name: ___________________________ Kinship: ______________ Address: ______________________________________ Medical History: ________________________________________________________________________ Allergies (Types): ______________________________________________________________________ Allergies to Medication: _________________________________________________________________ Chronic Disease: _______________________________________________________________________ Tenanus (Recent Date): _________________________________________________________________ Contact Lenses: _______________________________________________________________________ Physiological Problems (Previous Injuries): ________________________________________________ _____________________________________________________________________________________ Hospital Visited: _______________________________________________________________________ Hospital File #: _________________________________________________________________________ Attending Physician: ____________________________________________________________________ Phone No. of the Attending Physician: _____________________________________________________ CONSENT FORM This is to certify that I am the father/mother/legal guardian of ______________________ (skater’s name) who is under 18, and I hereby consent to any emergency medical procedure performed by a certified health care specialist should such a procedure become necessary as a result of his or her participation in a sports activity.
  25. 25. Signed by the father/mother/legal guardian: _________________________________ Date: _____________________________ Address: ______________________________________________________________ Home phone number: ___________________________________________________ Office phone number: ___________________________________________________ Witnesses: ____________________________________________________________
  26. 26. DATA FOR EMERGENCY PHONE CALLS FORM Name of Location: _____________________________________________________________ Address of Location: ___________________________________________________________ Telephone number of Location: __________________________________________________ Location of phones: ____________________________________________________________ _____________________________________________________________________________ Telephone number: Police _____________________________ Ambulance _________________________ Name of the hospital: ___________________ Address: _____________________________ Emergency services: ___________________ Fire: _________________________________ General emergency services: ____________________________________________________ Type of emergency: ____________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ How to get to the site: __________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Contact person at the location: __________________________________________________ EMERGENCY RESPONSE FORM 1. Pick-up Date: ____ / ____ / ____ Time of arrival on the accident’s site: __________ Y M D Code: ______ [ ] Urgent [ ] Non-urgent 2. Event
  27. 27. [ ] Accident [ ] Illness Specify: _______________________ 3. Identifying the victim Last name: ___________________________ First name: ___________________________ Date of birth: ____ / ____ / ____ Country: _____________________________ Y M D 4. Nature of the case: [ ] Stroke [ ] Marks and bruises [ ] Burn [ ] Back pain [ ] Chest pain [ ] Abdominal pain [ ] Diabetes [ ] Choking [ ] Unconscious [ ] Intoxication [ ] Headache [ ] Fracture [ ] Deep wound [ ] Superficial wound [ ] Dizziness [ ] Flu [ ] Neurological [ ] Behavior prob. [ ] Respiratory [ ] Others Problem problem [ ] Hypertension [ ] Hyperthermia [ ] Hypothermia [ ] Cardiopulmonary [ ] Dislocation, sprain, [ ] Fall Arrest elongation 5. Medication: [ ] YES [ ] NO 6. Allergies: [ ] YES [ ] NO 7. Contagious Disease: [ ] YES [ ] NO . 8. Medical history: [ ] Stroke [ ] Hypertension [ ] Diabetes [ ] Others ________________ [ ] Musculoskeletal [ ] Epilepsy [ ] Gastric [ ] Physical Disability [ ] Respiratory trouble [ ] Cardiac 9. Neurological signs: L Pupils R State of consciousness
  28. 28. [] Normal [] [ ] Alert [ ] Unconscious [] Dilated [] [ ] Agitated [ ] Comatose [] Shrunk [] [ ] Confused [] Ф reaction [] [ ] Drowsy 10. Vital signs: 1st 2nd 3rd Time Time Time _______ _______ _______ Pulse _______ Pulse _______ Pulse _______ Resting HR _______ Resting HR _______ Resting HR _______ ABP _______ ABP _______ ABP _______ Temperature _______ Temperature _______ Temperature _______ Skin [ ] Normal [ ] Pale [ ] Damp [ ] Cold [ ] Cyanosed 11. Responses [ ] No response [ ] Refused treat. [ ] Splint / Sling [ ] Spinal board [ ] Undetermined [ ] Pressure pad [ ] Cervical collar [ ] O2 [ ] Airways freed [ ] Cover [ ] Sugar [ ] Other___________ [ ] Pocket mask [ ] Dressing [ ] Suction device [ ] Oro-pharyngeal [ ] Applied ice [ ] Disinfect Airway 12. Equipment used: QTY Tongue depressor ______ Three-inch rolled bandage ______ Triangular bandage ______ Cold pack ______ 8 x 4 gauze sterile pad ______ Rescue blanket ______ One-inch adhesive tape ______ Latex gloves (non sterile; 1 pair) ______ Individual 4 x 4 gauze ______ Non sterile 4 x 4 gauze ______ Pressure pad ______ Adhesive bandage roll (approx. length: ____ cm) ______ Sugar bag ______ Antiseptic solution [ ] yes [ ] no ______ Antiseptic pad ______ Alcohol wipes ______ * Cervical collar ______ * Belt ______ * Wool blanket ______ * Spinal board ______
  29. 29. * Oro-pharyngeal airway, size ________ ______ Others: __________________ ______ * Show destination ______ 13. Circumstances relating to the event: Please describe any further information relating to the injury. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ MEDICAL PROTOCOL FOR CONDUCTING AN EVENT Name of the event: _____________________________________________ The aim of this document is to help organizers of an event respond to medical needs and to ensure that preparation is complete. This document must be returned four weeks before an event takes place. Requirements YES NO Will the medical team be easily recognizable by its uniform? Will a medical examination room be identified to evaluate and treat people with injuries or skaters who are ill? Will the medical room be large enough to accommodate two medical staff and two skaters at the same time? Will an evacuation plan be prepared for skaters on the ice, and will the medical staff be familiar with it? Will you have sufficient equipment to deal with the following:  bleeding (minor or major)  fractures, including vertebral and cervical fractures  head trauma Will your medical team be able to deal with bleeding, spinal cord Fractures, and head trauma?
  30. 30. Will you have sufficient medical personnel to meet the needs?  Physicians  Other (nurse, sports therapist, emergency medical technician) Will the closest trauma centre be informed that the event is being held? What is the distance, in minutes, from the competition site to the nearest trauma centre? _____ minutes In addition to general surgery, does the trauma centre identified have The following specialties?  neurosurgery  orthopedics  vascular surgery Please indicate the name of the trauma centre identified: __________________ Has an agreement been reached with an ambulance service for the rapid transport of skaters? Is the response time for an ambulance to the site less than eight minutes? If the ambulance response time is greater than eight minutes, please indicate the approximate time. Time: ________ Will a physician with knowledge of traumatology and/or emergency Medicine be present during the competition? Will an effective means of communication be available for medical officers? Will a telephone be available near the rink and in the medical treatment room? Will the medical team be located near the rink in order to be able to intervene quickly? Name of Medical Officer for the Event: _____________________________________ Address: ______________________________________________________________ Telephone No.: Home _____________________________ Office _____________________________ Email: ____________________________ Fax: ______________________________ Signature of Medical Officer for the Event: __________________________________
  31. 31. List of Equipment Needed for a Short-Track Event Equipment at the perimeter of the rink Basic equipment  Stethoscope Evacuation equipment  Material available immediately at rink-side:  Back board (local)  Vacuum immobilization mattress (when available, local)  Cervical collars “One Fit Stifneck”  Foil and wool blankets (local)  Stretcher at the skating rink (local) Equipment for immediate treatment of major hemorrhagic situations  Material immediately available at rink-side:  Latex gloves  Abdominal dressing  Compression bandages (4 and 6 inches)  Sterile gauze (4×4)  Kling gauze (3 and 4 inches)  Universal scissors  Straight hemostatic forceps  Velcro tourniquet  Vaseline Equipment for respiratory tract attack  Material immediately available at rink-side. These items are in a travel bag.  Laerdal pocket mask  Oro-pharyngeal airways  Nasopharyngeal airways (2 adult size plus children’s) Equipment at the Medical Clinic Basic equipment  Blankets (local)  Sphygmomanometer  Stethoscope  Thermometer with disposable tip  Hypafix  Standard tape (1 inch)  Mini flashlight  Baggies for ice (when ice is available)  Non-sterile gloves
  32. 32.  Disinfectant  Cold Pack compress Various dressings  Adhesive dressings of various shapes and sizes  Sterile gauze (4×4)  Sterile Kling of various sizes (3 and 6 inches)  Compression dressings of various sizes  Elastic bandages of various widths  Various tapes (transparent and white)  Adaptic or unitule  Hypafix Immobilization  Velpeau  Triangle bandage  Attelle Ambufix (2-3) Miscellaneous  Tissue glue  Tongue depressors  Ice (local)  Adhesive bandage  Kit Documents Available Notification of a Traumatic Event Document  Medical evacuation plan (to be completed by the local committee)  Prescription pads (by the physician at the competition)
  33. 33. On-Ice Intervention & Evacuation of Injured Skater The medical team is located at the edge of the skating rink, in the central area at all times. An effective means of communication must allow team members to communicate among themselves. Moreover, they must be able to communicate with one of the organizing officers who will ensure, among other things, that an ambulance is called at the request of the medical personnel. On-ice Intervention  The medical team is ready to intervene at all times.  The medical team intervenes at the specific request of the referee.  Only personnel who are members of the medical team are authorized to intervene. However, the physician may request assistance in certain circumstances.  When the surface is wet, they are assisted by skaters.  In most circumstances, the physician or another member of the team proceeds alone to the site of the accident and asks the other team member to meet him or her, if needed, and to bring any equipment necessary.  If the injury appears to be major, the two team members proceed to the site of the accident with all the equipment necessary.  The attending physician becomes the “trauma leader.”  On-ice intervention is as brief as possible. Appropriate medical stabilization measures must be applied.  An adequate immobilization must be performed to avoid any complications. Evacuating the Injured Person The physician decides if the injured person can be taken to the arena’s medical clinic or if the person must be transported immediately to hospital. Transport to the medical clinic The injured person is taken by the most direct route over the ice toward the arena’s medical clinic. During the acute phase, the injured person continues to be under the responsibility of the attending medical team. However, when a skater is accompanied by a parent or a health professional, they are consulted to establish the course of events to follow. They can then take over the injured person’s care as soon as the situation allows. When the injured person is transported from the arena’s medical clinic to an emergency service, the evacuation route must minimize exposure to the public. If the physician must leave the premises to accompany an injured person, another physician must take over, otherwise the competition will be delayed until the physician returns. Immediate transport to emergency service
  34. 34. In some circumstances, the injured person must be transported directly to an emergency service. An ambulance must be readily available and an exit route from the arena will have been determined previously. The physician decides on the need to accompany the injured person. If the physician leaves to escort the injured person, another physician must take over. Failure to do this will result in the competition being temporarily

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