Athletics: Operations – Emergency Action Plan

Purpose

Due to the intense nature of athletic participation, athletic personnel must be prepared to provide adequate and expedient care. The athletic staff to hopefully prevent some emergencies utilize pre-participation physical screenings, adequate medical coverage, safe practice and training techniques and other safety avenues. However, accidents and injuries are inherent with sport participation. Athletic organizations have a duty to develop an emergency plan that may be implemented immediately when necessary and to provide appropriate stands of emergency care to all sports participants. This preparation involves formulation of an emergency action plan, proper coverage of events, maintenance of appropriate emergency equipment and supplies, utilization of appropriate emergency medical personnel, and continuing education in the area of emergency medicine and planning.

Components of the Emergency Action Plan:

These are the basic components of this plan:

1. Emergency Personnel
2. Activating the EAP
3. Emergency Communication
4. Emergency Equipment
5. Medical Emergency Transportation
6. Emergency Procedures
7. Venue Directions

Emergency Personnel

With athletic practice and competition, the first responder to an emergency is typically a member of the sports medicine staff. A team physician may not always be present at every organized practice or competition, the type and degree of sports medicine coverage for an athletic event may vary widely, based on such factors as the sport or activity, the setting, and the type of training or competition. In some cases, the first responder may be a coach or a student athletic trainer. The first responder MUST carry a current CPR/AED certification to provide prudent care of the athlete. The emergency action plan should designate roles for personnel on the emergency team. However, these roles may vary depending on various factors such as the number of members available, the athletic venue, etc.

Roles within the Emergency Action Plan:

First Responder: Will evaluate the scene to establish that the scene is safe or unsafe and to provide immediate care of the athlete. The most qualified individual on the scene should provide acute care in an emergency. Those with lower credentials should yield to those with training that is more appropriate. If needed, they should provide basic life support (CPR).

Activator: Will activate the Emergency Medical System (EMS) in necessary situations where emergency transportation is not already present at the sporting event. This should be done as soon as the situation is deemed an emergency or a life-threatening event. Time is the most critical factor under emergency conditions. Activating the EMS may be done by anyone on the team. However, the person chosen for this duty should be someone who is calm under pressure and who communicates well over the telephone. This person should be familiar with the location and address of the sporting event.

Retriever: Will retrieve emergency medical equipment. They may be anyone on the emergency team who is familiar with the types and location of the specific equipment needed. Student athletic trainers, managers, and coaches are good choices for this role.

Navigator: Will meet emergency personnel as they arrive at the site and navigate them to the location of the emergency. Depending on ease of access, this person should have keys to any locked gates or doors that may slow the arrival of medical personnel. A student athletic trainer, manager, or coach may be appropriate for this role.

Emergency Care Team and Chain of Command: The emergency care team will consist of, but is not limited to, the Team Physician, Certified/Licensed Athletic Trainer, Student Athletic Trainers, Coaches, and student-athletes. Chain of Command will be as follows:

Team Physician: will assume control of situations and direct emergency personnel.

Certified/Licensed Athletic Trainer: begin rescue breathing and CPR as needed, application of splints or other

immobilization devices, take vital signs, keep written records of conditions and actions, direct someone to activate

EAP. The Certified/Licensed Athletic Trainer will assume the responsibilities of the Team Physician in their absence.

• If a team travels with a Certified/Licensed Athletic Trainer, he/she will initiate the assessment of the situation. The hosting athletic trainer will be on site for assistance with the emergency action plan.
  • If a team does not travel with a Certified/Licensed Athletic Trainer, the hosting Athletic Trainer will assume control of the assessment of the situation.

Student Athletic Trainer: assist with rescue breathing and CPR as needed, activate or assist with EAP, and direct police/EMS to the site, and crowd control.

Coaches: activate EAP, direct police/EMS to the site, crowd control.

Student-Athletes: activate EAP, direct police/EMS to the site, crowd control.

AT NO TIME OR ANY CIRCUMSTANCES SHOULD A SPECTATOR PERFORM ANY OF THE ABOVE DUTIES.

Activating the Emergency Action Plan

When an emergency occurs and a student-athlete is injured, follow the following steps:

1. Promptly evaluate the injury and activate the Emergency Action Plan
2. If the injury appears to be life-threatening,
   • For an emergency located on campus: have someone call the campus police at x1911 (or 210-431-1911 from a cell phone).
   • For an emergency located off campus: have someone call 911.
3. Guidelines for Activator of EMS.
   • Identify yourself, your exact location and telephone number,
   • Describe the situation and the care being given,
   • Give the exact location of the victim and time of injury,
   • Indicate the easiest possible access point for the ambulance to access the injured athlete, and
   • Do not hang up until told to do so.
4. University Police will perform the following:
   • Gain proper information of the situation (location, injury, etc.),
   • Contact the local EMS and any other required authorities and direct them to the proper points of entry for adequate entry to the venue,
   • Send an officer to the emergency site, and
   • Meet the ambulance and bring them to the scene.
5. Send Navigator to a place that is visible to wait for the police and ambulance and direct them to the injured/ill athlete.
6. If not present at the time of emergency, contact the host Head Athletic Trainer.
7. Whenever possible, an athletic trainer should accompany the student-athlete to the hospital.
8. An injury report should be thoroughly completed as soon as possible after the student-athlete’s condition has been stabilized.

Emergency Communication

Communication is the key to quick emergency response. Athletic trainers and emergency medical personnel must work together to provide the best emergency response capable and should have contact information such as telephone numbers established as a part of pre-planning for emergencies. Communications prior to the event is a good way to establish boundaries and to build rapport between both groups of professionals. If emergency medical transportation is not available on site during a particular sporting event, then direct communication with the EMS at the time of injury or illness is necessary.

Access to a working telephone or other telecommunication device, whether fixed or mobile, should be assured. The communication system should be checked prior to each practice or competition to ensure proper working order. A back-up communication plan should be in effect, should there be failure of the primary communication system. At any athletic venue, whether home or away, it is important to know the location of a workable telephone. Prearranged access to the phone should be established if it is not easily accessible.

Emergency Equipment

All necessary emergency equipment will be at the site or in the training room and quickly accessible. Personnel should be familiar with the function and operation of each type of emergency equipment. Equipment should be in good operating condition, and personnel must be trained in advance to use it properly. Emergency equipment should be checked on a regular basis and use rehearsed by emergency personnel. The emergency equipment available should be appropriate for the level of training for the emergency medical providers.

It is important to know the proper way to care for and store the equipment as well. Equipment should be stored in a clean and environmentally controlled area. It should be readily available when emergencies arise.

Medical Emergency Transportation

Emphasis is placed at having an ambulance on site at high-risk events, EMS response time is additionally factored in when determining on site ambulance coverage. Consideration is given to the capabilities of transportation service available (i.e. Basic/Advanced Life Support) and the equipment and level of trained personnel on board the ambulance. In the event that an ambulance is on site, there should be a designated location with rapid access to the site and a cleared route for entering/exiting the venue.

In the medical emergency evaluation, the primary survey assists the emergency care provider in identifying emergencies requiring critical intervention and in determining transport decisions. In an emergency, the athlete should be transported by ambulance, where the necessary staff and equipment is available to deliver appropriate care. Emergency care providers should refrain from transporting unstable athletes in inappropriate vehicles. Care must be taken to ensure that the activity areas are supervised should the emergency care provider leave the site in transporting the athlete. Any emergency where there is impairment in level of consciousness (LOC), airway, breathing, or circulation (ABC) or there is neurovascular compromise should be considered a “LOAD AND GO” situation and emphasis placed on rapid evaluation, treatment, and transportation. In order to provide the best possible care of St. Mary’s University Athletics, all emergencies are to be transported via ambulance

Emergency Hospitals

The following are the locations of near-by hospitals with directions to their locations.

Methodist Texsan Hospital	Methodist Metro
6700 IH 10 San Antonio, Texas	1310 McCullough San Antonio, Texas
(210) 736-6700	(210) 757-2200

Emergency Procedures

Injury Occurring During Practice/Game, Athletic Trainer Available

1. If the Certified (ATC)/Licensed (LAT) Athletic Trainer is not present, the coach should send for the ATC and hold the student-athletes motionless until the ATC arrives.
2. The coach should brief the ATC/LAT on the mechanism of injury, symptoms, and any other pertinent information.
3. The athletic trainer will conduct the evaluation and make a decision as to the disposition of the injury and the appropriate course of action.
4. If needed, the athletic trainer will activate the EAP

Injury Occurring During Practice/Game, Athletic Trainer Unavailable

1. The coach should stabilize the athlete. Check for airway, breathing, and circulation (ABC). If athletic trainer is not present, they should activate EAP and initiate CPR. Coaches SHOULD ALL BE CERTIFIED IN CPR/AED.
2. When EMS arrives, allow EMT’s and paramedics to work on the athlete and clear any unnecessary people from the area. Make sure the athlete’s parents are contacted as soon as possible.
3. The coach/assistant should obtain the athlete’s insurance information and take it to the hospital with the athlete.
4. Contact the Head Athletic Trainer as soon as possible.

For Non-Life Threatening Injuries

1. If ATC/LAT is not present, the coach should send for the athletic trainer or call them on their cell phone, indicating a potential injury. The coach should give their location, and remain with the athlete until the athletic trainer arrives.
2. The coach should brief the athletic trainer on the mechanism of injury, and any other pertinent information.
3. The athletic trainer will conduct the evaluation of the athlete, make a decision as to the extent of the injury, and take the appropriate action.

For Non-Life Threatening Injuries, Athletic Trainer Unavailable

1. The coach should make note of the injury, instructing the athlete to see the athletic trainer the next day for further evaluation. The coach should also call the athletic trainer and present the situation of the injury.
2. The coach should only give ice to the athlete for pain and swelling and provide any first aid needed. Never give the athlete any type of medication.

Visiting Teams without an Athletic Trainer

1. The StMU athletic training staff will assist the athlete with any injuries and will decide what course of action to take.
2. If the situation is a medical emergency, an ambulance will be notified through the EAP and the athlete will be transported to a hospital. The visiting team is responsible for contacting the athlete’s family and for providing the proper insurance information.
3. All other non-life threatening injuries will be treated using first aid protocols, and the visiting coach will be instructed to have the athlete be seen by the athletic trainer at their institution.

Injury Occurring on the Road

1. The ATC/LAT will evaluate the injury and make a decision as to the extent of the injury.
2. If needed, the athletic trainer wilt activate the EAP.
3. The host athletic trainer will provide medical assistance and provide navigation commands for EMS.

Injury Occurring on the Road, Athletic Trainer Unavailable

1. The coach should check for airway, breathing, and circulation (ABC). If athletic trainer is not present, they should send for the host team’s athletic trainer. They should keep the athlete still and not attempt to move the athlete and provide CPR if needed. Coaches should all be certified in CPR/AED.
2. When the host athletic trainer arrives, the coach will allow the athletic trainer to conduct an evaluation of the athlete. If it is a critical emergency, the host athletic trainer will activate their EAP.
3. The coach/assistant should obtain the athlete’s insurance information and take it to the hospital with the athlete.
4. Contact the Head Athletic Trainer as soon as possible.

Non-Life Threatening Injury on the Road, Athletic Trainer Unavailable

1. The coach should make note of the injury, instructing the athlete to see the host athletic trainer for evaluation.
2. The host athletic trainer will make the play/no play status call. The coach should respect the host athletic trainer’s decision. The coach should also call the athletic trainer and present the situation of the injury.
3. If the coach decides not to follow the host athletic trainer’s decision, the coach will be responsible for the athlete and will take full responsibility for any further injury that may occur. THE COACH WILL BE RESPONSIBLE FOR THE ATHLETE AND WILL TAKE FULL RESPONSIBILITY FOR ANY FURTHER INJURY THAT MAY OCCUR.