EMERGENCY PROCEDURES MANUAL GEORGE MASON UNIVERSITY SPORTS MEDICINE

Transcription

1 EMERGENCY PROCEDURES MANUAL GEORGE MASON UNIVERSITY SPORTS MEDICINE

2 Table Of Contents I. Emergency Phone Numbers pg. 4 II. Emergency Action Plan pg. 6 III. Emergency Transportation Guidelines pg. 8 IV. Planned Access to a Physician pg. 8 Access to Insurance Information and Medical Alerts V. Venue Emergency Plan and Campus Location pg. 9 A. Aquatic Center Natatorium pg. 10 B. Baseball Stadium pg.12 C. Boat House pg. 14 D. Field House pg. 16 E. Football Field pg. 18 F. Patriot Center Gymnasium pg. 20 G. Practice Fields (1, 3,4,5) pg. 22 H. Recreation and Athletic Complex pg. 24 I. Soccer Practice Fields pg. 26 J. Stadium Field/ Outdoor Track pg. 28 K. Softball Field pg. 30 L. Tennis Courts pg. 32 VI. Medical Emergencies pg. 33 A. Initial Assessment / Basic Life Support pg. 34 B. Heart Attacks / Stokes pg. 35 C. Severe Allergic Reactions pg. 36 D. Exercise Induced Asthma pg. 37 E. Diabetic Shock pg. 38 F. Seizures pg. 39 G. Severe Bleeding pg. 40 H. Dental Injury pg. 41 I. Shock pg. 42 J. Head Injury with Loss of Consciousness pg. 43 2

3 K. Cervical Spine Injuries pg. 44 L. Fracture / Dislocation of Extremity pg. 45 M. Sprains, Strains, Contusions pg. 46 N. Burns pg. 47 O. Lightning Safety pg.48 P. Heat / Cold Illnesses pg.50 Emergency Phone Numbers 3

4 Emergency Medical Systems 911 (campus phone connects to campus police) Cell phone (connects to EMS dispatcher) Campus Police (from cell phone) Athletic Training Rooms Field House /3280/3277 Recreation and Athletic Complex Patriot Center Building Staff Offices Certified Athletic Trainers Carla Boelte Debi Corbatto Kyle Damschroder Summer Gebhart Linda Pullen Joey Sierzega /3206 Field House RAC Patriot Center Office Aquatic Center Office (C) (C) (C) (C) (C) (C) Michael Spriggs (C) 4

5 Ray Yamrus Team Physician Dr. Frank Pettrone Team Dentist Dr. Dale Shewmaker Team Optometrist Dr. Court Thelen (C) (W) (W) (W) Emergency Facilities INOVA Emergency Care Fairfax Hospital Fair Oaks Hospital Virginia Hospital Center

6 EMERGENCY ACTION PLAN If an accident or medical emergency occurs, the following Emergency Plan must be enacted: Call 911 Dialing this number from a campus phone will connect you directly to campus police. Dialing this number from a cell phone will connect you directly to an EMS dispatcher. You will be asked Victim s age. Victim s sex. Is the victim conscious? Is the victim breathing? Does the victim have a head or neck injury? Is there severe bleeding? Do you suspect a fracture? Where are you located? Answer all of the questions the best that you can and do not hang up the phone until the person you called has hung up. They may have more questions or be able to provide verbal assistance. If you placed the 911 call from a campus phone or a cell phone: Call Call Call Call Field House Front Desk RAC Front Desk Patriot Center Front Office Aquatic Center Front Office Ask to speak to the Building Manager. Explain the situation and tell the manager exactly where the victim is located so they can direct EMS personnel to your location. 6

7 Emergency Transportation As a general rule these conditions may be transported to INOVA Access of Fairfax by athletic emergency plan personnel, if further medical attention is required. Individual circumstances will dictate the decision. 1. Suspected joint injuries with no apparent fracture. 2. Certain joint fractures/dislocations. 3. Non-severe bleeding. These conditions may not be transported by athletic emergency personnel: Call Suspected cervical spine injury. 2. Respiratory or cardiac arrest. 3. Severe bleeding. 4. Heat exhaustion and heat stroke. 5. hip or knee dislocation. 6. Obvious fracture of large bone. 7. Severe allergic reaction with anaphylactic shock. 8. Diabetic shock. 9. Head injury with loss of consciousness greater than 1 minute. 10. Repeated or prolonged seizure. 11. Significant impact that may cause internal injury. EMS will transport, according to emergency situation, to the appropriate medical facility: - INOVA Emergency Care Center - Fairfax Hospital - Fair Oaks Hospital - Virginia Hospital (by request of Head Team Physician) 7

8 Planned Access to a Physician Team physicians will be available on site for all home soccer and basketball games, wrestling matches, cross country meets and all CAA Championship Events. Team physicians will also be scheduled at specific times during multiple day athletic competitions. Team physicians are available to see athletes in the field house athletic training room on Monday and Wednesday afternoons. Certified Athletic Trainers will communicate and/or coordinate emergency care with team physicians. An emergency facility is located within ½ mile of campus and provides 24 hour emergency room service. Access to Insurance Information and Medical Alerts Athletic trainers and team coaches will travel with medical emergency information for each student athlete. Pertinent medical history, insurance information and emergency contacts are listed in this report. 8

9 VENUE EMERGENCY PLANS AND CAMPUS LOCATIONS 9

10 Emergency Plan Aquatic Center Natatorium 1. Emergency Personnel: A lifeguard and a certified athletic trainer will be on site for competitions. A lifeguard and coach with water safety and first responder training will be on site for all practices. Certified athletic trainers will be accessible from the field house athletic training room Monday Friday from 10:00 to 7:00 pm. 2. Emergency Communication: Emergency call placed from the guard station adjacent to the pool. 3. Emergency Equipment: Emergency equipment (AED, Ambu-bag, collar and spine board) will be on site for all competitions and practices. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. Lifeguards will provide emergency care in the pool. Athletic trainers cover all meets and will provide emergency care pool side. B. Emergency equipment retrieval by lifeguards. C. Activation of emergency medical systems (EMS) by lifeguards call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify building manager ( ). 3. Notify campus police ( ). 10

11 D. Direction of EMS to scene will be managed by campus police and/or athletic and building staff. 1. Make roadway to emergency entrance accessible. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Natatorium is located in the Aquatic Fitness Center on Patriot Circle. Natatorium is accessible through the side entrance located to the left of the Aquatic Fitness Center. 6. Venue Map: 11

12 Emergency Plan Baseball Stadium 1. Emergency Personnel: A certified athletic trainer will be on site for all competitions. A coach with first responder training will be on site for all practices and individual skill sessions. Certified athletic trainers may also be accessible from adjacent athletic fields or from the field house athletic training room. 2. Emergency Communication: Cell phone communication must be available at all competitions and practices. Cell Phone Call 911 Call Athletic Trainers ( ) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: First aid supplies including pocket mask will be available at all competitions and practices. Additional emergency equipment (AED, Ambu-bag, collar, spine board, and splints) will be accessible from the field house athletic training room ( ). 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff from field house athletic training room in response to emergency call. First aid supplies and pocket mask in team medical kit on site. 12

13 C. Activation of emergency medical systems (EMS) by athletic training staff or coaching staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify campus police if call made from cell phone ( ). 3. Notify building staff if call made from cell phone ( /3206). D. Direction of EMS to scene will be managed by campus police and/or athletic and building staff. 1. Open appropriate gates. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: baseball stadium is located on University Drive next to the Field House Recreation Sports Complex. Entrance to the field is available through the parking lot to the right of the field house. Gates will be opened for easy access. 6. Venue Map: 13

14 Emergency Plan Boat House 1. Emergency Personnel: A certified athletic trainer or emergency medical personnel will be on site for all competitions. A coach with first responder training will be on site for all practices. 2. Emergency Communication: Emergency call placed at the boat house or via cell phone. 3. Emergency Equipment: First aid supplies including pocket mask will be on site for all competitions and practices. Additional emergency equipment provided by EMS. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff or coaching staff during competitions and practices. C. Activation of emergency medical systems (EMS) by athletic staff or event staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify Sandy Run Recreation Staff ( ). 3. Notify athletic training staff ( ). 14

15 D. Direction of EMS to scene will be managed by event staff or Parks and Recreation staff. 1. Make roadway to emergency accessible. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Rt 123 South (Ox Road) to Fountain Head Regional Park. Turn right on Hampton Road, left on Van Thompson Road to Sandy Run Regional Park. Park officials will provide escort to George Mason University Boat House. 15

16 Emergency Plan Field House 1. Emergency Personnel: Certified athletic trainer will be on site during scheduled hours of operation of the athletic training room and for all scheduled practices and competitions. A coach with first responder training will be on site for all scheduled strength and conditioning or individual skill sessions. 2. Emergency Communication: Emergency call placed at the closest phone by dialing 911. Direct link to campus police who will call EMS and respond to the emergency. Notify athletic trainers and building managers. Cell Phone Call 911 Call Athletic Trainers ( ) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: First aid supplies including pocket mask will be available in the weight room and at the front desk. Additional emergency equipment (AED, Ambu-bag, collar, spine board, and splints) available from athletic training room during hours of operation. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff during practices and competitions. First aid supplies and pocket mask made available by athletic personnel during other conditioning sessions. 16

17 C. Activation of emergency medical systems (EMS) by athletic staff or building staff in field house call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify campus police( ). 3. Notify building staff ( /3206). A. Direction of EMS to scene will be managed by campus police, event staff and building staff: 1. Open appropriate doors and make hallways accessible. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Field House is located at the intersection of Chain Bridge Road (Rt. 123) and University Drive. 6. Venue Map: 17

18 Emergency Plan Football Field 1. Emergency Personnel: A certified athletic trainer will be on site for all practices and competitions. A team physician will be available at all competitions. 2. Emergency Communication: Cell phones must be available for all competitions and practices. Cell Phone Call Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: First aid supplies, AED, ambu-bag, collar, spine board, and splints will available at the football field. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff or coaching staff during competitions and practices. C. Activation of emergency medical systems (EMS) by the athletic trainer call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid given; specific directions; other information as requested). 2. Notify campus police ( ). 3. Notify RAC building staff( ). 18

19 D. Direction of EMS to scene will be managed by campus police, event and athletic staff. 1. Make roadway in front of building accessible. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Football field is located to the right of the Recreation and Athletic Complex off Patriot Circle on Anna River Court. 6. Venue Map: 19

20 Emergency Plan Patriot Center Gymnasium 1. Emergency Personnel: A certified athletic trainer will be on site for all practices and competitions. A physician will also be on site for all basketball competitions. A coach with first responder training will be on site for all conditioning and individual skill sessions. Additional athletic training staff accessible from field house Monday - Friday 10:00 to 7:00 pm. 2. Emergency Communication: Emergency call placed from closest office phone. Dialing 911 on campus phone provides direct link to campus police who will call EMS and respond to the emergency. Cell phones will connect directly to an EMS dispatcher. Cell Phone Call 911 Call Athletic Trainers ( ) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: Emergency equipment (AED, Ambu-bag, collar, spine board, and splints) will be on site for all competitions and practices. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff or coaching staff during competitions and practices. 20

21 C. Activation of emergency medical systems (EMS) by athletic training staff or coaching staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify campus police ( ). 3. Notify building staff ( ). D. Direction of EMS to scene will be managed by campus police, event staff and athletic staff. 1. Make roadway to loading dock accessible. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Patriot Center is located on Patriot Circle. The gymnasium is accessible through the rear loading dock doors of the Patriot Center. 6. Venue Map: 21

22 Emergency Plan Practice Fields 1, 3,4,5 1. Emergency Personnel: A certified athletic trainer will be on site for all competitions. A coach with first responder training will be on site for all practices and individual skill sessions. Certified athletic trainers may also be accessible from adjacent athletic fields or from the field house athletic training room. 2. Emergency Communication: Cell phone communication must be available at all competitions and practices. Cell Phone Call 911 Call Athletic Trainers ( ) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: First aid supplies including pocket mask will be available at all competitions and practices. Additional emergency equipment (AED, Ambu-bag, collar, spine board, and splints) will be accessible from the field house athletic training room. ( ). 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff from field house athletic training room in response to emergency call. First aid supplies and pocket mask made available by on-site coaching staff. 22

23 C. Activation of emergency medical systems (EMS) by athletic training staff or coaching staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid given; specific directions; other information as requested). 2. Notify building staff ( /3206). 3. Notify campus police ( ). D. Direction of EMS to scene will be managed by campus police, event staff and building personnel: 1. Open appropriate gates. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: The Practice Fields are located off University Drive past the Field House Recreation Sports Complex. After the baseball stadium, turn left on Rapidan River Road and the practice fields begin immediately on the left with Field #1, Softball Field, Fields Venue Map: 23

24 Emergency Plan Recreation and Sports Complex Venue 1. Emergency Personnel: A certified athletic trainer will be on site for all practices. A coach with first responder training will be on site for individual skill sessions. Additional athletic trainers are accessible from the field house athletic training room Monday Friday 10:00 7:00 pm. 2. Emergency Communication: Emergency call placed at the closest phone by dialing 911. Direct link to campus police who will call EMS and respond to the emergency. Notify athletic trainers and building managers. Cell Phone Call 911 Call Athletic Trainers ( /3279) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: Emergency equipment (first aid supplies and AED) will be on site for all practices and individual sessions. An AED is located at the front entrance and on the second floor by racquetball/squash courts. Additional emergency equipment (Ambubag, collar, spine board, and splints) will be accessible from the athletic training room. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff or coaching staff. 24

25 C. Activation of emergency medical systems (EMS) by athletic training staff or coaching staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify Campus Police ( ). 3. Notify building manager ( ) D. Direction of EMS to scene will be managed by campus police and building staff: 1. Make roadway in front of building accessible. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Recreation and Sports Complex is located in the off Patriot Circle on Banister Creek Court. 6. Venue Map: 25

26 Emergency Plan Soccer Practice Fields 1. Emergency Personnel: A Certified Athletic Trainer will be on site for all traditional season practices. A coach with first responder training will be on site for all non-traditional practices and individual skill sessions. Certified athletic trainers may also be accessible from adjacent athletic fields or from the field house athletic training room. 2. Emergency Communication: Cell phone communication must be available at all practices. Cell Phone Call 911 Call Athletic Trainers ( ) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: First aid supplies including pocket mask will be available in team medical kit on site. Additional emergency equipment (AED, Ambu-bag, collar, spine board, and splints) will be accessible from the field house athletic training room ( ). 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff from field house athletic training room in response to emergency call. First aid supplies and pocket mask in team medical kit on site. 26

27 C. Activation of emergency medical systems (EMS) by athletic training staff or coaching staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify campus police ( ). 3. Notify building staff ( /3206). D. Direction of EMS to scene will be managed by campus police, event staff and building personnel: 1. Open appropriate gates. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Soccer practice fields are located on University Drive behind the Field House Recreation Sports Complex. Entrance to the fields is available between the field house and the stadium field. Gates will be opened for easy access. 6. Venue Map: 27

28 Emergency Plan Stadium Field / Outdoor Track 1. Emergency Personnel: A certified athletic trainer and a physician will be on site for all soccer competitions. A certified athletic trainer will be on site for all lacrosse games and track meets. A coach with first responder training will be on site for all track practices. Certified athletic trainers may also be accessible from adjacent athletic fields or from the field house athletic training room. 2. Emergency Communication: Cell phone communication must be available at all practices and competitions. Cell Phone Call 911 Call Athletic Trainers ( ) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: Emergency equipment (AED, Ambu-bag, collar, spine board, splints) will be on site for all competitions. First aid supplies and emergency equipment are accessible from the field house athletic training room for all practices. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff from emergency equipment bag on site. First aid supplies and emergency equipment made available by athletic training staff from adjacent fields or field house athletic training room for track practices. 28

29 C. Activation of emergency medical systems (EMS) by athletic training staff or event personnel call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions; other information as requested). 2. Notify campus police ( ). 3. Notify building staff ( /3206). D. Direction of EMS to scene will be managed by campus police, event staff and building personnel: 1. Open appropriate gates. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Soccer stadium is located on University Drive to the right of the Field House Recreation Sports Complex. Gates will be opened for easy access. 6. Venue Map: 29

30 Emergency Plan Softball Field 1. Emergency Personnel: A certified athletic trainer will be on site for all competitions. A coach with first responder training will be on site for all practices and skill sessions. Certified athletic trainers may also be accessible from adjacent athletic fields or from the field house athletic training room. 2. Emergency Communication: Cell phone communication must be available at all practices and competitions. Cell Phone Call 911 Call Athletic Trainers ( ) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: First aid supplies including pocket mask will be available at all practices. An AED will be available at all competitions. Additional emergency equipment (AED, Ambu-bag, collar, spine board and splints) will be accessible from the field house athletic training room. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff from field house athletic training room in response to emergency call. First aid supplies and pocket mask in team first aid kit on site. 30

31 C. Activation of emergency medical systems (EMS) by athletic training staff or coaching staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid given; specific directions; other information as requested). 2. Notify campus police ( ). 3. Notify building staff ( /3206). D. Direction of EMS to scene will be managed by campus police, event staff and building personnel: 1. Open appropriate gates. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Softball field is located off University Drive past the Field House Recreation Sports Complex and the Baseball Stadium. Turn left on Rapidan River Road and the softball field is the second field on the left. 6. Venue Map: 31

32 Emergency Plan Tennis Courts 1. Emergency Personnel: A certified athletic trainer will be on site for all competitions. A coach with first responder training will be on site for all practices, conditioning, and individual skill sessions. Additional athletic training staff is accessible from the RAC and/or the field house athletic training rooms from 10:00 7:00 pm. 2. Emergency Communication: Cell phones must be available for all competitions and practices. Cell Phone Call 911 Call Athletic Trainers ( /3279) 1. Call Campus Police ( ) 2. Call Building Staff ( ) 3. Emergency Equipment: First aid supplies and pocket mask will be on site for all practices. An AED is located at the front entrance of the RAC and on the second floor by the racquetball/squash courts. A GMU staff ID is needed to access the side entrance closest to the second floor AED. Ambu-bag, collar, spine board, and splints are available from the football storage shed or from the RAC athletic training room. 4. Role of First Responders: A. Immediate care of the injured or ill student-athlete provided by the most qualified individual on the scene. B. Emergency equipment retrieval by athletic training staff or coaching staff during competitions and practices. 32

33 C. Activation of emergency medical systems (EMS) by athletic staff call (provide name; address; telephone number; number of individuals injured; condition of injured; first aid given; specific directions; other information as requested). 2. Notify campus police ( ). 3. Notify building manager ( ). D. Direction of EMS to scene will be managed by campus police, event and athletic staff. 1. Make roadway in front of building accessible. 2. Designate individual to flag down EMS and direct to scene. 3. Scene control: limit scene to first responders and move bystanders away from the scene. 5. Venue Directions: Tennis courts are located to the right of the Recreation and Athletic Complex off Patriot Circle on Anna River Court. 6. Venue Map: 33

34 MEDICAL EMERGENCIES 34

35 INITIAL ASSESSMENT/BASIC LIFE SUPPORT 1. Determine unresponsiveness. If conscious, obtain consent and reassure victim. 2. Call or send someone to call 911 and get the AED. 3. Open Airway - look, listen, and feel for breathing. 4. No breathing give 2 slow breaths with each breath allowing the chest to rise. 5. Check for signs of circulation and breathing. - check bleeding - skin color, moisture, temperature 6. If pulse is present but no breathing: - give 1 slow breath about every 5 seconds. - continue rescue breathing for 1 minute. - recheck pulse and breathing. - continue rescue breathing as indicated. 7. If no pulse and no breathing: - trace hand position on sternum. - position shoulders over hands. - give 2 slow breaths. - repeat steps of 30 compressions and 2 breaths - when AED arrives, open and push the green button and follow the commands. - continue CPR as indicated. 8. If there is a pulse and breathing: - check for disability (sensation, movement, strength) - look and feel (Disability, Open wounds, Tenderness, Swelling) - Signs and symptoms; Allergies; Medications, Past illnesses; Last food; Events before incident) 9. Continue emergency procedures until more qualified personnel arrive. 35

36 HEART ATTACKS / STROKES 1. Signs and symptoms of heart attack: - Uncomfortable pressure in chest or arms lasting 10 minutes or longer. - Weakness, dizziness, nausea, profuse sweating, shortness of breath. - If you suspect heart attack, call Manage by having victim sit with knees bent, loosen clothing, check for medications (give aspirin). 2. Signs and symptoms of stroke: - Weakness, numbness, paralysis of one side of body. - Blurred or decreased vision. - Problems speaking or understanding. - Dizziness, loss of consciousness, loss of balance. - Check the ABCs. Manage in recovery position. 3. Determine unresponsiveness. If conscious, obtain consent and reassure victim. 4. Call or send someone to call Open airway look, listen, and feel for breathing. 6. No breathing give 2 slow breaths with each breath allowing the chest to rise. 7. Check for a pulse at the carotid artery in the neck. - check bleeding. - skin color, moisture, temperature. - begin CPR of necessary. 36

37 SEVERE ALLERGIC REACTIONS Severe allergic reactions can occur during sport, particularly if the athlete reacts violently to an insect sting or bite. Signs and symptoms: (within 30 mins.) Management: - Generalized itching and burning. - Development of hives. - Swelling around lips and tongue. - Bronchospasm. - Wheezing. - Shortness of breath. - Chest tightness and cough. - Review allergy history. - Call for assistance or Remove the stinger by scraping. - Apply Damp gauze and bag of ice. - Administer Diphen/Benadryl. - Administer EpiPen as indicate 37

38 EXERCISE INDUCED ASTHMA Acute, reversible self-limiting airway obstruction which occurs during or after exercise. Predisposing factors: Signs and symptoms: Management: Exercise guidelines: - Cold air. - Low humidity. - Pollutants and allergens. - Type and intensity of exercise. - Upper respiratory infections. - Poor physical condition. - Chest pain, tightness, burning sensation. - Wheezing or coughing. - Shortness of breath during or after exercise - Anxious appearance. - Fatigue not related to activity. - Stop exercise, attempt to relax athlete. - Perform controlled breathing exercises. - Use prescription inhaler/medications. - Drink water. - Immediate medical attention if symptoms persist (change in 5-10 minutes max). - Use inhaler 15 minutes before exercise. - Perform 5-10 minutes warm-up prior to exercise. - Breath through nose to warm and humidify - Be prepared for pollutants/allergens. - Always have medications easily accessible. Call 911 if condition worsens. 38

39 DIABETIC SHOCK 1. If a known diabetic athlete exhibits symptoms of: - trembling - sweating - hunger - confusion - apprehension - irritability - lethargic appearance Suspect hypoglycemic shock or low blood sugar. 2. Administer sweetened beverage or glucose tablet as available. 3. If a known diabetic athlete exhibits symptoms of: - fruity odor from breath - frequent urination - excessive thirst - irregular breathing - lethargic appearance Suspect hyperglycemic shock or high blood sugar. 4. Administer sugar pack, sweetened beverage, or glucose tablets. 5. Monitor level of consciousness and vital signs. 6. Call for assistance or 911 if condition does not improve or worsens. 39

40 SEIZURES Brain disorder is characterized by episodes of sudden brief discharges of electrical activity and graded by severity of signs and symptoms. Signs and symptoms: Petit mal - Blank stare 5-10 seconds. - Twitching of facial muscles. - Fluttering eyelids. - Disorientation. - Uncontrolled motor activity. - Lasts 1-5 minutes. Grand Mal - Loss of consciousness. - Loss of bowel or bladder. - Tonic muscle contractions. - Disorientation after seizure. Management: - Keep athlete away from injurious objects. - Loosen restrictive clothing. - Do not restrain. - Do not put objects in athlete s mouth. - Activate emergency system. 40

41 SEVERE BLEEDING Always follow OSHA guidelines for managing bleeding and wound care. 1. Cover wound with dressing and press firmly against the wound. - when possible apply gloves first. - allow athlete to apply dressing until gloves applied. - place other cloth material over dressing until gloves applied. 2. Call for assistance or for 911 with severe bleeding. 3. If appropriate, elevate wound. 4. If bleeding continues, layer additional dressing over original. 5. In case of extreme blood loss, apply pressure over appropriate artery supplying wound (brachial, femoral). 6. Treat for shock: - have the athlete lay down. - maintain normal body temperature (avoid chill or heat). - elevate legs (unless head/spine injury or suspected fracture). - do not give athlete anything to eat or drink. 7. If bleeding cannot be controlled call 911. Nosebleeds - Place the athlete in a seated position, with the head slightly forward. - Pinch the soft parts of the nose together and upper lip. - If bleeding persists after 5 mins., have the athlete blow slightly. - Apply ice over the nose. - Persistent bleeding may require packing, seek medical attention. 41

42 DENTAL INJURY 1. Locate the avulsed tooth or broken part of the tooth. 2. Handle the tooth by the enamel with gloves or gauze. 3. Place the tooth in a closed container of sterile saline solution. 4. Call an Athletic Trainer immediately. 5. Transport athlete to dentist with tooth. - Typically the sooner an avulsed or broken tooth is replanted, the better the chance it will survive. Transport as soon as possible or as advised by Athletic Trainer/Team Dentist. 42

43 SHOCK All injuries effect the circulatory system to some degree. Be prepared to treat for shock. (pain, bleeding, spinal injuries) Signs and symptoms - Altered mental status, lethargic. - Pale, cold, clammy skin, lips, eye lids, nail beds. - Breathing rapid, pulse weak and rapid. - Dilated pupils. - Low blood pressure. - Unresponsive when shock is severe. Management -Have the athlete sit or lay down. - Face is pale, raise the tail. - Face is red, raise the head except w/head and spine injuries, leg fractures. - If unconscious or sick, lay them on their left side. - Prevent body heat loss or overheating. - Do not give anything to drink, moisten towel. - Monitor vital signs every 2-5 minutes. Call 911 if condition worsens with management procedures. 43

44 HEAD INJURY WITH LOSS OF CONSCIOUSNESS 1. Assume that all unconscious athletes have a cervical spine injury until proven otherwise. 2. Call for assistance or 911 if loss of consciousness is greater than 1 minute in duration. 3. Support the head and neck to minimize movement. 4. Maintain an open airway. 5. Monitor level of consciousness and breathing. 6. Manage any external bleeding. 7. Maintain athlete s body temperature (prevent chill or overheating). 8. All head injuries that cause a loss of consciousness greater than 1 minute will be transported by emergency personnel for further evaluation of head and cervical spine injury. 9. Perform head injury evaluation if loss of consciousness is less than 1 minute. - Dizziness, loss of balance. - Nausea, vomiting. - Blurred vision. - Altered mental status. - Amnesia (before and after incident). - Inability to focus and concentrate. - Headache that worsens with activity. 44

45 CERVICAL SPINE INJURIES 1. Check airway, breathing, and circulation in the position athlete is found. Check sensation and motor responses in the position athlete is found. 2. Assume that an unconscious athlete has a cervical spine injury until it has been proven otherwise! 3. Call via cell phone or emergency phone for Move athlete only if necessary to allow access to face for establishment of airway. If athlete does need to be moved, always stabilize the head first, use the assistance of others and use log roll technique. 5. Maintain head position and airway- no traction. 6. Keep athlete from getting chilled or overheated. 7. Monitor vital signs: - Pulse and respiration. - Level of consciousness. - Skin color. - Sensation, movement, strength. 8. Suspect head and spine injuries when: - Unconscious for unknown reason. - Did not observe mechanism of injury. - Mechanism had potential for head/neck injury. - Incident involved a lightning strike. 9. Repositioning an athlete lying prone: - Stabilize the head and neck. - Log roll the athlete to a supine position. - Stabilize the cervical spine. - Remove the face mask of a football player. - Assess level of consciousness. - Assess vital signs. 45

46 FRACTURE / DISLOCATION OF EXTREMITY 1. Initial Assessment: Deformity; Open wounds; Tenderness; Swelling 2. Support the injured area above and below the site of injury. 3. Call for assistance or 911 if large bone fracture, compound fracture, hip or knee dislocations. 4. Check for distal pulse, sensation, color of injured extremity, movement of fingers/toes. 5. If the athlete is stable and has normal neurological exam, athlete can be splinted and transported by non-emergency personnel for further evaluation and treatment. 6. If the athlete is not stable or has an abnormal neurological exam, support the injured area and call Monitor for signs/symptoms of shock: -Altered mental status. -Pale, cold, clammy skin, lips, eye lids, nail beds. -Breathing rapid, pulse weak and rapid. -Dilated pupils. -Low blood pressure. -Unresponsive when shock is severe. 46

47 SPRAINS, STRAINS, AND CONTUSIONS 1. Initial Assessment: Deformity; Open wounds; Tenderness; Swelling. 2. Initial management: - Rest (12-24 hrs.). - Ice (apply mins.) - Compression (elastic bandage). - Elevation (above the heart). 3. Muscle cramping: - Stretch the affected muscle. - Relax muscle by applying pressure. - Apply ice. - Pinch the upper lip hard to reduce cramp. - Drink water or sports drink. 47

48 BURNS THERMAL, CHEMICAL, ELECTRICAL 1. Determine unresponsiveness. Check A, B, C, D. 2. Determine burn severity. - Urle of nines (% of body). - Degree of burn (1 st causes redness; 2 nd causes blisters/wet; 3 rd causes charred, wxy, dry skin). - 3 rd degree burns and burns to face, hands, feet, genitals require medical attention. 3. Stop burning. 4. Remove or cut clothing and jewelry. 5. Immerse in cool water or apply cool wet cloth. 6. Do not apply ice paks, ointment, grease, lotion, butter. 7. Treat for shock. Sunburn - Type of thermal burn. - Increases risk of heat illness due to loss of body fluids. 48

49 LIGHTNING SAFETY 1. Athletic personnel should be aware and monitor local weather forecasts and warnings. 2. Have a designated person that watches for signs of threatening weather and notifies the athletic personnel in charge of dangerous conditions. 3. A chain of command will be established to identify who decides when to call an event and remove individuals from the field (i.e. athletic trainer, event staff, grounds staff, coach). 4. The field house is the designated safe shelter for the athletic fields. The secondary choice is a fully enclosed vehicle with a metal roof and the windows completely closed. Individuals should not touch any part of the metal framework of the vehicle during thunderstorms. 5. Use the Flash-to-Bang count to determine when to suspend practices and/or competitions. Begin counting when sighting a lightning flash. Counting is stopped when the associated thunder is heard. Divide this count by five to determine the distance to the lightning flash (in miles). When the count is sixty seconds or less, practice/competitions should be suspended and all individuals should seek the recommended safe shelter. Lightning has struck from as far away as ten miles from the storm s center. 6. Once practice/competition has been suspended, wait thirty minutes after the last sound of thunder or lightning flash, before resuming. 7. Avoid being the highest point in an open field as well as being on the open water. Do not seek shelter under or near trees, flagpoles, or light poles. Crouch on the ground with the head lowered and ears covered if body hair stands on end, skin tingles, or crackling noises are heard. Do not lie flat on the ground. 8. Observe the following basic first aid procedures in managing victims of a lightning strike: 49

50 - Survey the scene for safety. - Call Lightning victims do not carry a charge and are safe to touch. - If necessary, move the victim to a safer location. - Evaluate airway, breathing, and circulation, and begin CPR if necessary. 9. All individuals have the right to leave an athletic site in order to seek a safe shelter if the person feels in danger of impending lightning activity, without fear of repercussions or penalty from anyone. 50

51 HEAT / COLD ILLNESSES Heat Exhaustion Signs and symptoms: - Skin is moist, cool, pale, or flushed. - Lack of coordination. - Impaired mental state. - Muscle cramps, twitching, or spasms. - Nausea or abdominal cramps. - Increased body temperature. - Dry tongue and/or mouth. - Headache. - Excessive thirst. - Weakness. - Dizziness. Heat Stroke Signs and symptoms: - Skin is red, hot, and dry. - Rapid, strong pulse. - Shallow, rapid breathing. - Confusion, disorientation, unconsciousness - Other symptoms of heat exhaustion. - Seizures are possible. Management of Heat Illnesses - Remove victim immediately out of the heat to a cool place. - Give cool liquids (4-6 oz. every 15 minutes and suck on ice cubes). - Raise the victims legs 8-12 inches. - Remove excess clothing. - Sponge with cool water and fan. - Place ice bags behind the neck, at the armpits and groin. - For heat exhaustion, if no improvement in 30 minutes call Call 911 for heat stroke immediately. 51

52 Signs and Management of Hypothermia - Shivering, lethargic, skin color white or grayish-yellow. - Get victim into warm environment - Remove wet clothing. - Cover victim s body especially head. - Gradually re-warm boy parts with warm water (do not rub). 52