Injury Management Roles and Responsibilities of a first

Injury Management Roles and Responsibilities of a first‐ aider in prevention of injuries

Members Roles • Phyisican – – – – • Serves to advise and supervise ATC Physician and ATC must be able to work together Have similar philosophical opinions regarding injury management Helps to minimize discrepancies and inconsistencies Compiling medical histories and conducting physical exams Pre‐participation screening Diagnosing injury Decisions regarding athlete’s ability to participate based on medical knowledge and psychophysiological demands of sport Coach – – – Coach must be aware of the responsibilities of each individual associated with the team Coach must understand limits of their ability to function as a health care provider Directly responsible for injury preventions Construct injury prevention conditioning programs Must provide high quality and properly fitting protective equipment

• Athletic Trainer – Athletic trainer works under direct supervision of physician – Work with athletes from time of injury to resolution – Directly responsible for all phases of health care in an athletic environment – Injury prevention – Ensure appropriate training, monitor environment, nutrition, maintain & fitting equipment, appropriate use of medication – Recognition, evaluation, assessment of injuries – Immediate care of injuries and illnesses – Treatment, rehabilitation, and reconditioning – Health care administration – Professional development and responsibility

Keep it current! • Just like any skill we possess, with out proper up keep or use our skill can become rusty. • Although compared to riding a bike or completing Pythagorean theory, emergency first aid deals with someone else’s well being. You don’t want to forget a certain part of CPR because you are out of practice!

Observer vs First Aid Provider • Observer: a person or thing that observes (dictionary. com) • First Aid Provider: a person who is trained and certified to complete first aid in case of an emergency. • Although first aid providers get a great view of the game, they also have a very important job to do and must be focused at all times. They may also recognize a problem in the athlete even before the athlete does themselves!

Liability for first aid • It is human nature to help a person in need. The Emergency Medical Aid Act (next slide) helps to remove liability for those who are trying to help. However, you can still be responsible for damages caused by performing first aid that is out of your range of training.

Emergency Medical Aid Act Protection from action ‐ 2 If, in respect of a person who is ill, injured or unconscious as the result of an accident or other emergency, ‐ (a) a physician, registered health discipline member, or registered nurse voluntarily and without expectation of compensation or reward renders emergency medical services or first aid assistance and the services or assistance are not rendered at a hospital or other place having adequate medical facilities and equipment, or ‐ (b) a person other than a person mentioned in clause (a) voluntarily renders emergency first aid assistance and that assistance is rendered at the immediate scene of the accident or emergency, the physician, registered health discipline member, registered nurse or other person is not liable for damages for injuries to or the death of that person alleged to have been caused by an act or omission on his or her part in rendering the medical services or first aid assistance, unless it is established that the injuries or death were caused by gross negligence on his or her part. RSA 1980 c. E‐ 9 s 2; RSA 1980 c. H‐ 5. 1 s 34; 1984 c 53 s 27

Risk Management • As the first‐aider or teams sport medicine member you are responsible to manage the risk for your athletes. • This can be accomplished by: – Knowing the needs of your athlete(s) – Understanding the common injuries or illnesses of the sport – Understanding and monitoring the conditions that your athlete is competing under – Ensuring proper fitting protective gear and equipment – Providing examples of warm up, stretching and cool down activities for the athlete to participate in.

Code of ethics for athletic first aid • The Code of Ethics has been developed to aid coaches in achieving a level of behaviour that will allow them to assist their athletes in becoming well‐rounded, self‐confident and productive human beings. The athlete/coach relationship is a privileged one and professional coaches play a critical role in the personal as well as athletic development of their athletes. To create and maintain a positive and successful learning environment, all stakeholders involved in our sport (athletes, parents, coaches, officials and volunteers) must share a common vision and understanding of their role as their actions ultimately contribute to, or undermine, the existence of a positive learning environment. .

Documentation • It is vitally important for collection and management of the participants’ medical information; – For proper care of the injury after it can occurred; – To indicate if this injury has occurred before; – To minimize the liability for those who have preformed first aid or treatment; – What other reason’s do you think documentation would be important?

Facility and environmental conditions • Heat and humidity – First Major Concern: Dehydration • Dehydration can compromise athletic performance and increase the risk of exertional heat injury. – Causes • athletes do not voluntarily drink sufficient water to prevent dehydration during physical activity • education, increasing accessibility, and optimizing palatability can modify drinking behavior, and • excessive overdrinking should be avoided because it can also compromise physical performance and health (Armstrong et al, 1995; Casa & Hillman, 2000; Joy, 2002; Sadler, 2006). – Symptoms. • thirst, • irritability, • and general discomfort followed by headache, weakness, dizziness, cramps, chills, vomiting, nausea, head or neck heat sensations, and/or decreased performance.

Cont’d – Risk Factors. • • extreme heat and/or humidity, excessive perspiration, inadequate fluid intake, bouts of vomiting or diarrhea prior to exercise, d ark‐colored urine, use of medications that are dehydrating, alcohol consumption, and caffeine use. – Preventive Measures • • • Being aware of the student‐athlete’s sweat rate sport dynamics (i. e. rest breaks, fluid access) environmental factors acclimatization state of participants exercise duration exercise intensity http: //www. sportsmanagementresources. com/dehydration‐and‐cold‐and‐heat‐related‐illness

Humidex • Wikipedia states: – “The humidex is an index number used by Canadian meteorologists to describe how hot the weather feels to the average person, by combining the effect of heat and humidity. The humidex is a unit‐less number based on the dew point, but it is equivalent to dry temperature in degrees Celsius. For example, if the temperature is 30 °C (86 °F), and the calculated humidex is 40, then it indicates the humid heat feels approximately like a dry temperature of 40 °C (104 °F). The index is widely used in Canadian weather reports during summer. ” – “According to the Meteorological Service of Canada, a humidex of at least 30 causes "some discomfort", at least 40 causes "great discomfort" and above 45 is "dangerous". When the humidex hits 54, heat stroke is imminent. ” • Humidex Formula:

Facility and environmental conditions • Cold‐related illness: is inherent to physical activity outdoors and its incidence increases with dropping temperatures and in environments with wet or windy conditions (or a combination of these). – Descriptions & Symptoms • • Hypothermia. Frostbite. Chilblain. Immersion Foot. Immersion (Trench) Foot. – Risk Factors. • Extreme cold, precipitation, wind • Existing medical conditions • Previous cold injuries increases the chance of subsequent cold injuries two to four times, even if prior injuries were not debilitating or resolved with no or minimal medical care • Low caloric intake, dehydration, and fatigue • Low caloric intake (less than 1200 to 1500 kcal/day) or hypoglycemia (or both) • Fatigue associated with hypoglycemia is linked to impaired peripheral vasoconstriction and shivering responses and can lead to faulty decision making and inadequate preparations, indirectly resulting in cold injuries • Nicotine, alcohol, and drug use • Low body fat and muscle mass • Gender. • Insufficient clothing or clothing that does not reduce heat loss.

Cont’d – Preventive Measures • • Pre‐Participation Screening. Education. Hydration and Nutrition. Training Guidelines. Clothing. Warm‐Up. Emergency Supplies. The athletics department and certified athletic training staff will include the following supplies on the field, in the locker room, or at convenient aid stations for re‐warming purposes: – A supply of water or sports drinks for rehydration purposes as well as warm fluids for possible re‐warming purposes. – Heat packs, blankets, additional clothing, and external heaters, if feasible, for active re‐ warming. – Flexible low‐reading thermometer probe to assess core body temperature. – Telephone or two‐way radio to communicate with additional medical personnel and to summon emergency medical transportation. – Tub, wading pool, or whirlpool for immersion warming treatments http: //www. sportsmanagementresources. com/dehydration‐and‐cold‐and‐heat‐related‐illness

Wind Chill • Wikipedia states: – “Wind chill (often popularly called the wind chill factor) is the felt air temperature on exposed skin due to wind. It measures the effect of wind on air temperature. The wind chill temperature is always lower than the air temperature, and the windchill is undefined at the higher temps (above 10 °C (50 °F)). Humidity on the skin can result in a higher felt air temperature, which is accurately termed the heat index (or humidex), and is used instead. ” – Wind Chill formula: where is the wind chill index (TWC) based on the Celsius scale, is the air temperature in °C, and is the air speed in km/h measured at 10 metres (33 ft), standard anemometer height).

Wind Chill Table

The Right Tool for the Job • You would never use a golf club in a hockey game or a curling shoes on soccer pitch… would you? • Think about it: if your equipment does not fit correctly, this is accentually what you are doing. – It is important for your equipment to fit well so it can complete the task you want it to do!

Remove All Valubles! • Necklaces and chains on the neck can be very beautiful; however during a game, they turn into dangerous weapons and therefore should be removed during the game.

Knowing Your Athlete’s • Knowing an athletes physical fitness will help to create a fitness routine that will promote strength, flexibility and performance (depending on the sport) without risking injury of the athlete. • When an athlete pushes themselves too far or exceeds their capacity they increase their chance of injury. • To minimize risk an athlete should complete a warm‐up, training, practice, competition or active participation, and cool down.

Clean Up • As a first aider there are many hegience consideration you will need to make. To name a few: – Washing your hands – Wearing gloves – Proper disposal of biohazardous material – Proper sterilization techniques and use of sterilized product during procedures – Can you think of anything else?

• Therapeutic drugs – of or relating to the treatment of disease or disorders by remedial agents or methods (dictionary. com) – This can be over the counter or prescribe by a physician • Recreational drugs – Also known as street drugs. • Performance‐enhancing drugs – Used by athletes to enhance their performance in competition • • Lean mass builders Stimulants Painkillers Sedatives Diuretics Masking drugs Steriods

Ethical considerations for athletic first‐ aider • If you know that someone is taking drugs of any variety it is your responsibility to contact either the physician or coach • If you as a first aider give any drugs, this must be documented • It is important for you to know which over the counter drugs are permissible and which are not in competition of your sport • If you provide medication that is prohibited, then you may be liable for any consequences.