First Aid for Coaches

Part 1-- First Aid Fundamentals

Table of Contents

• Administrative Concerns• Emergency Planning• Injury Evaluation• First Aid Priorities• Moving Injured Athletes

Administrative Concerns

Objectives

• Understand the definition, rationale and goals of first aid

• Understand the concept of the sportsmedicine team, and the coaches role on it.

• Understand and apply the legal expectations of coaches.

Questions

• 1. First Aid is the_______ given to the victim of an injury or sudden illness.

• 2. Over one million high school athletes are injured each year, this a _________ for which coaches must be prepared.

• 3. Coaches, EMT’s, physicians, and other health care workers form a loosely connected team called the____________.

Questions

• 4. Prevention of injuries, securing medical care, and providing first aid are examples of ____________.

• 5. TRUE\FALSE-- There are nine legal duties that parents, administrators, athletes and fellow coaches can expect of you.

Questions

• 6. TRUE\FALSE-- Providing instruction involves teaching skills, strategies and taking unfair advantage of the rules.

• 7. The ninth legal duty is___________.• 8. Two important parts of this

expectation are that it’s a _____and to stay within a ____________________.

First Aid

• The immediate care given to the victim of an injury or sudden illness until more advanced care can be obtained, if necessary

Injury Statistics

• Over 1 million High School athletes will be injured this year.

• Expect 1 in 5 athletes on your team to be injured, approximately 20%

• This is a significant problem for which coaches must be prepared

• Injuries range from annoying and minor to serious and life threatening

Rationale

Be a Team Player

• Coaches are part of a larger group of health professionals caring for an athlete’s health

• Coaches must fulfill their obligation to the first aid goals stated in this course as a member of this team

• Coaches must respect the decisions and authority of other members of the team

Sportsmedicine Team

First Aid Goals

• 1. Prevent Injuries • 2. Prevent Further Harm• 3. Secure Medical Care• 4. Provide Information• 5. Be a Liaison• 6. Provide First Aid

First Aid Goals

• The remainder of this course will show you how to implement the First Aid Goals

Legal Duties

• Plan Activity• Provide

instruction• Safe Environment• Proper Equipment• Match Athletes

• Evaluate for injury• Supervise Closely• Warn of Risks• Provide First Aid

Legal Duties Explained

• Plan the Activity-- Keep written records of practice plans. Teach sport skills, strategies, fitness, and sportsmanship.

• Provide instruction-- Stay up to date on skill techniques and rule changes. Teach athletes the correct way to play the game.

Legal Duties Continued

• Safe Environment-- Base practice/competition decisions on environmental conditions. Inspect playing and training areas regularly. Have broken equipment repaired or replaced

• Proper Equipment-- Use high quality equipment. Inspect it regularly. Teach athletes how to wear and adjust it.

Legal Duties Continued

• Match Athletes-- Avoid creating mismatches in practice. Make sure athletes are paired up according to size, skill, maturity, experience and other pertinent factors.

• Evaluate for Injury-- Every athlete must have a physicians clearance to play. Remove athletes that cannot play without pain or loss of function.

Legal Duties Continued

• Supervision-- Do not allow athletes to practice unless supervised by a coach. Forbid and punish horseplay.

• Warn of Risks-- Make sure athletes and parents are aware that sport participation can lead to injury.

• Provide First Aid--See the Ninth Legal Duty.

Ninth Legal Duty

• Take Action-- A Duty-- The law assumes that by agreeing to coach you also agreed to provide first aid care for injuries and illnesses an athlete may suffer in your care. You are responsible for providing that care.

Ninth Legal Duty

• Standard of Care--Is a definition of the limits coaches are allowed while providing first aid care. The remainder of this course details the standard of care for coaches. Do not provide less and do not exceed it.

Ninth Legal Duty

• Good Samaritan Law-- Do not be afraid to provide emergency care to an injured athlete. These laws protect coaches from legal action if they stay within their standard of care.

• Consent-- Coaches have consent to treat injuries and illnesses. In non-sport situations obtain consent to treat the person. If unconscious-- consent is implied

Emergency Planning

Objectives

• Understand the need for an Emergency Plan

• Understand and be able to write a Health Protection Plan

• Understand and be able to execute the Emergency Action Steps

Questions

• 1. Athletic participation creates________that may overcome the body’s ability to withstand them.

• 2. The ____________ describes an overall plan of action taken by the coaching staff in the event of an injury.

Questions

• 3.TRUE\FALSE-- Emergency information cards are important source of data about an athlete and should be completely filled in.

• 4. ________ are a process used to initiate emergency care when an athlete is injured.

Questions

• 5. TRUE\FALSE-- Coaches should plan and practice both parts of their emergency plan.

• 6. After an injury situation has been concluded, coaches should complete an___________.

Emergency Planning

• In sports,emergency planning has two distinct and important parts.

• The first is the overall plan of who, what, when, where, how, etc that applies to all injury situations.

• This plan should be written down and is the team’s overall Health Protection Plan

Emergency Planning

• The second part deals with Emergency Action Steps. This is the actual process used when an athlete is injured.

• In order to have smooth, safe, consistent, and coordinated care for an athlete, coaches need to think through and practice their emergency plan

Health Protection Plan

• By its nature, the action involved in athletics creates forces that may overcome the body’s ability to withstand them.

• When this happens an injury or sudden illness occurs.

• Coaches put much time into preparing teams for competition. They should also plan for emergencies and illnesses.

Health Protection Plan

• 1. Make sure all records, information cards, and necessary forms are completely filled out and are up to date for each athlete.

• 2. Make sure that all athletes have had a preseason physical exam from a doctor

Health Protection Plan

• 3. Outline a list of duties to be performed in an emergency.

• 4. Identify who will carry them out and how/when that duty should be carried out.

• 5. Describe what actions need to be taken for the duty to be successful.

• 6. Explain what paperwork needs to be filled out.

Emergency Duty Checklist

• Who calls 911• How do we call 911• Who else needs to

be called• Who’s is in charge

of the first aid kit• Where will

emergency equipment be stored

• Who will perform First Aid care

• Who will call parents

• This is a partial list, add to it as your school district and sport situation demand

Emergency Action Steps

• Check the scene, then the victim, athletic situations generally have 1 or 2 victims and the scene is safe unless the injury is of a bizarre nature

• Call 9-1-1 or a local emergency number if the injury is serious and more help is needed.

Emergency Action Steps

• Care for the Athlete• 1. Perform a survey to confirm the

mechanism of injury and assess the extent and severity of the injury

• 2. Give care for injuries based on their severity and type

• 3. Provide for the athlete’s removal from play and continuing care

Emergency Action Steps

• Assist emergency personnel if the injury was severe

• Appoint an adult to accompany the athlete to the hospital. Make sure the athlete’s information card is completely filled out and also goes to the hospital with him/her

• Complete the injury report and other necessary paperwork

Emergency Action Steps

• When an injury occurs, whether it is life-threatening or minor, follow the Emergency Action Steps to ensure the best care the athlete could receive.

Injury Evaluation

Objectives

• Understand the importance of observation

• Be able to recognize and make use of the mechanism of injury

• Be able to recognize the signs of an injury

• Be able to carry out a head to toe assessment of an injured athlete

Questions

• 1._________is important to supervising and recognizing an injury situation.

• 2. ________is a force applied to the body that results in an injury.

• 3. The force causing the most serious injuries is called a ___________.

• 4. __________ is your best clue to the type of injury suffered by an athlete.

Questions

• 5. Good indicators of an injury are a change in _____, _______, _______, and _________.

• 6. TRUE\FALSE-- A secondary survey helps confirm the mechanism of injury and the type of injury.

Questions

• 7. Associate the following with H=history, I=inspection, T=touch

• A. Check long term memory• B. Looking for signs• C. Feeling for injuries• D. Asking Questions• E. Checking the eyes• F. Checking skin temperature

Observation

• Coaches should be able to see athletes at all times.

• By observing and supervising athletes coaches increase their effectiveness with regard to recognizing injuries and responding to them.

Mechanism of Injury

Mechanism of Injury

• Is the cause of the injury due to excessive force or forces acting in opposition to the body’s intended movement

• Keep in mind pre-existing conditions that may be aggravated during an action that causes an injury

• Careful observation of the mechanism of injury is the leading clue to an injury

Mechanism of Injury

• Direct blow--Colliding with another player, a piece of equipment, or a hard surface. Usually results in the worst injuries

• Torsion-- Results from a twisting force. Usually results in a joint injury or broken bones

Mechanism of Injury

• Shearing-- A friction injury caused by the skin rubbing on a coarse surface. Usual damage involves skin and soft tissue injuries

• Indirect(Overtraining)-- An injury caused by overusing a body area to the point of weakness and loss of function

Signs of an Injury

• 1. Point tenderness

• 2. Pain• 3. Swelling• 4. Discoloration• 5. Changes in

normal body function

• Good indicators• --changes in • --Appearance• --Function• --Physiology• --Sensation• Use a Pain Scale to

determine severity

Secondary Survey

• History• --Interview the athlete for what

happened, pain location, symptoms.

• --Check for short term and long term memory

• --Ask questions to confirm the mechanism of injury

Secondary Survey

• Inspection• -- Look for profuse bleeding, skin

appearance, pupil size and reaction, deformities, swelling, discoloration, breathing difficulty and other abnormalities(eyes,nose,ears,mouth)

Secondary Survey

• Touch• --Feel for point tenderness, skin

temperature, sensation\numbness, deformity

• --Check body by asking the athlete to move body parts: hands\fingers\arm, foot\toes\ankles\leg, head-sideways\up and down, shoulders.

First Aid Priorities

Objectives

• Understand that emergencies are classified by their severity or importance

• Recognize and give first aid for heart/lung injuries, profuse bleeding, shock, bone/joint injuries, slow bleeding, and local tissue damage.

• Understand the need for self-protection while giving first aid

Questions

• 1.Create a chart that names each First Aid priority, lists the signs and symptoms of each, and describes the First Aid care needed.

• 2. List four important rules for self-protection while caring for an injured athlete when body fluids are present.

Understand Priorities

• Always be prepared to initiate the emergency plan

• As you evaluate the athlete keep in mind the priority list

• Injuries that are higher on the list must be dealt with first before moving on

• If an athlete is bleeding slightly(6) but has a deformed ankle(5), treat the ankle first, it is higher on the priority list

First Aid Priorities

• 1. Initiate the emergency action plan• 2. Maintain life support• 3. Control profuse bleeding• 4. Treat for shock• 5. Splint unstable injuries• 6. Control slow,steady bleeding• 7. Minimize local tissue damage

Profuse Bleeding

• Can be life threatening. Athlete can bleed to death in 1 minute or less.

• Three types of bleeding--Venous(bluish color, flows from wound), Arterial(pinkish color, spurts from wound), Capillary(dark color, oozes from wound)

Profuse Bleeding

• Several types of wounds--• Laceration-- deep jagged cuts• Incision-- straight edge cuts• Punctures-- skin broken by a pointed

object• Avulsion-- skin is forcibly ripped from

the body• Abrasion-- Skin is scraped away

Care for Bleeding

Profuse Bleeding

• Use a sterile gauze pad• Apply direct pressure• Elevate the wound• Apply a bandage• Use a pressure point if bleeding

will not stop• Seek medical care, wash hands

Pressure Point

Internal Bleeding

• Tender, swollen, bruised, or hard areas such as the abdomen

• Rapid, weak pulse• Skin feels cool or moist or looks pale or

blue• Vomiting or coughing up blood• Excessive thirst• Confused, faint, drowsy, or unconscious

Internal Bleeding

• Care for internal bleeding--• 1. Treat for shock• 2. Keep athlete still• 3. Call for emergency help• 4. Give nothing by mouth

Shock

• A condition that exists when the circulatory system fails to deliver blood to all parts of the body

• When organ systems do not receive blood, they fail to function

• This failure triggers a series of responses that produce specific signals known as shock

Risk Factors for Shock

• Low pain tolerance• Emotional

personality• Tired• Dehydration• Extreme heat/cold

exposure

• These risk factors increase the chance of shock in an injured athlete, regardless if the injury is minor or serious

Signs/Symptoms of Shock

• Restlessness or irritability• Rapid and weak pulse• Rapid Breathing• Pale, bluish, cool, moist skin• Excessive thirst• Nausea and vomiting• Drowsiness or unconsciousness• Drop in blood pressure

First Aid for Shock

• 1. Monitor the athlete• 2. Give care for injuries/illnesses• 3. Lie athlete down, raise feet 6-18

inches• 4. Cover with a blanket• 5. Seek medical help if necessary

Care for Shock

Identifying Bone/Joint Injuries

• 1. Significant deformity• 2. Bruising and swelling• 3. Loss of function to area• 4. Victim feels a grating sensation• 5. A popping or snapping sound• 6. Area is cold or numb• 7. Mechanism of injury suggests it

Unstable Bone/Joint Injuries

• Do not allow athlete to move• Treat for shock• Allow Professional help to splint the

injury if they will arrive within 20 minutes

• If response time is longer than 20 minutes, splint the injury yourself

• Splinting will covered in more detail in Part 2 of this course

Local Tissue Damage

• The body’s reaction to injury may damage surrounding tissue

• Injury or infection can cause: bleeding or fluid loss, swelling, temperature increase, pain, loss of function

• PRICE is the best way to minimize this damage

R.I.C.E.

P.R.I.C.E. is Right

• Protection-- From further injury by not moving the athlete and not allowing them to be in harm’s way.

• Rest-- Remove from activity and provide a safe and comfortable place to rest.

• Ice-- Use real ice for the first 24-72 hours. Apply for 15-20 minute intervals.

P.R.I.C.E. is Right

• Ice Cont’d.-- place a pad between ice bag and the skin for protection. Avoid using chemical ice packs.

• Compression-- Use an elastic wrap to hold ice in place and to help control swelling.

• Elevation-- Raise injured area above heart level to control swelling.

Slow Steady Bleeding

• Follow the rules for profuse bleeding presented earlier

• After controlling bleeding for minor wounds, clean the area with soap and water to prevent infection

• Completely secure a minor wound before an athlete returns to activity

Universal Precautions

• Always use an effective barrier• Allow athlete to participate in his\her own

care as much as possible• Dispose of all waste properly• Wash hands with soap and water• Report all exposures to body fluids,

especially blood, to director• Use these rules whenever body fluids are

present during first aid care

Moving Injured Athletes

Objectives

• Understand the rules for moving injured athletes

• Know how to move non-critical athletes

• Know how to secure the head, neck and spine of a seriously injured athlete

Questions

• 1. Do not ______ an injured athlete until his condition is completely known.

• 2. Allow ______ to care for seriously injured athletes.

• 3. Always consider that ____, ______, or ______ injury may have occurred.

• 4. If a serious injury occurs, always err on the side of ___________.

Questions

• 5. If you suspect a head, neck, or spine injury, always ___________ the head and do not release it until emergency personnel tell you to let go.

• 6. Walking assists and carries can be used to help move ___________ injured athletes off the field.

General Rules

• Keep athlete still• Do not move the

athlete• Assume possibility

of head, neck, or spine injury

• Initiate emergency plan

• Give care

• Move non-critically injured athletes after careful evaluation.

• Allow emergency personnel to care for seriously injured athletes

Moving Critical Injuries

• Always err on the side of caution• Only move an injury if in danger of

further harm• Only move if you are unable to

evaluate or treat an injury• Do not move any life-

threatening or serious injury

Life Threatening injuries

• Respiratory or cardiac arrest

• Head, neck, or back injury

• Shock• Profuse Bleeding

• Internal injuries• Large joint

dislocations• Bone fractures• Seizures

Four Person Rescue

Four-Person Rescue

• One rescuer immobilizes the head and does not release it

• Other rescuers position themselves at the shoulders, hips, and legs

• On signal all rescuers roll athlete toward them

• Slide a board up to the athlete’s back and lower the athlete on signal

Moving Non-Critical Injuries

• Use caution• Make sure there are no life

threatening injuries• Non-critical injuries include: Minor

sprains, Solar plexus injury, Contusions, Facial injuries, Hand/finger/wrist fracture, Finger dislocations

Walking Assists

One-Person Walking Assist

• Ideal for helping dazed or slightly injured athlete

• Place athlete’s are around your shoulder

• Grasp the athlete around the waist with the free hand

• Instruct the athlete to lean on you while walking off

Two-Person Walking Assist

• Working together with another rescuer

• Each rescuer follows the one-person walking assist from both sides of the athlete

• Walk slowly and together to stay in balance

Carries

Two Handed Carry

• Use with athlete’s unable to walk without assistance

• Rescuers grasp forearms• Instruct athlete to sit on arms, and

put the athlete’s arms on the rescuers shoulders

• Support athlete’s back with other arms

Four Handed Carry

• Grasping your own forearms, create a chair with another rescuer as in the illustration

• Have the athlete sit on the chair, have the athlete put his arms around your shoulders

• Do not use this rescue if there is the possibility of loss of consciousness

The End