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July 24th • 2015 AHSAA ALL-STAR WEEKPresented by Dr. Lawrence “Larry” Lemak
Major League Soccer (MLS), Chief Medical Officer
Pop Warner Football, Medical Advisory Committee
National Federation of High Schools (NFHS), Sports Medicine Advisory Board
EMERGENCY ACTION PLANNING
HS FOOTBALL PLAYER DIES AFTER TACKLEPublished by CNN June 23, 2015
2014-15 BREAKDOWN OF CATASTROPHIC SPORTS INJURIES/FATALITIES AS REPORTED TO THE NFHSSPORT INJURIES FATALITIES *TOTAL
FOOTBALL 16 9 25
BASKETBALL 1 1 2
TRACK AND FIELD 0 3 3
BOYS LACROSSE 1 0 1
WRESTLING 1 0 1
BASEBALL 0 1 1
TOTALS 19 14 33
NATIONAL CENTER FOR CATASTROPHIC SPORT INJURY RESEARCHMISSION
The mission of the National Center for Catastrophic Sport Injury Research (NCCSIR) is to conduct surveillance of catastrophic injuries and illnesses related to participation in organized sports in the United States at the professional, collegiate, high school, and youth levels of play.
The goal of the Center is to improve the prevention, evaluation, management, and rehabilitation of catastrophic sports-related injuries.
The most common types of fatal events are acute trauma to the head/neck/spine, exertional-related heat events, exertional-related cardiac events, and disruption of cardiac rhythm due to blunt chest impacts (commotion cordis).
National surveillance of catastrophic sports-related injuries conducted by the NCCSIR over the last thirty years has facilitated the introduction of numerous sports safety interventions.
GOALS OF EMERGENCY ACTION PLAN1. Develop the Emergency Action Plan
2. Disseminate the Emergency Action Plan
3. Practice the Emergency Action Plan
4. Review the Emergency Action Plan
WHAT IS AN EMERGENCY ACTION PLAN (EAP)?• A written document that defines the standard of care for the
management of emergencies.• Provides an outline of the policies and procedures well in advance of
an emergency to establish protocols and avoid debate/confusion about critical decisions during the emergency.• Helps facilitate a prompt, efficient, coordinated response in a medical
emergency.
Preventing Sudden Death on the Athletic Field: The Emergency Action PlanRon Courson, ATC, PT, NREMT-I, CSCSCurrent Sports Medicine Reports 2007
SCIENTIFIC SUPPORT
SUDDEN CARDIAC ARREST• Sudden Cardiac Arrest (SCA) is the leading cause of death in young
athletes.
• Proper management of SCA in the athletic venue is critical. Preparation should include education and training, maintenance of emergency equipment and supplies, appropriate use of personnel, and the information and implementation of an emergency action plan (EAP).
National Athletic Trainers’ Association Position Statement: Emergency Planning in AthleticsJ.C. Anderson; Ronald W. Courson, Douglas M. Kleiner, and Todd A McLodaJournal of Athletic Training 2002
SCIENTIFIC SUPPORT
NATA POSITION STATEMENT 12 KEYS TO EAPs1. Each organization must have a written emergency plan. EAP must
be comprehensive and practical, yet flexible and adaptable.2. Emergency plans must be written documents and should be distributed to all personnel and developed in a consultation with local emergency medical services personnel.3. Identifies the personnel involved in carrying out the EAP and all
involved personnel should be trained in AED, CPR, first aid, and prevention of disease transmission.
NATA POSITION STATEMENT 12 KEYS TO EAPs4. The emergency plan should specify the equipment needed to carry out the tasks and location of equipment. The equipment available should be appropriate to the level of training of the personnel involved.5. Establishment of a clear mechanism for communication to appropriate emergency care providers and identification of the mode of transportation for injured participant.6. EAP should be specific to the activity venue. Each activity site should have a defined emergency plan that is derived from the overall organizational policies on emergency planning.
NATA POSITION STATEMENT 12 KEYS TO EAPs7. Emergency plans should develop, incorporate, and notify the emergency care facilities to which the injured individual will be taken.8. The emergency plan specifies the necessary documentation supporting the implementation and evaluation of the emergency plan.9. The emergency plan should be reviewed and rehearsed annually
or as frequent as necessary. The results of these reviews and rehearsals should be documented.
NATA POSITION STATEMENT 12 KEYS TO EAPs10. All personnel involved with the organization and sponsorship of
athletic activities share a professional responsibility to provide for the emergency care of an injured person.11. All personnel involved with the organization and sponsorship of
athletic activities share a legal duty to develop, implement, and evaluate an emergency plan for all sponsored athletic activities.
12. The emergency plan should be reviewed by the administration and legal counsel of the sponsoring organization.
EAP EXAMPLE: ANYONE CAN SAVE A LIFE
http://www.anyonecansavealife.org
NFHS Offers New "After-School“Emergency Response Training ProgramJuly 15, 2015
EAP EXAMPLE
EAP EXAMPLE • Emergency Personnel – Describe the emergency team involved when the EAP is activated and the roles of
each person.• Emergency Communication – What communication devices are available, where, what number to call in
an emergency, specific information and directions to the venue to provide to EMS response team.• Emergency Equipment – Location of equipment should be quickly accessible and clearly listed. Equipment
needs to be maintained on a regular basis.• Medical Emergency Transportation – Describe options and estimated response times for emergency
transportation. • Venue Directions with a Map – (should be specific to the venue, and provide instructions for easy access
to venue)• Roles of First Responders – Establish scene safety and immediate care of the athlete, activation of EMS,
equipment retrieval, direction of EMS to the scene• Emergency Action Plan for Non-Medical Emergencies – These emergencies can refer to the school
emergency action plan if one is in place
EAP EXAMPLE• Allows athletic directors, coaches, and
park and recreation directors the ability to answer a series of questions that will help build a customized EAP for a specific sports venue.
• The utility will help provide some general visualizations/site maps in order for user to customize their own rendering of a venue and assign responsibilities for emergency.
EXAMPLE OF EAP VISUALS USED AT A FOOTBALL FIELD OR STADIUM
EMERGENCY ACTION PLAN (EAP):WHY IT IS NECESSARY BUT DIFFICULT
• Rare events• Will never happen to me!• What do I do now?
• Multiple venues• Must be venue specific
• Multiple individuals involved• School and local EMS staff
• Constant turnover in personnel• AD’s, coaches, AT’s
• Takes prep time and practice
THE EMERGENCY ACTION PLAN• Can be recommended or mandated at state
level• Only works on a very local level
• Building by building• Field by field• Sport by sport
• Must have a plan in place:• Must be for each team and each venue• Phone access• Field access• AED access• Local EMS has to be involved from beginning
MOST COMMON CAUSES OF DEATH OR CATASTROPHIC INJURY• Medical Conditions
• Sudden Cardiac Arrest• PPE, AED, EAP
• Asthma• Medical management plan
• Diabetes• Medical management plan
• Exertional sickling• Suspicion/screening individual adjustments
• Traumatic Injury• Catastrophic brain injuries• Cervical spine injuries
• Environmental Conditions• Lightning
• Recognize and respond• Exertional heat stroke
• Plan, Monitor, Cool, Transport
• Behavioral • Exertional hyponatremia
• Don’t overhydrate• Suicide
• Awareness-Communication
EAP FOR EVERYBODY• Everyone is at risk for a medical
emergency - athletes, coaches, students, fans, and officials• Facilities used for PE classes, rec
and youth leagues• Guidelines can be applied to entire
campus• Great opportunity for cooperation
between school and local EMS
EAPPLANNING TO AVOID CONFLICT• Helmet/Facemask removal must be
addressed when pertinent• Must discuss with home team if
you are on the road• Must have someone in charge at
each level- in organization, sport, site• Must practice at least yearly with
all involved
EAPTRAINING AND AVAILIBILTY• Multiple programs across US to
increase AED access and availability
EAPPRACTICE, PRACTICE, PRACTICE• Takes prep time and practice• “Typically don’t rise to the
occasion, but default to level of training”
PEOPLE ARE WATCHING
GOALS OF EMERGENCY ACTION PLAN1. Develop the Emergency Action Plan
2. Disseminate the Emergency Action Plan
3. Practice the Emergency Action Plan
4. Review the Emergency Action Plan