MFLL Coaches First Aid ClinicApril 9, 2014
Jody Kuhlenbeck, MFLL Safety Officer/Paramedic/FF
Leigh Beyer, MFLL Safety Officer/Physical Therapist
“Safety Safety Safety, It’s All About Safety!”
Take first aid kit with player medical cards to every practice/game. Know which players have medical conditions.
Check your fields before every practice/game for debris, rocks, sharp objects, holes etc
Inspect all equipment before every use. Turn damaged equipment into the Equipment Mgr
All bats must be inspected and labeled prior to use
Prevention is the Key!
Properly fitting batting helmets with chin straps are required by all batters, base runners, player base coaches and anyone handling a bat.
All catchers must wear full catching gear. Coaches are not to warm up pitchers!
All male players are required to wear an athletic supporter
Mouth guards are highly recommended!! Baseball is #1 sport for mouth/dental injuries!
Remove all jewelry
Player Safety
Control “horse play”, no climbing on fences etc Teach safe practices- calling fly balls, NO sliding
head first unless returning to a base, designated area for swinging a bat, NO warm up swings while in the batter’s box, “Heads up and PAY ATTENTION!”
Perform proper warm up and stretching before play. See stretching power point on website.
Know and follow the Thunder & Lightning Policy
Player Safety
Perform basic first aid treatment as appropriate and within your comfort zone/skills
For more serious injuries or deciding to call for an ambulance, it is best to have the parent be apart of the decision.
If the parent is unavailable, the coach should make a decision in the best interest of the player
It is ALWAYS ok to call 911 and let the EMT’s assess the situation when you are not sure of the severity of injury.
“Man Down on the Field”
Direct EMS Dispatch Line for cell phone use: 262-532-1700 Emergency Dentist: player’s family dentist or
CMH dentist on call: 262-251-1000 Jody Kuhlenbeck, Safety Officer: 262-227-6571 Leigh Beyer, Safety Officer: 262-617-1649 Mark McLean, President: 414-975-8451 Jason Marquardt, VP BB: 262-470-9315 Gail Onasch, VP SB: 262-894-9176
Emergency Phone Numbers
MFLL Injury Reporting Policy
Record all injuries on the Little League Baseball & Softball Accident Notification Form
Forms can be found in team first aid kits and concession stands
The player’s parent and league official/coach will complete the form AT THE TIME OF THE INJURY
Forward the accident form to the Safety Officer within 48 hours of the incident. Use the mailbox at the complex.
MFLL Injury Reporting Policy
Notify a Safety Officer the same day of the incident: Jody Kuhlenbeck, cell: 262-227-6571 OR Leigh Beyer, cell: 262-617-1649 The Safety Officer will complete an injury follow up
with the player’s parents and coaches If a concussion is suspected, a signed MD release is
required prior to the player returning to practice/ game play. NO EXCEPTIONS!
In all other cases, a signed MD release is only needed if an injury was serious enough to seek medical evaluation/treatment.
MFLL Injury Reporting Policy cont.
Blood/Body Fluids
#1 Goal is to prevent spread of infectious microorganisms (HIV, hepatitis B/C, MRSA etc)
Pathogens are found in blood, vomit, urine/stool, saliva, & other bodily fluids
Pathogens are spread when you come into contact with another person’s blood/body fluids, or contaminated sharps/needles
Pathogens enter through broken skin, mucous membranes of eyes, mouth, nose
Blood/Bodily Fluids
Treat ALL blood/bodily fluids as if they are contaminated
Wear gloves, eyewear, mask, gown, CPR mouth barrier etc (“PPE”)
Always check PPE for tears, defects before use. If PPE becomes torn, defective or dirty, remove and replace. Do not reuse PPE!
Properly dispose of used PPE and all contaminated materials in a red biohazard bag/receptacle.
Wash hands (or use hand sanitizer if soap/water are not available) immediately after removing PPE
How to Protect Yourself
Prior to participation, all open and possible contagious wounds should be covered with a dressing that will not allow for transmission
Always wear gloves, PPE when tending to player wounds or cleaning up bodily fluids
Clean and disinfect all items covered in blood or bodily fluids-player, equipment etc with antiseptic wipes
Clothing/uniforms with blood must be changed or cleaned w/ “Blood Buster” solution in spill kit caddy in concession stand
MFLL Blood/Bodily Fluid Policy
For large spills- use spill kit from Concession stand. Sprinkle powder over fluid. Use scraper to scoop up & put in biohazard bag.
Place ONLY contaminated items in red biohazard bags located in first aid kit, or at concession stand
Put biohazard bag in biohazard container in concession stand. If closed, contact Jody for disposal
Wash hands after removal of PPE
MFLL Blood/Bodily Fluid Policy
Wash the area exposed immediately with soap and water
See Medical provider immediately - personal MD, urgent care MD etc for evaluation, treatment
Notify the MFLL Safety Officer same day of incident
Complete the Little League Baseball & Softball Accident Notification Form and forward to the Safety Officer within 48 hours of incident
Exposure Incident Guidelines
Concussions
Type of traumatic brain injury (at the cellular level) caused by a blow to the head or body that moves or twists the brain inside the skull.
Injury examples- direct hit in head w/ ball or bat, collide with another player/the ground/or fence
Concussions cause problems with brain function vs brain structure
T or F? Loss of consciousness is required to have a concussion. Answer: FALSE!
Concussions affects people in 4 areas of function: physical, thinking, emotions, sleep
Concussions
They are more vulnerable to concussions They get concussions more often Their concussions take longer to heal than
adults Players can be reluctant to admit their
symptoms for fear of being removed from play Many times the player does not realize the full
extent of his symptoms or think to tell you all of the things he is feeling
Concussions Concerns Unique to Adolescents
Loss of consciousness (? serious head injury?) Decreasing level of alertness Unusually drowsy, difficult to arouse Severe or worsening headache Seizure Unequal pupil size Slurred speech Persisting vomiting Difficulty breathing
Concussions- When to Call 911
Headache Vision changes, ringing in ears Nausea/vomitting Dizziness, unsteadiness Numbness and tingling Change in mental alertness, drowsiness Decreased awareness- person, place, time Feeling “foggy”, groggy, confused, forgetful
Concussion Signs & Symptoms
Dazed or stunned appearance Clumsy, decreased reaction time Answers questions more slowly than usual Player asks repetitive questions Has memory, concentration concerns Changes in sleep patterns (too much/little) May feel irritable, sad, nervous, depressed
**Symptoms can be delayed and can occur 1-2 days after the hit/jolt**
Concussion Signs & Symptoms
Research has shown it may take up to 2 weeks to heal, and in some cases even longer.
Player needs to “rest” his/her brain following a concussion- NO physical activity, video games, computer use, texting, reading, watching TV, social activities etc until they are symptom free and cleared by MD
Concussions- The Need to Heal
Can worsen symptoms and prolong recovery Increases the risk for repeat concussion. This may increase the chance of long term
problems (ie decreased brain function, potentially chronic traumatic encephalopathy) or
Second Impact Syndrome (rapid brain swelling and death)
Avoid Returning to Activity too Quickly
Immediately remove the player from practice/ game play Assess for emergent signs- need to call 911? Notify the parents of the injury and have them come get
their child. Do not allow the player to drive himself home.
Complete the Accident Notification Form w/ the parent and notify a Safety Officer the same day
Issue the Parent Concussion Letter w/ concussion fact sheet found in the first aid kit
Write the details of the injury and circle all signs and symptoms the player is reporting on the letter
You suspect a concussion, now what?
Advise the parent to take their player for medical evaluation that day. The player should not be left alone. **Very Important to monitor for a worsening in condition**.
Advise they take the Parent Letter with them to the appt. This letter also states the MFLL requirements for return to play.
Remind them that a signed MD release will be required before the player may return practice
Concussion First Aid response cont
Player must be symptom free for a minimum of 48 hours and off any pain medication
Player must be in school full time without modifications
Player must have a signed MD release allowing him to return
Player will go through a stepwise return to full play (either on own under MD guidance or with MFLL)
Neuropsych Testing and SCAT 3 Assessment by MD is highly recommended!
MFLL Stepwise Return to Play
Program allows for one step per 24 hours Player’s symptoms are monitored before, during
and after each step. Safety will keep a log. If the player experiences any symptoms, the
player will be pulled from activity & must return to his medical provider for re-evaluation
It is a 5 step process to return to full competition/ game day
These steps will be coordinated by the Safety Officer, coach and parents
MFLL Stepwise Return to Play
Heat Illness
Occurs when the body becomes dehydrated and cannot cool the body by evaporation of sweat
Players who are overweight, in poor physical condition or not acclimated to the heat are at more risk
Important to know which players have a history of heat intolerance!! Watch them closely.
Heat Illness
Kids do not adapt to extremes of temperature as effectively as adults
Kids have a higher surface area-to-body mass ratio than adults, allowing a greater amount of heat to transfer from the environment to the body.
During physical activity, children produce more metabolic heat than adults.
Sweating capacity is considerably lower in children than adults
Heat Concerns Unique to Adolescents
Heat Related Illness Treatment
Heat Cramps: Involuntary Muscle Spasms *Rest in a cool, shady place*Massage the muscle gently, stretch*Replenish fluids*May return to activity as tolerated
Heat Exhaustion: Profuse sweating, dizziness, weakness, unsteadiness, nausea/vomiting, headache, red flushed face or pale color
*Remove player to cool/shady place*Remove unneeded clothing/equip*Cool body w/ wet towels/ice to arm pits, abdomen, back of neck, groin area*Replenish fluids*Hold activity until fully recovered
Heat Stroke: disoriented, dry/hot skin, lack of sweating, glassy stare, visual disturbances, high body temp, seizure, unconsciousness, chills, rapid pulse
*MEDICAL EMERGENCY, call 911*Move player to cool/shady place*Remove clothing/equipment*Cool body as noted above*Replenish fluids if able*Treat for shock- raise feet above heart*MD Release needed for return to play
Types of Heat Illness
Heat Illness Prevention
Drink before, during, and after!! 20 oz prior, 16 oz for every # lost due to sweating following activity. Avoid high sugar drinks, caffeine
Wear light colored clothing & little as possible Remove hats and equipment whenever possible
to let heat leave top of head What’s the color of your pee??
Heat Illness Prevention
Green Flag: Index is b/n 80-89. Watch players closely, give frequent water breaks. 75% regular activity/25% light activity, rest.
Yellow Flag: Index is b/n 90-94. Water breaks every 20-25 min, use iced towels. Practice in shaded area, 50% regular activity/50% light activity, rest. Limit equipment
Orange Flag: Index is b/n 95-99. Mandatory water breaks every 15-20 min, limit-no equipment, practice in shade or indoors, iced towels. 25% regular activity, 75% light activity, rest. Limit activity to <90 min
Heat Index Practice Recommendations
Red Flag: Index is b/n 100-104. Mandatory water breaks every 15 min. Practice in shade/indoors, before 10 AM or after 5 PM, Remove equipment. 25% regular activity/75% light activity, rest. Limit activity to <90 min.
Awe, heck just have fun and go to a water park instead!!
Black Flag: Index is above 104. Cancel Practice and games.
Heat Index Practice Recommendations
Lumps, Bumps and Bruises
Always assume the possibility of a spine injury with an unconscious player
If player is unconscious, DO NOT move him. Call 911. Check for a pulse, & breathing. If no pulse:
* Have a trained person begin CPR * Get the AED from the concession stand If player is conscious but reports severe pain in her spine,
numbness/tingling, or weakness in arms and legs etc, DO NOT move her. Hold player still, call 911.
Also always consider possibility of concussion with a neck injury
Head/Neck/Back Injuries
Always consider possibility of a concussion Any vision changes, flashes of light, “curtain
over field of vision”?? ER VISIT! Uneven pupils or blood in the pupil? ER visit! Foreign body: flush with water, do not attempt to
remove object to avoid further injury Corneal abrasions: irrigate, patch with gauze
and send to MD Black eye: check for visual changes, apply ice
Eye Injuries
Wear Gloves when assisting player If tooth is loose: stabilize tooth, Dentist! If tooth is knocked out: Do not touch root of tooth,
brush/scrub tooth or sterilize tooth. Gently rinse w/ water if needed. If able, reimplant tooth and stabilize. If not, place tooth in milk (prefer), saline soaked gauze, under tongue or in water Dentist!
If tooth breaks: stabilize remaining part of tooth, control bleeding, save all fragments of tooth (see above) Dentist!
Dental Injuries
Always wear gloves when tending to a wound Use gauze/towel & apply direct pressure to wound Flush wound with water Apply antibiotic ointment and bandaid/dressing Properly discard contaminated gauze/dressing and
wash/sanitize your hands after removing gloves! If unable to stop bleeding w/ holding direct pressure,
call 911. Do not apply a tourniquet. Bloody Noses: gloves, pinch nostrils and hold for 15
min with head tilted forward. Apply ice to back of neck. If unable to stop bleeding, see MD.
Cuts/Wounds/Bleeding
Assess for any obvious deformity If fracture/dislocation is suspected: Do not move
the area. Splint/support the area with a stiff object. Do not let player drink/eat- may need surgery
If area below the injury turns blue/cold, no pulse- Medical emergency! call 911
Elevate area if possible and apply ice Contact parents
Bumps & Bruises/Fractures
Assess for trouble breathing, swollen throat, rash/hives,
Call 911 if allergic reaction/anaphylaxis shock Use epi pen if child has one Remove stinger Wash area with soap and water, apply antibiotic
ointment Apply ice for 15 min to reduce redness and
swelling
Bee Stings