EMERGENCY

PROCEDURES AND
PRIMARY CARE
PHYSICAL THERAPY
MOHAMMAD IRFAN
TOPICS

 UNIT 1: Organization and Administration of

Emergency care
 UNIT 2: Physical examination of the critically injured
patient/athlete
 UNIT 3: Airway management
Organization and
Administration of
Emergency care
 INTRODUCTIO
 N
Emergency medical situations can occur in athletics
at any time. When they do occur, it is important to
have the proper emergency action plan (EAP) in
place to provide the best possible care to the
athletes with potentially life-threatening injuries or
illness.
 The development and implementation of the EAP will
help ensure that the quality of care provided to the
athletes is the best possible.
 The goal of the sports medicine staff of any athletic
organization is to have an EAP that will minimize the
time needed to provide an immediate response to a
potentially life-threatening situation or medical
emergency.
 Because medical emergencies can occur during any
activity, the sports medicine staff must be prepared for
any type of situation
 Emergency care preparation includes the formation of an
EAP, proper coverage of athletic events and practices,
maintenance of emergency equipment and supplies,
utilization of appropriate personnel involved with the
sports medicine team.
 Although every precaution may be taken by the athletic
organization and its sports medicine staff, it is important
to understand that medical emergencies may still occur
 Factors to consider in the proper organization and
administration of emergency care in athletic activity
include the following:
1. Development and implementation of an EAP
2. The sports medicine staff and emergency team
3. Initial patient assessment and care
4. Emergency communication
5. Emergency equipment and supplies
6. Venue locations
7. Emergency transportation
8. Emergency care facilities
9. Legal need and documentation
Develop and Implement an EAP
 Significant research regarding athletic injuries has been
collected over the past decade, and it has been found
that almost one third of athletes are injured in some way
during their careers
 In a National Athletic Trainers’ Association Position
Statement it was recommended that each organization or
institution that sponsors athletic activities or events
develop and implement a written EAP
 Emergency action plans should be developed by
organizational or institutional personnel in consultation
with local emergency medical services
 The EAP needs to be implemented for the safety of all
athletic personnel, including athletes.
 It should be concise yet detailed enough to facilitate
prompt and appropriate action
 The development of an EAP and proper use of this plan
often can make the difference in the outcome of an
injury. All components of an EAP are connected, and they
all must be considered to ensure a complete and
favorable outcome in a potentially dangerous situation.
 Once the importance of the EAP is realized and the plan
has been developed, the EAP must be implemented.
 This is done through documentation of the plan,
education of those involved, and frequent rehearsal of
the plan itself.
 The EAP must provide a clear explanation of how it is
going to work, allowing continuity among all
members of the sports medicine staff and
emergency team members.
 It is important to have a separate plan for different
athletic venues and for practices versus games.
 Emergency team members, such as team
physicians, may not necessarily be present at all
athletic events, and this should be taken into
account during development of the various EAPs.
 Also, the location and type of equipment required
may be different among the sports teams and
venues.
 For example, outdoor sports with a high risk of heat
illness may require a large tub or wading pool to be used
for emergency cooling of athletes at risk of heat stroke.
 This equipment would not be required for indoor sports.
 It is important to properly educate all members of the
emergency team regarding the EAP and its contents.
 All members of the team should be familiar with the
emergency medical services (EMS) that will provide
coverage to the venues.
 Each emergency team member, in addition to the
athletic organization administrators, should have a
written copy of the EAP that provides complete
documentation of their roles and responsibilities in all
emergency situations.
 A copy of the EAP specific to each venue should be
posted by an available phone or some other
prominent marked position at that site.
 The emergency team must rehearse the EAP. This
provides the team members with a chance to
maintain their emergency skills at a high level of
competency.
 It also provides the opportunity for athletic trainers
and other emergency medical personnel to
communicate regarding specific procedures in their
respective areas.
 The EAP rehearsal can be accomplished through
meetings held several times throughout the year.
 It is suggested to rehearse prior to the preseason for
the high-risk sports, such as football in the fall, ice
hockey in the winter.
 Updates should be addressed as needed throughout
the year because venues, emergency medical
procedures, and emergency team members may
change at any time.
Sports Medicine Staff and
Emergency Team
 Athletic trainer: First responder and immediate care
 Team physician: First responder and immediate care
 Team coach: First responder and activate
emergency medical system
 Equipment manager: First responder and direction
of EMS to scene
 The implementation of an EAP cannot take place
without the formation of an emergency team
 The primary members of this team consist of the
sports medicine staff, which includes the athletic
trainer and the team physician.
 During an emergency the makeup of the emergency
team can vary depending on who is at the scene at
the time of the emergency.
 The emergency team can include athletic trainers,
team physicians, team coaches, and equipment
managers.
 Any member of the emergency team can act as a
first responder.
 A first responder is defined as a person who has been
trained to provide emergency care before EMS
arrives on the scene.
 For this reason, all members of the emergency team
should be trained and certified in first aid,
cardiopulmonary resuscitation (CPR), automatic
external defibrillation (AED), and prevention of
disease transmission (bloodborne pathogens).
 Frequent EAP review and practice should be required
for all members of the emergency team
 In any emergency situation the roles of the members
of the emergency team will vary depending on how
many people are on the team.
 The four roles within the emergency team are as
follows:

 1. Immediate care of the athlete

 2. Emergency equipment retrieval
 3. Activation of the EMS system
 4. Direction of EMS to the scene of the emergency
 Activation of the EMS System:

Provide Information to the EMS System:

1. Name, address, and telephone number of the caller
2. Number of athletes involved in the emergency
3. Condition of the athlete(s)
4. Treatment initiated by members of the emergency team
5. Specific directions to the emergency scene
Initial Patient Assessment and Care
 Immediate care of any injured person needs to be the main
concern for the emergency team. A CHECK—CALL— CARE
system should be put into place for every member of the
emergency team to follow when an emergency occurs.

CHECK
 The scene to make sure it is safe to aid the athlete
 The scene to find evidence on what happened to the athlete
 The victim for airway, breathing, fractures, and bleeding
CALL
 911 or the local emergency management service
 Give proper directions to the injury site
 Meet ambulance at scene and direct to injured athlete

CARE
 Calm and reassure the injured athlete
 Reassess and monitor all vital signs
 Control any bleeding
 Immobilize any injured body part
 Provide CPR/AED and appropriate first aid as needed
Emergency Communication

 Communication is the key to quick and effective delivery of

emergency care in any athletic trauma situation
 If emergency medical transportation is not available on site
during a particular event, then direct communication with
the emergency medical system at the time of injury or
illness is necessary
 Access to a working telephone or other telecommunications
device, whether fixed or mobile, should be assured.
 The communications system should be checked prior to each
practice or competition to ensure it is in proper working
order.
 A backup communications plan should be in effect
should there be failure of the primary communication
system.
 A list of all appropriate emergency numbers, such as
local emergency medical services, should be posted
by the communication system most used by the
athletic trainers and should be readily available to all
emergency team members.
Emergency Equipment and Supplies
 All appropriate emergency equipment and supplies must
be on hand at all athletic practices and events.
 All assigned emergency team members should be aware
of the location and function of all emergency equipment
and supplies
 Ensure that emergency equipment and supplies are
properly inventoried annually and stored in a secure
storage area for safekeeping by the athletic training
staff.
 All athletic personnel and administrators must recognize
the importance of the availability of AEDs as stated by
guidelines set forth by the American Heart Association
 It is also important to utilize proper airway
techniques for resuscitation when necessary
 Emergency team members should be educated in
the proper use of AEDs and airway adjuncts before
being allowed to use them.
 All emergency equipment and supplies must be in
good operating condition and should be checked
regularly
 Use of equipment and supplies should be regularly
practiced by all emergency team members so that
there is no delay in the effective use of the
equipment during an actual emergency.
Venue Locations

 The EAP should be specific to venue locations and

any unique features that might be found as part of
that facility
 The EAP for each venue should include information
concerning the accessibility to emergency
personnel, communications systems, emergency
equipment, and emergency vehicle transportation
 At all home venues, the host athletic trainer should
communicate the EAP for the venue to the visiting
team and its medical personnel
 At neutral or away venues, the athletic trainer or any
other member of the emergency team should identify
the availability of communication with emergency
medical services for that location.
 It is also important that the name and location of the
nearest emergency care facility and the availability of
emergency transportation at the venue be identified
prior to the event.
Emergency Transportation

 The EAP should include a policy for transportation of

the sick and injured for all athletic events.
 The policy on transportation should explain in detail
when and where an ambulance will be during all
athletic events.
 Emphasis should be placed on having an ambulance
on site for all high-risk or collision sporting events,
such as football, lacrosse, and ice hockey.
 In any emergency situation, the injured athlete
should be transported by ambulance, where the
necessary staff and equipment are available to
deliver appropriate emergent care.
Emergency Care Facilities

 The EAP should include information regarding the

transportation directions to an emergency medical facility
from all athletic venues.
 It is also recommended that the EAP be reviewed and
practiced with both the emergency care facility
administrators and medical staff in regard to important
information concerning athlete care.
 For example of the information that must be reviewed is
the proper removal of athletic equipment, such as football
helmets and shoulder pads, in the emergency care facility
 Legal Need and Documentation
 The creation of EAPs is not just a recommended practice but a legal
requirement and duty for those involved in the care of athletes and
physically active participants.
 Standards of Care: Athletic trainers and other allied health
professionals are held to high standards of care, especially in emergency
situations. EAPs serve as a critical framework for meeting these standards
 Having a written EAP in place is crucial for ensuring that emergency
procedures are well-defined and communicated, allowing for
efficient and effective responses during critical situations.

The following are important pieces of documentation needed as part of the

EAP;
 1. Athlete Emergency Information Card, used to describe current
medical conditions and medications being used by the athlete. This
card should only be used when there is written approval from the
athlete in accordance with patient confidentiality considerations.
 2. Individual Injury Evaluation Form, used for the documentation of
the athlete’s injuries
 3. Delineation of the person or group responsible for documenting
the events of the emergency situation.
 4. Follow-up documentation on the evaluation of response to
emergency situation.
 5. Documentation on personnel training and regular rehearsal of
the emergency action plan.
 6. Documentation of purchase, inventory, and maintenance of all
emergency equipment and supplies.
 7. School/athletic organization coaches’ Emergency Information
Palm Card, provided to members of the sports medicine team and
coaching staff for easy EAP reference.
THANK YOU