Emergency planning for H.S. athletics.

Over the years, many high school athletic programs have faced unexpected medical emergencies, without an organized emergency plan to handle them.

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Heat illnesses, severe dehydration, sudden cardiac arrest, commotion-cordis (cardiac concussion), severe bleeding, shock, head/neck injury, and limb-threatening injuries are a few examples of medical emergency situations in athletics.

Even though most athletic injuries and illnesses are non-emergent, a carefully organized emergency plan is needed for the athletic injuries and illnesses that required emergency care.

Whenever certified athletic trainers or other sports-medicine personnel are unavailable to the high school program, it will often require the coaches to act as first responders.

The following recommendations are provided as a means for athletic directors, other school administrators, and coaches to provide the best possible care for any medical emergency:

1. Realize the need to improve your current or future medical situations. Evaluate your current plan to decide what you can use to improve your plan.

2. Organize meetings with proper school officials, coaches, local police, local Emergency Medical Service (EMS), and other available medical personnel to develop a plan right for your athletic program and put it in writing.

3. Reinforce the plan through education. Plan in-services and workshops for your emergency team to acquire emergency skills.

4. Avoid hesitation in activating the plan when needed by scheduling rehearsals at various points throughout the school term.

5. After Pre-Participation Physical Examinations for each school term, make a list of the current medical condition of the athletes and keep it handy at each practice and competition. (Be aware of medical risks.)

6. Obtain First Aid and Cardiopulmonary Resuscitation (CPR) Certification even if your state does not require you to.

PROCEDURES

Step 1: Identify all personnel involved in the emergency action process and assign roles.

Personnel: Look for certified athletic trainers (if available), coaches, physicians, emergency medical technicians (EMTs), team managers, local police, game officials, and school administrators.

Typical roles: Ensure a safe scene, stay calm, provide immediate care for the injured/ill athlete, activate the EMS, retrieve equipment, direct EMS to the scene (this person should have access to the keys needed to unlock any locked gates or doors for quick EMS access), clear uninjured athletes and bystanders away from the scene, notify parents, and document the events.

Step 2: List all pieces of equipment and/or medical devices you have for emergency situations and decide if you would like to obtain more. Types of basic equipment and medical devices include: CPR shields and other personal protective equipment (such as gloves), blood pressure cuffs and stethoscopes, thermometers, bag-valve masks, splints, penlights, wound care supplies, bronchial inhalers (prescription only), EpiPens (prescription only), ice bags, oral fluids for hydration, sterile water for irrigation, ice and cooling tubs for heat emergencies.

An advanced source of equipment that may be found in the high school setting is an automatic external defibrillator (AED). Once you establish the equipment/medical devices available for use during medical emergencies, it is imperative that you develop a weekly or monthly inventory of supplies and schedule periodic maintenance checks to ensure proper working condition of each piece of equipment.

Most importantly, train the individuals to operate any type of medical equipment/device.

Step 3: Make sure your emergency response team has effective sources of communication (landline phones, cellular phones, and/or radios). Before each practice or event, it is important to ensure the proper working condition of any communication source.

It is also important to notify EMS of all scheduled dates and times of practices and competitions. Also included in this section of the plan are important telephone numbers (911 or local EMS number, local police number, hospital number, high school number, coaches numbers, etc.), and directions and maps of practice and competition venues and location of medical equipment.

The person assigned to activate EMS should provide the following information to the dispatcher: name, address and telephone number of event location, number of injured/ill, treatment given and condition of individual(s) involved, directions to the scene, and other information requested by the dispatcher.

Step 4: Schedule a meeting with your local EMS to determine the response time it takes from making the call to the arrival time of the ambulance to the scene.

Step 5: Ensure quick accessibility of the emergency plan. Along with giving all those necessary a copy of the plan, it may be helpful to post a copy of the plan near each fixed telephone for immediate access.

Medical emergencies can occur at any time. A carefully developed emergency plan for your high school athletic program would increase the chances of handling these situations effectively, thereby increasing the athlete's chance of survival.

The above recommendations and steps to developing an emergency plan are provided as a means to help improve your athletic program's current method of handling medical emergency situations.

By Renarda S. Tolbert, ATC, Women's Track Graduate Asst. Trainer, University of Alabama