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Emergency Action Plans

Emergency Action Plan - SAMPLE PROTOCOL


This is a generic sample for an emergency action plan that should be used as a guide only. A specific emergency action plan should be developed based on your own site and in consultation with the medical staff, administrators and other relevant personnel.


Emergency situations may arise at anytime during athletic events. Expedient action must be taken in order to provide the best possible care to the sport participant in an emergency and/or life threatening conditions. The development and implementation of an emergency plan will help ensure that the best care will be provided.

As emergencies may occur at anytime and during any activity, the medical staff and related personnel must be prepared. Sport and athletic organizations have a duty to develop an emergency action plan that may be implemented immediately and to provide appropriate standards of emergency medical care to all sports participants. As athletic injuries may occur at any time and during any activity, the sports medicine team must be prepared to give appropriate care to the injured athlete. This preparation involves formulation of an emergency plan, proper medical coverage of events, maintenance of appropriate emergency equipment and supplies, utilization of appropriate emergency medical personnel, and continuing education in the area of emergency medicine and planning. Hopefully, through careful pre-participation physical examinations, adequate medical coverage, safe practice and training techniques used by the coaches and other safety measures, some potential emergencies can be prevented. However, accidents and injuries are inherent with sports participation, and proper preparation on the part of the sports medicine team should enable each emergency situation to be managed appropriately.

Components of the Emergency Plan

These are the basic components of an Emergency Action Plan:

  1. Emergency personnel
  2. Emergency communication
  3. Emergency equipment
  4. Emergency transport
  5. Emergency action plan for non-medical emergency
  6. Venue directions with map

Emergency Plan Personnel

Ems_team

During practice and competition, the first responder to an emergency situation is typically a member of the sports medicine staff a coach or non-medical personnel. A team physician may not always be present at every organized practice and a first responder will be responsible for implantation of the emergency action plan. The type and degree of sports medicine coverage for an athletic event may vary widely, based on such factors as the sport or physical activity, the risk of injury, the venue, and the type of training or competition. The first responder in some instances may be a coach or other institutional/association personnel. Certification in cardiopulmonary resuscitation (CPR), first aid, prevention of disease transmission, and emergency plan review is required for all personnel associated with practices, competitions, skills instruction, and strength and conditioning.

The development of an emergency plan cannot be complete without the formation of an emergency team. The emergency team may consist of a number of healthcare providers including physicians, emergency medical technicians, certified athletic trainers; athletic training students; coaches; managers; and, possibly, bystanders. Roles of these individuals within the emergency team may vary depending on various factors such as the number of members of the team present at the time of the emergency, the athletic venue, or the preference of the Team Physician. There are four basic roles within the emergency team.

Roles within the Emergency Team

  1. Bag_valveEstablish scene safety and immediate care of the athlete
    The first and most important role is establishing safety of the scene and immediate care of the athlete. Acute care in an emergency situation should be provided by the most qualified individual on the scene. Individuals with lower credentials should yield to those with more appropriate training.

  2. Activation of the Emergency Medical System
    EMS activation may be necessary in situations where emergency transportation is not already present at the sporting event. This should be done as soon as the situation is deemed an emergency or a life-threatening event. Time is the most critical factor under emergency conditions. Activating the EMS system may be done by anyone on the team. However, the person chosen for this duty should be someone who is calm under pressure and who communicates well over the telephone. This person should also be familiar with the location and address of the sporting event.
  3. Emergency equipment retrieval
    Equipment retrieval may be done by anyone on the emergency team who is familiar with the types and location of the specific equipment needed. Students, managers, and coaches are good choices for this role.
  4. Direction of EMS to scene
    The fourth role of the emergency team is that of directing EMS to the scene. One member of the team should be responsible for meeting emergency medical personnel as they arrive at the site of the emergency. Depending on ease of access, this person should have keys to any locked gates or doors that may slow the arrival of medical personnel. A student, manager, or coach may be appropriate for this role.

Activating the EMS System - Making the Call:

  • 911 (if available) or whatever emergency phone number is appropriate for the location or venue
  • Telephone numbers for local police, fire department, and ambulance service should be available

Providing Information to EMS Dispatch:

  • Name, address, telephone number of caller
  • Nature of emergency, whether medical or non-medical
  • Number of athletes
  • Condition of athlete(s)
  • First aid treatment initiated by first responder
  • Specific directions as needed to locate the emergency scene ("come to south entrance of facility")
  • Other information as requested by dispatcher

When forming the emergency team, it is important to adapt the team to each situation, sport and venue. It may also be advantageous to have more than one individual assigned to each role. This allows the emergency team to function even though certain members may not always be present at the time of the emergency.

Emergency Communication

Communications

Communication is the key to quick emergency response. All medical and emergency medical personnel must work together to provide the best emergency response capability and should have contact information such as telephone directory established as a part of pre-planning for emergency situations. Communication prior to the event is a good way to establish professional responsibilities and to build rapport between both groups of professionals. If emergency medical transportation is not available on site during a particular sporting 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 proper working order. A back-up communication plan should be in effect should there be failure of the primary communication system. The most common method of communication is a telephone located near the field of play or practice/competition area or a cellular phone is another option if one is available. At any athletic venue, whether home or away, it is important to know the location of a workable telephone. Pre-arranged access to the phone should be established if it is not easily accessible to the field of play.

Emergency Equipment

Ems_equip2

All necessary emergency equipment should be at the site and quickly accessible. Personnel should be familiar with the function and operation of each type of emergency equipment. Equipment should be in good operating condition, and personnel must be trained in advance to use it properly. Emergency equipment should be checked on a regular basis and their use rehearsed by emergency personnel. The emergency equipment available should be appropriate for the level of training for the emergency medical providers. Creating an equipment inspection log book for continued inspection is strongly recommended. It is recommended that a few members of the emergency team be trained and responsible for the care of the equipment.


Ems_equip1

It is important to know the proper way to care for and store the equipment as well. Equipment should be stored in a clean and environmentally controlled area. It should be readily available when emergency situations arise.

Medical Emergency Transportation

Ems_activation

Emphasis is placed at having an ambulance on site at sports with high injury risks. EMS response time is additionally factored in when determining on site ambulance coverage. Ambulances may be coordinated on site for other special events/sports, such as major tournaments or championship events. Consideration is given to the capabilities of transportation service available (i.e., Basic Life Support or Advanced Life Support) and the equipment and level of trained personnel on board the ambulance. In the event that an ambulance is on site, there should be a designated location with rapid access to the field of play and a cleared route for entering/exiting the venue.

In the medical emergency evaluation, the primary survey assists the emergency care provider in identifying emergencies requiring critical intervention and in determining transport decisions. In an emergency situation, the athlete should be transported by ambulance, where the necessary staff and equipment is not available to deliver appropriate care. Emergency care providers should refrain from transporting unstable athletes in inappropriate vehicles such as personal cars. Care must be taken to ensure that the practice/competition areas are supervised should the emergency care provider leave the site in transporting the athlete.

Any emergency situations where there is impairment in level of consciousness (LOC), airway, breathing, or circulation (ABC) or there is neurovascular compromise should be considered a “load and go” situation and emphasis placed on rapid evaluation, treatment and transportation. It should be determined in advance which hospital will receive the athlete based on the condition of the athlete and strengths of each facility.

Non-Medical Emergencies

For the following non-medical emergencies: fire, bomb threats, severe weather and violent or criminal behavior, a plan should be developed for the evacuation and patient evaluation and treatment from related injuries. Close coordination should be developed between medical personnel and community base medical services.

Conclusion

The importance of being properly prepared when athletic emergencies arise cannot be stressed enough. An athlete’s survival may hinge on how well trained and prepared athletic healthcare providers are during the emergency. It is prudent to invest “ownership" in the emergency plan by involving the athletic administration/organization and sport coaches as well as sports medicine personnel in each aspect of the plan. The emergency plan should be reviewed at least once a year with all athletic personnel, along with CPR and first aid refresher training. Through development and implementation of the emergency plan will help ensure that the athlete will have the best care provided when an emergency situation does arise.

Final Approval

The final approval of the Emergency Action Plan should be reviewed and approved by the Medical Director of the team/association as well as related personal to include such positions as Director of Sports Medicine and/or the Emergency Medical Director for the team/association.