Program and Facility Emergencies in Youth Sports, Part II: Dealing with the Event

Communication
plays an integral role in the prevention of youth sport injuries, as the
evidence in Part I of this paper suggested. Communication regarding
expectations, policy and procedures, and post-injury protocol can facilitate a
safe youth sport environment. However, preventing youth sport injuries also
involves several other areas, such as protective equipment, strength and
cardiovascular conditioning, environmental and facility management, proper
coaching, and proper nutrition and hydration. According to the American College
of Sports Medicine (1993), 50% of injuries that occur in children and
adolescents are preventable. Even when steps are taken to ensure safe
participation in youth sport programs, however, injuries will happen; what happens
before, during, and after an emergency can make the difference in the eventual outcome
of injuries.

Dealing with
emergencies in youth sport requires sufficient preparation and planning to
ensure prompt resolution of the event. Prevention measures preclude injury or
have the potential to reduce the severity of injuries and should thus be
considered most effective (Roberts, 1998). League administrators and youth
coaches must ask and answer several questions: Who is the most qualified
individual to treat injuries? Are the persons dealing with the emergencies
adequately prepared for a variety of emergency situations? Are coaches properly
trained to coach? Are there mechanisms in place for prompt medical care? Coming
prepared with this kind of information prior to any emergency can promote
optimal medical care and prevent litigation.

Coach and Parent Education

To make decisions
in answer to the questions just reviewed, league administrators must understand
the qualifications of coaches. The National Association of Sports and Physical
Education (NASPE) has developed standards of fundamental competency that
communities, school systems, private leagues, parents, and athletes should require
of coaches. League administrators and parents are responsible for ensuring that
youth coaches are appropriately qualified to supervise the sport in question and
to maintain a safe playing area and environment. Moreover, coaches should be
required to complete (at a minimum) a community course in first aid and CPR;
there are several sport safety courses available as well that are recommended
for all youth coaches.

A critical
component of caring for an injured athlete is familiarity with the medical
history and condition of the athlete. Before activity commences in any sport, each
athlete should undergo a pre-participation physical examination. This examination
should be required of all athletes prior to participation and should be
comprehensive. Necessary checks include a medical physical to assess heart and
lung function; a medical history to identify any pre-existing problems and
family health history; a musculoskeletal examination assessing alignment,
strength, flexibility, and laxity; a “vitals” examination ensuring heart rate,
blood pressure, height, and weight are appropriate for the individual; body
composition assessment; vision screening; and finally, a sport performance
assessment
determining whether the individual’s cardiovascular condition
and strength are appropriate for the anticipated exertion.

First Aid Equipment

In addition to
familiarity with each athlete’s health status, it is also key to have
appropriate emergency medical supplies available. Most youth leagues provide
first aid kits or small athletic trainer kits for each team. When preparing a
kit for a team in a given sport, it is crucial to plan for a broad scope of
needs, stocking the kit properly to address all of them. Kits must be prepared before
each practice or contest in order to be of reliable use. Having the correct
supplies could be the difference in delivering essential care to an injured
athlete appropriately.

Although a wide
variety of first aid supplies can be helpful depending on the sport, there are
items of common value across sports. Key items include the following:

  1. information such as phone
    numbers, release forms, and emergency cards (as well as paper and pen)
  2. instruments including paramedic
    scissors, tape cutters, tweezers, fingernail clippers, fingernail files,
    and a microshield or CPR mask
  3. bandages and related supplies including
    athletic tape, tape adherent, underwrap, elastic tape, band-aids, gauze
    pads, ace wraps, and petroleum jelly
  4. splinting supplies including slings,
    safety pins, finger splints and other splints, and crutches
  5. eye care kit including contact
    solution, contact case, saline, and a pocket mirror
  6. miscellaneous items including
    rubber gloves, antiseptic cleaning solution, insect repellent, water
    bottles, ice chests and/or coolers, tongue blades, and felt or foam
    padding material

This list is not exhaustive but it provides
the foundation of a well-stocked sport first aid kit. In some sports, kits may
need to be augmented with items such as mouth pieces, nose plugs, analgesic rub,
hand cream, sun glare, and feminine hygiene products. Organization of the kit
is important in emergency situations when first aid must be provided quickly.
Similar items should be stored in the same area of the kit; there should be
nothing unnecessary in the kit obscuring needed items that need to be located
quickly following an injury.

Administrators and
supervising coaches must make certain that each youth coach is qualified to use
and comfortable in using all first aid kit supplies. A general rule is not to
pack in the kit any supply with which the coach or coaches are uncomfortable.
It is important to designate one person to maintain the first aid kit and order,
as needed, items replenishing the kit’s supply.

Although they can
be expensive, first aid kits are highly recommended for all youth sport
programs. League commissioners typically determine who purchases kits and supplies
to stock them. When there is no funding for emergency medical supplies, asking
health care facilities and drug stores to donate supplies is a potential
course; firefighting and other emergency departments may also be willing to
help. League administrators and/or coaches are ultimately responsible for
providing players with the best possible first aid should they be injured; the
expense of good first aid kits is, ultimately, relative.

After an Injury

Providing care is a
top priority in an emergency. Care can be provided best and most quickly when
those involved remain calm while activating appropriate medical assistance. When
a young athlete may be injured, it must always be remembered that nothing less
than his or her well-being is at stake. It is therefore better to err on the side
of cautiousness, when in doubt about the injury or first aid, by seeking
additional medical assistance immediately. It should also be remembered that
children’s and adolescents’ bodies are distinct from the adult’s and cannot
always be treated in the same way. Therefore, it is always recommended that a
young athlete seek medical attention from a physician for any injury that does
not improve in a short period.

Fortunately, most
injuries in youth sports are not complicated and can be resolved with little
medical intervention. Often, the best approach is what has been called, for
ease of memory, RICE, which stands for rest, ice, compression,
and elevation. Rest the injured area by supporting it with a sling, splint,
or crutches. Ice the injury for approximately 20 min at a time. Compress the
area with an elastic bandage to control swelling. Finally, elevate the area
above the level of the heart, also to manage swelling. These steps comprise a standard
and long-advocated treatment for many sport injuries.

When an emergency
has occurred and first aid has been rendered, notification of certain
individuals becomes necessary, when those individuals are not present at the
sport facility. Again, parent phone numbers and the league commissioner’s phone
number, along with emergency numbers, should be kept easily available in the
front of the first aid kit. It is also recommended that useful emergency information
is provided as a courtesy to each visiting team, for example on a reference
card. Having access to emergency numbers and directions to nearby hospitals is
greatly appreciated by teams unfamiliar with an area.

Conclusion

All sports pose
some injury risk. While coaches and administrators should make every effort to
keep that risk as low as possible, they must also ensure that appropriate care
is available in the event an injury does occur. Injury-prevention programs are
advocated by the American Academy of Orthopaedic Surgeons and are readily
available to the general public (Purvis & Burke, 2001). Completing the programs
can help prepare youth coaches to manage emergency situations. Furthermore,
youth sports leagues are well advised to maintain a written emergency plan that
staff know how to implement. The plan should be reviewed yearly by league
officials, coaches, parents, and care providers from the local community’s emergency
medical service. It is important that this plan be reviewed yearly due to the
typically high number of changes in coaching staff each year.

References

American
College of Sports Medicine (1993). The prevention of sports injuries of
children and adolescents. Medicine and Science in Sports Exercise, 25(8),
1–7.

National
Association of Sport and Physical Education. National standards for athletic
coaches.
Reston, VA: Author.

Purvis,
J. M., & Burke, R. G. (2001). Recreational injuries in children: Incidence
and prevention. Journal of the American Academy of Orthopedic Surgeons, 9(6),
365–374.

Roberts,
W. O. (1998). Keeping sports safe: Physicians should take the lead. The
Physician and Sports Medicine, 26
(5).

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