Emergency Procedures &

Primary Care in Physical Therapy

ORGANIZATION AND ADMINISTRATION

OF EMERGENCY CARE

NIPRM
Lecturer @ NIPRM

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 ORGANIZATION AND ADMINISTRATION
OF EMERGENCY CARE
Outline
• Develop and implement emergency action plan
• Emergency Team
• Initial patient assessment and care
• Emergency communication
• Emergency equipment and supplies
• Venue location
• Emergency transportation
• Emergency care facilities
• Legal need and documentation
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 Develop and Implement an Emergency
Action Plan (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.
• Emergency action plans should be developed
by organizational or institutional personnel in
consultation with local emergency medical
services.
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 Develop and Implement an Emergency
Action Plan (EAP)
• Once developed, the EAP is implemented
through documentation of the plan, education
of those involved, and frequent rehearsal of
the plan itself.
• 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.
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 Develop and Implement an Emergency
Action Plan (EAP)
• 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

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 Develop and Implement an Emergency
Action Plan (EAP)
• 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.

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Develop and Implement an Emergency
Action Plan (EAP)

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 Emergency Team
• The implementation of an EAP cannot take
place without the formation of an emergency
team.
• During an emergency the makeup of the
emergency team can vary depending on who
is at the scene at the time of the emergency.
• A first responder is defined as a person who
has been trained to provide emergency care
before EMS arrives on the scene.
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 Emergency Team
• Any member of the emergency team can act
as a first responder
• 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 (blood
borne pathogens)

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Emergency Team

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 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 venue that is being used,
and the preferences of the athletic trainer (who is
usually in charge of executing the EAP).

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 13
 Emergency Team
• The first and most important role involves the
immediate care of the injured athlete. The most
qualified individual on the scene is usually the
athletic trainer or team physician, either or both of
whom should provide acute care in an emergency
situation.
• Emergency equipment retrieval may be performed
by a person on the emergency team who is familiar
with the names and locations of the specific
equipment that is required. Athletic training students
would fit this role nicely.
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 Emergency Team
• All necessary emergency equipment should be
on site, in good condition, and easily
accessible. Examples of emergency equipment
include splints, spine board, bag valve mask,
an AED device, first aid kit, and cell phone.
• Activation of the EMS system is a priority
where emergency transportation is not
already present at the location of the
emergency.
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 Emergency Team
• If EMS is not at the scene, the system should be
activated as soon as the situation is deemed to be
an emergency.
• The person chosen for this role, such as a team
coach, should be someone who is calm under
pressure and who can communicate well over the
telephone.
• This person should be able to communicate the
nature of the emergency and the location of the
emergency with specific directions to the venue.
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 Emergency Team
• The emergency team should designate an
individual to be in charge of opening any
locked gates or doors and directing the local
EMS to the scene of the emergency.
• An appropriate person for this responsibility
would be an equipment manager because he
or she typically is responsible for keys to
locked gates or doors around the playing
areas.
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 Emergency Team
• When assembling the emergency team, it is
important to prepare each member of the
team to adopt any of the emergency role
situations.
• It may be a good idea to have more than one
individual assigned to each of the four roles.
• This allows the emergency team to function
without delay in the event that some
members are not present.
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 Initial Patient Care and Assessment
• 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.

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 Initial Patient Care and Assessment
• All emergency team members need to have
appropriate protection from bloodborne
pathogens while taking care of any injured person.
• Such articles of protection might include latex
gloves and protective eyewear.
• Proper clean up of bodily fluids, such as blood or
vomits, and disposal of contaminated articles in
biohazard containers or bags must be done as part
of the proper management of any emergency
situation.
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 Emergency Communication
• Communication is the key to quick and effective
delivery of emergency care in any athletic
trauma situation.
• Athletic trainers, other emergency team
members, and EMS personnel must work
together to provide the best possible care for
injured athletes.
• A backup communications plan should be in
effect on failure of the primary communication
system.
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 Emergency Communication
• A list of all appropriate emergency numbers, such
as local emergency medical services, should be
posted.
• Specific directions to on-site venues should also be
included and posted with the emergency numbers.
• Directions should include the actual street address
of the venue, main road, secondary road, and other
landmark information that will assist EMS personnel
in arriving at the scene as soon as possible.

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Emergency Communication

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Emergency Communication

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 Emergency Equipment and Supplies
• 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

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 Emergency Equipment and Supplies
• The middle of an emergency situation is not the
time to find out that a piece of emergency
equipment is missing or is not working.
• Each emergency team member must be trained in
advance in how to use all first aid equipment and
supplies.
• 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.
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Emergency Equipment and Supplies

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 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.

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 Venue
Location

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 Emergency Transportation
• The EAP should include a policy for transportation of
the sick and injured for all athletic events. By
definition, an emergency dictates that transport
should be via EMS vehicles (ambulance).
• 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.

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 Emergency Transportation
• In some cases, the number of spectators who are
expected to attend an event may warrant the
presence of one or more ambulances on site, even
if the sport is not considered collision or high risk in
nature.
• Although spectators typically are not the
responsibility of the sports medicine team, this
point should be clear with administrators. If the
team’s medical staff is also responsible for the care
of spectators, staffing for the event and the EAP
itself must reflect this fact.
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 Emergency Care Facilities
• The EAP should include information regarding the
transportation directions to an emergency
medical facility from all athletic venues.
• When selecting an appropriate emergency care
facility, consider the proximity to the venues and
the level of care available at the facility.
• An 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.
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 Legal Need and Documentation
• Several legal cases have supported the need for written EAPs,
the most prominent of which is Kleinknecht vs. Gettysburg
College.12 As part of the 1993 decision, the court stated that
Gettysburg College owed a duty to all its recruited athletes
and that the college must provide “prompt and adequate
emergency services while athletes were engaged in school-
sponsored intercollegiate athletic activities.”12 The same
court also ruled that reasonable measures must be ensured
and in place to provide adequate and prompt treatment in
any emergency situation. It can be concluded from this ruling
that planning is critical to ensure that athletes get proper
emergency care,which further reinforces the need for a
written EAP as a requirement for all athletic organizations.
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 Legal Need and Documentation
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.
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 Legal Need and Documentation
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.

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HIGHLIGHTS

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