On-Field Examination and Care: An Emergency Checklist
abstract & commentary
Synopsis: A review of the basics of emergency evaluation and care of the conscious and unconscious athlete.
Source: Stuart MJ. Physician and Sportsmedicine 1998; 26(11):51-55.
Stuart provides an excellent, quick review of basic principles of emergency evaluation and care of the conscious and unconscious athlete and reminds us of the importance of adequate planning and preparation for emergencies, including establishing and practicing protocols and developing a mental checklist for assessing severe injuries. The latter should include ensuring an adequate airway, breathing, and circulation (the ABCs); determining the level of consciousness and mental status; and a quick assessment for additional injuries while summoning emergency transport personnel. Remember that all unconscious athletes should be treated as if they have a cervical spine injury.
Comment by Letha Y. Griffin, MD, PhD
The NCAA Committee on Competitive Safeguards and Medical Aspects of Sport recently encouraged member institutions to review emergency coverage at all sporting events, particularly emphasizing the need to designate a "responsible person" knowledgeable in first aid and CPR to cover out-of-season sport practices and skill instruction sessions where traditional medical coverage is not typically available. This individual should have immediate phone access for summoning additional help as well as a clear understanding of the procedures to follow if an emergency situation occurs.
Often physicians are asked to cover an athletic event at the last minute, and they arrive on the scene lacking equipment needed to remove athletic gear that could impede emergency evaluation and treatment (for example, tape shears to remove athletic tape and cutters to remove face masks on football helmets). Often they are without full knowledge of available emergency equipment, phone accessibility, and potential paths for evacuation of an acutely injured athlete (for example, can an ambulance access the sporting field?). It behooves us to always consider these essentials when covering an event and to make certain all is ready if an emergency should arise. Forgetting to check on such essentials may result in a preventable tragedy.
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