Emergency Action Plans
Introduction
Emergency situations may arise at anytime during athletic events. Expedient action must be taken in order to provide the best possible care to the athletes of emergency and/or life threatening conditions. The development and implementation of an emergency plan will help ensure that the best care will be provided.
Athletic organizations have a duty to develop an emergency plan that may be implemented immediately when necessary and to provide appropriate standards of health care to all sports participants. As athletic injuries may occur at any time and during any activity, the sports medicine team must be prepared. This preparation involves the formulation of an emergency plan, proper 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. Hopefully, through careful pre-participation physical screenings, adequate medical coverage, safe practice and training techniques and other safety avenues, some potential emergencies may be averted. However, accidents and injuries are inherent with sports participation, and proper preparation on the part of the sports medicine team will enable each emergency situation to be managed properly.
Components of the Emergency Plan
There are three basic components of this plan:
1. Emergency personnel
2. Emergency communication
3. Emergency equipment
With athletic association practice and competition, the first responder to an emergency situation is typically a member of the sports medicine staff, most commonly a certified athletic trainer. A team physician may not always be present at every organized practice or competition. The type and degree of sports medicine coverage for an athletic event may vary widely, based on such factors as the sport or activity, the setting, and the type of training or competition. The first responder in some instances may be a coach or other institutional personnel. Certification in cardiopulmonary resuscitation (CPR), first aid, prevention of disease transmission, and emergency plan review is required for all athletics 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; student athletic trainers; 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, the athletic venue itself, or other extenuating circumstances. There are four basic roles within the emergency team. The first and most important role is immediate care of the athlete. The most qualified individual on the scene should provide acute care in an emergency situation. Individuals with lower credentials should yield to those with more appropriate training. The second role, equipment retrieval, may be done by anyone on the emergency team who is familiar with the types and location of the specific equipment needed. Student athletic trainers, managers, and coaches are good choices for this role. The third role, 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 situation. 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. After EMS has been activated, the fourth role in the emergency team should be an individual who is responsible for meeting emergency medical personnel as they arrive at the site of the contest. Depending on the ease of access, this person should have keys to any locked gates or doors that may slow the arrival of medical personnel. A student athletic trainer, manager, or coach may be appropriate for this role.
Roles within the Emergency Team
1. Immediate care of the athlete 2. Emergency equipment retrieval
3. Activation of the Emergency Medical System
4. Direction of EMS to scene
Activating the EMS System
Making the Call:
• 9-1-1 (if available)
• telephone numbers for local police, fire department, and ambulance service
Providing Information:
• name, address, telephone number of the caller
• number of athletes
• condition of athlete(s)
• first aid treatment initiated by first responder
• specific directions as needed to locate the emergency scene
• other information as requested by dispatcher
When forming the emergency team, it is important to adapt the team to each situation or sport. It may be advantageous to have more than one individual assigned to each role. This allows the emergency team to function although certain members may not always be present.
Communication is the key to quick delivery of emergency care in athletic trauma situations. Athletic trainers and emergency medical personnel must work together to provide the best possible care to injured athletes. Communication prior to the event is a good way to establish boundaries 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 communications plan should be in effect should there be failure of the primary communication system. The most common method of communication is a public telephone. However, a cellular telephone is preferred if 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 telephone should be established if it is not easily accessible.
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 its use rehearsed by emergency personnel. The emergency equipment available should be appropriate for the level of training of the emergency medical providers.
It is important to know the proper way to care for and store equipment as well. Equipment should be stored in a clean and environmentally controlled area. It should be readily available when emergency situations arise.
AED Locations
- Baseball (Couch Ball Park): Mobile unit on site, unit in weight room and unit on concourse during games
- Basketball (Budd and Shah Gyms): Wall unit located on third floor in hallway just outside sports medicine room of Shah Gym
- Basketball (LJVM): Mobile unit on site or wall unit in back hallway near locker rooms
- Field Hockey (Kentner Stadium): Mobile unit on site or in Miller Center ATR
- Football (McCreary Field House): One unit located near drinking fountains and another unit located in opposite corner of end zone
- Football (Practice Fields): Mobile unit on site or in football storage shed
- Football (Truist Field): Multiple mobile units on site
- Golf (Haddock House): Unit located in lobby
- Soccer (Spry Stadium): Mobile unit on site or in sports medicine storage area
- Sports Performance Center: Unit located between Olympic sports and football weight rooms near elevator, unit located right outside basketball weight room
- Tennis: Indoor Center lobby
- Track: (Kentner Stadium): Mobile unit on site or in Miller Center ATR
- Volleyball (Reynolds Gym): Mobile unit on site or in hallway between gym and locker room
Transportation
Emphasis is placed at having an ambulance on site at high risk sporting events. EMS response time is additionally factored in when determining on site ambulance coverage. The athletic association coordinates on site ambulances for competition in football, soccer, and men's and women's basketball. Ambulances may be coordinated on site for other special events/sports, such as major tournaments or ACC/NCAA regional 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 site and a cleared route for entering/exiting the venue.
In the 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 available to deliver appropriate care. Emergency care providers should refrain from transporting unstable athletes in inappropriate vehicles. Care must be taken to ensure the activity areas remain supervised should the emergency care provider leave the site in transporting the athlete.
Wake Forest University Emergency Action Plans
• Lawrence Joel Veteran's Memorial Coliseum (Basketball)
• Kenneth D. Miller Center
• David Couch Baseball Park
• Davis Field
• Kentner Stadium (Field Hockey and Track and Field)
• Allegacy Federal Credit Union Stadium - Game Day (Football)
• Allegacy Federal Credit Union Stadium - non-game day
• Football Practice Fields
• McCreary Field House
• Dave Budd Basketball Practice Gym
• Sutton Sports Performance Center
• Shah Basketball Complex
• Haddock Golf House
• Leighton Tennis Stadium
• Indoor Tennis Center
• Reynolds Gymnasium (Volleyball)
• Cheerleading practice gym
• Dennie Spry Soccer Stadium
• Manchester Athletic Building
• Throws Field (Track and Field)
• Water Tower Field
• Poteat Field
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. It is prudent to invest athletic department "ownership" in the emergency plan by involving the athletic administration and sport coaches as well as sports medicine personnel. The emergency plan should be reviewed at least once a year with all athletic personnel, along with CPR and refresher training. Through development and implementation of the emergency plan, Wake Forest University helps ensure that the athlete will have the best care provided when an emergency situation does arise.
Acknowledgement
The following emergency plan template was developed by Ron Courson, Director of Sports Medicine, University of Georgia and the University of Georgia Sports Medicine Staff. This document follows the recommendations of individualized emergency plans for all athletics activities as noted in Section 11 of the NCAA Sports Medicine Handbook Guideline No. 1-A. Special acknowledgement to Scott G. Spernoga, ATC-L, for his assistance in the development of this document.