Wondering how to improve training for non EMS responders like coaches and staff at parks and sports games.

Tonight we had an incident at a local recreation league. The kids are playing basketball and we had a 13 year old go up for a rebound and got pushed very hard and twisted upside down landing on his head.. I knew immediately that we had a situation on our hands. The child never got up from the fall..
I stabilized the neck and tried to keep his as still as possible. He had minor blood loss from the back of the head. As I was holding his head, I also put light compress on the head to control the bleeding. I asked all the park staff for Ice packs and any kind of neck collar...Nothing..I felt really helpless at this point. I knew we had a trauma on our hands. 911 was called and it felt like forever before help got there. Response was over 10 min..and they were in no hurry when they arrived..
Finally got a brace on the neck and on the board. At this point no feeling in the legs and severe pain in the entire back. Periods of blacking out and no knowledge of who, where or what happened, minor convulsing of arms and legs.
Now, I am really wondering why no training is given or supplies on hand for basic first aid? This was a serious incident and it really woke me up as to how unsafe it is to have our children and youth playing recreational sports..
What if a person had a heart attack? Heat stroke? Head injury..Time is so important..
This needs to change...

I pray for my sons friend and hope that he is ok. He was taken to Hershey Med Trauma Center. No word yet. I will keep you posted..

pj

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Comment by Mike Schlags (Captain Busy) Retd on July 1, 2009 at 3:58pm
Not to be redundant here but, here's your basic lesson plan outline as to what to teach your parents, coaches and teachers... (in my humble opinion...)

A - Airway
B - Breathing
C - Circulation / C-Spine
D - Delegate someone to call 911 and someone needs to be in charge. Determine who this is before an incident, not during an incident.
E - EMS Pre-Arrival (people staged at specific locations to direct emergency personnel to the scene)
F - Forms (all students should have some sort of medical record available at the event and one duplicate copy for each to enable providing a written copy of the students emergency contact and medical information for use by the EMS folks and the hospital.
G - Go To The
H - Hospital... : )
I - Injury Prevention Forms and Documentation / This may include developing forms to both document what happened as well as make note of witnesses in the event that a civil or other type of litigative issue arrises down the road...

Failure to prepare is preparing for failure, so make sure folks do their home work and preplanning in advance an as soon as possible. With the above outline, you should be able to come up with some Standard Operating Guidelines for your events, kind of like an Incident Action Plan. When in doubt, copy the ICS flowchart and change the names around to meet your needs. This way, people know, in writing, what is expected of them and you will have a better response from parents. This program can eventually include actual hands on training once you network with the local EMS agency, school officials and EMS responders. Training can include a course in high school called Sports Medicine. My daughter just graduated from high school and took this course her last semester. They were trained in C-Spine stabilization, CPR, and other common emergencies in addition to sports medicine related issues.

Treat this as a long term problem with achievable goals such as...

Short Term Goals - Develop SOG on one-piece of paper, get buy in from teachers, school nurse, EMS folks, coaches, etc. Pass the draft SOG along via email to all the players, Get comments from all and you will get your needed buy in.

Mid Range Goals - Arrange organized training, taking advantage of local resources such as the Red Cross or FEMA's CERT Program. Use the media to attract parents interested in taking training that could save their child's life... Be careful what you wish for, you may end up with too much interest and will be forced to be selective. You may want to anticipate this and qualify the selection to those folks with training or medical backgrounds (like a medic with time in the military for example, nurses, doctors, etc.

Long Term Goals - Develop an ICS flow chart, modify it to include things like coaches, staff, etc. Regardless, someone is the Incident Commander, and that person needs a command staff (FLOP) or Finance, Logistics, Operations and Planning. Once the flow chart is developed, then you can again copy the format and put in writing what each position is responsible for. This can be as simple as making sure someone is assigned to call 911, someone else to coordinate directing the ambulance and fire engine to the scene and designated folks to attend to the injured student.

Finally, you might have noted that I used the term SOG verses SOP or Standard Operating Procedure. The use of the term guideline is a lot less restrictive should you find yourself defending your actions in court.

Good luck, CB
Comment by Steven on July 1, 2009 at 2:55pm
I'm a youth soccer coach. I'm also an EMT and I have a "jump bag" in my car with basic first aid stuff plus a BP cuff, stethescope, SAM splints and water for wound irrigation and a pocket NRB mask.
Last year I carried it to the field for every game. Never used it. This year I keep it in my car which is close to the field. There are at least half a dozen other firefighter/soccer parents on the field at any given moment during games which is really nice. My only concern is getting a "bus" through the log jammed parking lot for a serious injury.

First aid is as much as you can expect at community parks and the like. Organized leagues should make first aid training available and/or ask for EMS standby. I've seen people get hurt in adult leagues too, even heard of an off-duty medic take a softball to the nose while playing.

In an ideal world, there would be an ambulance on the field for every game and they'd never be put into service.....

Common sense: Any injury to the head or trunk, kept the victim still at least, c-spine precautions if you know how. If it's bleeding, cover it, if it's broken, keep it still. Cold packs (or ice) are good for heat related emergencies but no fluids.

Everyone should know CPR and what to do for the guy choking on a piece of hot dog and in this day and age of cellphones, a 911 call is practically on everyone's hip.
Comment by Nick Anderson on July 1, 2009 at 3:06am
I agree that it would never work to try and train coaches to a first responder/basic level and with the economy the way it is getting the equipment would be a whole other issue. I would reccomend giving the ambulance company a call. Here they have various points throughout the city where they stage when they aren't on a call. Maybe they could make the park one of their staging areas. There wouldn't be coverage there all the time, but it would be better than nothing, and maybe just a starting place to work towards more coverage.
Comment by Patrick J Cronen on June 30, 2009 at 11:17pm
Wow really good suggestions from all. Thank you so much. I have a few calls to Township adm, and Ems to see if we can meet and get them to stand by at the park. I think at this point in the season this is the easiest and most effectice solution..
To get parents together and trained this late would be tough..plus I need to spark the interest in the ones who were not present and scared to death the other night..
I agree totally about training and the turnover of parents and coaches..That will be a battle if we go that direction.
You are also very correct about caring parents and possibly doing the wrong thing with all the best intentions.. I am glad this situation just worked out well. Now, to get something done before the next incident, We all know its going to happen so we need to be prepared..
Thanks again for all the good suggestion. This site is awesone..
pj
Comment by Mike Schlags (Captain Busy) Retd on June 30, 2009 at 8:07pm
sounds to me like you need to do the following:

1. invite the local ambulance to standby at the game(s)
2. invite whoever provides EMS services, including the fire department to demonstrate to a group of interested parents, coaches, students, what exactly it is that we do and arrange for some red cross orientated training that comes with a certification card.
3. this sure sounds like a community that could use CERT training, consider this as a long term goal
4. you have to be really careful to get the tools to do the job and not have folks trained to use them, talk about a lawsuit ready to happen, it's not uncommon to have someone who really cares get chewed up by the system, by making sure that 911 is called immediately and keeping the victim from hurting themselves before arrival of the medics is the priority.
Comment by FETC on June 30, 2009 at 7:23pm
Backboards and collars are beyond the first aid training of any coach. Take in the numbers and the turnover of coaches and that adds up to equipment without proper training. Besides if done wrong it may cause more injury to the victim. Even if they or you boarded him correctly what if the victim decides to now vomit? Is that equipment cache going to have a suction unit too?

Your still gonna wait for the bus to arrive for some equipment. Manual c-spine stabilization and bleeding control was the "best" care given at the right time. Good for you Patrick!
Comment by Patrick J Cronen on June 30, 2009 at 2:58pm
Just wanted to follow up on the injury..The child had a sever Concusion.He was kept overnight at Hershey and sent home with follow up scheduled for 2 days..

This Township activity has 15 BASKETBALL games and Baseball not sure how many and 5 Vollyball games per night. The park at any time has close to 800 people in it..
There is a pool also but that is seperate from the actual park...Just feel more need for safety,
Thanks for the kind words..
pj
Comment by Patrick J Cronen on June 30, 2009 at 12:43am
we have no no requirement here for coaching. No first aid or anything..My theory on the collars and boards are to have some first responders on the field..I was not aware but this is the 4th time in 2 weeks that the ambulance was called to the field..Not sure of the other injuries..I just think they should be closer. It seemed like forever until help arrived tonight..
Our tee ball just has band aids and ice packs..just verified..
Comment by Jay Nicholson on June 29, 2009 at 9:53pm
For the most part, organized youth sports have some sort of basic first aid requirement for their coaches/staff. We even have a Little League around here that was able to obtain some AEDs for their field. But I have yet to see c-collars or backboards at any field I've ever been too. The difference between basic first aid, EMT level and paramedic level.

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