AFL Emergency Response Coordinator (ERC) Fundamentals

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May 4, 2018
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AFL Emergency Response Coordinator (ERC) Fundamentals

Emergency Response Coordinator Fundamentals

Colbrow Medics in conjunction with the AFL have been training hundreds of parents with essential skills to manage emergencies in community football. To book a course, contact operations@colbrowmedics.com.

The key fundamentals of the Emergency Response Coordinator (ERC) include:

 

Role of the ERC:

1. Understand and implement emergency management procedures including:
Ensure unobstructed entrance for emergency vehicles (gate unlocked and nil parked cars)
Designate person to meet ambulance at street entrance and direct to casualty
Be aware of location of defibrillator, spine board & oxygen
Know the street address of the venue
Emergency planning
Be aware of underlying health conditions of children on own football team

2. Provide immediate assessment and management of acute on field injuries and medical emergencies including:
Soft tissue injures
Concussion
CPR
Running onto field
On field communication
Calling 000
Transporting injured patients off field
Calling off the game if necessary

Have basic knowledge of first aid and administration of salbutamol using a spacer and other common medications children may be taking

Communication – on and off the field

Signals – Stretcher: Two arms raised straight overhead
Blood rule: Two arms raised overhead and crossed over
Defibrillator: Two arms crossed over chest then brought straight down & continued over
Medic required on field: One arm raised straight overhead

Teamwork – Knowledge of preexisting injuries, general health of players, and communicating between players, parents / guardians, coaches and umpires.

 

Soft Tissue Injuries

Damage to any muscle, tendon, ligament or surface tissue caused by strain, sprain or overuse. Assess injuries using STOP and TOTAPS acronyms

STOP
Stop – Stop the player to avoid further injury and to allow for thorough investigation
Talk – Ask the player questions surrounding the injury
Observe – Observe the affected limb, being careful to compare with the unaffected limb whilst also noting the demeanor of the patient
Prevent – Prevent further injury through the activation of RICER technique

TOTAPS
Talk – Talk to the player and ask questions about what has occurred
Observe – Observe the site of injury and compare with unaffected limb. Observe the distress level of player
Touch – Touch the injury noting irregularity, pain, and heat
Active Movement – Have the player move the injured limb and observe ability to use
Passive Movement – Move the players injured limb yourself observing rotation, flexion and extension ability
Skills – Instruct patient to perform skills that mimic those used on the game (running back and forward, jumping, hopping, side to side movements, ball catching)

RICER
Rest – Have the patient stop play and rest – sleep is the best form of rest.
Ice – Ice for 20 mins every 2-3 hours over 24 – 48 hours to cool the tissue and minimize bleeding and swelling. Be careful to use a cloth to avoid burning the skin.
Compression – use a compression bandage to decrease swelling
Elevation – position the limb above the heart (eg. lying down with leg up) to decrease blood flow and therefore swelling to the area
Referral – refer patient to local physio or most relevant health professional for advice on treatment

Be mindful to avoid HARM
Heat
Alcohol
Running
Massage

 

Concussion

Concussion is traumatic brain injury which can be cumulative if not treated effectively. If there is ANY chance a player might be concussed they must be taken off the field and must NOT return to play until cleared by a medical professional.

http://www.afl.com.au/afleducation/concussion

Signs and symptoms
Brief loss of consciousness
Seizure / convulsions
Dizziness
Lethargy
Nausea / vomiting
Short term memory loss
Headache
Confusion
Loss of coordination
Slurred speech
Irritability
Unequal pupils

What questions to ask a player with suspected concussion:
Where are you today?
What day is it?
Which team are you playing for?
Which quarter are we in?
Do you have any of the above signs and symptoms?

Comfort and reassure the patient. If you are unable to move the patient consider blankets or warm jumpers in winter. Monitor patient continually (5 mins) checking for deterioration. Medical advice should always be sought ASAP. Serious signs and symptoms can develop later indicating serious concussion or fractured skull.

 

Suspected Spinal Injury

Be aware of mechanism of injury:
Fall from height
Collision / whiplash
Sporting incident
Signs and symptoms (assess using head to toe assessment):
Altered sensations (usually in extremities)
Neck / back pain
Irregular lumps / bumps in spine or back
Breathing difficulties

**An unconscious patient must always be suspected of having a spinal injury due to their inability to communicate**

Management of suspected spinal injury
D.R.A.B.C.D
Dangers – Response – Airway – Breathing – CPR – Defibrillation
Call 000
Do not move the patient
Support head, neck and shoulders
Rest, reassure and keep patient warm if necessary

**Airway management takes priority over any other injuries**

 

Blood Rule

Player with any active bleeding (blood nose, cut) cannot be treated on the ground. Affected player must leave play immediately to be treated off side.
Player must not return to play until:
Bleeding has been abated
Injury securely bound
Blood stained clothing washed
Blood on player cleaned off
**Remember to wear protective gloves**
Patients experiencing nosebleeds should not return to play until 20 minutes after bleeding has stopped. Returning to play will increase body temperature, which may cause bleeding to begin again shortly after.

 

Transporting Injured Players

Remember both player and staff safety. Communicate with the umpire and check for DANGERS:
Ball play
Players running
Wet and slippery grass
Muddy grounds

Teamwork – KNOW YOUR ROLE – and be clear with delegation
Plan the route prior to moving a patient
Activate emergency response (000) if necessary
Don’t rush – remain calm and organized while waiting for the ambulance if arranged

One person crutch: player assistance from one person
Two person crutch: player assistance from two people (able to weight bare in one leg)
Stretcher: trainer directing lift from head using 2 or preferably 3 assistants on each side of stretcher (player unable to weight bare)

*Do not attempt to carry a patient who is unable to weight bare without using a stretcher

 

Teamwork
On and off field with players, coaches, guardians
Everyone must know their game day role
Share information with medical staff and coaches
Follow up with player injuries throughout the week
Trainers must request return to play documents from patient’s medical professionals before child is clear to play future games
Refer patients to health professionals (medic on duty, physio, GP, emergency department, concussion specialist)

 

Paperwork

Maintain thorough and succinct paperwork taking note of what you saw and did, advice and handover you gave to patient / guardian. Refrain from detailing in first person what others saw or told you.
Important to have a history of patient’s underlying issues.

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