Emergency Action Planning

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Emergency Action Planning
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Emergency Action Plan

• Emergency Care Plan (ECP) or Emergency Action
  Plan (EAP)
• A written document that defines the standard of
  care required in every conceivable event during
  an emergency on the practice or playing field
• Standard Operating Procedures must be explicit
• Scope of coverage must be specified
• Appropriate medical records must be identified
  prepared

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Emergency Action Plan

• Development of plan should be shared by essential
  medical non-medical personnel including
  athletic department, coaches, administrators
• This plan should minimize time the injured
  patient needs to enter the emergency care system.
• This plan should provide the certified athletic
  trainer with the guidance protection necessary
  to protect all members of sports medicine team
  against legal ramifications

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Standard Operating Procedures (SOP)

• Agreed-upon procedures that are carried out
  during the execution of an ECP/EAP
• Available resources dictate who will be involved
• Must have plan for each site in which the team
  will practice or have an event at
• Key Personnel
• Qualifications
• Roles
• Equipment
• Implementation
• Consistency
• Contacts

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Key Personnel

• Qualifications NCAA ACSM have published
  guidelines for ensuring that qualified
  individuals are available during an emergency
• NATA requires that all certified athletic
  trainers maintain CPR certification
• Non-certified students should also receive
  certification in basic or advanced first aid in
  order to increase their ability to function
  within the ECP
• Roles define the role of each member of the
  sports medicine team
• Members may assume different roles depending on
  site, specific skills, certifications
• Roles must be assigned prior to emergency

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Questions to Ponder

• Who will go onto the practice or event playing
  surface?
• How is the EMS activated?
• Where is the communication equipment?
• Who will provide crowd control?
• Who will complete the incident report that is
  thorough accurate?

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Equipment

• Appropriate equipment must be on hand to
  administer sufficient advanced life support
  techniques
• Types of equipment depend on
• Budget constraints
• Activity type
• Professionals preference
• Individual athletes needs
• Team physicians preference

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Equipment

• Everyone must know how to operate emergency
  equipment
• Avoids critical time loss
• Should be easily accessible
• Should be in good working order
• Types of equipment
• Backboard, splints, stethoscopes,
  sphygmomanometers (BP cuffs), blood-borne
  pathogen containers, oxygen, facemask cutters,
  one-way-valve pocket mask, AED, cellular phones,
  other communication, suctioning apparatus,
  physicians crash kit (IV bags, meds, syringes,
  needles)

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Implementation

• All personnel should know ECP/EAP well
• May want to provide each person with laminated
  card with pertinent emergency info for specific
  location
• Rehearse the plan a minimum of two times per year
• Can occur during in-service sessions
• Failure to carry out ECP/EAP can be catastrophic
  to the victim a liability to individuals
  involved!
• Share information with visiting athletic trainers
  (data book may be compiled)

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Consistency Contacts

• Check with departmental ECP/EAP for consistency
  with institutional ECP/EAP
• Make sure they are consistent
• Seek guidance from institutional legal medical
  representatives
• Check with team physician regarding emergency
  protocols
• Check with local EMTs regarding stabilization,
  transportation helmet removal
• Check with local hospital

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Writing the ECP

• THIS PLAN IS A NECESSITY!
• Outline of ECP/EAP (Rankin Ingersoll, 3rd ed.,
  p. 194)
• Materials
• First aid kit
• Appropriate medical forms
• Emergency care equipment
• Detailed maps of facilities
• Procedures
• Identify responsibilities of emergency care team
• Assign individuals to responsibilities
• Assign duties to responsibility
• Supervisor, emergency care provider, traffic
  controller, EMS contact, emergency vehicle

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Procedures

• Chain of command
• Team Physician
• Head Certified Athletic Trainer
• Assistant Certified Athletic Trainer(s)
• Athletic Training Student
• Emergency Medical Services
• Nurse
• Security Personnel
• Administrators

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Emergencies

• ECP/EAP is activated when main decision-maker
  determines emergency services should be summoned
• Life-threatening emergency RECEIVES PRIORITY!
• Non-life threatening emergency resources may be
  limited to stabilization until EMS arrives

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Guidelines for Contacting Emergency Assistance

• Identification
• Nature of emergency
• First aid implemented
• Directions
• Termination of phone call

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Notification of Parents

• The athletes parents must be contacted during an
  emergency when the athlete is a minor
• Actual Consent notification that permission is
  granted to give treatment for a particular
  incident
• May be given at prior time
• Minor Consent may apply when parents are not
  available or no consent is on file
• Implied Consent takes over when parents cannot
  be contacted

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Scope of Coverage

• a statement that will drive your functional
  goals which in turn formulates your entire
  medical operation Reiff, 1998
• A statement may be individualized to each site or
  all-inclusive
• Development of ECP/EAP should center on care of
  athletes (everyone else is secondary)
• Issues that may be included in the statement
• Budget constraints
• Number of spectators participants
• In out of season activities
• Indoor outdoor facilities
• Personnel available

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Records

• Fill out records completely on appropriate
  medical forms
• Make sure they are signed, dated, legible.
• Liability or Malpractice Insurance insurance
  that covers AT who is practicing their profession
  legally against liability awards to an injured
  party