SPORTS FIRST AID
aid practice (2), it is unlikely that a civil action for alleged negligence in the application of first aid would succeed. By legal definition, correct first aid is that which is approved by the voluntary aid societies for publication in their manuals, where this is used in the training of the first aider. When dealing with children, notification of the need for first aid and the involvement of parents (or of those acting in locum parentis) is strongly advised at the earliest opportunity. However, contacting the next of kin should not delay first aid treatment, or the transfer of the casualty to hospital or to medical care.
The first aider should also be conversant with child protection law when working with minors (under 18 years in England, Wales and Northern Ireland, under 16 years in Scotland). A Criminal Record Disclosure check will be needed before accepting any appointment involving children. This can normally be obtained through the club or organisation concerned. I feel that this standard of care must involve knowledge of the risks involved in that particular sport eg. the consequences of a wrong throw and landing in a martial arts or what exactly (legally or otherwise) happens in a rugby scrum or line out.
The problem area On the wet Sunday morning the mini sports teams of under 16 year olds are out with coaches who have had their child protection checked and they have obtained sports specific coach- ing awards. Too often our future gold medallists and world champions are having ‘medical’ cover that does not understand the potential sports specific injuries with various sports moves and they are not getting the best immediate sports first aid care. Often the first aid does not exist at all. The voluntary first aid organisations are sometimes asked to help but they have to cover all types of events and are trained in generic first aid with generally no sports medicine specific. One of the most important elements of this is when athletes can return to play where erring on the side of caution is important on most occasions. Here is an example. A long jumper sustains a spike leg injury. It requires stitching but the athlete needs to make another jump in order to qualify for a major tournament or to be eligible for a lottery grant. The non sports specific first aid staff recommend removal from the event. Bang goes the grant. A suitably trained and experienced sport specific first aider however may decide to dress the wound to allow completion of the competition and stitch it afterwards. Most importantly they can clinically justify and know that they need to document their actions. The implications of unnecessary removal may be that an athlete may miss out on the qualifying event for major career changing event because of a small cut that could have been covered up to allow them to participate.
THE IDEAL FUTURE ■ Step 1 - Getting first aid cover into all sports training and
matches. Considering the recommendations in the Green book, this will be the standard by which the sports organisers will be judged in court.
■ Step 2 a. Train the first aiders in sports specific first aid or b. Train sports coaches in first aid in sport
■ Step 3 - Getting sports first aid trained coaches and parents who understand the sports and know what they can and cannot do immediate at all sports.
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SPORTS FIRST AID COURSES The costs of sports first aid courses Most first aid courses of 16 hours or more cost between £100-£400, but this is tiny compared with a lawyers fee or compensation claim and not much different to the costs of other sports equipment.
National sports first aid This course was originally developed and run under the auspices of the National Sports Medicine Institute in 1996 but since the demise of the NSMI, this course has been updated and is being run from the National Stadium in Glasgow. The course is accredited by the Faculty of Sport and Exercise Medicine, The Scottish Rugby Union, Scottish FA and several other governing bodies.
What are other governing bodies doing? The Football Association have run football specific sports first aid courses for many years. Several other governing bodies have been very proactive in the last 10 years in providing sports specific first aid training at higher levels of their sport and often open to the lowest club level (eg. rugby league and RFU). Other governing bodies have not been as active and appear to be waiting for a disaster to happen or until the lawyers force them to spend money training their staff.
CONCLUSIONS In my ideal world all coaches and referees would be conversant and up to date with sports first aid and not able to look after sport at any level without sports specific first aid knowledge, regularly updated. Before the lawyers force this it would be cheaper if all professionals and clubs and staff took this challenge on before more athletes are injured or die due to heads in the sand sporting historical views.
THE AUTHOR
Dr Jane Dunbar MBChB, FFSEM, Dip,sports Med, DRCOG, DTM&H began her medical career as a GP and 10 years ago made the decision to concentrate on sport and exercise medicine. She has worked with Team GB at two Olympic Games and two Commonwealth Games (most recently as head doctor with Scottish Commonwealth Games in Melbourne), at European Tour Golf events and in local sports injury clinics. Dr Dunbar also lectures through- out the UK in sport and exercise medicine and in the last couple of years has worked increasingly with the Ladies European Golf Tour events in the UK. She is also the author of the original National Sports Medicine Institute Sports First Aid course which has recently be updated and is now being run from the National Stadium in Glasgow as the National Sports First Aid Course.
References 1. Guide to Safety at Sports Grounds 4th edition. The Stationary Office ISBN 0113000952 2. National Sports First Aid Handbook by Dr Jane Dunbar ISBN 0952665727 3. Modern Law Review, 1990, p53.
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