WHY SPORTS FIRST AID?

FIGURE 2: SPECTATOR FIRST AID REQUIREMENTS No spectators Less than 2,000 2,000 to 5,000 More than 5,000

First aiders

1 per 1,000 (min.2) 1 per 1,000 (min.2) 1 per 1,000 (min.5)

Facilities Doctors

First aid room (1 x 15 sq.m.) 1 x rapid on call First aid room (1 x 15 sq.m.) 1+ rooms inc. beds

1 x on-site 1 x specialist

Table 1: Spectators - arrangements for events Note: Spectator arrangements are IN ADDITION to the arrangements for the sports participants.

doctors but the equivalent need for specialist sports first aid cover is often not reflected at lower levels of sport.

Injuries in sport are not exclusive to international events, so why are sports organisers, managers and coaches still too often not prepared to spend the money to look after their athletes optimally and risk large law suits? An 11 year old mountain biker can sustain a life threatening head or neck injury at an international downhill championship or recreationally on the many off road forest tracks where local competitions are held. Sadly often change only comes about after legal cases with resulting costs. Below are some example scenarios which have or could happen.

FIRST AID FACILITIES Any sport that involves vigorous exercise and/or is attended by spectators may require first aid for injury/illness in athletes or spectators. Most sports involve an element of risk, but if the risk factors are accurately identified and assessed, appropriate action can be taken to minimise these. Indeed, risk assessment may be a condition for any insurance cover. In UK sports, recommendations for medical cover were updated following the Hillsborough disaster and Lord Justice Taylor’s report. In 1997 the

SCENARIOS - CONSIDER THESE

Scenario 1 - Neck injury A 13 year old rugby player, who has been identified as an exceptionally talented player with future international potential, is playing on an outer training pitch at school and gets caught by an accidental high arm tackle. He sustains a very sore neck but none of the parents helping that day know what to do and try and walk him back to the cars half a mile away. On the way back he slips on the wet slope banging his head and what had been an unstable neck fracture with no neurological deficit is converted to a catastrophic spinal cord injury with resultant paralysis…just because the significance of a high arm tackle and a sore neck were not recognised by well meaning personnel without sports first aid knowledge. He and his parents sue the school and the volunteer parent.

Scenario 2 - Head injury Another scenario is the head injury, unconscious, with airway obstructed who sustains brain damage due to lack of oxygen to the brain for want of simple immediate airway opening by a competent sports first aider.

Scenario 3 - Knee injury A twisting knee injury at judo that swells immediately but the athlete feels they can fully weight bare and has a full range of movement. The athlete is allowed to fight the next bout without a full assessment….but what was a straight isolated knee ligament rupture should not be ignored. If the athlete continues, the knee may give way resulting in the athlete overbalancing and sustaining more serious neck and shoulder injuries. The organisers of the event may find themselves in court, but worse still the athlete’s future international career ruined.

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"Guide to Safety at Sports Grounds" (known as the Green Guide) was published (1). It includes recommended medical cover for crowds and athletes at all levels of sports (see Table 1). Although it is most applicable to stadium or pitch-based activities rather than cross country, off road biking or golf events spread over a large area. Despite the fact that this guidebook was written before sport and exercise medicine became a recognised medical speciality, if things do go wrong these recommendations are probably the main reference that lawyers will use to define negligence of the club or sports organisers and their medical cover.

Duty of care When contracted by a sports club, the first aider has assumed the duty of care for their athletes. (By contrast the duty of care if you find a casualty lying on the street only starts if you start assessment of the casualty). The first aider must therefore understand the sports and all the facilities there. This is best done by someone both involved in the sport and with an appropriate level of first aid qualification.

Standard of care If first aiders practice their skills in accordance with accepted first

1 fully equipped Ambulance