Commentary

Your crucial preseason checklist -- first-aid kit and emergency action plan

With the spring season underway, this is the perfect time to make sure you've got the first-aid kit in order -- and have prepared an Emergency Action Plan (EAP).

Your First Aid Kit

Every youth coach should have a very basic sideline first-aid kit. You should have this at each training session and game. Remember that this is not meant to be used for comprehensive treatment, but only for immediate sideline first aid. The supplies below should get you through almost any minor to moderate situation and are easily obtained from your local drug store. (One of the most essential items is your cellular phone. If you have any doubts about the severity of the medical situation, use your phone to call the local emergency medical personnel for help.)

The absolute bare minimum supplies:
Instant cold packs (have several of these!).
Adhesive bandages of assorted shapes and sizes.
Blister care.
ACE bandages (3-inch and 4-inch sizes).
Disposable non-latex gloves (use when you are looking at a cut or abrasion).
Alcohol-based gel hand sanitizer (for your own hands).
Antibiotic ointment (individual packets or a tube of Bacitracin works well).
Sterile gauze bandages.
Sterile gauze roll.
Sterile saline bottle (to gently wash dirt or grass from a cut).
Saline rinse bottle and Hibiclens bottle (very effective and not painful to clean an abrasion or cut).
Athletic tape (1-inch and 2-inch sizes).
Paramedic scissors.
Hydrogen peroxide -- to get blood off a uniform.
Plastic bags to dispose of used gauze, etc.

Here are a few extras that are nice to have:
Foam underwrap.
Finger splints (popsicle sticks work well).
CPR instructions and plastic ventilation mask.
Watertight bags to keep items dry.

Packing it up:
Keep your supplies in a brightly colored bag (red is a popular color for this) so that you can find it quickly.

Your Emergency Action Plan (EAP)

The Emergency Action Plan (EAP) is a written set of systems and processes that are followed if a serious health or environmental condition occurs.

By having a plan and rehearsing it ahead of the season it gives an organization the best possible chance that appropriate steps are taken to address the situation. This is an area that is often neglected, even at the high school level where state laws might require that schools have and rehearse a plan. When something happens, you absolutely don’t want to be panicking thinking of “what do we do now” scenarios.

The club or recreational team

I wouldn’t expect a club or rec team to have a formal written plan, but there are three things that come to mind that will really help you a lot.

Have a first aid kit! This is a simple thing and I find that it’s rare that teams actually have basic first aid supplies (see above).

If you travel to an away game or tournament, enter the local emergency service number ahead of time into your mobile. This would be a good thing for a team manager to do. The local number will often be faster than calling 911.

Coaches and managers should be trained in basic injury recognition.

Club directors and tournament organizers

Requirements for tournament organizers will vary by state and your national governing body for sport, as will the requirements for individual clubs. Here are some key elements you’ll want to include in your EAP:

Key personnel. Describe the emergency team involved when the EAP is activated and the roles of each person. How to communicate. What communication devices are available? Are there areas on the ground that don’t have cell service? What number do you call in an emergency? What specific information and directions to the venue must be provided to the EMS response team?

Emergency equipment. I strongly recommend you have an Automatic External Defibrillator (AED) at your main fields or sports complex. The location of equipment should be quickly accessible and clearly listed. Equipment needs to be maintained on a regular basis.

Who to call for Emergency Transport. Describe the options and estimated response times for emergency transportation.

Venue directions with a map. This must be specific to each location and provide instructions for easy access to the venue. Entryways for emergency vehicles must be unlocked during tournaments or regular practices! Don’t be searching for keys (or the person who has them) during an emergency!

Roles of first responders. Establish scene safety and immediate care of the athlete, activation of EMS (emergency medical services), equipment retrieval and direction of EMS to the scene.

How to get an EAP

Most national governing bodies for sports have guidelines on the types of elements they recommend that you include in an EAP. I’d start with them, but unfortunately I find that most of them are lacking in specific steps you should take. However, here’s a template from the National Alliance for Youth Sports that’s an excellent starting point. It contains the key elements, and can be modified for your particular situation. Another guideline can be found here from USA Football.

Finally: Make sure you practice

Having an Emergency Action Plan and an Automatic External Defibrillator are fantastic and necessary steps, but you need to go beyond that to be truly prepared. At least every 6 months, key personnel should review the plan and actually know how to use the AED. Preparation is massively helpful.

Key Points

An Emergency Action Plan (EAP) is a key document that outlines the specific steps taken by a club, tournament director, high school, or individual team in case of a serious health or environmental emergency.
Be sure to develop and practice your EAP before the season.

(Dr. Dev Mishra is an orthopedic surgeon and sports medicine specialist in private practice in Palo Alto, California. He is formerly a team physician with U.S. Soccer, Stanford University, the University of California-Berkeley, and the Oakland A’s.)

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