Transcript Safety Clinic PPT

Safety Clinic
Safety Clinic
Emergency
Management
Overview
Emergency Management
Injury Prevention
Safety Awareness
Steve Taylor, Justin Ireland
and Clay Berry
California District 33
January, 2014
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Introduction
Safety Clinic
Emergency
Management
Overview
Objectives
•Be familiar with basic sports injury
terminology.
•Enhanced awareness aimed at preventing sports
injuries.
•Be able to differentiate among mild, moderate
and severe injuries.
•Know appropriate first aid techniques for the
injuries you may encounter.
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Introduction
Safety Clinic
Emergency
Management
Overview
Objectives
•Know how to implement your league’s safety
plan and manage when severe injuries occur.
•Know techniques to determine when an injured
player is ready to resume practice and is prepared
to play.
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Injury Assessment
Safety Clinic
Emergency
Management
Injury Assessment
A symptom is what your player reports:
“My head really hurts, Coach”
A sign is what you observe:
Billy has a swelling, discolored lump on his head.
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Injury Assessment
Evaluating Injuries
Safety Clinic
Emergency
Management
Injury Assessment
The sooner a player has disability the more
serious the injury.
•The larger and more immediate the swelling, the
more serious the injury- swelling seen externally
means bleeding internally.
•A noticeable deformity, either swelling or
depression, means a serious injury.
•Consider unconsciousness or an eye injury a
serious situation, in the category of severe
injuries.
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Injury Treatment
Safety Clinic
Emergency
Management
Injury Treatment
P
R
I
C
E
S
Protection
Rest
Ice
Compression
Elevation
Support
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Injury Treatment
Safety Clinic
Emergency
Management
Injury Treatment
Protect the injured part of the body.
Rest Have the player rest and avoid using the
injured part.
Ice not only makes your player more
comfortable by easing pain, it reduces swelling
and inflammation.
Compression should be applied carefully to
keep swelling at a minimum.
Elevation of the injured part decreases pooling
of blood and other fluids in the area.
Support the injured part as necessary.
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Communication
Safety Clinic
Emergency
Management
Communication
Treatment Decisions and Parents
In the event of an injury at a game or
practice, the player’s parent/guardian is to
be informed as soon as possible and given
your evaluation of the injury. If you suspect
a serious injury, encourage the parent to
seek immediate medical treatment.
In the absence of the parent, you must make
the decision as to whether EMS are to be
called. Do not attempt to transport the child
to medical treatment yourself- risk of shock.
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Communication
Special considerations for young players
Safety Clinic
Emergency
Management
It is important that coaches and parents
be responsive to complaints of pain from
athletes in all age groups.
Communication
You should be aware that any athlete
who is not playing up to his or her skill
level may be suffering from a significant
injury- and afraid to tell you and let you
down.
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Communication
Safety Clinic
Emergency
Management
Managers and coaches must cultivate
timely, open and trusting two-way
communication with their players,
parents and guardians.
Communication
If this were my child….
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Safety Essentials
Safety Clinic
Emergency
Management
Safety Essentials
Safety Plan, First Aid Kit and Ice Bags
A League Safety Plan, First Aid Kit and
Chemical Ice Bags must be at all practices and
games.
Your Safety Plan has emergency numbers and
the location of the nearest emergency medical
services.
You also need parent contact information as well
as Medical Releases signed by parents.
Know the nearest street address/cross streets of
game and practice sites (to give to EMS via
phone).
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Types of Injuries
Injuries can be categorized into 3 groups
Types of Injuries
Muscle-Skeletal
Environmental
•Muscle-Skeletal
•Environmental
Head-Face
•Head-Face
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Skeletal
Safety Plan
Emergency
Management
Skeletal
Broken Bones (Fractures)
Call 911- Possibility of shock
•Immobilize the injury (splint if possible).
•Do not move the injured individual- players
to dugouts.
•Stop bleeding if it is present (open fracture).
Apply a sterile pad and direct pressure to
wound, raise splinted limb above the heart,
apply a tourniquet if necessary.
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Skeletal
Safety Plan
Emergency
Management
Skeletal
Broken Bones (Fractures)
Call 911- keep the injured person still
Evaluation: Look for obvious deformityswelling, displacement. Swelling of tissue.
Treatment: Apply ice for swelling and pain
reduction while awaiting EMS.
Prevention:
•Safe playing environment- no holes…
•Proper maintenance of playing field
•Teach proper techniques- sliding, throwing,
catching.
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Skeletal
Injuries to Small Joints
Safety Plan
Emergency
Management
Skeletal
Call 911- keep the injured person still
Evaluation: Look for obvious deformity,
swelling, inability to move the joint.
Treatment: PRICES, buddy taping to
another finger as a temporary splint.
Further medical evaluation.
Prevention: Teach proper playing
techniques. For catchers, free hand behind
the back.
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Skeletal
Falls
Safety Plan
Emergency
Management
Skeletal
Call 911- keep the injured person still
•Immobilize head and neck.
•Lay individual on his or her back.
•A fall from 3 times the individual’s height
is a major trauma.
•Falls from lower levels can still result in
awkward landings and create significant
injury.
•Small Joints
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Muscle-Skeletal
Contusions (Bruises)
Safety Plan
Injury
Management
Muscle-Skeletal
Contusions
Evaluation: Discoloration- red > bluish from
broken blood vessels. Swelling. Possible
damage to the skin.
Treatment: PRICES, notify parents. Talk to
the parents before the child does to maintain
their trust in you.
Prevention: Safe playing area for games and
practices.
Proper protective gear, especially catcher’s
gear and cup.
Guidance on avoiding wild pitches when
batting.
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Muscle-Skeletal
Internal Organ Injury/Bruising
Safety Plan
Injury
Management
Muscle-Skeletal
Organ Injury
Pay particular attention to the possibility of
internal injury from a blow from a hard
thrown or batted ball:
Cardiac- ball strikes the rib cage over the
heart, can result in bruising of the heart.
A bruised heart subjected to stress (increased
heartbeat) can go into cardiac arrest.
Spleen- injury to the left abdomen just below
the rib cage. Signs: soreness, tenderness.
Suspected injury of an internal organ needs
medical evaluation.
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Muscle-Skeletal
Internal Organ Injury/Bruising
Safety Plan
Injury
Management
Muscle-Skeletal
Organ Injury
Kidney injury- a blow to the lower back
(flank).
Parents need to be informed to watch for
signs of blood in urine- seeing pinkish urine
or continued severe flank pain shows a need
for medical evaluation.
Suspected internal organ injury needs
medical evaluation.
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Muscle-Skeletal
Internal Organ Injury/Bruising
Safety Plan
Injury
Management
Possible testicular injury from a blowswelling in and around area of scrotum and
testicles. Untreated swelling may cause
permanent injury.
Muscle-Skeletal
Organ Injury
Parents need to watch for signs of swelling,
continued tenderness.
Suspected injury to testicles (remaining
swollen) requires medical evaluation.
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Muscle-Skeletal
Muscle Pulls and Strains
Safety Plan
Injury Prevention
Muscle-Skeletal
Pulls and
Strains
A strain is a tear of muscle to tendon or pulled
tendon where it attaches to bone.
Evaluation: Obvious deformity (depression),
discoloration red > bluish from broken blood
vessels, swelling, painful movement.
Treatment: Rest, ice, notify parents. Suggest
medical evaluation, especially if symptoms
persist. Return to throwing/running program.
Prevention: Proper warm up, avoid over-use:
hard throwing, excessive throws, excessive
play outside of practices and games, i.e. travel
ball...
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Muscle-Skeletal
Over-Use Injuries
Safety Plan
Injury Prevention
Muscle-Skeletal
Over-Use
Injuries
Part of the body is subjected to repeated stresselbows (Tommy John), knees, wrists (carpal
tunnel), rotator cuff in shoulder.
Evaluation: Reluctance to use to injured limb,
soreness. Tenderness to pressure on injured area.
Treatment: Rest from activity, ice, notify parents.
Suggest medical evaluation, especially if symptoms
persist. Return to throwing program.
Prevention: Proper warm up, avoid over-use: hard
throwing, excessive throws, excessive play outside
of practices and games, i.e. travel ball... Develop
skills that are age-appropriate.
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Muscle-Skeletal
Over-Use Injuries
Safety Plan
Injury Prevention
Muscle-Skeletal
Over-Use
Injuries
Special considerations
Shoulder and elbow over-use problems can affect
bone growth plates and soft tissue, resulting in
serious complications in growing limbs.
With the elbow, more serious problems are shown
by pain on the inside and bottom of the elbow
rather than on the outside.
The player might be released by the physician
because the injury has “healed.” However, a
Return to Throwing Program must be followed
before the player returns to full participation…
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Muscle-Skeletal
Sprains
Safety Plan
Injury Prevention
Muscle-Skeletal
Sprains
A sprain is an injury to a ligament. Ligaments
are the strong connective tissue that holds bones
together. Ankles, knees…
Evaluation: reported “popping” sound, joint is
destabilized. May not be painful- no nerves
associated with ligaments.
Treatment: PRICES Notify parents. Severe
injury- immediate medical evaluation.
Prevention: Stretching and warm up before
games and practices.
Proper maintenance of playing fields (hazards).
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Muscle-Skeletal
Return to Play Progression- Leg Injury
Safety Plan
Muscle-Skeletal
Injury Recovery
When a physician releases an athlete to return to
play, that means that the physician feels that the
injured area has “healed.”
It is up to the manager or coach to determine when
the child is ready to return to full participation. A
rehab program should be implemented:
Progressive activity over days- without pain.
Walking > jogging > running > sprinting > figure
8’s > basic drills and then sports drills (motions of
play).
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Muscle-Skeletal
Return to Play Progression- Arm Injury
Safety Plan
Muscle-Skeletal
Injury Recovery
When a physician releases an athlete to return to
play, that means that the physician feels that the
injured area has “healed.”
It is up to the manager or coach to determine when
the child is ready to return to full participation. A
rehab program should be implemented:
Progressive activity over days- without pain.
Soft Toss> Medium Toss> Long Toss> Simulated
pitching> 25 pitches> 50 pitches.
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Environment
Environmental Risks
Safety Plan
Heat Illness
Environmental
Heat Exhaustion
Heat Illness
Heat Exhaustion
Heat Stroke
Asthma
Heat Stroke
Asthma
Spider Bites and Insect Stings
Snake Bites
Insect Bites/Stings
Snake bites
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Environment
Heat Illness
Safety Plan
Environmental
Heat Illness
•Muscle cramping
•Sweating
•Irritability or disorientation
Treatment: Drink cold water/sports drinks to
lower internal temperature.
Prevention: Hydration before games or
practice. Water is best for hydration.
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Environment
Heat Exhaustion
Safety Plan
Environmental
Heat Exhaustion
Evaluation: Skin cool and clammy despite
heavy sweating.
Irritability or disorientation
Treatment: remove from environment, get to
shade.
Think rapid cooling. Remove outer clothing.
Drink cold water/sports drinks to lower internal
temperature.
Prevention: Hydration before games or practice.
Water is best for hydration.
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Environment
Heat Stroke Call 911 Threat to life
Safety Plan
Environment
Heat Stroke
•Internal temperature 105o
•Hot dry skin, no sweating.
•Seizures, coma. Death is eminent.
Treatment: remove from environment, get to
shade.
Think rapid cooling. Remove all clothes.
Ice packs in armpits and groin.
Water and IV fluids (EMS).
Prevention: Hydration before games or
practice. Water is best for hydration.
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Environment
Asthma
Safety Plan
Environment
Medical Emergency
Asthma
Asthma is a chronic condition induced by the
environment- pollen, allergens… You must
know which players have asthma and the
location of their inhaler (in their equipment).
Call 911 if breathing difficulty persists and his
or her inhaler is not effective.
Triggers: Cold air, exercise, food, stress,
medications, stings.
Can progress to anaphylaxis- throat swelling,
closure of airway.
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Environment
Anaphylactic Shock- Allergic Reaction
Safety Plan
Environment
Medical
Emergency
Anaphylactic Shock
Throat swelling cuts off breathing.
A severe allergic reaction to nuts, bee sting,
latex, medications…
If possible, remove the allergen- flick a bee’s
poison sac away with a credit card. Pinching
to pull the stinger out injects more poison.
Administer an epi-pen- inject in the child’s
thigh. Needle will penetrate clothing.
Call 911 if relief is not immediate. Notify
parents.
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Environment
Spider and Flying Insect Bites
Identify the source of the bite/sting.
Safety Plan
Wash the area and apply a cold compress.
Environment
Watch for signs of anaphylaxis- throat
swelling/difficulty breathing, rash on body.
Potential
Emergency
Insect Bites/Stings
Notify parents.
Be prepared to call 911 in the event of an
allergic reaction.
Scorpion Bite
Constricting band above the bite, no tighter than
a wristwatch.
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Environment
Snake Bites
Safety Plan
Environment
Potential
Emergency
Snake Bites
If possible, identify the kind of snake.
Even non-poisonous snakes will bite to
defend themselves if harassed.
•If the snake is believed to be poisonous,
call 911- swelling, pain…
•Lay the individual on back, neutral
position.
•Immobilize limb- a cardboard splint will
do.
•No constricting band, no ice.
•Notify parents.
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Head and Face Injuries
Concussion/Traumatic Brain Injury
Safety Plan
Head and Face
Potential
Emergency
Concussion/TBI
Any blow to the head has the potential to
cause a concussion and must be evaluated.
Common physical, mental and emotional
signs of concussion a person may display
after a blow to the head are on the next slide.
One or more of these signs could indicate
concussion (traumatic brain injury) and
warrant medical evaluation.
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Head and Face Injuries
Signs of Concussion
Loss of consciousness (knocked out cold)
Safety Plan
Head and Face
Potential
Emergency
Concussion/TBI
Confusion or feeling dazed
Concentration difficulties
Balance problems or dizziness
Ringing in ears- signals a more serious concussion
Slurred speech
Slow Speech (difficulty processing)
Sensitivity to light
Sensitivity to noise
Memory loss
Blurred vision
Clumsiness
Sluggishness
Nausea or vomiting
Headache
Behavior or personality changes- agitation, silly…
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Head and Face Injuries
Evaluating Concussions/Traumatic Brain Injury
Safety Plan
Head and Face
Potential
Emergency
Concussion/TBI
While a concussion (TBI) can be rated as mild, moderate or
severe by medical professionals, this is what you need to
know:
A concussion, which is a traumatic brain injury, occurs when
the brain strikes the inside of the skull. All neurons within the
brain fire at one time.
The brain needs 20 minutes to “reset” itself- while glycine,
carried by the blood circulatory system, enters the neurons and
recharges them.
Reducing stimulation- resting in a dark, quiet area helps the
process. The more signs initially present and still evident after
20 minutes suggest a more severe concussion (TBI).
The brain could be bleeding and creating pressure following a
severe concussion, leading to further brain damage.
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Head and Face Injuries
Seizures
Epileptic or Other
Safety Plan
Head and Face
Potential
Emergency
Seizures
Evaluation Loss of consciousness with extremity
movement- may be subtle or pronounced motion.
Treatment Place patient on her/his side, allow
saliva/emesis to drain from mouth, monitor closely,
notify parents. Helpful to time the seizure. Do not place
anything in patient's mouth, do not hold/restrain
extremities.
Prevention Know about any player's pre-existing
diagnosis of seizures from Medical Release.
Individuals may be more prone to seizures during hot
weather and exertion.
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Head and Face Injuries
Nosebleeds
Safety Plan
Head and Face
Potential
Emergency
Injuries To Teeth
Nosebleeds may be spontaneous or a result of a
traumatic injury.
For nosebleeds, apply compression to the top of the
nostrils. If bleeding continues, gently pack bleeding
nostril with sterile gauze or cotton or a tampax, and
continue compression.
Notify parents.
Physician evaluation if nose bleed persists or is the
result of a traumatic injury.
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Head and Face Injuries
Injuries To The Teeth
Safety Plan
Head and Face
Potential
Emergency
Injuries To Teeth
Listen for:
•History of direct blow to the mouth.
•Complaints of pain in and around the teeth
•A report by the player that he or she feels a chip, a
crack, looseness or other abnormality of a tooth.
•Complaints of numb feeling in a tooth.
Look for:
•The tooth or fragment of tooth in the mouth or on the
ground (if it has been knocked out).
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Head and Face Injuries
Injuries To The Teeth
Safety Plan
Head and Face
Potential
Emergency
Injuries To Teeth
Listen for:
•History of direct blow to the mouth.
•Complaints of pain in and around the teeth
•A report by the player that he or she feels a chip, a
crack, looseness or other abnormality of a tooth.
•Complaints of numb feeling in a tooth.
Look for:
•The tooth or fragment of tooth in the mouth or on the
ground (if it has been knocked out).
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Head and Face Injuries
Injuries To The Teeth
Safety Plan
Head and Face
Potential
Emergency
Injuries To Teeth
Treatment
Immediate referral to dentist or hospital for a
damaged tooth.
Be sure to send tooth or fragment with player.
Special considerations
•A knocked-out tooth must be replaced within one hour!
•The tooth must be kept wet/put back into place.
•The tooth should not be handled by the root.
•Gently rinse tooth with sterile water and put back into
place.
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Head and Face Injuries
Injuries To The Teeth
Prevention
Safety Plan
Head and Face
Potential
Emergency
Proper maintenance of playing field.
Teaching proper playing techniques.
Do not mismatch players during ball toss warm ups.
Injuries To Teeth
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Head and Face Injuries
Injuries To The Teeth
Safety Plan
Head and Face
Potential
Emergency
Little League’s insurance covers dental injuries
within the context of its insurance policy. In the
event an injury occurs and a claim is filed, Little
League will address this with the responsible
parties as the claim progresses.
Injuries To Teeth
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Head and Face Injuries
Eye Injury
Safety Plan
Evaluation Bleeding, swelling of eye, obvious injury.
Puncture or foreign particles in the eye.
Blurred, double or partial vision.
Head and Face
Potential
Emergency
Eye Injury
Treatment Ice is the only acceptable pain killer.
Protect the eye from direct contact and possible
contamination. Notify parents. Medical attention ASAP
for bleeding, swelling or puncture.
Prevention Instruction in proper ball catching
techniques and making sure individual is prepared to
catch the ball. Avoid mismatching skills between
players during warm ups.
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Head and Face Injuries
Eye Injury
Special considerations
Safety Plan
Head and Face
Potential
Emergency
Eye Injury
Return to play: Only when you are confident that none
of the abnormalities described are present, and that
your player has normal vision with full painless motion
of the eye in all directions, should you allow that player
back into a game (or practice).
Making an eye shield: The purpose of an eye shield
that you use is to protect the eye from pressure as well
as to keep it clean until a doctor can examine it.
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Head and Face Injuries
Blow To Face Or Head
Safety Plan
Head and Face
Potential
Emergency
Head/Face Injury
A blow to the face can result in more than one injury,
each possibly serious.
Evaluation What area of the face/head was struck?
Possible eye socket or facial bone injury along with eye
injury. Any appearance of asymmetry?
Treatment PRICES, evaluate for concussion, notify
parents.
Prevention
•Instruction in proper ball handling techniques, avoid
mismatching skills between players.
•Use of protective head gear.
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Triage
Multiple injuries, possibly two or more players.
Safety Plan
Potential
Emergency
Multiple Injuries
Collision with another player while tracking a ball,
sliding into a base…
Treat the most severe injury first, another adult may
treat a second individual at the same time.
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Safety Awareness
Safety Plan
Effective
Implementation
Reduces Injuries
Safety Awareness
Is The Key
Even though much of this clinic has focused on
management of injuries, our main emphasis is still
prevention of injuries. Ideally, if all injuries were
prevented, none would need to be treated.
ASAP = A Safety Awareness Program
Each team must have a copy of their League Safety
Plan and it should be readily available to coaches and
managers, along with a first aid kit and a Medical
Release for each player. Be aware of medical
conditions for any player, sign- how to treat them.
The implementation of safety plans and increased
safety awareness has reduced injuries in Little
League by 70%, resulting in lower insurance rates for
leagues.
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Safety Awareness
Manager/Coach Responsibilities
Proper maintenance of the playing site.
Safety Plan
Effective
Implementation
Reduces Injuries
Safety Awareness
Is The Key
Pay close attention to playing conditions.
Avoid over-use of player muscles and joints.
Consistent and proper use of protective gear,
especially a player wearing a catcher’s mask when in
the presence of an adult with a bat.
Effective coaching supervision and organization of
warm ups, practices and games.
Always emphasize proper playing techniques- attend
Fundamentals Clinics and Safety Clinics to stay up to
date.
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Walked into a swing
Compliance with LL Rules
Manager/Coach Responsibilities
Safety Plan
Catchers wearing a catcher’s helmet at all practices when in
the vicinity of an adult with a bat.
Effective
Implementation
Reduces Injuries
Catchers must wear a protective cup.
Safety Awareness
Is The Key
Players retrieving bats wear helmets.
No swinging of bats away from the playing field.
No loose bats in the dugout…
Do not condone horseplay- it gets out of control too quickly.
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Using your Safety Plan
Manager/Coach Responsibilities
Safety Plan
Effective
Implementation
Reduces Injuries
Safety Awareness
Is The Key
Safety Plan
There is nothing complicated about your safety
plan. Look ahead and anticipate problems you
could encounter. Your league provides you with
a written safety plan to stay with your
equipment.
Make sure the local fire department has an
accurate address for your site- know where
they are going to come to, send someone out to
meet the response team at the street and guide
them in.
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Insurance Information
Safety Plan
Effective
Implementation
Reduces Injuries
Safety Awareness
Is The Key
Insurance Info
Little League’s insurance covers expenses for medical/dental
treatment, within its policy. If the individual does not have
insurance, LL Ins. will reimburse parents for treatment within
policy limits- provided an Accident Notification Form was
completed within 5 days and mailed to LL to establish the
claim.
Accident Notification Form is filled out by league and parents.
Ideally, the league and parents each retain a copy before it is
mailed to Little League- mailing address on the form.
Accident/Injury Tracking Form also completed in the event of
any injury and mailed or faxed to Little League. Retain a
copy for your league records. Mailing instructions on the form.
Forms available at Little League Online, hover over League
Officers, select Forms and Publications, then Insurance.
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