What is Sports Medicine?

Primary Care Sport Medicine 

Physicals

Concussion

Adult and Pediatrics

Medical issues related to sports

Heat Illness

Sports related psychological

Non-musculoskeletal issues

Surgical Sports Medicine 

Musculoskeletal issues

Operative repair

Support

Rehabilitation

Athletic Trainers

Who does Sports Medicine service? 

Professional Teams and organizations through local community youth athletes - everyone

Professional Event Planning

Professional planning scales down to local events

Professional planning - small hospital worth of assets 

Emergency action plans developed and trained / re-evaluated yearly

If stakeholders can't get together to make sure the EAP is solid, then you are dealing with wrong people

Away team staff leans on home / local team planning and plans

Events of recent highlight the need / necessity / and outcome of EAP's and traning

Smart Heart Sports Coalition  - Tenants - Access to AED, EAP, and CPR training

Professional event may have multiple Physicians (Medial / Ortho / Neuro / EM / Anethesia), EMS, Trainers and observers

Visiting doctors have treatment "rights" in locker room  or sidelines - need local docs to get local assets

Local Event Planning

Must have communications with the athletic trainers before the event

Plan for hyperthermia - are tanks available 

Availability of ice, water, and shade

Availably of rectal thermometer - continuous monitoring

Handoff procedure

Use of backboards - what is expectation

Hyperthermia

If core temp can be gotten down in first 30 mins, good outcomes near 100%

Approximately 0.5 degree per min in ice water

Put tub in shade

Stir ice and water 

It is worth the time to cool on scene

Ad-hoc methods are worth the time for non-sports hyperthermia

Hospitals have poor ability to cool anyone

Stay in tub regardless of siezure, vomiting, etc.

Use sheet / blanket / towel under arms to keep patient over water line

Transport when temp <102 or return of mental status

Time in tube important - can estimate what was, or what should be

Benzodiazepines may be helpful if combative

FRST Program

Goals of the Program

Developed by Robert Flannery, MD and the University Hospitals Drusinsky Sports Medicine Institute, the FRST course has two primary goals:

• To provide first responders with instruction and hands-on training in treatment protocols for unique emergencies during athletic events.

• To enable a dialogue between EMS, medical staff and other first responders to formulate a unique emergency action plan for a venue before the start of each season.

Specific training modules include:

• Optimal responses to traumatic injury in an athlete as opposed to the injuries, conditions and patients more typically seen by EMS

• Various EMS sports response case studies and scenarios

• Methods for communicating and collaborating with athletic trainers, team physicians and emergency department clinicians

• Hands-on instruction and best practices for helmet and pad removal

• Four hours of continuing education units and a two-year FRST certification, accredited through University Hospitals EMS Institute

AED in 3

If an athlete experiences sudden cardiac collapse, the goal from time of collapse to shock is 3 minutes or less. The goal of the AED in 3 challenge is to raise awareness about this importance of practicing and implementing at Emergency Action Plan.

PRE-GAME™ Approach

The FRST course teaches an innovative PRE-GAME approach to ensure that first responders are ready for any situation or emergency that might arise during an athletic event.

Prepare: Review the emergency action plan (EAP) for each venue prior to the rehearsal
Rehearse: Have every team member rehearse each aspect of the EAP
Evaluate: After the rehearsal, evaluate the EAP and make changes based on the most up-to-date recommendations or changes to the venue

Get the Picture

Access & Activate

Mobilize Plan

Evacuate

Sudden Cardiac Death

Get the Picture

May look like a seizure

Access & Activate

ABCs, Send for the AED

Mobilize Plan

Start CPR & defibrillate

Evacuate

Transport as soon as possible

Cammotio Cordis

Get the Picture

May look like a seizure, will take a couple of steps before falling

Access & Activate

ABCs, Send for the AED

Mobilize Plan

Start CPR & defibrillate

Evacuate

Transport as soon as possible

Heat Illness

Get the Picture

Noticeable confusion, lack of sweat

Access & Activate

ABCs, level of consciousness, Prep cold tub with ice water

Mobilize Plan

Wrap towel under arms to control body weight

Evacuate

Do not transport until core temp reaches 102°F or starts to shiver

Sickle Cell Trait

Get the Picture

ATC or family should know the history; No confusion, lack of sweating, soft muscles

Access & Activate

Send for or bring to closest oxygen, IV

Mobilize Plan

Administer oxygen, IVF, pain medication

Evacuate

Transport as soon as possible

Concussion

Get the Picture

Must give time to allow adrenaline to wear off, then look for worsening symptoms

Access & Activate

ABCs, Neuro checks

Mobilize Plan

Re-evaluate at 10 – 20 minutes to allow symptoms to emerge

Evacuate

Transport only if worsening mental status, vomiting, agitation, slurred speech or facial asymetry

Cervical Spine Injury

Get the Picture

Note any deformity or if head is turned any mechanical block to moving back to midline. Do not move

Access & Activate

ABCs, Send for immobilization resources and removal tools if needed

Mobilize Plan

C-spine stabilization if mechanical block, do not force to neutral position

Evacuate

Transport as soon as possible

FRST for coaches coming soon, will include other required coach for training so its a one stop course