Football EMS Standby

When I worked as a student the procedure was always to have the ATC go in the ambulance and the students and other teams ATC would handle the game until anothe ATC could get down.
 
I was a medic for women's roller derby for several years. They where low on funding so the first year I was the only medical provider they had. There where obvious training gaps I was faced with along with confusion on my behalf and the girls of what I could and could not do. There should really be a card class (like PHTLS) for sports injuries and sporting stand by's in my opinion.
Anyway, It all got figured out by the 2nd year when I was partnered with an AT. We worked together for several years.The rule we made was if it was an injury out on the field, he would go out first. Normally I stayed behind. If it was an emergency, then I got waved in and assumed patient care until the patient was either transported to the hospital or signed a refusal for EMS. He did most of the work, taping wrist, dealing with preexisting injuries ect... Even out on the field, he would normally clear c-spine ect with out me, because once I made patient contact it created legal paper work due to our protocols. I mainly handled unconsciousness patients, suspected spinal injuries, or obvious fractures which warranted an ambulance transport(unless the patient refused). I also handled medical emergencies of patrons. At the end of the day though, at least where I was working, once I made patient contact the patient could only be handed off to another EMS provider of my level or to a physician. PA-C's, AT's, RN's, ect where explicitly not allowed. However, the way around this was simply to have a girl sign the EMS refusal. The AT had a masters degree and could normally care for the girls better than I could (unless maybe it was an arrest for example), but rules are rules.
I would suggest the medics ( and all other medical staff) get a simple 1-2 pages of information handed out to them on who is in charge of what. You could also review a copy of the medics protocols so you know what to expect on their end. It would also be beneficial if the entire medical team had a brief meeting together prior to the games start.
 
Last edited:
ExpatMedic0 said:
There should really be a card class (like PHTLS) for sports injuries and sporting stand by's in my opinion.
Click to expand...
Hopefully you noticed the knowledge and skills gap between you and the AT you worked with. You can't bridge that gap with a "card class" by any stretch of the imagination. What would make sense would be to have an "awareness" course that teaches the EMS provider how to best work with these kinds of injuries and AT providers because of their skillset. That can be accomplished in a day or two very easily.
 
Sure there was a huge knowledge and skills gap on my end in the environment we worked in. Overall he had a better education and was more knowledgeable of A&P and long term injuries. He was also great at managing less severe acute injuries. To be honest though, with no doctor present we needed each other and I think we complemented each other quite well. Despite the impressive education and professional standards that AT's have, the Athletic Trainer is an Athletic Trainer, not an emergency provider or a doctor. There was also a gap on his end. The one I worked with did not necessarily know how to run a code or administer many of the medications and interventions that we use. Not to mention by law, I was the one responsible for patient care once patient contact was made from an EMS stand point.

In regards to the card class, I think its a great idea and I think you misunderstand my expectations of such a class. Lets be honest, most of us have been assigned to special event stand by's in an ambulance. The medical crews at football games, karate tournaments, ect... range from only the ambulance crew, to more. Such as a team AT, or an RN, to chiropractors or even MD's. I think the hypothetical card class could introduce how to work with these providers in a sporting event/ athletic environment and lay down some ground rules for what the EMS provider can and can not do, such as athletic taping for example and some better criteria and emphasis on mild to moderate brain injuries, clearing of c-spine in these type of environments, special legal considerations, management of less severe acute injuries from trauma ect..
 
Last edited:
ExpatMedic0 said:
Sure there was a huge knowledge and skills gap on my end in the environment we worked in. Overall he had a better education and was more knowledgeable of A&P and long term injuries. He was also great at managing less severe acute injuries. To be honest though, with no doctor present we needed each other and I think we complemented each other quite well. Despite the impressive education and professional standards that AT's have, the Athletic Trainer is an Athletic Trainer, not an emergency provider or a doctor. There was also a gap on his end. The one I worked with did not necessarily know how to run a code or administer many of the medications and interventions that we use. Not to mention by law, I was the one responsible for patient care once patient contact was made from an EMS stand point.
Click to expand...
Yes, I know about that gap, probably better than most here on this forum. I have worked both sides, as have a few people here. It really wouldn't take much from an educational standpoint to update an AT to be able to do any of the things that a Paramedic does. Such a hypothetical bridge course (AT to P) could probably be very short, about that of a refresher course + field internship, slightly extended to first hone the EMT-B skills. When I went through EMT and then later P school, I only learned a few new things (to me). Later that combined education made RN school reasonably easy as well. The toughest part of that was learning to think like a nurse. Considering that I'd spent the better part of 15 years (or more) doing basically medical model thinking, the transition wasn't easy.

As to the EMS provider being, by law, the responsible provider for patient care, some EMS systems have (probably) inadvertently built into their protocols that could be taken advantage of by a sports medical system to allow the AT to retain overall medical control. Usually the protocols are very explicit about this and state that (for instance) that an RN may provide only BLS care and an MICN can provide ALS care under the direction of the Paramedic on scene and transfer of care can only happen between Paramedics or through a triage mechanism down to an EMT. Some systems aren't explicit about transfer of care from a Field Paramedic to a Flight Nurse even though they have an explicit P to P only transfer of care. When that happens, they often rely on a mechanism where different agencies supplying medical personnel follow a policy stating something along the lines of "person most medically qualified" to render care. Flight agencies aren't usually from the same ground entity. Same could be said for a closed medical system for athletics. Under that situation, the AT would retain patient care control unless the AT turns the patient over to you OR there's an identified problem that requires a Paramedic's specific skills, like running a code, IV fluid administration, or medication administration and transportation.

In that arena, it really does work more like that because you're NOT summoned unless EMT-P knowledge/skills are needed, it's just not formalized through EMS policy/procedures. (This is specific to athletics and not a general EMS situation.)

ExpatMedic0 said:
In regards to the card class, I think its a great idea and I think you misunderstand my expectations of such a class. Lets be honest, most of us have been assigned to special event stand by's in an ambulance. The medical crews at football games, karate tournaments, ect... range from only the ambulance crew, to more. Such as a team AT, or an RN, to chiropractors or even MD's. I think the hypothetical card class could introduce how to work with these providers in a sporting event/ athletic environment and lay down some ground rules for what the EMS provider can and can not do, such as athletic taping for example and some better criteria and emphasis on mild to moderate brain injuries, clearing of c-spine in these type of environments, special legal considerations, management of less severe acute injuries from trauma ect..
Click to expand...
Actually, in this area, I think you and I are very much on the same page.
 
Alright, follow up question for y'all...

I'd like to bring in paramedics from a couple local stations so they are familiar with us and vice versa. What are some things that you'd like to learn from our sports medicine team? What's beneficial? This could apply both with EMS onsite and with EMS running as 911 call-out.. Also, what are some things that you think we need to learn to better work with EMS?
 
You must log in or register to reply here.
Back
Top