Special Considerations for the Special Olympics Athlete
Atlantoaxial Instability in Down Syndrome Crisis and Emergency Management
Developing an Emergency Management Plan
Development of an Emergency Management Team
Ideally, a physician, an athletic trainer, or a physical therapist knowledgeable in the triage and immediate management of athletic injuries should cover practices and games.
The coach should provide the athletes' medical forms and any special instructions to medical personnel.
An emergency medical technician (EMT) and ambulance should be available immediately upon calling.
The coaching staff should be educated and skilled in immediate management designed to contain the extent of the illness/injury until appropriate medical personnel are available.
The coach and all personnel should be certified in cardiopulmonary resuscitation (CPR) and first aid.
Each coach is responsible for activating an Emergency Management Plan.
The coach should assess the situation as quickly as possible after an incident has occurred.
The coach should assess the incident right where it occurred to determine whether the athlete can be safely moved.
The coach should know the athlete and his/her personality to best assess injury versus reaction.
The coach should remain calm, which will also serve to keep the athlete and others calm.
The coach should listen to the athlete describe what happened.
The coach should ask simple, clarifying questions.
The coach should observe the athlete's face and eyes while talking.
The coach should observe for any asymmetry, trauma, general body alignment and functional abilities.
The coach should survey the area where the injury occurred for any unsafe articles or terrain.
The coach should evaluate the criticality of the situation, and then institute action based on the evaluation of the situation (see enclosed chart).
The primary survey evaluates airway, breathing, circulation and consciousness.
The secondary survey evaluates the seriousness of all other injuries once it is determined that the athlete is breathing and alert with good cardiac function.
If no medical personnel are available, the coach should respond based on his/her assessment of the criticality of the situation.
When in doubt, do not put the athlete back into play.
Always refer to a health care professional for additional follow up.
All activities should be calmly and simply explained to the athlete.
A telephone or cellular phone should be immediately available in case of an emergency situation.
Plans for access to emergency transportation and early notification of a physician or emergency room are recommended.
Parents should be immediately notified not only for information but also for planning of immediate or follow-up care.
All illnesses and injuries should be thoroughly documented on an Incident Form. The form should be kept on file.
The coach should obtain a report from the medical personnel who handle an incident.
This report should also indicate changes in risk or future participation.
Immediate Care Skills Certain immediate care skills are necessary for triage and containment of injury.
Cardiac or respiratory dysfunction or arrest — follow the tenets of CPR.
Abrasions or Contusions — clean the area with either soap and water or hydrogen peroxide. Keep the area clean and dry. Bandage the area securely while exercising, but expose it to air whenever possible.
Blisters — do not cut the skin off a blistered area. Use a foam or felt pad to keep pressure off the area. Only break the blister if it impedes activity. When puncturing a blister, use a sterile pin to make an entrance on two sides of the blister. Place a pressure bandage or second skin on the blister to allow the covering skin to re-adhere to the skin below.
Heat Cramps — heat cramps normally accompany strenuous activity in which there is profuse sweating. These cramps are not usually serious and will respond to gentle stretching and hydration.
Heat Exhaustion — this is the result of exercise in hot weather. The athlete will sweat profusely and have cool, clammy skin. The athlete will complain of a slight headache, dizziness, nausea or fatigue. The athlete should be taken out of the heat (and sun) and the uniform or equipment removed. The athlete should lie down with his/her feet elevated, and be cooled by drinking cool water and/or being sponged. If the athlete does not respond in a short period of time, he/she should be sent for immediate referral.
Immediate care for sprains, strains, and contusions (RICE):
R
—
rest; stop any activity that causes pain
I
—
ice for 24-48 hours after the injury
C
—
compression with an elastic bandage to contain the swelling
E
—
elevate the injured area to control swelling
All other injuries or illnesses should be evaluated by an appropriate healthcare professional for management and advice. The coach should communicate with the health-care personnel for information and instructions regarding future care and return to sport.
