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Preparing for the Worst: Developing and Implementing Emergency Action Plans

Posted May 10, 2018

By Beth Druvenga, M.S. Ed, LAT, ATC

Athletic Trainers (ATs) are lauded for acting swiftly in emergency situations. The National Collegiate Athletic Association1 and the National Federation of State High School Association2 both recommend that ATs and athletic administration have emergency action plans (EAP) created for their event venues. The reasoning behind these recommendations is twofold: to provide the best access to early medical care and to protect institutions from liability.3-4 ATs are the first line of defense when it comes to emergency events, and the EAP is the road map which we follow.

Components of a good Emergency Action Plan:

Who 1-7

Individuals who are involved in the EAP should be those most commonly at practices, events and other athletic activities. ATs, coaches, school administration and emergency medical providers should all be aware of their role in the EAP and/or prepared to activate it at a moment’s notice.

What 1-7

Personnel involved in the EAP should have roles that are clear, concise and specific. ATs should always be the EAP coordinators who determine individual roles within the EAP. They should establish, as best as possible, a relationship with local emergency medical services and discuss the EAP in depth so that lines of communication are clear when transporting an athlete or spectator from an athletic venue. Quick communication is imperative to an efficient EAP.

Where 1-7

The EAP should be venue specific and readily available at all athletic venues. Access to the EAP should be publically visible, mounted on a wall, in a dugout or press box with clear and concise instructions that any layperson would be able to activate and coordinate the EAP if necessary. There should also be easy access to Automated External Defibrillators (AED) at all locations. Coaches should be well versed in the EAP at their specific location, especially if they may be off campus and access to an AT is not immediately available.

When 1-7

ATs should conduct annual reviews of the EAP at all venues. This should include personnel and their specific responsibilities, any signs or signals to look for from the AT if/when an emergency situation arises. It should also involve locations of phones or radios to activate the EAP, emergency routes for EMTs to take and who will be designated to meet the EMTs at the gate. All involved parties should have proper keys to open any necessary access gates. The plan itself should be reviewed and updated as needed, and staff should review their roles. This can easily be done by creating a mock emergency scenario to practice with staff and emergency medical services (EMS) personnel. ATs should also practice a pre-event “time out” to meet with visiting ATs, referees, EMS (if onsite) and coaches to discuss what would happen in the event of an emergency.

Why 1-7

It is important to have a solid communication system and clearly defined roles in the EAP to increase efficiency and decrease confusion. Communication about the EAP is crucial before a situation arises so that when it is activated all personnel involved are confident in their roles and can carry them out efficiently. In addition, communication while the EAP is in action is important so that all parties are prepared for the next step in the plan. Emergency situations are stressful and chaotic, but a refined and practiced EAP will help personnel handle the situations with ease.

How 1-7

Establish a relationship with local EMS, review the EAP with them and establish a quick system of communication to activate them at athletic events.

Train all personnel involved with the EAP in CPR and AED use.

Ensure that all necessary emergency equipment is available at athletic venues. Access to AED should be quick and easy to locate. Coaches should carry cell phones or other methods of communication if they are off site and don’t have immediate access to an AT. Pocket masks/barrier-shields should be available at all venues.

Transportation routes for emergency medical services to and from athletic venues should be well known and easily accessible. There should always be someone in the EAP tasked with flagging down and directing EMS to the playing field where they are needed.

And possibly most important, the EAP should be practiced annually and updated as necessary. To make sure that all those involved are familiar with and comfortable activating the EAP, scenarios should be run at each venue with ATs, coaches and administration having to activate and perform their specific duties. Utilizing each venue with an EAP, ATs can create an emergency scenario for which the EAP would need to be activated. These scenarios can also involve practicing CPR/AED usage which are skills all coaches and staff must have, as well as basic first aid skills, calling 911, practicing communication, opening gates and directing EMS. This is a good time to collaborate with local EMS so critiques can be made, questions can be answered, and if/when the EAP needs to be activated those responsible can act swiftly and in the best interest of the patient.

For more information on developing an EAP or other policies and procedures for your athletic training facility, visit the BOC Guiding Principles for AT Policy and Procedure Development document and online tool. The document and online tool offer a template to guide the development of policies and procedures including EAPs. Learn more at www.bocatc.org/-policy.

References

1. Parsons, J. T. (2014). 2015-2015 NCAA Sports Medicine Handbook. Indianapolis: National Collegiate Athletic Association.

2. National Federation of State High School Associations. (2016, October). Sports Medicine. Retrieved from National Federation of State High School Associations: http://www.nfhs.org/media/1017522/2016-nfhs-essent...

3. Almquist J, Valovich McLeod TC, Cavanna A, Jenkinson D, Lincoln AE, Loud, K., . . . Woods, T. S. (2008). Summary Statement: Appropriate Medical Care fo the Secondary School-Aged Athlete. Journal of Athletic Training, 416-427.

4. Andersen, J., Courson, R. W., Kleiner, D. M., & McLoda, T. A. (2002). National Athletic Trainers' Association Position Statement: Emergency Planning in Athletics. Journal of Athletic Training, 99-104.

5. Courson, R. (2007). Preventing Sudden Death on the Athletic Field: The Emergency Action Plan. Current Sports Medicine Reports, 93-100.

6. Drezner, J. A., Courson, R. W., Roberts, W. O., Mosesso Jr, V. N., Link, M. S., & Maron, B. J. (2007). Inter-Association Task Force Recommendations on Emergency Preparedness and Management of Sudden Cardiac Arrest in High School and College Athletic Programs: A Consensus Statement. Journal of Athletic Training, 143-158.

7. Drezner, J. A., Rao, A. L., Heistand, J., Bloomingdale, M. K., & Harmon, K. G. (2009). Effectiveness of Emergency Response Planning for Sudden Cardiac Arrest in United States High Schools With Automated External Defibrillators. Circulation, 518-525.

About the Author

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Beth Druvenga is an Athletic Trainer currently living in northern Virginia. She has experience working in both a collegiate and high school setting. Druvenga is originally from Iowa where she earned her Bachelor of Arts degree in Athletic Training from Central College in 2012. She graduated from Old Dominion University in 2014 with a Master of Science in Education. Her professional interests include patient-reported outcomes, psychology of injury and rehabilitation as well as using yoga to increase flexibility.

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