Sports Standby

Patient Care Goals

Provision of care while maintaining safety for the patient, EMS personnel, and others.

Patient Care Goals

Assessment 
Pediatric Pearls: Signs & Symptoms: Differential: 
□ Use approved reference document for medication dosing, electrical therapy, and equipment sizes. 
□ Parents may recognize when their child is behaving abnormally		□ Confused, repetitive questions
□ Nauseated
□ Headaches
□ Very “hot” to touch 		□ Concussion
□ TBI
□ Heat exhaustion
□ Heat Stroke 
EMT-B
• Check a temperature
• Obtain a GCS score
• Ask questions about the game (what’s the score, inning/quarter of the game)
• Maintain C-spine stabilization if a patient has been knocked out or complaining of neck pain
• Splint any painful joints and provide ice
Paramedic
• Vascular access as appropriate for patient condition 
• Fluid therapy as needed with Isotonic Crystalloid, preferred cold if overheated
• Cardiac monitor and 12 ECG if syncope during activity
• If the patient suffers cardiac arrest, then consider a fluid bolus and Sodium Bicarbonate early 

Consult Medical Control as needed

Pearls 

  • EMS does not determine if the patient can return to play. We are there for illness and concern. Clearance is performed by the patient’s primary care doctor vs Emergency Department
  •  For complaints not listed, please refer to 911 Protocols and Guidelines
  • Concussion
    • Concussion is common in contact sports, with football having the highest incidenceCommon symptoms are nausea, vomiting, headaches, and loss of balance/coordinationLoss of consciousness occurs in only 10% of cases. Do not assume that there is no concussion if there has been no loss of consciousness
    • Patient who have lost consciousness are assumed to have a spinal injury
  • Spinal concerns
    • Patients who are altered should be assumed to have a concern for spinal injury. Equipment should be removed while maintaining in-line C-spine support and a C-collar should be placed.
  • Syncope and Sudden Cardiac arrest
    • Syncope during or right after activity is concerning. This may be a sign of undiagnosed Brugada or other genetic channel mutation
    • All syncope patient’s need an EKG and an evaluation.
    • The most common initial rhythm is Vfib/Vtach in sports cardiac arrest. Place pads early in the arrest.
    • Consider fluids and bicarb, especially in summer sports
  • Heat Illness
    • Consider heat illness early in young athletes with fatigue, vomiting, lightheadedness
    • Check a temperature in patients where there is a concern
    • Give fluids and start cooling rapidly if temperature is elevated