With the bulk of our work at this time year being dedicated to athletics (in stadia and arenas) looking after the athletes competing at British Athletics and England Athletics events; we decided to focus our blog this week on the medical provision needed within an athletics based environment.
The importance of this was underlined last week by the story in America of the Jamaican elite distance runner Kemoy Campbell (28), who suffered a cardiac arrest while acting as a pace maker a 3000m race.
Kemoy collapsed just after the 1000m point and received immediate medical care (including defibrillation) on the track before being taken to the local hospital’s intensive care unit. The prompt actions of the onsite medical team gave him the best chance of survival and a full recovery.
More than anything this highlights the importance of having AED’s (defibrillators) at all venues where athletes are training or competing.
The Chain of Survival
This is a phrase describing the steps needed to give a patient in cardiac arrest the greatest chance of survival. Medical teams should practice cardiac arrest scenarios frequently so that key roles are assigned to each person in advance. This ensures that in a real life situation everyone is clear on what they need to do. This is particularly key when there are new people in the team, or when using a new venue.
Defibrillators save lives and for every minute a patient waits for one to arrive, their chance of survival reduces by 10% showing that every second counts in this scenario.
Stadium/arena based athletics events commonly involves running, over a variety of distances eg 110m hurdles or steeplechase, and also field events consisting of jumps and throws eg high jump or javelin. From a medical perspective this generates up a number of challenges to the team who need to be able to treat everything from collapses to major trauma.
Field Event Extrication
Pole vault, high jump and long jump bring about their own extrication conundrums and should be practiced in advance using the competition equipment before the athletes begin to compete each day. Extricating off a pole vault bed might look simple, but can be surprisingly difficult to log roll and scoop on due to the softness of the surface. Often it is easier to slide the patient (while maintaining c-spine control) onto a spinal board rather than using a scoop in this scenario.
Sand can also make fastening a scoop together problematic if it gets into the clips, so special attention should be made to try and prevent this occurring when possible.
Having the Right Equipment
Given the variety of medical presentations that can occur, its important that the medical provider has the appropriate equipment trackside for the duration of the event. This should include:
· Wheelchair/Carry chair (useful for hamstring injuries etc.)
· Scoop (with head blocks and straps)
· Spinal board
· C – spine colour
· Vacuum/box splints
· Vacuum mattress (for events not near a hospital)
· Response bag continuing airways, intravenous access, medications etc.
Generally athletics events generate low severity incidents (eg hamstring ruptures, blisters etc.) however the risk of significant injury or illness is a real possibility and as such the medical team need to be alert to all possibilities to produce the best possible outcome for the individuals concerned.
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