First Aid

1. First Aid You’re the first point of contact… What do you do?

2. First Aid First Aid is known as the emergency treatment administered to an injured or sick person before professional medical or surgical care is available. ‘First aid is the initial management and treatment(of a player) for the purpose of preserving life and minimising the consequences of serious injury/illness in (football) environments until professional medical (ambulance/paramedics) help is obtained’. (The F.A.) The F.A. define it as...... Always remember, you must be qualified to deliver First Aid or you may make the injury/condition worse.

3. When applying first aid, you must assess the situation. This will help you to prioritise who, what and when to help! Think back to the last injury you witnessed and imagine you are the designated First Aider, answer the following questions... What did you see? What was the mechanism (how did it happen) of injury? Is it safe to approach? Are their any hazards or dangers to you or others? Can you assess situation quickly/safely? Does the injured player respond to you? Does player appear conscious or unconscious? What are your priorities and what should you do next?....

4. Resuscitation If the player has no pulse and/or is not breathing the First Aider may have to perform resuscitation. This is keeping the injured players heart beating and lungs breathing for them. Watch the follow video on YouTube to learn how to perform Resuscitation… You will be having a go! http://www.youtube.com/watch?v=JR0aZX1_TD8 Remember only a qualified First Aider should attempt to resuscitate someone unless there is no-one else around to help you!

5. Bleeding Severe Bleeding is a life-threatening condition, therefore the bleeding must be controlled quickly. There are 4 procedures to follow; Apply Pressure Elevate Dress the Wound Monitor 4. Monitor If the wound is severe you may need to monitor the player as they may go into shock due to blood loss. You may also want to check that the dressing isn’t too tight and restricting circulation. 1. Apply Direct Pressure This is to try and stop the flow of blood and encourage a clot to form. 3. Elevation Elevate the bleeding limb or area above player’s heart (if practicable). This will reduce the amount of blood flow to the wound. 2. Apply a Dressing Applying a sterile non-fluffy dressing covers the wound protecting it and preventing the spread of infection.

6. Shock Shock is a life-threatening condition. It is caused by severe blood loss resulting in loss of oxygen to body’s vital organs. It requires immediate hospital treatment or it could be fatal. • Signs & Symptoms of Shock • pale/cold/clammy skin sweating • blueness of lips (cyanosis) weakness, dizziness • thirst rapid shallow breathing • unconsciousness. • Treatment for Shock • •Dial 999 or take the player to hospital. • •Treat cause of shock i.e. stem the bleeding causing the excessive blood loss. • •Help player lie down • •Raise/support player’s legs above level of heart (if injury permits). • •Do not raise head. • •Loosen player’s clothing if constrictive at neck/chest/waist. • •Constantly reassure / do not leave player unattended. • •Monitor breathing/level of consciousness whilst awaiting ambulance.

7. Fracture ‘A fracture is a loss of continuity in the bones surface’. (The F.A.) What is a Fracture? A fracture is a break, crack, flake or chip in the bone. Signs &Symptoms of a Fracture •The player or others may have heard a ‘crack’. •There will be localised pain •Sometimes there can be a visible deformity, for example a bend in the limb or bone protruding from the skin. •Localised swelling &) bruising. •The player may be unwilling or unable to move or put weight on the limb. •Sometimes there can be numbness or tingling (pins & needles). • Treatment of a Fracture • •Do not move the player. • •Immobilise the injured limb. • •Call 999 for an ambulance. • •Keep player warm. • Monitor

8. Prevention of Infection After breaking the skin there is a risk of infection for both the injured player and the First Aider. This can be prevented by following the guidelines below: •hand cleansing (as/when appropriate) •cover own wounds (particularly on hands) •wear disposable gloves •carry ‘yellow’ plastic bags (disposal of ‘contaminated’ items) •personal immunisation, e.g. tetanus immunisation.

9. Qualified Assistance & Accident Report Forms A First Aider should always know their capabilities and never attempt to treat beyond those. After initial treatment they should summon qualified assistance, for example, call 999, advise them to see their GP or refer the player to the Physio. A First Aider should also complete an Accident Report Form, which most clubs should have. This is a legal document that logs the injury, the treatment provided and who was involved. This covers the First Aider from repercussions e.g. A case of negligence. Take a look in the resources section at the example Accident Report Form Template.

10. Scenario… • You should now be prepared to write instructions for a First Aider who has come across a player with one of the following: • - An open fracture • - Collapsed and not breathing • - A large gash to the thigh Choose 1 of the 3 scenarios above and explain how to administer first aid at the scene.

11. Common Treatmentsfor Sports Injuries

12. S.A.L.T.A.P.S. After following these steps you can make an informed decision on whether the layer should come off or carry on playing. Stop – when the player goes down Ask – the player what happened and how they feel? This will give you an indication of the severity of the injury. Look – for obvious visual signs of an injury e.g. bleeding, swelling or deformity Touch – to see if you can locate the source of pain (if the player allows it) which may indicate what the injury is and how severe it may be Active – is the player able to actively move the injured area themselves with full range of movement? Passive – are you able to passively move the area with full range of movement? Strength – does the player maintain original strength?

13. P.R.I.C.E.D. After administering First Aid, you may go on to follow the PRICED acronym. Protect – your first objective is to protect the injury from further damage Rest– by resting the injury (for example not weight bearing) you prevent further damage and allow the injury to begin the healing process Ice – applying ice reduces inflammation and decreases discomfort and pain Compression – applying compression through a bandage or tubigrip helps reduce swelling Elevation – elevating the injured area allows gravity to drain some swelling Diagnosis by Professional – always refer the player to a professional such as a Doctor or Physio for an accurate medical diagnosis

14. Taping, Bandaging & Tubigrip Strapping and taping is used in sport to prevent injuries and also aid a smooth return to sport post-injury. Tape can restrict unwanted movement or activate inactive (or lazy) muscles. There are many different types of tape, all claiming to optimise sports performance, some of which include; kinesio tape, zinc oxide, elastic adhesive and self cohesive . Bandages and Tubigrip are more likely to be used in the acute stages of an injury to create compression, reduce swelling and give added support.

15. Hot & Cold Therapy • After an injury ice can be very beneficial. It can: • Reduce bleeding within tissues • Prevent or reduce swelling • Reduce muscle spasm • Reduce pain by numbing the area and reducing swelling (which causes pain through pressure) Ice or cold packs should be applied for 10-15 minutes every 2-3 hours. Be sure to protect the skin if you apply ice/cold packs to prevent an ice burn. • Heat is only beneficial when the injury is 48-72 hours old, otherwise it can worsen the bleeding and inflammation. • Heat can be applied in the form of: • Deep heat creams • Heat pads • Hot water bottles • Heat lamps • Heat works by dilating the blood vessels allowing more blood to the area which has a soothing effect. It eases pain and muscle spasms. Heat can be used at the players preference but, again, care should be taken not to burn the skin.

16. Sprays & Creams Sprays and creams work on the same principle as Hot & Cold Therapy. However, they are more mobile and so are used more “on-the-go”. They work more superficially and are thought to be less effective. Limb Supports & Splints Splints are used to immobilise a limb or joint, where range of movement needs to be restricted (maybe after an operation or after a torn ligament for example) Limb supports include devices like Fracture packs, leg or arms braces and foot orthotics. Fracture packs are used in emergencies to immobilise joints. Limb braces may help with introduces movement to a joint gradually, after an operation and foot orthotics are used to improve the biomechanics of the foot.

17. Electrotherapy Electrotherapy is used to reduce symptoms and promote healing. Ultrasound This uses sound waves at a high frequency to penetrate tissues. The vibration caused by the sound waves stimulates cell membranes to enhance the repair process. T.E.N.S. (Transcutaneous Electrical Nerve Stimulation) A low intensity electrical current is passed through electro pads placed on the tissues. The result is decreased pain and swelling and increased blood flow, all of which promote healing. Laser Therapy It is unclear as to how this method of therapy works, but it is thought to be effective in reducing pain in the short term as well as promoting healing.

18. Medical Referrals GP or Doctor Chiropodist MRI Scan Severe or on-going injuries may need a medical referral to a specialised professional or for the use of specialised equipment. This may include: Physiotherapist Chiropractor/Osteopath Podiatrist

19. Scenario… • After familiarising yourself with common treatments used, write down the possible treatments for: • Lower back pain • Ankle sprain • Fractured tibia • ACL rupture • Choose 1 of the above and remember to include: • Which of the treatments would be appropriate to use • The timescale of these treatments, when to use them? • What are the benefits of the treatments?