Collie Salmon October 4, 2008

1. Serious Injuries Collie Salmon October 4, 2008

2. Purpose Your authority to deal with serious injuries How to identify a serious injury What to do, and what not to do when handling a serious injury

3. Is this a serious Injury?

4. Is this a serious Injury?

5. Is this a serious Injury?

6. Is this a serious Injury? Will be different for different ages: From under 8 to Over 35’s

7. INSTRUCTIONS Group Workshop • Group should breakout into small groups and answer the questions presented; • Write down your answers to each question; • Elect a speaker. Time: 13 minutes

8. Group WorkshopQUESTIONS • What authority does the referee have when dealing with injured players? • Can the Referee / Assistant Referee be held liable for an injured player? • Define a serious injury (give examples)? • What should you do if you determine the injury to be serious? Time: 13 minutes

9. Referee’s Authority under the LOTG Law 5 states that the Referee has the authority to: “Stop the match if, in his opinion, a player is seriously injured and ensures he is removed from the field of play. An injured player may only return to the field of play after the match has been restarted.”

10. FIFA Law 5Decision 1 “A referee (or AR) is not held liable for any kind of injury suffered by a player, spectator or official.”

11. Authority of the Referee Control The Situation

12. 3 Main Serious Injuries Head (concussion), back / neck Injury Broken leg / ankle / arm Large cut (bleeding)

13. How to recognize a serious Injury See the injury Sound of the injury Actions of the injured player Actions of the other players

14. See Injury

15. Actions of the Players

16. Definition of a serious Injury If the player sincerely demonstrates serious physical distress due to an injury to his/her person Source: Collie Salmon Will be different for different ages: From under 8 to Over 35’s

17. Examples of a Serious Injury becomes unconscious; has trouble breathing (not normal); has swallowed his/her tongue; has chest pain or pressure; is bleeding severely; has pressure or pain in the abdomen that does not go away;

18. Examples of a Serious Injury is vomiting or passing blood; has seizures, a severe headache, or slurred speech or blurred vision; has possible broken bones; disfigurement (significant scarring or burns); spinal cord injuries; heart attack; has injuries to the head, neck, or back;

19. Signs and Symptoms of Fractured Bones pale, cool, clammy skin rapid, weak pulse pain at the site Tenderness loss of power to limb associated wound and blood loss associated organ damage Nausea Deformity Crepitus (peculiar crackling, crinkly under skin) These are examples from the English F.A.

20. Transmission of Infectious Diseases Referees are not responsible for administering treatment, Advise against dirty water from a bucket being used to treat an injury - particularly if the injury is an open wound. Some participants may have infectious diseases including HIV/AIDS and Hepatitis B (blood borne pathogens). Contaminated towels, dressings, and other articles containing body fluids should be properly disposed of or disinfected These are examples from the English F.A.

21. Damaged ligaments Damaged ligaments can be more serious than a broken bone; Great care must be taken to isolate the injury; Moving unsupported and improperly bandaged injuries can have a devastating effect in causing further injury and pain to the injured player; Where serious neck or back injuries are suspected, any movement by untrained hands has the greatest consequences. The player should be immobilized pending arrival of medical personnel. These are examples from the English F.A.

22. Head Injuries Stop the game immediately for head injuries

23. Why is a head injury so serious? A head injury may cause serious injury to the brain, even when there is no visible bleeding or injury visible on the outside of the skull. The impact of a hard blow to the head may jar or shake the brain within the skull (closed head injury). The rapid movement of the brain within the skull can cause bruising, swelling, or tearing of the brain tissue. It can also stretch, pull apart, or tear nerves or blood vessels within or around the brain. These are examples from the English F.A.

24. Why is a head injury so serious? Head injuries can sometimes be more complex when players have been taking alcohol or drugs, which can make injury evaluation and recognition difficult. Do not assume any altered behaviour is only from alcohol or drug use. Where serious head, neck or back injuries are suspected, any movement by untrained hands has the greatest consequences. The player should be immobilized pending arrival of medical personnel. These are examples from the English F.A.

25. What do you do (player)? Stop play immediately (blow whistle) Do NOT touch player – Speak to player in a calming tone Assess injury for seriousness Call for assistance: coach/team medic. Call for ambulance if necessary (do not move player if unsure of seriousness of injury) Arrange for the player to be removed from the field safely

26. What do you do (technical)? Remember where the ball was last Note time of stoppage (Stop watch?) Card player before he/she leaves the field Restart with a dropped ball if the game was stopped due to the injury Allow player to return only after play has restarted

27. What do you do (technical)? Add (lost) time to the end of the half Allow substitution, if necessary Write a report if incident is serious and if your decision is being questioned (Discuss with more senior referee before submitting)

28. S.E.R.I.O.U.S. Serious? (The first consideration is to decide if an injury is serious or not.) Evaluate? (Evaluate each injury situation as it arises. Does play need to be stopped?) Race. (Sprinting to the scene of the injury). Inspect. (Taking up a position that allows inspection of the injury and monitoring the remaining players). Organise. (Taking charge, positioning andseeking medical assistance if it is required). Usher. (Overseeing the safe removal of injured players). Start. (Starting the game again after the injury has been seen to). Source: English Referee Association

29. Safety First Referees should always err on the side of safety You will not be criticized for stopping play to inspect a player for an injury

30. Take Appropriate Action

31. OSA Insurance 2. How does this coverage work in terms of referee assault? Accident Coverage The Accident Policy excludes injuries sustained from fighting but does provide coverage if injury is caused by an assault against the referee during a sanctioned game. Liability Coverage The Liability policy is there to defend if an injured party purses compensation as a result of alleged/proven negligence against an individual – in this case a referee. So, yes only provides coverage if the ref is sued (not if the ref tries to sue) Source: OSA Referee Insurance FAQ Document

32. Summary You have the authority to stop the game Study and know all the things you should do and what you should not do to ensure the player is dealt with safely Study Law 5 and Law 5 instructions for referees Review S.E.R.I.O.U.S. article from the English Referee Association Inform authorities if necessary

33. Resources Head Gear: http://www.safety-council.org/info/sport/soccer-ls.html http://www.footballreferee.org/better_refereeing_injury.php http://corshamref.org.uk/newsletter/news06nov.htm http://corshamref.org.uk/serious.htm http://corshamref.org.uk/emergen.htm OSA Insurance: www.hkmb.com/osa