Acute and Emergency Care in Athletic Training

The primary job of athletic trainers is to provide immediate care to injured athletes.

Acute and emergency care is the athletic trainer’s responsibility, as athletes are at risk of injuries and suffer medical emergencies during training and competition.

Emergency Action Plan for Athletic Trainers

All athletic programs should have a detailed emergency action plan (EAP) in place. A good EAP includes well-defined steps to take in a medical emergency during training and competition. Along with developing and rehearsing these plans, athletic trainers should make certain that all staff are trained in the procedures and able to implement them should an emergency occur. The National Organization for Athletic Trainers (NATA) offers an online guide to create a custom EAP, which athletic trainers can download here.

Recommended course: Emergency Management in Athletics

The role of an athletic trainer in an emergency care situation

Athletic trainers must be ready to provide immediate first-aid care and support to injured athletes until advanced medical attention arrives. Fast and injury-appropriate first aid can help minimize the severity of injuries and facilitate recovery. In case of injury or medical emergency, initiate the EAP and follow these general steps.

Assess the scene

Confirm that the area is safe for the injured athlete, staff, and first responders. Check the field, court, or training area for potential threats and hazards. If any are found, determine the next steps to ensure safety. This may include removing obstacles or training aids, or other measures. Remember that each situation is unique, and the priority is safety.

Care for the athlete

Determine if the athlete is conscious and responsive. Conduct a primary assessment to identify life-threatening conditions:

• A (Airway): Make certain that the athlete's airway is open and unobstructed.
• B (Breathing): Look for normal breathing.
• C (Circulation): Check pulse. If present, control bleeding.

Start CPR if necessary. If an AED is available, follow its instructions for use. If the athlete is conscious and alert, obtain a quick medical history. Ask about how the injury occurred, and any previous injuries, medical conditions, medications, or allergies that could impact immediate care.

Control bleeding

To control bleeding, apply direct pressure to wounds using sterile bandages, dressings, or a clean cloth. Any materials that touch an open wound should be as sterile as possible to prevent infection.

Immobilize

If the athletic trainer suspects a head, neck, or spinal injury, immobilize the athlete's head and neck to prevent additional injury. If available, use a cervical collar and/or backboard to further limit movement until advanced aid arrives.

Palpate

Provided the athlete allows, gently touch and feel the injured area to check for tenderness, bony abnormalities, muscle spasms, and temperature changes to skin. Gentle palpation can help to determine the specific location and source of pain.

Tape and brace

Taping and bracing techniques provide immediate support and stability to injured joints or muscles. Do this once an initial assessment is complete and the athletic trainer is confident the athlete is conscious, doesn’t have an immediate life-threatening condition, and the athlete is agreeable.

Splint

For suspected bone fractures or joint dislocations, immobilize the injured limb to prevent movement and reduce pain.

Elevate

To reduce swelling and discomfort associated with musculoskeletal injuries, elevate the injured limb. If allowable and once elevated, evaluate the injured joint or limb's range of motion. Compare it to the uninjured side to identify any limitations or abnormalities. This can help determine the type and extent of the injury.

Ice

Apply ice directly to the injury to reduce inflammation.

Monitor

Monitor the athlete's condition while providing first aid and waiting for first responders to arrive. Pay careful attention to any changes in consciousness, breathing, and/or heart rate.

Communicate

Keep the athlete informed about what is happening and the next steps. Communicate to coaches, staff, team members, and medical personnel about the situation.

Document

Once first responders and/or advanced medical personnel assume care of the athlete, clearly document the details of the injury, the actions taken, and the athlete's current condition. Detailed records are important for follow-up care for the athlete and for legal purposes for the staff and facility.

Remember that first aid is a temporary measure. Acute and emergency care in athletic training and injury assessment is a fundamental aspect of athletic training. It involves a systematic evaluation of an injury that occurred during training and competition with the primary goal of initial injury assessment to determine the nature and severity of the injury until first responders can arrive and the injured athlete can be referred for more advanced medical care.