Safety comes first at all sports levels

Justis column: Youth teams need Emergency Action Plans

Dyersville Beckman's Carter Gassman (9) holds his shoulder after an injury from a collision with a Mid-Prairie player in the Class 1A soccer state semifinal at Cownie Soccer Park in Des Moines on Friday, June 6, 2014. (Liz Martin/The Gazette-KCRG)
Dyersville Beckman's Carter Gassman (9) holds his shoulder after an injury from a collision with a Mid-Prairie player in the Class 1A soccer state semifinal at Cownie Soccer Park in Des Moines on Friday, June 6, 2014. (Liz Martin/The Gazette-KCRG)

Editor’s note: Nancy Justis is a former competitive swimmer and college sports information director. She is a partner with Outlier Creative Communications. 

The most important consideration in the realm of youth sports is safety.

From my personal experience in following my 10-year-old grandson as he plays football, baseball and basketball under the umbrellas of city recreation and AAU programs, I have seen a glaring lack of emergency personnel on site to aid in the care of minor or serious injuries.

“Preparing for an athletics-related emergency should be the top priority at the secondary, youth and club level,” said Dr. Robert A. Huggins, assistant research professor in the Department of Kinesiology and vice president of research and athlete performance and safety at the Korey Stringer Institute.

“Through the implementation of required policies and procedures, these levels of sport can be well prepared in the unfortunate event of a catastrophic injury ... Unfortunately, many state athletic associations, youth sport governing bodies and leagues have yet to fully adopt and implement these lifesaving policies.”

I believe secondary education programs have fulfilled this need admirably, but the children involved in competitive sports at younger ages do not have the medical coverage necessary.

Thankfully, most injuries are minor, encompassing sprained ankles, maybe a broken bone. Many occurrences can be cared for with an ice bag and maybe a trip to the Urgent Care or doctor’s office for an X-ray. However, more than a fifth of traumatic brain injuries in American children are related to playing sports, according to U.S. Representative Bill Pascrell of Colorado who, several years ago, introduced legislation to address a wide range of dangers to young athletes — concussions, cardiac arrest, heat-related illnesses and energy drinks.

There are many Emergency Action Plans (EAPs) available. MomsTeam lists what a comprehensive EAP should include:


• Provide for on-site recognition, evaluation and immediate treatment of injury and illness, which can mean the difference between life and death from such conditions as heat stroke, sudden cardiac arrest, neck or cervical spine injury or serious brain injuries.

• Designate individuals to provide beginning implementation of the cardiac chain of survival, including calling 911, giving CPR and using an Automatic External Defibrillator in the event a player or spectator experiences sudden cardiac arrest, such as a blow to the chest.

• List the circumstances in which referrals to an emergency room or further evaluation by a physician must be made (such as in the case of suspected concussion).

• Require every team have a cellphone, preprogrammed with emergency medical care access numbers, at all games and practices, and that a hospital has been designated for transport.

• Designate individuals responsible for calling EMS and provide such individuals with information on how to place the call and what specific directions to give to direct paramedics to where the game or practice is being held.

• Phone numbers at which players or guardians and the players’ family physicians can be reached in case of emergencies.

• A list of medical conditions (such as asthma or allergies to nuts or bee stings) for each player.

• Medical release/treatment authorization forms for each player.

• Identify the individuals responsible for monitoring non-injured members of the team during an emergency.


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• Insure emergency equipment is available and has been checked or tested to confirm it is in working order and fully ready for use, including an AED, rescue inhalers, peak flow meters (or portable spirometers) for athletes with asthma, along with a nebulizer; an EpiPen for those children with severe allergies available at all times and that coaches are educated in their use.

Parents, if your child’s organization doesn’t provide any of these safety measures, ask why not. I know these steps can cost money, but what is the cost of an injury or death? If your organization cannot or will not provide any of these measures, you need to take steps among yourselves to at least provide the bare minimums — emergency contact information in phones, emergency responder numbers, medical release forms for your coaches, etc.

The National Alliance for Youth Sports lists eight areas to examine when a player is injured.

• Pulse. Normal range is 60-80 beats per minute in children, 80-100 beats in adults. A rapid, weak pulse indicates shock; absence of a pulse indicates cardiac arrest. Athletes may have slower pulses because of the effects of training.

• Respiration. Normal is 12-20 breaths per minute in children, 13-17 in adults. Shallow breathing indicates shock, irregular or gasping indicates air obstruction, and frothy blood from the mouth indicates chest injury.

• Temperature and skin reaction. Hot, dry skin indicates infection; cool and clammy shock.

• Skin color. Red indicates lack of oxygen, heat stroke or high blood pressure. White can indicate shock or heart disease and blue indicates air not being carried adequately or airway obstruction.

• Pupil size. Dilated pupils may indicate an unconscious athlete. Unequal pupils may indicate neurological problems.

• Movement ability. Inability to move a muscle part may indicate a serious Central Nervous System injury.


• Pain reaction. Immovable body part with severe pain, numbness or tingling indicates a CNS injury. Injury that is extremely painful, but not sensitive to touch may indicate a lack of circulation.

• Level of consciousness. Evaluate the level of alertness. Is the person able to respond verbally? What is the response to pain? The patient does not respond to eye, voice, motor or pain stimulus.

I can help you develop an EAP and provide charts and forms if needed.

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