A Coach's Guide to First Aid

In this article, we walk through best practices for assessing and treating head injuries, bleeding, fractures, sprains, heat exhaustion & heat stroke.

A Coach's Guide to First Aid

A coach is often responsible for the safety of their athletes and knowing first aid gives them the ability to respond to an emergency situation.

Whether you're a dance instructor, a skating coach, a music teacher, or football coach, keeping your students safe is always the top priority.

In many cases, a coach is the first responder to an athlete who is injured and knowing how to properly assess and treat an injury can mean the difference between walking away and serious injury.


In this article, we'll walk through the best practices for assessing and treating:

  • head injuries
  • bleeding
  • fractures
  • sprains & strains
  • abdominal pain
  • heat exhaustion & heat stroke

Learn to assess and treat the injury

CPR and First Aid certified coaches are not only able to treat minor cuts and scrapes, but they can also assess injuries and make informed decisions about whether a student should continue to train or not.

Whether or not it is required by a regulating body, you are responsible for your students well-being, and you should have an up-to-date first aid certification. You don't want to be caught off-guard and not know what to do!

While serious injuries are rare during children’s sporting events, they can happen, and they can be catastrophic. Even relatively minor injuries like strains and sprains can be less frightening if you know what to do when they happen.

One of the more difficult jobs of a coach is deciding whether a child can or cannot return to a game following an injury or if they require evaluation by a healthcare professional.

When in doubt about the seriousness of any injury, you should always have the child assessed by a healthcare professional before allowing them to return to the game or even to leave the facility at the end of a game.

It should go without saying, but a child with any significant injury should not be permitted to return to the activity without a medical release from a physician.

It is better to miss one game than to miss an entire season or worse. Remember, a minor cannot consent to a treatment and therefore cannot refuse said treatment.

When a parent or legal guardian is not present, you have (or should have) his or her medical consent. That makes you the decision maker, not the child.

Head injuries

Concussions and head injuries in the sports community have been getting a lot of attention in recent years. They can have serious long-term effects and be difficult to assess at the time of the injury. That's why it's important to be cautious and have the child evaluated by a healthcare professional if there is any doubt.

Any significant blow to the head should result in the student being removed from the activity and seen by a healthcare professional.

If the student is unconscious, call for EMS and carefully observe for signs of shock or skull fracture.

If the student is conscious, check for alertness and orientation, numbness or tingling, weakness, dizziness, or slurred speech.

If the student is unconscious:

  • Immediately call for EMS services.
  • Evaluate if there are signs of shock or skull fracture — look for bleeding around the eyes, nose, or ears.
  • Observe for the length of time that unconsciousness lasts.
  • Immobilize the student to prevent any further damage to the brain, spinal cord, or neck.
  • Wait for EMS to arrive.

If the student is conscious:

  • Check for alertness and orientation — assess whether or not the student knows where they are or what day it is.
  • Assess for numbness, tingling or weakness of any extremity.
  • Check for dizziness, or general weakness.
  • If the student is unable to stand, allow them to assume a position of comfort and summon EMS.
  • Check the student for slurred speech, ringing in the ears, a full feeling in their head, or memory loss.

If any of these signs are present, the student needs to be taken to the hospital for evaluation by a medical professional.

Concussions that are left untreated can lead to Second-Impact Syndrome, which is life-threatening. So it's important to get any head injury checked out by a healthcare professional.

Bleeding

Injuries that involve bleeding are unfortunately quite common in any sport. It's important to remember that blood can be infectious, which means that any student who is bleeding must be removed from the practice or game immediately.

The wound must be cleaned and covered in order to protect the other students from exposure to potentially infectious material.

In most cases, bleeding is not considered an emergency and can be controlled relatively easily by the coach. However, in some sports that involves sharp edges – such as figure skating, power skating, or hockey – there is a higher risk of serious cuts and gashes.

Coaches for these sports need to be able to stop or slow the bleeding quickly, and take appropriate action.

Call 911 if:

  • Bleeding is severe
  • You suspect internal bleeding (how to spot internal bleeding)
  • There is an abdominal or chest wound
  • Bleeding can't be stopped after 10 minutes of firm and steady pressure
  • Blood spurts out of wound

Step 1: Stop the bleeding

  • Apply direct pressure on the cut or wound with a clean cloth, tissue, or piece of gauze until bleeding stops.
  • If blood soaks through the material, don’t remove it. Put more cloth or gauze on top of it and continue to apply pressure.
  • If the wound is on the arm or leg, raise limb above the heart, if possible, to help slow bleeding.
  • Wash your hands again after giving first aid and before cleaning and dressing the wound.
  • Do not apply a tourniquet unless the bleeding is severe and not stopped with direct pressure.

Step 2: Clean the wound

  • Gently clean with soap and warm water. Try to rinse soap out of wound to prevent irritation.
  • Don’t use hydrogen peroxide or iodine, which can damage tissue.

Step 3: Protect the wound

  • Apply antibiotic cream to reduce risk of infection and cover with a sterile bandage.
  • Change the bandage daily to keep the wound clean and dry.

Step 4: When to Call a Doctor

  • The wound is deep or the edges are jagged or gaping open.
  • The wound is on the person’s face.
  • The wound has dirt or debris that won’t come out.
  • The wound shows signs of infection, such as redness, tenderness, or a thick discharge, or if the person runs a fever.
  • The area around the wound feels numb.
  • Red streaks form around the wound.
  • The wound is a result of an animal or human bite.
  • The person has a puncture wound or deep cut and hasn’t had a tetanus shot in the past five years, or anyone who hasn’t had a tetanus shot in the past 10 years.

Fractures

Most fractures in children are not life-threatening, but they can be serious.

All fractures should be taken seriously by a healthcare professional until proven otherwise.

In the case of fractures of the upper leg, they can be life threatening and require immediate attention, especially if there has been any injury to the femoral artery.

Sprains and strains

As a coach or instructor, watching your students compete can be both exhilarating and terrifying. You want them to have fun and do well, but you also know that injuries are always a possibility.

While sprains and strains may not be considered medical emergencies, they can still be pretty painful. If your student does suffer a sprain or strain, don't allow them to bear weight on the injured limb. They should be assisted off of the field.

Most sprains and/or strains can be treated with by applying the RICE framework:

  • rest
  • ice
  • compression
  • elevation

If there is any doubt whether or not the injury represents a sprain/strain or a fracture, always err on the side of caution and treat it as a fracture until proven otherwise by an x-ray.

As a coach, it's important to be prepared for everything, and lnowing how to properly deal with a sprain or strain can help ensure a speedy recovery.

Abdominal pain

If your student is experiencing abdominal pain, it is important to pay attention to other symptoms that may be present.

If the pain is accompanied by dehydration or heat exhaustion/heat stroke, then the student should be evaluated by a medical professional.

If the pain is the result of an injury, then a careful assessment of the symptoms is necessary. In some cases, abdominal injuries can be as dangerous as head injuries. If you are concerned about your students's condition, it is always best to seek medical attention.

Heat exhaustion and heat stroke

With the summer heat in full swing, it’s important to be aware of the dangers of heat exhaustion and heat stroke. Both are very serious medical emergencies and can be prevented during sporting events. An increase in body temperature and a decrease in the body’s ability to get rid of the heat are complicated by dehydration and loss of electrolytes.

Heat exhaustion begins with profuse sweating, cramping of the extremities and the abdomen (sometimes referred to as heat cramps), nausea/vomiting, headache, dizziness, and cool, clammy skin.

If left untreated it will quickly progress to heat stroke which is a life threatening emergency.

Heat stroke is characterized by the body’s inability to deal with its increasing temperature. The skin becomes hot and dry because the body can no longer sweat. The patient begins to have difficulty breathing, becomes agitated and confused, and sometimes loses consciousness. This can quickly lead to irreversible brain damage and even death.

Prevention of dehydration is key to preventing heat stroke and heat exhaustion. Children should always remain hydrated. They should be drinking plenty of water and taking frequent breaks on hot days. Everyone should be drinking water during non-playing times.

You should remember that even on a day that doesn’t feel hot to us, if you are coaching a sport that requires protective gear such as football, body heat can be trapped and become exaggerated.

If it is a hot day, players should be switched frequently to provide rest and to replenish fluids.

Treatment is aimed at cooling the child down. Interventions such as removing clothing, applying cool water to the skin, and placing ice packs to their underarms and groin should assist with reducing their temperature.

Heat stroke is an extreme emergency and requires emergency medical treatment at a hospital. EMS should be summoned immediately if a heat stroke is suspected.


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