Procedures for Medical Transport of Student-Athletes

Unfortunately, medical emergencies happen during athletic events. When a student-athlete goes down on the field with a significant injury, the medical team led by the athletic trainer will respond. Occasionally, after the initial evaluation it is determined that the venue specific Emergency Action Plan (EAP) should be activated, and transport to a medical facility such as a hospital is needed for the student-athlete. Hopefully the medical team’s training kicks into gear and everything goes according to the EAP.

Once the student-athlete is stabilized and turned over to the emergency medical services personnel, that is not the end of the school medical team’s services. It is an important aspect of any EAP to continue to track the situation. All aspects of the EAP are just as vital as the activation, and the transport of the athlete should be tracked and documented.

Following are other aspects of the event that should be factored in to help ensure a smooth transition of care during what will be an important and often stressful event.

1. Stay Calm and Organized:
Maintaining a calm demeanor helps to reassure not only the student-athlete and the medical professionals but also administrators, onlookers and the family members of the downed athlete. It is important to organize one’s thoughts before the handover to EMS to communicate clearly and concisely.

2. Engage with Medical Personnel:
Making eye contact and addressing the medical responders directly is critical. This shows respect for their expertise and also, they will pay better attention to the information being provided.

a. Be prepared to communicate what medical facility to transport the athlete.
b. Call ahead to ERD to alert the hospital about the athlete.
c. Call ahead to the team physician so he/she can be a valuable resource to help communicate with the ERD and attending physicians.

3. Be Open to Questions:
Allow the medical professionals to ask questions. They may need clarification or additional details to fully understand the situation.

a. Don’t get offended if emergency medical personnel have not worked with an athletic trainer before and do not understand the background and training that they have. When this happens, the EMS personnel may try and discard the information from the athletic trainer or ask very basic questions. All entities should try and be patient and clearly communicate the situation.

4. Documentation:
If possible, the initial care team should provide any documentation or notes made during the assessment and treatment. This can be invaluable for medical personnel.

a. Previous medical history.
b. Pre-existing medical conditions.
c. Contact numbers – if parent/guardian not available.
d. Medical Authorization to Treat Form (needed if no parent/ guardian is available).

Another consideration is who from the school, if any, should go with the athlete. This could be a coach or an administrator. Also, will a parent or guardian be available to go with the injured athlete. If the parent or guardian is not present, there needs to be a plan to notify the family regarding the situation. Other things to consider:

1. In the event there is only one athletic trainer for the school, it would not be in the best interest of the event for that person to travel with the injured athlete.
2. Can a staff member from the school such as a coach or administrator go with the injured athlete? A coach is always a good option, but it is important to not leave the team unsupervised or minimally supervised. If there is a family member or a family member of the student-athlete’s friend, that person could be considered.
3. Although not ideal, sometimes there is no one to travel with the athlete, and that is OK.

After the transport, what can the athletic trainer do to continue to monitor the situation? Depending on the many variables, the athletic trainer may have to remain at the venue until finished and then go to the hospital. The athletic trainer should be the point of contact for keeping coaches and administrators apprised of the situation. There will always be those injuries that require a little follow up; however, there may be a time where the school will have to be prepared to determine what information is shared and who it is shared with.

An extreme example would be if a football player with a subdural hematoma required immediate surgery to relieve the pressure. Something like this could garner media attention. School staff, including the athletic director and athletic trainer, should work with the family and school administration on developing press releases. While this is not a normal situation, disseminating what information and how it is done should be considered.

After the transport of the athlete, following are some steps the school staff should consider:

If the game is still in progress, follow up with personnel and injuries that were put on hold due to the EAP being activated.
1. Don’t be hesitant to jot down information on the situation; it will help with recall when completing documentation.
2. Once the game is over, a debrief with a colleague, an administrator, a coach, or even loved one will help immensely. After a stressful situation such as this, talking through the situation will often help the individual think more clearly about the situation.
3. Another aspect that should not be overlooked is if the contest will continue and, if so, getting another EMS vehicle on site to replace the one that left with the injured student- athlete. Hopefully, the athletic trainer and the EMS supervisor have had this conversation prior to the EMS leaving the facility.

The transportation of an injured athlete is a vital part of the entire Emergency Action Plan. The continuity of care from the field to EMS to the ERD can ensure that the athlete receives the best care in the fastest way possible. Not all situations are the same, and the school’s athletic trainer cannot always cover everything that occurs during an emergency event; however, a well-planned and practiced EAP will ensure the best possible care for student-athletes.