Emergency Medical Services System

Serious injuries can be frightening, particularly if breathing or circulation is impaired. As the first responder on the scene, the athletic trainer (or any clinician with first aid training) is expected to evaluate the situation, assess the severity of injury, recognize life-threatening conditions, provide immediate emergency care, and initiate any emergency procedures to ensure the individual is transported to the nearest medical facility without delay.

An emergency medical services (EMS) system is a well-developed process that activates the emergency health care services of the athletic training facility and community to provide immediate care to an injured individual. Every athletic training facility should develop a plan that details the activation of their EMS system. The emergency medical plan should be a written document that is comprehensive yet flexible enough to adapt to any emergency situation at any activity venue. The plan should identify the following general principles: (1) The personnel, with their qualifications, needed to perform responsibilities in executing the plan. (2) Equipment needed to carry out the tasks required in the event of an emergency. (3) Mechanism of communication to the emergency care providers, and the mode of transportation for the patient. (4) The facilities to which the patient will be taken, including how and when those facilities will be notified in advance of the scheduled event or contest. (5) Documentation verifying the implementation and evaluation of the emergency plan, actions taken during the emergency, evaluation of the emergency response, and institutional personnel training. (6) Documentation of an annual review and rehearsal of the emergency plan, and notations indicating whether the emergency plan was modified and, if so, how the plan was changed.

Emergency Medical Services SystemEvery institution/facility should have an emergency response team. The designated emergency response team should meet with representatives from local EMS agencies to discuss, develop, and evaluate the facility’s emergency plan. As part of this process, individual responsibilities and protocols for an emergency situation should be determined. In developing the emergency medical plan, it is important to recognize that in any given situation, the members of the emergency response team can vary. The following questions should be addressed relative to each event: What emergency equipment must be available? What equipment will be provided by the local EMS agency (e.g., spine board and splints) if in attendance at an event? Who will be responsible for ensuring that the emergency equipment is operational? What type of communication will be used to contact emergency personnel? Who will activate the facility’s emergency medical plan? Who will assess the injured individual on-site, and under what circumstances will a local EMS agency be called to the site? If a physician is present, what are the responsibilities of other medical personnel (e.g., athletic trainer and emergency medical technician)? If a physician is not present and the athletic trainer is evaluating the situation, what are the responsibilities of emergency medical technicians responding to the situation? If it becomes necessary to stabilize and transport an individual to a medical facility, who will direct the stabilization, and what protocol will be followed for the removal of protective equipment? Who will supervise other participants if the athletic trainer is assessing and providing care to an injured individual? Who will be responsible for the proper disposal of items and equipment exposed to blood or other bodily fluids?

A written emergency plan should be developed for each activity site to address these questions. The emergency response team should practice the emergency plan through regular educational workshops and training exercises. The use of interactive or simulation practice exercises can better prepare individuals to assume their roles in rendering emergency care.