6. Doctor on the sidelines

Abstract

he most evident role of a doctor on the sidelines of both amateur and professional sports is appropriate recognition and management of injury. As the professionalism of the team increases, so does the need for the team doctor to have additional skills to help minimise time lost from injury and maximise sporting performance.Doctors for both amateur and professional teams require competence in the ability to recognise the need for emergency care and coordinate it. Care and management of less seriously injured athletes will often depend on the experience and skill of the team doctor. However, the old sports medicine maxim of "if in doubt, sit them out" is still a reasonable guide to management. Preparing for game dayAdequate preparation is essential. This includes preparing an emergency plan for evacuation of injured athletes, and being aware of the facilities available at the venue (eg, stretchers, collars, examination room). For sports that involve body contact, such as all of the football codes, a stretcher must be available, and this stretcher should be able to be dismantled (for use with patients who have spinal injury). The minimum equipment that a doctor should have access to is a bag and mask, cervical collars and an intravenous cannula.Most football leagues at national and state level supply an emergency pack (comprising cervical collars, airways, oxygen and ABSTRACT • Effectively managing on-field emergencies is the most important role of the doctor on the sidelines. Pre-event preparation is essential and should include a formulated plan for dealing with emergencies and access to emergency equipment such as a stretcher and a bag and mask.SERIES EDITORS:

Return-to-Play in Sport: A Decision-based Model

“…The large black circles represent the states of nature elements (the circumstances under which a decision is made). 15,29,34,50,58,59,62 For example, the evaluation of health status is very different for a concussion versus an ankle sprain. The texts on the far right are individual factors or components identified from the literature that contribute information to the states of nature.…”

“…Therefore, for the same level of risk, the balance of advantages and disadvantages changes with respect to the timing and season involved. [14][15][16]32,34,41,50,88 Some of these groups may provide valuable additional information for the evaluation of risks and benefits, and some may provide misinformation and undue pressure related to their focused concern. 17,29,32,41,59,73,74,92,93 In brief, the primary decision is left to the clinician because it is often difficult to determine if the athlete is in a position to provide informed consent because of the nature of the injury (eg, concussion) or if she/he is being coerced by ''handlers'' or ''superiors'' (eg, coach) or family members.…”

“…[18][19][20][21][22][23][24][25][26][27] Even though musculoskeletal trauma represents the majority of injuries in sports medicine, there is little original RTP research for them. 33,34 Practices such as game-day injections to mask pain and deviations from the typical medical approaches to allow full healing have become commonplace in sports medicine practice, leading to questions among bioethicists, 35,36 media, 37,38 legal professionals, 39 and medical professionals. 31,32 More importantly, the RTP process may be open to influence by those not trained or experienced in medical decision making.…”

Recovery From Injury in Sport: Considerations in the Transition From Medical Care to Performance Care

“…6,7 Under most circumstances, individual providers should not be expected to possess the knowledge and training needed to ensure complete recovery for athletes through all stages of the return-to-play process.…”

The FIFA medical emergency bag and FIFA 11 steps to prevent sudden cardiac death: setting a global standard and promoting consistent football field emergency care

“…Medical emergencies on the football field are not common2 but, if and when they occur, it is imperative that immediate recognition, on-field response and acute medical management are available to the player. Such emergency treatment is most efficiently administered by on-duty medical personnel3 using the appropriate equipment,4 until such time as emergency medical services arrive on scene to assist with additional treatment and/or transfer of the player5 to the nearest, most appropriate medical facility 6…”