Coaches and the Injured Athlete
By: Herndon P. Harding, Jr., M.D. Medical Director
Florida Hospital Center for Behavioral Health
Member, USA Baseball Medical & Safety Advisory Group
December 2001

Despite all the efforts of those sharing responsibility for the conduct of the baseball program, injuries are unavoidable. They will occur to spectators and even passersby as well as to the players involved, during practices or games. As in other aspects of the sport of baseball, a coach must be prepared for whatever situation presents itself. The possibility of injury necessities an "EMS" (emergency medical system) that is to work for the coach with the team in any situation.

Four fundamental actions must be employed and first aide training and CPR certification can improve the response.

1. HAVE A ROUTINE EMERGENCY PLAN

A previously determined "first responder" must recognize quickly the possible significance of the sudden injury or other condition and immediately determine the next action. A catastrophic injury such as a cardiac arrest or a neck injury will require a specific immediate response. A "routine" on the field injury will afford more time to implement the appropriate intervention.

2. YOUR EMERGENCY SYSYEM

If a catastrophic or significant injury or event has occurred, immediately activate the local emergency system. This will require: A. Immediate access to a telephone with appropriate money if required. (confirm information if using a cell phone). B. Available telephone numbers of emergency services. A card with these numbers could be made available to every coach and adult supervisor. C. Clear identification of the field site of the injury. If the field is in a remote area an individual should be assigned to meet the ambulance or EMT vehicle. D. Specific tasks should be established in advance. If personnel are available, a call to the individual's family should be made. E. An adult supervisor should be prepared to accompany a child to the hospital to provide support.

3. STABILIZE THE INJURED INDIVIDUAL

CPR should be initiated if this is required. The site of a musculoskeletal injury must be stabilized so that no more damage will be done until experienced personnel arrive.

4. THE REST OF THE TEAM

The non-injured participants must also be supervised to maintain appropriate control. Designate an adult or team member to be in control and notify the group. One can contact the National Center for Sports Safety (205-930-7154), or the National Federation of State High Schools (www.nfhs.org) for established emergency response plans.

If a minor injury occurs, the injured individual can be removed to a safe area and a determination should be made if a return home or a return to previous participation is appropriate. The skill of the appraiser and the type of injury will determine this judgment. Planning is as important as knowledge and skill. Indeed the term should be "pre-planning" to better emphasize the need for being prepared in advance of the event. Pre-planning is essential to an appropriate medical response and USA Baseball strongly recommends that each league have an existing plan for an emergency situation.