Being faced with a catastrophic and life-threatening injury is something most Athletic Trainers (ATs) deal with every day. However, being prepared and rehearsed in an emergency can create better outcomes and potentially save a life. This is what makes an emergency action plan (EAP) important at all levels of athletics.

An EAP is a detailed plan of procedures, personnel and equipment to be utilized in case of an emergency. While there are different variations to EAPs, there are certain components that should be included in every EAP to provide safe, organized and efficient care in case of an emergency.

1. Emergency Personnel - What personnel are on staff for each practice or game? There is normally a difference between the number of healthcare professionals on the sideline for a collegiate football game in comparison to a high school football game. Your EAP should include a list of all ATs, team physicians, athletic training student aides and head coaches. Also, listing the personnel in an order of the chain of command will help when an emergency happens with the delegation of tasks to the appropriate team members.

2. Emergency Communication - If an ambulance is not already present, what phone will be used to call 911? The location of the backup land line should be described with specific instructions on where to locate the telephone.

3. Emergency Equipment – What equipment is onsite in the event of an emergency? Each venue should have an automated external defibrillator onsite, whether in a stationary position or with the AT. Other important pieces of emergency equipment can include, but are not limited to, different types of splints, a spine board, airways (nasopharyngeal/oropharyngeal) and/or oxygen. This can vary depending on the setting.

4. Role of First Responders - What is the responsibility of each first responder? Assign a role to each personnel member. Who will be in charge? Who will call 911? Who will retrieve the emergency equipment? Who will be in charge of the equipment removal? Who will unlock the gates and show emergency medical services (EMS) the location of the injured athlete? Who will accompany the athlete to the hospital if no parent or guardian is present? These are all important questions that should be outlined in the EAP and be rehearsed at least once a year to ensure everyone knows their role.

5. Activation of EMS - What information is important to state during the 911 call? One designated person should be responsible for calling 911. During the call, the first responder should state the phone number he or she is calling from and the address of the incident, including specific directions if warranted. The first responder should also state the patient’s name, age, condition, what treatment has been provided and any other pertinent health information that would need to be included with the treatment.

6. Venue Directions - What is the easiest way to get to the venue? Include specific directions from major highways or streets most people will know how to access. It may also be important to provide directions to or from the nearest hospital. This will help any family members who may need to drive separately. Also, including a map of the venue can be helpful with showing different entry points, location of telephones and any other pertinent information.

There are also many other vital aspects to constructing an efficient EAP. Below are some key points that should be discussed.

Each venue, field, court or gymnasium should have a specific EAP for each sport

Establish specific procedures and policies for equipment removal

Phones should be accessible at all times. The easiest method is using a cell phone, but it is important to also have a backup plan, such as using a landline phone in the athletic training room or any nearby facility

Each personnel member should have a copy of keys for each door or gate, or a copy of the keys should be in a place accessible by all personnel

If possible, assign a person to accompany the injured athlete to the hospital. This maybe a parent in some cases

When traveling, it is important to have a copy of contact information for each athlete and other personnel

If you are the home team or venue for the competition, it is your responsibility to review the EAP with the healthcare professionals from the other team(s). A time out should be held prior to the competition beginning to review a checklist of the important components of the EAP. It would be helpful to give the members of each emergency response team a hard copy of the EAP, providing them with the necessary phone numbers and directions they may need in case of an emergency. Conducting a time out will help all personnel be on the same page if a life-threatening or severe injury should arise. All healthcare providers should meet prior to the start of the competition or practice and discuss the following topics.

Introduce each person, along with their title, and decide their role in the combined EAP

Discuss how communication will occur (cell phone, radio, hand signals, etc.). Pick a first line of communication and a backup communication

Inform all members if there is an ambulance onsite or not. If the ambulance is onsite, is it a dedicated unit or is it on stand-by? What is the plan if the ambulance leaves and an emergency occurs? Discuss the process of calling 911 for an ambulance, and approximately how long it will take for the ambulance to get there

Discuss the designated hospital in case of an event of emergency transport

Talk about what emergency equipment is available on both sidelines

Leave time for questions at the end of the time out

EAPs are important documents that can make a positive difference in a life-threatening situation. Make an effort to review and practice your EAP and ensure that all the critical components are covered. Also, ensure all members of the healthcare team including EMTs, physicians and student aides are well rehearsed with the EAP and know their role in case of an emergency. ATs are typically the first responders when an injury occurs, and need to have support from the healthcare team to make sure the emergency is handled properly.

For more information on developing an EAP or other policies and procedures for your athletic training facility, visit the BOC Guiding Principles for AT Policy and Procedure Development document and online tool. The document and online tool offer a template to guide the development of policies and procedures including EAPs. Learn more at www.bocatc.org/policy.

References

Andersen, J. C., Courson, R. W., Kleiner, D. M., & McLoda, T. A. (2002). National Athletic Trainers' Association position statement: emergency planning in athletics. Journal of Athletic Training, 37(1), 99.

Arnheim, D. D., & Prentice, W. E. (2002). Essentials of athletic training. McGraw-Hill.

National Athletic Trainers Association (2012). National Athletic Trainers’ Association Official Statement on Athletic Health Care Provider “Time Outs” Before Athletic Events [Handout].