Pitch-side Management

The world of sport is changing and managing pitch-side medicine can be as traumatic as the on-field bumps and bruises we treat. The speed of the game, the size and fitness of the players; the physicality of the contest; the laws, regulations and media expectations have all changed.

The most pressing issue involves the on field management of significant head and neck injuries.

Many global sporting bodies are already addressing the issue of concussion management including pitch-side management of injury, formalising rigid ‘return to play’ criteria and reviewing long term sequelae of recurrent concussive episodes.

Correspondence with Australasian medical defense agencies has yielded affirmatory statements of support for adequate training for those preparing to manage pitch-side trauma. For example MIPS position statement on healthcare professionals providing immediate care in the sports environment:”…there is a requirement that members have the appropriate recognised qualifications, training and experience for the health services they provide. This is also expected from GP’s and physiotherapists who may also undertake such services.”

Over the next series of posts we will review the best evidence, guidelines and #FOAMed resources available to assist in educating the players and coaching staff; the parents and support staff; fellow pitch-side medical staff and emergency care facilities.

Hopefully more informed first aid education for players and support staff will prevent scenes like this following a collision between Dynamo Kyiv captain Oleg Gusev and the opposing goalkeeper.

A standardised approach to the management of concussion and potential neck injuries will reduce the risk of serious injury to the player, dispel the medical myth of tongue swallowing, and may prevent serious finger injuries…

In addition, the latest guidelines to the management of on-field concussion should prevent the ‘heroic‘ return to play of the post concussion, neurologically impaired player…

…but it will take time! Only this weekend I watched in abhorrence as an AFL commentator extolled the virtues of a concussed player returning to play “…that takes strength and courage, out cold one minute, disorientated and woozy, but he is back up on his wobbly pins and straight back into the action – good on you…”

With the standardisation of guidelines and better understanding of the management of concussion for coaches and support staff…Reggie Ray will stay off the field for medical observation and follow a subsequent graded return to training and contact sport

Doc: It doesn’t look good coach..
Coach: Can he play?
Doc: He’s in a coma!
Coach: ANSWER MY QUESTION, CAN HE PLAY?
Doc: I don’t even think he can breathe, we gotta take him to a hospital immediately!
Coach: YOU LISTEN TO ME RIGHT NOW, I DON’T CARE WHAT YOU HAVE TO DO, REGGIE RAY STAYS IN THE GAME GODDAMNIT!!!

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.