PREVENTION AND CARE
An integral component of all coaching and playing activity throughout the season must be the prevention and management of injury to players (and coaches). There are numerous simple tasks a coach can and should do in order to secure the health of his or her players. Before the season begins, the coach should make sure all parents know the emergency procedures for all situations (injuries, accidents, weather problems). This procedure should be clear and simple. If it includes cell phone use, the coach should make sure he/she gets reception at all playing sites.
Field Safety/Weather Conditions
Before starting practice or a game, it is important to check the field for dangerous objects. Often glass and other sharp objects can be found on fields, as well as holes and other hazards. Goals need to be inspected and anchored properly, or moved away from the playing area if not being used. When moving goals, it is important to utilize adults and to supervise them, as often it is the first time they are moving goals. They may not know how to move them or realize how heavy they are.
At every field you need to look to see where you could go in case of lightning or heavy rain. Is there a building or public bathroom nearby where you could fit all the children? If not, do enough parents stay to watch practices and games in order that all the children could fit in their cars in case of severe weather? At the first sign of lightning, get the players into a safe environment. This is where your written emergency plan comes into use. Lightning detectors are already in use at many of the parks in which you play. Make sure you know the meaning of all signals coming from this system. If you do not have a lightning detection system, seek out ways to get one installed.
Seeing all the Children
Players can not be let out of your sight. Often times, young players need to go to the bathroom. Make sure they are supervised when they go (preferably by their parent). Never allow a child out of your sight without adult supervision.
Second Adult Present
Always have a minimum of two adults at every practice. This allows one person to care for injuries or bathroom breaks as the other tends to the rest of the team. It also provides for another witness in the case of injury or accident. Make sure that both of you are present until the parents of the last child arrive. You should stress to parents they should arrive on time to pick up their children.
Before the season starts, check to see if you have a player whose parent is a doctor or nurse. Also ask parents if their children have any pre-existing conditions and how they normally deal with these conditions. Ideally, the coach is CPR and First Aid qualified. The coach should have a simple first aid kit and ice (or ice packs) at all events. It should be mandated that players always wear shin-pads and come to practice with water. Parents should be told to apply sunscreen on their children on sunny days. If players come to the field with a hat on to protect their head from the sun, ask that they wear a soft-brimmed hat as baseball caps could cause eye injuries to other players.
What To Do In Case of Injury
When a player goes down with an injury, it is important to remain calm, and ask your assistant or a parent to take care of the team. If you have had to stop practice, it must be fairly serious. Even if you are qualified, you need to make sure that you get immediate assistance for the player. After caring for your own safety, checking for responsiveness and calling for help, it is important to check ABC's. ABC's stand for Airway, Breathing, and Circulation.
The most likely problems you may encounter are two children running into each other and banging heads, heat exhaustion, prior medical issues (i.e. inhalers) and dehydration. Make sure that the parents of an injured player know their son or daughter was hurt during practice. Err on the side of safety.
Cuts – If blood is involved, always wear latex gloves for protection. Clean the wound and apply a clean, sterile bandage. If a deep cut, apply light pressure to the wound to control bleeding. Recommend that the parent immediately take the child to the hospital for a professional opinion.
Head injuries – When approaching a player that has suffered an apparent blow to the head, do not try and move them until you have been able to establish communication with them and can confirm they are conscious and in no immediate severe pain. If the player is unresponsive, immediately call 911. Do not move a player who has suffered a head trauma as there may be internal damage. Only consider moving an unconscious player if their airway is obviously blocked due to the position of their head and body (.i.e., face down with face in the grass). If the player is responsive, ask them to identify where they were struck (head, face, jaw or neck area) and if and where they are experiencing any pain. If the player is experiencing any pain, dizziness, or nausea, they should be removed from the field and not be considered for re-entry into the game. Immediately contact the parents so that they are aware of the nature of the injury and can decide to take their child to the hospital or doctor. It is best for both safety and liability issues to ask the player to provide a doctor’s note clearing him to play before allowing a head injured player to participate in any future training or game.
Heat exhaustion – A player with heat exhaustion may feel sick and dizzy, have a high body temperature, and is still sweating. This may come on suddenly. Have the player stop playing, find some shade, and cool him/her down by using cool water on his/her clothes, head and neck. Ice may shock the body and can be dangerous. Use cool water to gradually reduce body temperature. If the player is able, it is alright to have him/her take sips of water.
Heat cramp - Heat cramps are painful, brief muscle cramps that occur during exercise or work in a hot environment. Muscles may spasm or jerk involuntarily. Cramping may also be delayed and occur a few hours later. Heat cramps usually involve the muscles fatigued by heavy work such as calves, thighs, abdomen, and shoulders.
Abrasions - Abrasions are very common sports injuries that are usually caused by a fall on a hard surface. As the athlete falls or slides on the ground, friction causes layers of skin to rub off. General treatment of abrasions includes treating the area by cleaning the wound with mild soap and water or a mild antiseptic wash like hydrogen peroxide, and then covering the area with an antibiotic ointment and a dry dressing. Be sure to wear latex gloves before you treat the player!
Heat stroke – If a player shows signs of heat stroke their sweating will stop, the player may be confused or dizzy, have pale skin, an extremely dry mouth or be unconscious. It is important to call an ambulance immediately. This can be life threatening. While waiting for the ambulance, similar steps to that which are taken for heat exhaustion should be followed. Making sure your players are properly hydrated will help prevent heat injuries.
Nose Bleed - Place the player in a sitting position with the head forward. Apply pressure to just below the bridge of the nose. Use ice when necessary. Be sure to wear latex gloves before you treat the player! If you suspect a head or neck injury do not try to control the bleeding. Instead, stabilize the head and call 911.
Fractures & Dislocations - If a body part does not have a normal appearance or function then suspect a fracture. Do not move the player, keep warm and make comfortable, call 911. With a possible dislocation, the joint will have a marked deformity with intense pain. If a player can walk, immobilize the joint and immediately transport to hospital. If the player is unable to walk then call 911.
Sprains, Strains and Contusions –
Strains are injuries that affect muscles or tendons, thick bands that attach muscles to bones. They occur in response to a quick tear, twist, or pull of the muscle. Strains are an acute type of injury that results from overstretching or over contraction. Pain, weakness, and muscle spasms are common symptoms experienced after a strain occurs.
Sprains are injuries that affect ligaments, thick bands of cartilage that attach bone to bone. They occur in response to a stretch or tear of a ligament. Sprains are an acute type of injury that results from trauma such as a fall or outside force that displaces the surrounding joint from its normal alignment. Sprains can range from a mild ligamentous stretch to a complete tear. Bruising, swelling, instability, and painful movement are common symptoms experienced after a sprain occurs.
Contusions or bruise, is caused when blood vessels are damaged or broken as the result of a blow to the skin.
R.I.C.E. Principle (Rest, Ice, Compression, and Elevation) is the best method of dealing with these injuries. Using these 4 immediate first aid measures can relieve pain, limit swelling and protect the injured tissues.
The R.I.C.E. Method of Acute Injury Treatment
Rest: Resting is important as it will allow the injured area the time to heal itself as well as help prevent further injury.
Ice: Use ice bags & cold packs to limit swelling by reducing blood flow to the injured area. Do not leave ice on an injury for more than 20 minutes at a time.
Compress: or wrap the area with an ACE bandage around the swollen part of your body. If throbbing occurs, remove the bandage and re-wrap the area so the bandage is a little looser.
Elevation: Elevating an injury reduces swelling. It's most effective when the injured area is raised above the level of the heart. For example, if you injure an ankle, try lying on your bed or sofa with your foot propped on a couple of pillows.
Two important factors with dealing with field injuries of this nature:
1) If you see clear visual evidence of abnormal deformity to the injured area, call emergency professional care immediately.
2) If symptoms persist (pain, swelling, severe bruising) after 24-48 hours of using the R.I.C.E. method, consult your doctor.
D Course Manual, 2010, Mass Youth Soccer