Definitive Care

On completion of the primary and secondary surveys it is important to understand that the player’s clinical condition may change, therefore regular re-evaluation is important.

It is equally important that assessments of vital signs are documented to allow for trends to be identified. This information along with the above mentioned documentation (including the SAMPLE history) should accompany the player to the hospital.

Documentation of observations on copies of the local Emergency Department observation charts may assist in the continuity of care of the player. In addition to sending the appropriate paperwork it is of value to contact the receiving Emergency Department prior to the player’s arrival to allow for preparation of the appropriate staff and equipment.

The transport of critically injured or ill players should be undertaken by appropriately qualified ambulance crews with appropriate equipment immediately available in case of a deterioration in the player’s condition. If the medical team at the ground can add to the skills of the ambulance crews it may be necessary for them to travel with the player, assisting in their management en route.

The mnemonic ATMIST has now been widely adopted by the ambulance service and pre hospital care medical teams for the handover of trauma patients. This would be appropriate to be used for seriously injured players both when pre alerting emergency departments and when giving a face to face handover.

A – Age of the player (sex of player often also included)

T – Time of the injury & expected time of arrival

M – Mechanism of injury

I – Injuries present and suspected

S – Signs including physiological parameters

T – Treatment given and needed