Definitive Care

On completion of the primary and secondary surveys it is important to understand that the player’s clinical condition may continue to change, and 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 clinical documentation (including the SAMPLE history) should be sent with the player to the hospital.

Documentation of physiological observations/vital signs on copies of the local Emergency Department observation charts may assist in the continuity of care of the player, as they would also be sent with the player to the hospital. 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 them to organise the appropriate staff and equipment.

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

The mnemonic ATMIST has now been widely adopted by ambulance services and pre-hospital care medical teams for the handover of trauma patients. This is appropriate to use for a seriously injured player both when pre-alerting an emergency department and also 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 observations/vital signs

T – Treatment given and needed