World Rugby First Aid In Rugby

Cold Injury

Cold injury is damage to the peripheral tissues due to the direct effects. The milder form is known as “frost nip”, where the skin will become white and numb. This is fully reversible on warming. The more severe form is known as “frost bite”, where the affected area becomes white on freezing, but on rewarming will become blue/purple and may progress to be black and thickened. This area will eventually separate away and in most patients this will reveal healthy tissues beneath.

Steps to manage Cold Injury

  1. The patient should be removed from the cold environment and rewarmed.
  2. Rewarming should not be attempted until it is sustainable and when the player will not be re-exposed to the same cold conditions.
  3. In milder cases, passive rewarming may be appropriate,
  4. In more severe cases active rewarming using circulating warm water should be considered.
  5. Rewarming can be extremely painful and adequate analgesia will be required.
  6. Avoid rubbing the affected area, this may cause damage to the skin and soft tissues.

Near Drowning

For the purposes of First Aid in Rugby, the term “near drowning” refers to a patient who has suffered an immersion or a submersion injury.

Rescuer safety is paramount, it is important that you do not put yourself in danger.

The exact pathophysiology is variable, but it is important to assess for low oxygen levels, hypothermia, or breathing of the fluid into the lungs (aspiration). 

When removed from the water, it is important that these patients are kept horizontal where possible. In the water, the patient will be exposed to significant pressure. If this is suddenly removed and the patient is in an upright position, this may cause a dramatic fall in blood pressure.

Steps to manage near drowning:

  1. The patient should be rescued and kept in the supine (flat position).
  2. An assessment of ABCDE should take place and any first aid carried out.
  3. It is particularly important to ensure that any period of no oxygen is minimised and particular attention must be paid to ensuring airway patency, adequate respiratory effect and rate and good oxygenation.
  4. Vomiting is a significant problem in individuals who have suffered near drowning, and it is important that the first aider is aware of this and prepared to deal with this immediately, to minimise the risk of aspiration.
  5. If appropriate the patient should be managed in the recovery position.
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