Responding Injuries and Medical Conditions in Sports

• On field assessment of sports injuries considers the appropriate courses of action immediately following an acute sports injury whilst at the scene.
• If a player is injured and you need to decide whether they should continue to play or train. The 'on field assessment of sports injuries' needs to be carried out. The mnemonic SALTAPS helps.
• Never move a player with a suspected neck or spine injury or an unconscious player.
• With increasingly serious injuries, it is important to cease the SALTAPS process at an appropriate stage.
• SALTAPS stands for:

  S - see and stop

  A - ask the player

  L - look

  T - touch

  A - active movement

  P - passive movement

  S - strength testing
• See and stop means see what happened to prevent further accidents and stop the performance if a player is injured.
• Ask the player means evaluate for pain, orientation, confusion, fainting and consciousness.
• Look means observe the injured area and evaluate the appearance for obvious signs of injury: bleeding, bruising, swelling, and deformity. Take the player off if there are significant signs of injury.
• Touch means if the player will allow, gently palpate to find source of pain. If you are unsure do not touch or move the limb until a qualified person can assess the player.
• Active movement means can the player move the injured area, with or without pain, if the player is unable to move take them off.
• Passive movement means can someone else move them limb, does it hurt, and if there is a significant range of motion.
• Strength testing means can pressure be placed on the injury or stand up, is the player up and running or trying to 'run it off'. Whatever the answer keep a close eye and take the player off in doubt.
• It is important to give first aid, get help, protect others, and reassure the injured person.
• Soft tissue injuries can be treated and managed using PRICE.
• Careful management of an acute injury in the first 24-72 hours is important.
• Most minor soft tissue injuries can be managed at home.
• For the first 2-3 days after injury, for acute but less severe soft tissue injuries you need to follow PRICE procedure, seeking medical advice if symptoms are bad or worsen.
• The purpose of PRICE is to reduce swelling, prevent further damage and ease pain.
• PRICE stands for:

  P - protect

  R - rest

  I - ice

  C - compression

  E - elevation
• Protect means protect the person and the injured area to minimise further damage.
• Rest means rest the injured area to allow time to heal and to prevent further damage.
• Ice means apply ice indirectly to the skin for 10 minutes to reduces swelling and promote healing, can be repeated after an hour.
• Compression means compress with a bandage acts as support and helps to reduce swelling.
• Elevation means raise the injury above heart level reduces blood flow to the area which reduces swelling.
• After completing PRICE, athletes should seek professional help for more severe acute injuries or if symptoms worsen.
• Pain relief or anti-inflammatory medicines are sometimes used to help a performer.
• Cryotherapy is the use of extreme cold to treat a variet of soft tissue damage.
• The World Rugby Recognise and Remove messgae incorporates 6 Rs.
• The 6 Rs stand for:

  Recognise

  Remove

  Refer

  Rest

  Recover

  Return
• Recognise means learn the signs and symptoms of a concussion so you understand when an athlete might have a suspected concussion.
• Remove means if an athlete has a concussion or a suspected concussion they must be removed from play immediately.
• Refer means once removed from play, the player should be referred immediately to a qualified healthcare professional who is trained in evaluating and treating concussions.
• Rest means players must rest from exercise until symptom free and then start a graduated return to play.
• World Rugby recommends a more conservative return to play for children and adolescents.
• World Rugby recommends a minimum 1 week full rest for adults following a concussion.
• World Rugby recommends a minimum 2 weeks rest following a concussion for under 18s.
• Recover means a full recovery from the concussion is required before return to play is authorised. This includes being symptom free. Rest and specific treatment options are critical for the health of the injured participant.
• Return means in order for a safe return to play, the athlete must be symptom free and cleared in writing by a qualified healthcare professional who is trained in evaluating and treating concussions. The athlete completes the GRTP protocol. Earliest return to play is 23 days.
• World Rugby's GRTP programme incorporates a progressive exercise protocl introducing a player back to sport slowly.
• World Rugby's GRTP include: minimum rest period with complete body and brain rest without symptoms; light aerobic exercise to increase heart rate; sport specific exercise incorporating running drills without any head impact; non-contact training drills with growing complexity to increase the cognitive load; full-contact practice with normal training activities to assess functional skills; and return to play.