Sports Medicine: Just the Facts

CHAPTER 4 • FIELD-SIDE EMERGENCIES 11

• Dispensing medications by individuals not licensed
  to do so, even if OTC, may not be allowed and
  could open those doing so to prosecution under
  appropriate laws. This may also open the individu-
  als to liability for negligence if an untoward effect
  occurs.

DRUG TESTING (SEE CHAPTER 20)

• The team physician may be asked to participate in
  drug testing program for teams.


• Careful consideration regarding the physician’s role as
  an enforcer of rules versus a counselor for medical
  care must be undertaken.


• Proper protection of rights and “due process” of the
  athlete must be maintained.
  •Testing may include recreational as well as perform-
  ance enhancing drugs.
  •Testing may be voluntary or mandated by certain
  organizations, such as the National College Athletic
  Administration (NCAA) or International Olympic
  Committee (IOC).

CAPTAIN OF THE SHIP

• Though the doctrine relates to surgeons and assistants,
  the philosophy could be expanded to team physicians
  and those they work with.


• Choose your partners in sports medical care wisely to
  avoid being drawn into bad situations.

RISK MANAGEMENT

• Manage risk by being prepared, documenting care,
  working with likeminded professionals, anticipating
  problems, and communicating with athletes and,
  where appropriate, their families.


• Advice of legal counsel should be sought in planning
  team coverage, writing contracts, and if any events
  occur.


• Bad outcomes often lead to legal actions (lawsuits).

REFERENCES

Nolan JR, Nolan-Haley JM: Black’s Law Dictionary, 6th ed.
St Paul, MN, West Publishing, 1990.

BIBLIOGRAPHY

Birnie B: Legal issues for the team physician, in Rubin AL (ed.):

Sports Injuries and Emergencies, a Quick-Response Manual.

New York, NY, McGraw-Hill, 2003.

Davis T, Mathewson AD, Shropshire KL: Sports and the Law: A

Modern Anthology. Durham, NC, Carolina Academic Press,

1999.

Gallup EM: Law and the Team Physician. Champaign, IL,

Human Kinetics, 1995.

Gilbert Law Summaries: Law Dictionary. Chicago, IL, Harcourt

Brace 1994.

Herring SA, Bergfeld J, Boyd J, et al: Team Physicians Cons-

ensus Statement. http://www.acsm.org/pdf/teamphys.pdf 2001.

4 FIELD-SIDE EMERGENCIES

Michael C Gaertner, DO

Loren A Crown, MD

INTRODUCTION

•While most sports injuries are nonemergent and

musculoskeletal in nature, there are certain life- and

limb-threatening injuries that the field-side physician

(FP) must be prepared to handle immediately. The

most important step in the management of field-side

emergencies is preparation, and depending on the

setting of the event and the level of competition,

resources may be limited. The FP must at a mini-

mum have ready access to appropriate health care

personnel to assist in an emergency, appropriate

medical supplies and emergency equipment, imme-

diate access to a telephone, and the ability to trans-

port an athlete to a medical facility. It would also be

advisable to be certified in basic life support(BLS),

advanced cardiac life support (ACLS), and advanced

trauma life support (ATLS) and to have a working

knowledge of the common and uncommon injuries

specific to the event being covered.

GENERAL APPROACH TO THE

FALLEN ATHLETE

• When approaching the fallen athlete, the field-side
  evaluation should be both rapid and focused. The
  “primary survey” should follow the “ABCDE”