Sports Medicine: Just the Facts

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•Winter sports



  • Surveillance data: Limited published data is avail-
    able on injury and illness patterns in Special
    Olympic Winter Sports. Injuries and illness encoun-
    tered by Team USA at the First International Special
    Olympics Winter Games in 1993 in Austria are
    included in Table 99-4.


EVENT COVERAGE



  • General considerations: Coverage of Special Olympics
    events is a dynamic process that frequently relies heav-
    ily on past event experiences. A systematic approach,
    such as the one outlined in event planning below,
    ensures success.
    •Minimal medical facilities: SOI mandates the follow-
    ing be present for large competitions:

    1. A qualified emergency medical technician (EMT)
      be in attendance or readily available at all times.

    2. A licensed medical professional must be on-site or
      on immediate call at all times during the competi-
      tion.

    3. First aid areas must be clearly identified, ade-
      quately equipped and staffed by a qualified EMT
      for the duration of the event.

    4. An ambulance with advanced cardiac life support
      (ACLS) capabilities, including equipment for han-
      dling seizures, must be readily available at all
      times.
      •Event planning



    • Crowd size: Estimated event attendance determines
      the personnel, supplies, and evacuation routes. Each
      community event is a potential mass casualty event.
      •Environmental concerns: Climate, geography, and
      time of day of the event need to be considered along
      with the availability of adequate shelters from sun,
      rain, and cold. Access to and availability of drinking
      water and restrooms should be identified. Fluids
      must be provided for athletes and drinking breaks
      encouraged minimizing risk of heat-related ill-
      nesses. Special Olympics athletes often lack the
      normal perception of thirst.

      • Population: Each Special Olympics athlete popula-
        tion has its own unique composition of ages and ill-
        nesses. Preevent screening of the ages and disabilities
        of the athletes may assist in preparing for unique
        issues that may arise.

      • Injury rates: As discussed above, prior experiences
        have shown that rates will be similar to other events
        involving able-bodied athletes.
        •Transportation: On-field transportation to transfer
        athletes to an aid station may include golf carts or
        stretchers. Ambulances are most commonly used for
        transport to hospitals. Helicopters have been used at
        larger events where distance or traffic may have
        resulted in unacceptable transportation times.
        •Evacuation routes: Routes need to be well planned,
        clear, accessible, and secure.

      • Security: The role of security is to assist with locat-
        ing those with medical needs, to assure appropriate
        identification of athletes and personnel, and to
        maintain crowd control and evacuation routes.

      • Supplies needed: The items needed are similar to
        other community sports events. An automated exter-
        nal defibrillator(AED) and lorazepam or diazepam
        are also recommended.

      • Site layout: The location and quantity of aid stations
        required will be determined by the number of par-
        ticipants and by the quality and quantity of geo-
        graphic sites. The need for a central aid station alone
        or in conjunction with multiple peripheral venues
        will be further determined by potential patient loads,
        ability to transport patients, potential holding capac-
        ity, and shelter availability. Site selection should
        also take into account visibility, accessibility, and
        proximity to evacuation routes.

      • Medical records: Records should be maintained in a
        central location and be readily transported to the
        treating provider owing to the complexity of preex-
        isting medical conditions. Athlete’s current medica-
        tions, allergies, and medical conditions may be
        listed on the back of the identification badge.

      • Medical reporting: The use of standard forms assists
        in tracking supplies used, and incidence and types of
        injuries including time of day and location.

      • Communication: Medical directors must be in con-
        tact with event organizers, as well as in contact with
        each on-site medical station, local medical facilities
        and EMS. Cellular phones, two-way radios, and
        pagers are useful tools.

      • Local resources: Resources should be solicited
        from local ambulance services and hospitals. These
        resources should be advised of the specifics of the
        event so they can plan and prepare, as well.

      • Scope of care: Most care provided at the event will
        involve general first aid. Advanced trauma life support






584 SECTION 7 • SPECIAL POPULATIONS


TABLE 99-4 Injuries and Illnesses for Team U.S.A. First
International Special Olympics Winter Games Austria, 1993


INJURIES ILLNESSES


Abrasion Respiratory illness
Strain Dehydration
Sprain Behavioral/psychiatric
Contusion Gastrointestinal illness
Laceration Dermatologic problem
Blister Canker sores, gingivitis
Fracture

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