MFLL Coaches First Aid ClinicApril 9, 2014

Jody Kuhlenbeck, MFLL Safety Officer/Paramedic/FF

Leigh Beyer, MFLL Safety Officer/Physical Therapist

“Safety Safety Safety, It’s All About Safety!”

Take first aid kit with player medical cards to every practice/game. Know which players have medical conditions.

Check your fields before every practice/game for debris, rocks, sharp objects, holes etc

Inspect all equipment before every use. Turn damaged equipment into the Equipment Mgr

All bats must be inspected and labeled prior to use

Prevention is the Key!

Properly fitting batting helmets with chin straps are required by all batters, base runners, player base coaches and anyone handling a bat.

All catchers must wear full catching gear. Coaches are not to warm up pitchers!

All male players are required to wear an athletic supporter

Mouth guards are highly recommended!! Baseball is #1 sport for mouth/dental injuries!

Remove all jewelry

Player Safety

Control “horse play”, no climbing on fences etc Teach safe practices- calling fly balls, NO sliding

head first unless returning to a base, designated area for swinging a bat, NO warm up swings while in the batter’s box, “Heads up and PAY ATTENTION!”

Perform proper warm up and stretching before play. See stretching power point on website.

Know and follow the Thunder & Lightning Policy

Player Safety

Perform basic first aid treatment as appropriate and within your comfort zone/skills

For more serious injuries or deciding to call for an ambulance, it is best to have the parent be apart of the decision.

If the parent is unavailable, the coach should make a decision in the best interest of the player

It is ALWAYS ok to call 911 and let the EMT’s assess the situation when you are not sure of the severity of injury.

“Man Down on the Field”

Direct EMS Dispatch Line for cell phone use: 262-532-1700 Emergency Dentist: player’s family dentist or

CMH dentist on call: 262-251-1000 Jody Kuhlenbeck, Safety Officer: 262-227-6571 Leigh Beyer, Safety Officer: 262-617-1649 Mark McLean, President: 414-975-8451 Jason Marquardt, VP BB: 262-470-9315 Gail Onasch, VP SB: 262-894-9176

Emergency Phone Numbers

MFLL Injury Reporting Policy

Record all injuries on the Little League Baseball & Softball Accident Notification Form

Forms can be found in team first aid kits and concession stands

The player’s parent and league official/coach will complete the form AT THE TIME OF THE INJURY

Forward the accident form to the Safety Officer within 48 hours of the incident. Use the mailbox at the complex.

MFLL Injury Reporting Policy

Notify a Safety Officer the same day of the incident: Jody Kuhlenbeck, cell: 262-227-6571 OR Leigh Beyer, cell: 262-617-1649 The Safety Officer will complete an injury follow up

with the player’s parents and coaches If a concussion is suspected, a signed MD release is

required prior to the player returning to practice/ game play. NO EXCEPTIONS!

In all other cases, a signed MD release is only needed if an injury was serious enough to seek medical evaluation/treatment.

MFLL Injury Reporting Policy cont.

Blood/Body Fluids

#1 Goal is to prevent spread of infectious microorganisms (HIV, hepatitis B/C, MRSA etc)

Pathogens are found in blood, vomit, urine/stool, saliva, & other bodily fluids

Pathogens are spread when you come into contact with another person’s blood/body fluids, or contaminated sharps/needles

Pathogens enter through broken skin, mucous membranes of eyes, mouth, nose

Blood/Bodily Fluids

Treat ALL blood/bodily fluids as if they are contaminated

Wear gloves, eyewear, mask, gown, CPR mouth barrier etc (“PPE”)

Always check PPE for tears, defects before use. If PPE becomes torn, defective or dirty, remove and replace. Do not reuse PPE!

Properly dispose of used PPE and all contaminated materials in a red biohazard bag/receptacle.

Wash hands (or use hand sanitizer if soap/water are not available) immediately after removing PPE

How to Protect Yourself

Prior to participation, all open and possible contagious wounds should be covered with a dressing that will not allow for transmission

Always wear gloves, PPE when tending to player wounds or cleaning up bodily fluids

Clean and disinfect all items covered in blood or bodily fluids-player, equipment etc with antiseptic wipes

Clothing/uniforms with blood must be changed or cleaned w/ “Blood Buster” solution in spill kit caddy in concession stand

MFLL Blood/Bodily Fluid Policy

For large spills- use spill kit from Concession stand. Sprinkle powder over fluid. Use scraper to scoop up & put in biohazard bag.

Place ONLY contaminated items in red biohazard bags located in first aid kit, or at concession stand

Put biohazard bag in biohazard container in concession stand. If closed, contact Jody for disposal

Wash hands after removal of PPE

MFLL Blood/Bodily Fluid Policy

Wash the area exposed immediately with soap and water

See Medical provider immediately - personal MD, urgent care MD etc for evaluation, treatment

Notify the MFLL Safety Officer same day of incident

Complete the Little League Baseball & Softball Accident Notification Form and forward to the Safety Officer within 48 hours of incident

Exposure Incident Guidelines

Concussions

Type of traumatic brain injury (at the cellular level) caused by a blow to the head or body that moves or twists the brain inside the skull.

Injury examples- direct hit in head w/ ball or bat, collide with another player/the ground/or fence

Concussions cause problems with brain function vs brain structure

T or F? Loss of consciousness is required to have a concussion. Answer: FALSE!

Concussions affects people in 4 areas of function: physical, thinking, emotions, sleep

Concussions

They are more vulnerable to concussions They get concussions more often Their concussions take longer to heal than

adults Players can be reluctant to admit their

symptoms for fear of being removed from play Many times the player does not realize the full

extent of his symptoms or think to tell you all of the things he is feeling

Concussions Concerns Unique to Adolescents

Loss of consciousness (? serious head injury?) Decreasing level of alertness Unusually drowsy, difficult to arouse Severe or worsening headache Seizure Unequal pupil size Slurred speech Persisting vomiting Difficulty breathing

Concussions- When to Call 911

Headache Vision changes, ringing in ears Nausea/vomitting Dizziness, unsteadiness Numbness and tingling Change in mental alertness, drowsiness Decreased awareness- person, place, time Feeling “foggy”, groggy, confused, forgetful

Concussion Signs & Symptoms

Dazed or stunned appearance Clumsy, decreased reaction time Answers questions more slowly than usual Player asks repetitive questions Has memory, concentration concerns Changes in sleep patterns (too much/little) May feel irritable, sad, nervous, depressed

**Symptoms can be delayed and can occur 1-2 days after the hit/jolt**

Concussion Signs & Symptoms

Research has shown it may take up to 2 weeks to heal, and in some cases even longer.

Player needs to “rest” his/her brain following a concussion- NO physical activity, video games, computer use, texting, reading, watching TV, social activities etc until they are symptom free and cleared by MD

Concussions- The Need to Heal

Can worsen symptoms and prolong recovery Increases the risk for repeat concussion. This may increase the chance of long term

problems (ie decreased brain function, potentially chronic traumatic encephalopathy) or

Second Impact Syndrome (rapid brain swelling and death)

Avoid Returning to Activity too Quickly

Immediately remove the player from practice/ game play Assess for emergent signs- need to call 911? Notify the parents of the injury and have them come get

their child. Do not allow the player to drive himself home.

Complete the Accident Notification Form w/ the parent and notify a Safety Officer the same day

Issue the Parent Concussion Letter w/ concussion fact sheet found in the first aid kit

Write the details of the injury and circle all signs and symptoms the player is reporting on the letter

You suspect a concussion, now what?

Advise the parent to take their player for medical evaluation that day. The player should not be left alone. **Very Important to monitor for a worsening in condition**.

Advise they take the Parent Letter with them to the appt. This letter also states the MFLL requirements for return to play.

Remind them that a signed MD release will be required before the player may return practice

Concussion First Aid response cont

Player must be symptom free for a minimum of 48 hours and off any pain medication

Player must be in school full time without modifications

Player must have a signed MD release allowing him to return

Player will go through a stepwise return to full play (either on own under MD guidance or with MFLL)

Neuropsych Testing and SCAT 3 Assessment by MD is highly recommended!

MFLL Stepwise Return to Play

Program allows for one step per 24 hours Player’s symptoms are monitored before, during

and after each step. Safety will keep a log. If the player experiences any symptoms, the

player will be pulled from activity & must return to his medical provider for re-evaluation

It is a 5 step process to return to full competition/ game day

These steps will be coordinated by the Safety Officer, coach and parents

MFLL Stepwise Return to Play

Heat Illness

Occurs when the body becomes dehydrated and cannot cool the body by evaporation of sweat

Players who are overweight, in poor physical condition or not acclimated to the heat are at more risk

Important to know which players have a history of heat intolerance!! Watch them closely.

Heat Illness

Kids do not adapt to extremes of temperature as effectively as adults

Kids have a higher surface area-to-body mass ratio than adults, allowing a greater amount of heat to transfer from the environment to the body.

During physical activity, children produce more metabolic heat than adults.

Sweating capacity is considerably lower in children than adults

Heat Concerns Unique to Adolescents

Heat Related Illness Treatment

Heat Cramps: Involuntary Muscle Spasms *Rest in a cool, shady place*Massage the muscle gently, stretch*Replenish fluids*May return to activity as tolerated

Heat Exhaustion: Profuse sweating, dizziness, weakness, unsteadiness, nausea/vomiting, headache, red flushed face or pale color

*Remove player to cool/shady place*Remove unneeded clothing/equip*Cool body w/ wet towels/ice to arm pits, abdomen, back of neck, groin area*Replenish fluids*Hold activity until fully recovered

Heat Stroke: disoriented, dry/hot skin, lack of sweating, glassy stare, visual disturbances, high body temp, seizure, unconsciousness, chills, rapid pulse

*MEDICAL EMERGENCY, call 911*Move player to cool/shady place*Remove clothing/equipment*Cool body as noted above*Replenish fluids if able*Treat for shock- raise feet above heart*MD Release needed for return to play

Types of Heat Illness

Heat Illness Prevention

Drink before, during, and after!! 20 oz prior, 16 oz for every # lost due to sweating following activity. Avoid high sugar drinks, caffeine

Wear light colored clothing & little as possible Remove hats and equipment whenever possible

to let heat leave top of head What’s the color of your pee??

Heat Illness Prevention

Green Flag: Index is b/n 80-89. Watch players closely, give frequent water breaks. 75% regular activity/25% light activity, rest.

Yellow Flag: Index is b/n 90-94. Water breaks every 20-25 min, use iced towels. Practice in shaded area, 50% regular activity/50% light activity, rest. Limit equipment

Orange Flag: Index is b/n 95-99. Mandatory water breaks every 15-20 min, limit-no equipment, practice in shade or indoors, iced towels. 25% regular activity, 75% light activity, rest. Limit activity to <90 min

Heat Index Practice Recommendations

Red Flag: Index is b/n 100-104. Mandatory water breaks every 15 min. Practice in shade/indoors, before 10 AM or after 5 PM, Remove equipment. 25% regular activity/75% light activity, rest. Limit activity to <90 min.

Awe, heck just have fun and go to a water park instead!!

Black Flag: Index is above 104. Cancel Practice and games.

Heat Index Practice Recommendations

Lumps, Bumps and Bruises

Always assume the possibility of a spine injury with an unconscious player

If player is unconscious, DO NOT move him. Call 911. Check for a pulse, & breathing. If no pulse:

* Have a trained person begin CPR * Get the AED from the concession stand If player is conscious but reports severe pain in her spine,

numbness/tingling, or weakness in arms and legs etc, DO NOT move her. Hold player still, call 911.

Also always consider possibility of concussion with a neck injury

Head/Neck/Back Injuries

Always consider possibility of a concussion Any vision changes, flashes of light, “curtain

over field of vision”?? ER VISIT! Uneven pupils or blood in the pupil? ER visit! Foreign body: flush with water, do not attempt to

remove object to avoid further injury Corneal abrasions: irrigate, patch with gauze

and send to MD Black eye: check for visual changes, apply ice

Eye Injuries

Wear Gloves when assisting player If tooth is loose: stabilize tooth, Dentist! If tooth is knocked out: Do not touch root of tooth,

brush/scrub tooth or sterilize tooth. Gently rinse w/ water if needed. If able, reimplant tooth and stabilize. If not, place tooth in milk (prefer), saline soaked gauze, under tongue or in water Dentist!

If tooth breaks: stabilize remaining part of tooth, control bleeding, save all fragments of tooth (see above) Dentist!

Dental Injuries

Always wear gloves when tending to a wound Use gauze/towel & apply direct pressure to wound Flush wound with water Apply antibiotic ointment and bandaid/dressing Properly discard contaminated gauze/dressing and

wash/sanitize your hands after removing gloves! If unable to stop bleeding w/ holding direct pressure,

call 911. Do not apply a tourniquet. Bloody Noses: gloves, pinch nostrils and hold for 15

min with head tilted forward. Apply ice to back of neck. If unable to stop bleeding, see MD.

Cuts/Wounds/Bleeding

Assess for any obvious deformity If fracture/dislocation is suspected: Do not move

the area. Splint/support the area with a stiff object. Do not let player drink/eat- may need surgery

If area below the injury turns blue/cold, no pulse- Medical emergency! call 911

Elevate area if possible and apply ice Contact parents

Bumps & Bruises/Fractures

Assess for trouble breathing, swollen throat, rash/hives,

Call 911 if allergic reaction/anaphylaxis shock Use epi pen if child has one Remove stinger Wash area with soap and water, apply antibiotic

ointment Apply ice for 15 min to reduce redness and

swelling

Bee Stings