Tuesday, April 14, 2009

Your TEAM Med Kit

Dr. James, at EmbraceHealth.org offered this article concerning sports team's med kit:

ICS Article


Title: Content Recommendations for the Sideline Bag


By William A. Moreau, D.C., DACBSP

Estherville, Iowa 51334-2409

DConline@myclearwave.net


Drs. Bart Green and Hal Rosenberg recently published an article entitled Contents for Chiropractors Emergency Sideline Bags in the November / December issue of the Journal of Manipulation and Physiological Therapeutics (Volume 25, Number 9, Event-Site Emergency Bag). The authors explored the idea of what we should carry with us to athletics events. This is a significant article for those of us who attend to athletes and athletics teams. After my involvement in working with athletic teams for almost twenty years, my inventory has changed and steadily increased. The days of showing up with your doctors bag and a roll of tape are long gone my friend! One of the fundamental principles of treating athletes in the field is - what you bring with you will dictate what you can and cannot treat. If you need a set of crutches, but you did not bring them you cannot use them! The problem is identifying what it is that we need to have with us before we need it. This article attempts to help us in identifying the items we should have with us.


Basically there are two types of sideline kits, hard side and soft side. Each type of kit has it’s own advantages. Hard sided kits protect the contents better from becoming wet or getting crushed and the soft side kits are easier to carry and they can be packed with more materials. It is a good idea to compartmentalize the kit so emergency supplies (airways, mask, stethoscope) are in one location. Spend some time organizing the contents of the kit. Another organizational tip is to tag the location of the emergency equipment in your bag with a luggage tag or other marker. This way if you are engaged in an emergent situation you can direct others to quickly locate and provide you with the equipment you need. There are many different containers you can use within the kit itself to further organize the inventory. Simple small adjustable fishing tackle boxes can be organized and loaded with materials to be placed inside the kit. I really appreciate the tape tubs that organize and protect the tape rolls from becoming damaged. You will need more than one bag as you increase your inventory. I use three right now, a general sideline bag, a waist pack, and a crutch bag (loaded with much more than just crutches).


Another challenge is keeping the sideline kit stocked and organized. Our inventory of sideline equipment will also change with the sports that we cover. Like a good scout we should always be prepared. . The key to making sure you have what you need is rechecking your kit inventory on a weekly basis. You should check the inventory yourself to make sure you know what is in the kit and where it is located. The following tables can be cut out and laminated for you to include in your kit. You can then use them as a starting point for your inventory checklist. The first table identifies the recommended inventory items. The second table identifies the items that were still mentioned by the experts, but the consensus was not as strong for these items.



Recommended Items for an Emergency Kit

Latex Gloves

Telephone numbers ( Press box, police, ER, AD, etc)

Gauze pads various sizes, (sterile & nonsterile)

Oral airways, various sizes

Penlight

Reflex hammer

Sling, arm

Writing utensil

Stethoscope

Bags, plastic

Antiseptic solution

Glucose paste or gel

Knife, multipurpose

Bandages, adhesive

Antibiotic ointment

Bag valve mask

Bandages, elastic

Bandages, triangular

Eye patch

Bandaids

Betadine / Benzoin swabs

Scissors

Forms (exam and consent)

Butterfly/steristrips

Scissors kit

Gauze, absorbable

Gauze, cling, various sizes

Scissors, bandage

Cervical collar – rigid

Splints

Tape, adhesive

Dressings (various sizes, sterile and nonsterile)

Sphygmomanometer with various sized cuffs

List of players with medical conditions

Thermometer

Biohazard disposal bag

Tape cutter

CPR equipment

Betadine solution

Telephone, cellular

Hydrogen peroxide

Irrigating solution

Tongue blades

Irrigation kit

Instant (chemical) cold pack

Forceps

Coins for a pay phone

Screwdrivers

Airways, nasal, various sizes

Ring cutter

Tourniquet

Bandages, rubberized

Scissors, EMT

Manual ventilating bag

Safety pins (sensory testing)

Saline solution, ophthalmic

Splints, SAM-type

Swabs, cotton

Tape, elastic-type, various sizes

Tooth preservation kit


Additional Items for an Emergency Kit

Alcohol pads

Hemostats, various sizes

Antidiarrheals

Mask, simple face

Notebook

Clipboard

Tape Measure

Skin lubricant

Benadryl

Alcohol

Suction

Elastoplast, 4-in roll

Blankets

Walkietalkie

Blocks for CS stabilization

Opthalmoscope/otoscope

Antifungal ointment

Foam, closed-cell

Oxygen tank

Benzoin solution

Pads, abdominal

Pinwheels

Immobilizer, knee

Pager, two-way

Saline, normal

Safety razor

Petroleum jelly

Patient instruction sheets

Air splints - extremity

Antihistamines

Bite block

Ambubag

Eye shields

Cleaning cloths, disposable

Ammonia capsule

Glucose solution, 50%

Corticosteroid cream

Antacid, oral or H2 blocker

Orthoplast sheet, 6x6

Healthcare License laminated copy

Povidone-iodine solution

Penlight, with cobalt blue filter

Splints, aluminum

Tegaderm

Penlight, ultraviolet

Splinting tape, fiberglass

NSAIDS

Prewrap

Mirror

Screw, oral

Scalpel

Elastic sleeves

Sharps container

Crutches

Decongestants

Dictation tape recorder

Spray, cooling

Thumb forceps

Iodine

Brace, ankle stirrup

Cardiac defibrillator

Posterior elbow splint

Surgilube

Padding, felt

Suture scissors

Suture removal kit

Bofor’s collapsible splint

Tubin, solution

Tape remover

Splints, inflatable

Acetaminophen

Tuff skin spray

Splints, ladder

Eye kit with eye chart

Dipsticks, urine

Splint, neutral wrist

Swabs, chlorhexidine

Foil

Cast padding

Pack, disposable ice

Forceps

Horseshoe pads

Pack, instant heat

Nasal cannula

Splint, Collie’s wrist

Pack, reusable ice

Visine

Splinting, wire

Sterile field

Collodion

Splints, board

Non-narcotic cough med

Flourescein strips

Paper bags (for treating hyperventilation)

Portable electrotherapy unit

While the list may seem quite imposing, remember to focus on the first table and consider what your particular needs is. Some of the experts pooled travel around the world with their teams, and that is why there are several medications and other medical equipment identified. Many of the different types of splints can be replaced with one or two moldable sideline splints. The one I use are called One-Step® splints. I also noted that some items that I consider essential were omitted and they are identified in the next chart.

Moreau’s Additional Items to Consider

Cell Phone

An absolute must, make sure you know the phone numbers mentioned above ahead of time (you already have one)

Pulse Oximeter

Very helpful when evaluating asthmatics ($300)

Pruning Shears

The best tool to remove a football face mask ($15)

Laminated Spine Injury Card

These cards provide concise step-by-step directions for the management of a spine injured individual ($2)

One Step Splints

They reduce your inventory of splints ($15)

PDA (Personal Digit Assistant)

This is where you can store contact numbers; dictation information, rosters, schedules, treatment guidelines for concussion, injury notes – the works!

Electrolyte Replenishment

Carry with you a solution that you can provide the dehydrated athlete.

Antiseptic wipes

Disposable wipes for cleaning athletes and equipment

Nail clippers

A torn nail is no fun


Just as important as having the equipment is your ability to safely and properly use the equipment. This comes with repeated practice. Ask your local EMTs to allow you to work with them when they practice the skills you would like to know more about. Another important point is in regards to blood borne pathogens. Remember, to separate out the materials (gloves, gauze, antiseptic solution, bags, tape, etc) you will need to treat the bleeding athlete before the contest begins. If you reach into or touch your sideline bags with a contaminated hand you have just contaminated your entire contents of your bag!


For more information regarding the contents of sideline bags visit <www.iahsaa.org/WU02-7.html> to read the recommendations of the Iowa High School Athletic Association wellness coordinator, Alan Beste, ATC. By coordinating, practicing and working with others we can help to ensure that all the needed equipment and materials we need will be on site when the injured athlete needs them.


WJM



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