First Aid

Keep in mind that this article does not cover every scenario and is not intended as any form of qualification. It is here to help you get started, take an interest and to go out and learn more.

A first aid course will never be a waste of your time. You can find courses by St Johns on their website and the Red Cross but also get in touch with the junior committee to help you find an appropriate one.

Ask your parents if one of them would like to take the role of 'Team Doctor'. They could look after the medical kit and ice each week. It just may be a role that someone may really like to take up and help the team.

Hopefully, the worst you will need to deal with is some bumps, a nose bleed and some bruised egos. But here are some guidelines to help you deal with some injuries you may be faced with.

At Northcote

If you have called an ambulance make sure that the driveway onto the field is not blocked by any cars. There is a chain the prevents cars from driving onto the field this should be unlocked on Saturday mornings but if not, you should approach the Food Hut for help to get this unlocked.

Do not leave or move after you have called an ambulance. You must wait for it to arrive unless directided by the 111 operator.

During the week you can locate the club manager inside the club or call them on 027 277 3520.

If you need a stretcher you can find this located in the senior gear shed next to the Food Hut. Again the Food Hut will be able to help unlock it.

In the case of a heart attack, you can find a defibrillator located in the club downstairs in the foyer next to the trophy cabinet.

There is an ice machine inside the club located downstairs in what is known as the 'plant room'. If the foodshed is operating they can help you get access to this though it is recommended to have your own initial ice packs ready as there will be some delay in getting access and you will need to provide your own bags.

Assessment

Whatever the scenario start your aid by following these steps.

• Talk - Establish the person is conscious, responsive and ask what happened.
• Observe - Look over the scene, make sure it is safe for both you and them.
• Touch - Let the player know what you are about to do and lightly feel around the injured area.
• Active Movement - Ask the player what movement they can do.
• Passive Movement -Gently try moving the injured limb and watch the players reactions.
• Skills - What skills can they perform such as holding a bottle with an injured hand.

You may of course need no more than observe to work out that a bone is broken and you should immediately call 111 but do progress through these steps to help you assess any issues.

Bleeding and Bandages

Ensure you have your gloves on. If needed and possible pass the player padding that they can hold over the wound while you prepare.

Rest and reassure the player first. Then expose the bleed by removing any clothing or obstructions and look to keep it elevated. Apply a bandage to keep the dressing in place. 

Do not look to replace the original padding. Place additional padding on top of the first though these extra ones can be replaced if required.

When you apply your bandage ensure that it is firm. You should be able to get one finger under it but not two. Check circulation at teh extremities by pushing a finger into the skin. You will see it white and then slowly back red as the blood flows back in. Test on the alternate arm to see what is normal for this player.

Bumps and Donks

The first issues you may face, especially in the younger grades, are those first bumps and donks. Being knocked over or running into someone. Sometimes the injury is just that first experience and shock of it happening and no real damage has been done. Nonetheless, treat it as if something has happened. Assume it has until you know it hasn't. If they learn this process this will only help if they do experience a more serious injury.

Don't be in a rush to move them and focus on first trying to calm them. Let them know you are there to help. Just like a real injury, their heart rate will be up and adrenalin will be being released into their system. Get them to focus on you and your voice. Try and get them to take three deep breaths. Help them to focus on something other than what's just happened.

"Jasper, I am here to help, what happened? Now I want you to take one big deep breath and hold it a bit while I pour some of this magic water over the injury. That's it. Now let's do it one more time."

Your main job as a sports first aider is to prevent further damage.

Abrasions

The skin is a protective organ that shields our insides from all the nasties on the outside. When it is damaged we need to first look at cleaning it and using a sterile bandage to protect it. If there is some bleeding we should look to stop that first by use compression and ice for 5 minutes. Then check to see about cleaning the wounded area and covering.

• Clean the wound with a non-fibre shedding material or sterile gauze, and use an antiseptic such as Betadine. If there is embedded dirt, Savlon may be used as it contains an antiseptic and a surfactant to help remove debris then rinse the wound after five minutes with sterile saline or flowing water.
• Don’t scrub at embedded dirt, as this can traumatise the site even more.
• Cover the cleaned wound with an appropriate non-stick sterile dressing.

For any bleeding injury ensure that you put on gloves and or use sanitiser beforehand.

Cuts

A cut is where something has pierced the skin and tissue under the skin and is more serious than an abrasion.

• Apply pressure to the wound to stem the flow of blood.
• Cover the wound with a sterile dressing and bandage firmly if possible. Continue to apply direct pressure.
• Look to use ice around the area and/or raise the injured area above the heart if practical.
• Don’t remove existing dressings if they become saturated with blood, but instead add fresh dressings over the top.
• If you can not stop the bleeding seek urgent medical attention.

Sprains, Strains and Joint Injuries

These types of injuries are when the ligaments (hold two bones together), tendons (attach muscles to bones) and muscles are damaged. Symptoms include pain, swelling or stiffness.

When this tissue is damaged the blood is flowing into the area and clotting. This spilling of blood into the area causes swelling. The first thing to do is immobilise the area and apply an ice pack. The cold helps prevent blood flow by shrinking the blood vessels which slows the volume of blood flowing into the area. Apply compression to the area to also help reduce swelling and elevate the injury above the heart as gravity will then aid in reducing the blood flow to the area.

Avoid any heat as this will increase blood flow and do not massage the area. This will only increase the damage and delay healing. Do not use any heat rubs.

Ice should be applied for 15 minutes and repeated every 2 hours for the first 8 hours to help with pain relief. The injured area should be rested and supported for at least 48 hours. Before any use of the injured area, you should have it seen to by a physiotherapist or a doctor.

Bloody Nose

The first thing is to remove the player from the activity. Find a place for them to sit with the head leaning forward. They then need to pinch their nostrils together and breathe through the mouth. The Bleeding may take some time to stop especially if their heart rate is high, to begin with. If bleeding continues beyond 30 minutes seek medical advice.

Dislodge Teeth

It may be possible to save a tooth that has been knocked out with prompt dental treatment. Rinse the tooth in water or milk, and see your dentist immediately.

Junior tacklers - always wear a mouthguard

No mouth guard, no contact training, no game.

Black Eye

A black eye is caused by bleeding under the skin around the eye. Most injuries that cause a black eye aren't serious. But a black eye may indicate a more serious injury, such as an internal injury to the eye or a fracture of the thin bones around the eye. You may have a skull fracture if you have double vision, bruising around both eyes (raccoon eyes) or bleeding from the nose.

Apply a cold compress soon after the injury. Using gentle pressure, place a cold pack or a cloth filled with ice to the area around your eye. Take care not to press on the eye itself. Apply cold as soon as possible after the injury to reduce swelling. Have the player repeat this several times a day for a day or two.

Look for blood. If you see it in the white or coloured parts of the eye, seek urgent care by an eye specialist.

Seek medical care immediately if the player has vision problems (double vision, blurring), severe pain, bruising around both eyes, or bleeding in an eye or from the nose.

Broken Bone

If you suspect a broken bone ensure the game is stopped and suspended.

You may be able to see a clear deformity in which case you should get the player as comfortable as possible without moving the injured area. If not you can start by gently feeling the extremities of the limb away from the suspected broken area first before gently feeling the injured area for tenderness.

If it is a compound fracture meaning that the bone has pierced the skin use a wet sterile bandage to cover the wound to help prevent infection and keep the bone healthy. Apply padding around the wound and find the best possible comfortable position for the player. You can have them sitting and leaning their back on you.

Do not try and push the bone back in or realign a bone as this can cause more damage and pain. Use ice around the area to help prevent bleeding and swelling while at the same time keep the player warm to avoid going into shock.

If the broken bone is in the leg you should avoid moving the player and call an ambulance.

If it is an arm or shoulder injury you can find a pillow or wrapped towel to support the arm by resting the forearm on it. You can also look to just wrap the arm against the body. When the player is ready, you may try to walk or carry them off the field and get them to a hospital.

A rib injury can cause a lot of pain just by breathing. It is very important to calm the player down, breathe slowly and do not make any jokes to try and lighten the situation.

Dislocations

Do not attempt to put the dislocation back in yourself and seek medical help because there may be a fracture along with the dislocation which you will make worse if you try to relocate the joint.

Hyperthermia - Too Hot

A normal body temperature is 36.5 degrees. Heat exhaustion hits us at 38 degrees. Our bodies are very good at regulating our body temperature but if we run into trouble we should act quickly. 

Start by going to a cool area and get out of the sun.

Wet the person down and fan them. If you have ice packs wrap them in a paper towel and place them on the back of the neck, armpits and groin as these have arteries close to the skin.

Provide sips of water but nothing more. The body will be shutting down the digestive system and large quantities may bring on vomiting and more problems.

If the person does not show signs of improvement call 111 as becoming more serious can happen very fast.

Hypothermia - Too Cold

Hypothermia can start when the body's temperature drops to 35 degrees. Signs are cold and shivering and slurred speech as well as clumsiness and loss of coordination. 

Get the person to a sheltered spot away from the wind. Remove any wet clothing and find dry clothing to replace it. Look to cover the head, hands and toes - the extremities.

Avoid hot drinks and food. This may cause a shock reaction. Look for warm options instead.

Concussion

It is very hard for a first aider to diagnose a concussion and thus the best approach is to assume there is one.

If the player has clearly been knocked out ensure they stay still. Lie them down with the head and shoulders slightly elevated. Stop and suspend the game if necessary and call an ambulance. If the player is unconscious move them into the recovery position and check their airway. Don't move the person unless necessary and avoid moving the person's neck. If the person is wearing headgear, loosen the straps but do not remove it from their head.

Check for any bleeding and deal with that.

If the player has come to the sideline because the referee considers there has been a head knock first ensure the player is sitting and calm. Ask them if they know why they have been sent to the sideline and what happened. See if they can recall some basic facts about the current day. "Who did they come to the game with?" for example. Any confusion could probably indicate a concussion.

Make sure somebody is with the player the whole time checking their state and most importantly any deterioration of consciousness, awareness or behaviour. Monitor the player for 24 hours, paying particularly close attention for the first 4 hours.

If a concussion is suspected the player/parents should be advised to see a GP.

More information about concussions is supplied by the NZRU and we encourage you to read this and our Head Injuries article.

Prevention of Sports Injuries

The best prevention of sports injuries is an appropriate warmup for the activity ahead. This includes both a physical and mental warm-up. If the player is late to the game and your team is playing a player short, they should still take time to warm up correctly before joining the game.