Sports Injuries: Emergency Assessment and Field-side Care

Abstract

1. Anthony Luke, MD* 2. Lyle Micheli, MD† 1. 2. *Fellow, Division of Sports Medicine, Harvard University, Children’s Hospital, Boston, MA. 3. 4. †Director, Division of Sports Medicine, Associate Clinical Professor of Orthopaedic Surgery, Harvard University, Children’s Hospital, Boston, MA. After completing this article, readers should be able to: 1. Describe the steps for assessing a fallen athlete. 2. List the requirements for clearing an athlete to return to play. 3. Describe the procedure for handling a suspected cervical injury. 4. Delineate the procedure for handling a child or adolescent who has a concussion or transient neurologic deficit. 5. List the primary factors to consider when dealing with heat-related illnesses. 6. Describe the appropriate procedure for handling a suspected significant eye injury. Sports injuries are very common in the pediatric population; approximately one third of injuries from all causes in children are sports-related. Primary care physicians are becoming more involved in sports medicine both in the office and on the sidelines of athletic events. This article is designed to provide a practical guide to increase knowledge and facilitate management of urgent and emergent problems in pediatric sports medicine. Fortunately, most sports injuries are nonemergent musculoskeletal injuries, but certain problems must be addressed immediately. The initial on-site approach to an injured athlete as well as management of neck injuries in children, head injuries, heat-related illnesses, and ophthalmologic problems receive particular emphasis in this article. Any physician who assumes the role of team doctor should be knowledgeable and prepared for the acute management of these injuries. Recommendations for their prevention also are offered. A sports physician should work to improve awareness of sports injury prevention through counseling and promoting interventions that help reduce injuries. For more detailed, definitive management of sports injuries in a tertiary care setting, the reader is directed to the Suggested Reading. Management of the athlete who has collapsed begins before the injury occurs with proper preparation. Depending on the location and level of the event, resources may be limited. At the very least, it is imperative that the physician has quick access to a …