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Choking Emergencies And Infant Massage

November 1, 2016/3 Comments/in CPR, First Aid, First Responder, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

More and more I’m seeing Massage Therapists offering infant massage as well as massage classes for parents to teach them how to connect with baby and give that extra bit of care to their new infant.

But what happens when there is a medical emergency with an infant in your clinic?

Do you know what to do when one of those infants starts choking?

To start, play the first video below and I’ll get into some instructions on how to handle this kind of emergency in your clinic.

It’s a valuable skill to have and is important in and out of your clinic. But keep in mind, the videos are not a substitute for taking a proper course.

So remember, if the baby is coughing that means they have an open airway it is just somewhat restricted.

We don’t do anything except encourage them to cough up whatever it is they are choking on.

You need to intervene if:

The baby is making high pitched noises.
Is too weak to cough.
Is wheezing.
Becomes rigid due to a completely restricted airway.

Have someone call 911, get an AED (if available) and start your back blows and compressions.

Make sure the baby is always supported on your thigh, so there is a solid surface to deliver your back blows and compressions against. With the baby sandwiched between your forearms deliver five back blows between the shoulder blades.

Then flip baby over and rest on your other thigh, deliver five chest compressions with two fingers land marking between the nipples. You want to deliver about a 1.5 inch compression.

Continue to do this until the object is cleared and baby starts to cry, or becomes unconscious.

If the back blows and compressions didn’t clear the airway, now you’re doing CPR.

However once the baby went unconscious there is a chance the airway opened up because of the musculature in the neck relaxing, so we “look listen and feel” for 15 seconds to see if baby has started to breathe at all.

If they’re still not breathing, we slightly tilt the head back to try and open the airway and attempt to give two breaths. If there is still a blockage and we see that no air went in with the breaths, (if air does go in and baby is still unconscious and not breathing, we still continue) we landmark between the nipples and deliver 30 chest compressions using two fingers.

We continue with 30 compressions and two breaths until the baby starts breathing on its own, or more help arrives to take over CPR.

When First Responders arrive, they will take over CPR but have some equipment and different techniques they will use to help the baby.

Hopefully if you are doing infant massage, or just know someone who has a baby, these videos will help you feel a little more confident should you ever have to deal with a choking emergency. Please remember that these videos and this blog should not be used as a replacement for taking an actual CPR course. If this is something you do a lot in your practice, please take the time to go and get the necessary training to be confident in dealing with infant emergencies, it could literally mean someones life one day. If you know someone or have a colleague that could benefit from the information here please share it with them.

Osteoporosis And My Mistake

October 25, 2016/15 Comments/in First Aid, First Responder, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

I came around the corner just as he was sitting this elderly gentleman down.

He looked at me and said: “deal with this I’m going back to the bench”.

Fairly confused, I looked at this elderly gentleman and asked what happened?

He was on the ice taking pictures of the hockey team, as he walked off he slipped and fell on the ice.

Bearing weight on the right side was painful, but there wasn’t a lot of pain while sitting down. I grabbed his leg and passively moved it, no pain.

He called his wife (who was more than a little upset as the game had just started and now she was missing it) because I said he needed to go to the hospital.

We draped his arms over our shoulders and walked him out to their mini-van. She took him to the hospital and I didn’t see them for another year.

The Mistake

For years I have taught first aid courses to other Massage Therapists.

I have viewed the power point slide, I have repeated the information in the slide, I have highlighted the importance of the slide.

The slide I’m talking about says you should all 911 if:

The injury involves the head, neck, or back.
The injury makes walking difficult.
The injury involves the thigh bone or pelvis.
There is an altered level of consciousness.

However, things didn’t add up.

When it comes to treating injuries and dealing with first aid, one of the things we always harp on is “Mechanism Of Injury” (MOI).

We always use this as a method to quickly determine if there is a spinal, head or neck injury, to see if spinal precautions need to be taken. For those of you who have taken advanced or even basic first aid (and let’s be honest, just as the anatomy pro’s that you are) you understand the importance of stabilizing the neck to reduces possible spinal injuries.

But in this case the mechanism of injury made me second guess myself.

We always worry about further injury when a persons injury is a result of:

A fall from any height.
Found unconscious for an unknown reason.
A diving injury.
A blow to the head, neck or trunk.
A car accident.
Lightning strike or electrocution.
A persons helmet is damaged.

But this guy didn’t fall from a height, so why would I worry about the injury being that extensive!?

All he did was slip on the ice, there was no fall from a height of any kind.

But like an idiot, I didn’t use the information I had taught so many times.

Walking was difficult and the injury was to the pelvis, it should have been a 911 call.

However since I didn’t think the mechanism was bad enough, I was comfortable to get him to the hospital without using an ambulance.

Photo by: CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=243621

Osteoporosis

For years I taught these courses and never understood why there would be a power point slide about Osteoporosis.

NOW I KNOW!

When I saw this fellow a year or so later, he looked completely different (he had developed some other health issues well beyond his fall that night).

I asked him how things turned out, he said he had broken his hip and had to have a full hip replacement (as a disclaimer, the injury caused the hip problem, not the fact that I didn’t call 911 that day, I just should have handled things a bit better).

Osteoporosis is the leading cause of bone and joint injuries in older adults, the bones don’t have enough calcium, which makes them frail.

According to osteoporosis.ca there are some frightening statistics:

70-90% 0f 30,000 annual hip fractures are a result of osteoporosis.
1 in 3 women and 1 in 5 men will suffer a fracture due to the disease.
Without BMD (bone mineral density testing) 80% of fracture patients are not getting proper osteoporosis therapy.
80% of all fractures in people over the age of 5o are a result of osteoporosis.
Fractures from Osteoporosis are more common than heart attack, stroke and breast cancer combined.

Think about what this means for your practice.

How many people do you see on a regular basis that are over the age of 50?

This exact situation could happen at any point in your clinic with an older person coming in for treatment. That gentleman didn’t know he had Osteoporosis, but was diagnosed with it after he fell.

If at anytime one of your patients comes in and suffers a fall on-site that seems harmless enough but there is an injury to the pelvis or thigh and makes it difficult to walk, be sure to call 911 and get them to the hospital in an ambulance. If the person suffered a fall at home and is coming in for treatment, there are some things to look out for. Check for any deformities in the area they are complaining about, along with swelling and point tenderness that could indicate possible injury.⁽¹⁾

Studies are showing how exercise and strength training are effective ways to manage Osteoporosis once a patient receives the diagnosis, which also plays an important role in building confidence to prevent future falls. As Massage Therapists we want to make sure to use the appropriate pressure when giving treatment, to avoid any injury while the patient is on your table. One study researched a L5 unilateral pedicle fracture on a 66 year old man as a result of an aggressive back massage.⁽²⁾

Do yourself, and your patients a favour by not making either of these mistakes when trying to help them out.

References

Badiyani K, Bottomley J. OSTEOPOROSIS AND ITS MANAGEMENT IN THE ELDERLY. Gerinotes [serial on the Internet]. (2014, Mar), [cited October 24, 2016]; 21(2): 11-18. Available from: CINAHL Complete.
Guo Z, Chen W, Su Y, Yuan J, Zhang Y. Isolated unilateral vertebral pedicle fracture caused by a back massage in an elderly patient: a case report and literature review. European Journal Of Orthopaedic Surgery & Traumatology [serial on the Internet]. (2013, Nov 2), [cited October 24, 2016]; 23(2): 149-153. Available from: CINAHL Complete.

A Massage Therapist Guide To Dealing With A Stroke

February 23, 2016/2 Comments/in First Aid, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

Every time I teach a First Aid course, I use the story about an old workmate who had a stroke.

I use it because it’s effective in painting the picture of how a person presents when this happens.

It was around 1am Monday morning, when I realized there was an issue.

That night, something seemed different but nobody else really noticed. Standing with his arms crossed almost supporting one arm with the other, our conversation seemed confused as he constantly gazed at the floor.

As we walked to the First Aid shack for a coffee, I asked how he was feeling:

“not good”

How was the weekend?

“I don’t remember, apparently I didn’t show up to work on Friday”

Did you leave the house to go to work that day?

“I remember dropping the kids off at school Friday morning, but that’s really the last thing I remember”

As we kept talking, his slurred speech became more noticeable. When he relaxed, those crossed arms became one crossed arm and one seemingly limp arm. Looking into the eyes and face of this normally strong, athletic man there was something missing. His left side was almost motionless, wilted.

Can you lift your arms above your head for me?

The right arm went up, left one didn’t move.

Can you kick your legs out for me?

The right one kicked out, left one stayed put.

We need to get you to the hospital.

Tips For Recognizing Someone Has Had A Stroke

How To Help A Patient With A Stroke

One of the reasons this is so important for us as healthcare professionals is because we see our patients so regularly. In my friends case in the story, he went the entire weekend and not one friend or family member picked up that anything was wrong. I saw him about five years later and he was a shell of the man he once was. If only someone would have recognized his situation sooner, the damage from the stroke could have been significantly less than what he went on to live with. Later that morning I went to the hospital to check on him. As I walked in the room he looked at me and shouted to the nurse:

“Hey nurse there’s the little jerk that sent me in here” (they had him on some pretty good stuff)

“You should thank that little jerk, he saved your life”

Concussion Management For Massage Therapists

December 3, 2015/in Massage, Massage Clinic, Massage Therapist, Massage Therapy, Sport Massage/by Jamie Johnston

“The tricky part is that concussion signs and symptoms are not always straightforward and the effects and severity of injury and safe return-to-play can be difficult to determine”

– Mark Lovell

“That’s kind o the line I’ve got to walk now. I think the difference is the post-concussion is light-headedness, where I get that disconnect. Anything else is working and getting your heart rate up. I’m still a little nervous. It’s still a little scary”

– Keith Primeau

The sound from the hit echoed through the arena.

He laid there motionless on the ice.

The other players stared at us with a look of disbelief on their face.

As we opened the door to the bench to step on the ice, two players grabbed me and the AT to help get us to their team mate.

We crouched down beside him trying to get as good of an assessment as possible.

Thank god…he’s breathing.

Getting as close as I could to him to speak, to block out what was happening around us I simply asked “are you there?”.

He responded “yeah my head hurts, I just got my bell rung”.

“Can you move your legs?” Glancing down, they moved.

“Does it hurt if you try to move your neck?”

“No, it’s good, just my head”

As we stood him up and took him back to the bench, it was immediately noticeable, he wasn’t acting like himself.

Once in the treatment room, we could set up for a better more thorough assessment.

He was groggy and lathargic. He lost his usual jovial attitude.

Everything bothered him and his headache was getting worse.

Even the lights in the room were causing an issue.

So was it just a headache? Does he remember what happened? Is there something more going on?

The AT went to work with his assessment. He started asking the player a bunch of questions as I sat back and watched.

Some of the questions made sense.

Do you remember the hit?

Do you know what day it is?

Do you know approximately what time it is?

Then he gave the player a list of words and asked him to repeat it back.

Elbow, apple, carpet, baby, saddle, bubble.

I sat there with a dumb look on my face trying to remember the words too, couldn’t do it.

Afterwards the AT explained what he was doing and showed me this document called SCAT2. I had never seen it before.

First Aid Protocols For Acute Concussion

As research develops so does concussion protocols.

People of my generation probably remember as kids the only thing we were asked was: “how many fingers am I holding up” as if we were Billy Bob on Varsity Blues.

Back then there was talk about “degrees, grades or severity” of concussions, but that thinking is out the window now. There is no such thing as a “minor” concussion anymore.

When I started working in sport the SCAT2 document was the more commonly used method for concussion protocols. It has since evolved into the SCAT3.

Part of the SCAT3 is using the Glasgow Coma Scale (GCS) to assess level of consciousness before you decide to move an injured person. The GCS has been around as an assessment tool for years and if you take advanced levels of First Aid it is incorporated into those courses.

The GCS is used to decide if an injured person requires immediate transport to advanced medical care. It assesses the person on three different types of response (eye, verbal and motor) and gives them a numbered grade according to response. It looks something like this:

Eye Opening

Open Spontaneously (4)

Open To Speech (3)

Open In Response To Pain (2)

Do Not Open (1)

Verbal Response

Communicates Normally (5)

Confused (4)

Inappropriate Words (swearing) (3)

Confused Sounds (groaning etc) (2)

No verbal response (1)

Motor Response

Obeys Commands (6)

Localizes Pain (swats your hand away) (5)

Flexion To Pain (elbow flexes in direction of pain) (4)

Abnormal Flexion To Pain (3)

Extension To Pain (2)

No Response (1)

Once you designate a score for each level of response you add the scores together for a total. If it comes out to less than 15, the person should be transported to hospital for more advanced care due to the possibility of a brain injury. There is a great video you can watch here to see how it is done.

The player in the story above scored a 15, his eyes opened spontaneously, he obeyed movement commands and could communicate just fine so we were okay to take him to the dressing room.

SCAT3 A Valuable Tool For Massage Therapists

Once the GCS is complete and determined it is okay to move someone, the rest of the SCAT3 can be used for assessment.

The document goes through several other assessment tools that include symptom evaluation, cognitive assessment, neck examination, balance and coordination examinations.

This is where those memory techniques of saying five words to the athlete and having them repeat the words back is completed to get an idea of their cognitive function.

Symptom evaluation is assessed by noting things like headaches, pressure in the head, sensitivities to light and noise along with feelings of anxiousness and sadness. Few things are tougher than watching a young athlete cry uncontrollably because of a head injury and being frustrated by not being able to understand what’s going on.

The SCAT3 also goes through return to play protocols for athletes. Most importantly is that once an athlete (or anyone for that matter) has been diagnosed with or assessed a concussion, they must be referred to a doctor (preferably a sport med doctor) to receive clearance to start physical activity again.

Typically with a sports team each player is evaluated on the SCAT3 at the start of the season. This gives training staff a baseline to compare in case someone sustains a head injury. If the original is kept on file, it can then be used as a comparison during the acute injury and also as part of the return to play.

While this document was intended for athletes, it could be a valuable tool to be used in a clinical setting with anyone who comes in that has suffered a head injury whether in the workplace, MVI, or as the result of a fall.

Making the SCAT3 part of your intake, combined with regular communication with the patients doctor could give you a better idea how the patient is progressing.

Photo by: University of the Fraser Valley

Massage Therapy Treatment For Concussions

Most people dealing with Post Concussion Syndrome will experience a variety of symptoms ranging from dizziness to headaches and balance issues as well as depression.

In order to help any patient that comes to you who has suffered a concussion, one of the biggest things we need to understand is the Mechanism of Injury that caused the concussion.

Was it a car accident?

Sports injury?

A fall?

Has the person suffered a concussion before?

Which direction did impact come from?

Most concussion treatment revolve around aerobic exercise (after periods of complete physical and mental rest) and then return to play protocols for athletes working up to full contact practices (depending on which sport).

When a patient suffers an injury significant enough to cause a concussion it is likely that they have also suffered an injury to the neck which can contribute to headaches as well as dizziness. It is important for us to try and differentiate where the patients dizziness is coming to discern if it is cervicogenic dizziness or a vestibular issue.

I asked a sportmed doctor why they always refer their concussion patients to a Massage Therapist and he said “it’s because there is usually a whiplash injury associated with the concussion, so getting treatment for anything associated with the neck helps in the concussion treatment”. One study showed that Massage Therapy helped a 23 year old athlete by having two 45minute treatments focused around the pelvic girdle, neck and atlanto-occipital and atlanto-axial joints one month after injury.

The SCAT3 (or any other acute concussion assessment tool) is important for Massage Therapists to understand because it will give the therapist better insight, not only on what was done to help a person immediately, but also as a tool to see how a patient is progressing. Above all when it comes to treatment, your clinical experience is going to be the best guide on how to treat someone with post concussion syndrome. While these tools were intended for athletes, it can also be a great tool in dealing with MVI and workplace injured people who are referred to you. Quite often these ones will be dealing with issues like depression, lack of focus, irritability and not understand why they feel this way. Using these tools can be a great method of tracking their progress and helping you refine or change your treatments according to their needs. There is always a concern around Second-Impact Syndrome where someone sustains a second head injury before the initial concussion symptoms are gone. There are companies starting to develop new protocols and services to help with concussion management like imPACT, King-Devick Test, Shift and axonsports but these all come with a cost. Using free resources like the SCAT3 and CATTonline are widely recognized and may be more suitable for sideline and clinical settings for you until the others are more affordable. Take it from someone who has suffered major head injuries in the past, this needs to be managed properly for successful outcomes, the delay in recovery can be frustrating and depressing. But hey, at least when it happened to me I thought I was in Hawaii, and my dad said it knocked some sense into me!

How Massage Therapists Can Recognize And Deal With A Heart Attack

October 8, 2015/17 Comments/in First Aid, First Responder, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

“I have had a few times in practice where I’ve caught a myocardial infarction and called 911, if this has yet to happen to you, be forewarned, it will” – Robert Libbey RMT

I’ll never forget that day walking into the hospital.

He didn’t look like himself and wasn’t acting like himself.

He was too young for this to happen and I was too young to really understand it.

Years later he told me the story about, feeling chest pain at home and thought there was something wrong so he jumped in the car and headed to the hospital.

Halfway there he lost the use of his arms and had to steer with his knees.

My dad was in his thirties and had a heart attack. I use this story whenever I teach a First Aid course. You wouldn’t think an otherwise healthy guy in his 30’s would suffer a heart attack, let alone one with two young boys and a wife at home.

Thankfully he survived but had an issue with his heart a couple years later.

We had to change the way we did things, the way we ate and the way we lived.

He wasn’t sure how to recognize what was happening that day or even acknowledge that it was a heart attack.

How about you?

Could you recognize it if this happened in your clinic, or to one of your family members?

Differentiating Chest Pain In Your Massage Therapy Clinic

I’ve said it before and will continue to harp on it.

As healthcare professionals this is something we really need to be able to pick up on, which isn’t always easy to do.

If someone is having a heart attack, they really don’t want to admit it. Their mortality is staring them in the face at this point and realizing that something major is going on isn’t an easy thing to face, in fact most people will completely deny the possibility they are having a heart attack.

That day my dad didn’t want to admit things might be worse.

It would have been fatal if things has progressed anymore on the drive to the hospital. Thankfully he didn’t drive off the road when he lost the use of his arms.

We need to realize the differences in pain to understand whether someone is having a heart attack, indigestion or if something muscular is going on.

If you are going through your typical assessment before a treatment and your patient is having brief chest pain as a result of bending or breathing deep, it’s probably not a heart attack.

Some even feel that it is, or starts as indigestion. However, if it is a heart attack it will continually get stronger over time.

If someone is having a heart attack I have heard it described as “an elephant sitting on my chest”.

While writing this post, I called my dad to ask what the pain was like. He said:

“It felt like someone drove a sword through my chest, pain down both arms and through to the back, it was ten times worse than having any kind of indigestion”

The pain can range from mild to a description of squeezing, or tightness and constricting to a crushing feeling in the chest.

If one of your patients is having chest pain and it lasts longer than ten minutes, it’s time to get them some help.

Signs And Symptoms For Massage Therapists To Recognize

These are going to be a bit different between women and men.

As my dad mentioned he had pain going down both arms. Generally, it will be in the left arm as well as going up the neck and into the jaw. These signs are pretty much the norm when it comes to men.

With women, they quite often get low back pain. Women can also exhibit some soft signs, which are a little harder to pick up on, but just as important to understand and read because it sometimes goes unrecognized.

Some of these can be stomach pain, flu symptoms and some chest pain that changes with the level of activity. These symptoms are also common in those with diabetes and the older population.

There are a few other signs that usually don’t get talked about much (at least in basic First Aid courses).

Here are a few of the other things that you may see:

While you won’t see this every time, they are all signs that can help you make a decision as to what is happening with someone or how severe their condition is.

Photo by: Alessandro Bonvini

What Massage Therapists Can Do To Help

The first thing we need to do as Robert mentioned is call 911.

Stay calm!

When you call 9-1-1 the dispatcher needs some information from you and the calmer you stay, the better!

They need your address and this is the most critical piece of information because if they can’t get that from you, they can’t get help to you.

They will also ask for your return phone number. They need this to be able to call you back and get more information or to help the crews on their way locate you. It is also so that if you need help they can coach you through what you’re doing.

They will also try to get as much information about the patient as they can. Age, sex, physical condition, level of discomfort, pain and surroundings are all critical information for the arriving crew to have before they get there, so they know what they are getting into.

After that call is made, getting the patient into a position that provides them with the most comfort is the best thing we can do for them. Usually, this is going to be in a seated position leaning forward, but just go with whatever position they say is most comfortable.

Now I know most clinics aren’t going to have this on hand, but getting them some aspirin is going to help things out. And it has to be Aspirin, not Tylenol or Ibuprofen…Aspirin.

It works as a blood thinner so it can help relieve tension on the heart as well as help diminish clots.

All too often this goes unrecognized or people don’t want to admit it, so they don’t ask for any help. Unfortunately, this could be fatal as it leads to cardiac arrest and the need for CPR.

The more you can do to recognize and be aware of what’s going on with your patients, the more you’ll be able to help and prevent things from getting to that point. Being able to recognize and differentiate the pain a person is experiencing is key to understanding what’s going on with them. Also knowing that the signs and symptoms can be different between men and women can go a long way to recognizing that there is an emergency happening. And remember, this is the only time it’s okay to ask about erectile dysfunction drugs!

“Heart disease is no laughing matter. After my father suffered a massive heart attack, I realized just how serious heart disease can be” – Cheryl Hines

The One Thing Every Massage Therapist Should Have In Their First Responder Bag

July 21, 2015/in First Aid, First Responder, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

Blood is leaking from his left leg.

The players get him to the bench and throw one arm over the AT’s shoulder, I grab the other one and we hobble him down to the treatment room.

Once he’s on the treatment table we start cutting gear off.

He’s been cut by a skate over the Extensor Retinaculum on his left ankle with the tendons exposed. The AT immediately grabs gauze and puts pressure over the cut to control the bleed. He’s gonna need to go to the hospital.

Let’s back up a few hours.

Pregame Warmup, Massage And Treatment

That day started like a typical Saturday afternoon.

Stop at Tim Horton’s to grab coffee’s around 4:45, at the rink by 5pm.

Step into the dressing room, talk with a few of the players, then into the treatment room.

Have a quick chat with the Athletic Therapist about some injuries etc. going on with players and have our coffee’s.

One by one players came in for treatment.

I do some pre-event massage and help players with their warm up. The A.T. gets to work taping and working on some nagging injuries.

One of the management team comes down to inform us there will be a first aid company in the stands tonight, since none of the Dr’s could make it to the game (it was league rules to have a doctor or a certain number of First Responders in the building for every game).

The first aid company is there to help with any fans at the game and back us up if we need any help.

Pregame skate starts at 6:35, we go and watch one of the players to see how he’s skating with a chronic groin injury.

7:15 puck drop.

Halfway through the 1st period there’s a crash into the boards that resulted in the injury from the beginning. But dealing with the injury wasn’t the difficult part.

The Inexperienced First Aid Attendant

In walks a young man who works for the first aid company, he looks about 18 years old, accompanied by an older gentlemen that just kind of sits back and watches.

The young man immediately attempts to take control of the situation pushing his way around. Me and the AT look at each other somewhat dumbfounded by what’s going on.

He tries to take a pulse (dorsalis pedis) on the injured side. He can’t get it and exclaims “we need to cut the other skate off so that he can compare”.

Of course he can’t get a pulse, the AT is holding pressure on the injury right above to stop the bleeding. He cuts the other skate off while we tend to the injured leg.

Once he gets the skate off he continues to follow protocol, takes the pulse and has the player wiggle the toes on his good leg. He continues to follow protocol and asks the player to wiggle the toes on his bad leg.

Now we’re getting angry!

In as stern a voice as possible I yell out “DO NOT WIGGLE YOUR TOES!”.

The kid looks at me like I’m from outer space (since I’m not following his first aid protocol), the AT looks at him and says: “who the hell is in charge here?”

A little stunned the kid looks and says “well I’m the first aider” (meanwhile his partner, the older gentlemen is just standing watching).

The AT says “there’s over 30 years experience between the two of us, now smarten up and get the hell out of our room”.

I had a big grin on my face.

After he leaves, another team volunteer comes down and we ask him to call an ambulance. The first aid kid comes back and tells the volunteer (who is at least three times his age) to go outside and wait for the ambulance and direct them in.

If looks could kill, he would have been dead three times over.

He was directed to go outside and wait for the ambulance and was shocked that he would have to do such a thing.

Ambulance arrives and we package the player up and pass on all the information they need. The first aid kid continually tries to put his two cents in while the ambulance attendants give him a look like they wanted to pat him on the head and feed him a cookie for a good job.

The player is sent off and we are cleaning up the room.

The kid comes back in and says “good job guys, thanks a lot”. I’m pretty sure I had to restrain my AT buddy… and yet the kid never did thank me for saving his life that night.

As much as I know the kid was just trying to help, it taught me a valuable lesson.

Our anatomy knowledge is one valuable tool. When he took his First Aid course he never had to memorize the Origin, Insertion, Action of muscles.

Your average First Responder isn’t going to know terms and structures like:

Things just aren’t taught that much in detail in a First Responder course (heck I had to open the textbook, just to make sure I was naming things right).

I went through three of my First Responder Instructor books and the best I could find is that students would learn:

I don’t say all of this as an insult to First Responders or the program, it’s just they don’t need to know that much (even though some go on to higher level paramedics and learn more) because their biggest job is to stabilize someone until more advanced help arrives.

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Your Massage Knowledge Makes You A Better First Responder

When the player got to the hospital he immediately went into surgery. I don’t recall which tendons were repaired but it required surgery nonetheless.

It’s hard to know if it was just the initial skate blade cut that did it, or if it was once the player started wiggling his toes that caused the most damage.

If you’re working at sports events (or anywhere else for that matter) remember:

The people you are there for are YOUR responsibility and you are in charge (along with other AT’s, Chiro’s, Physio’s that are working)
The average first responder or paramedic does not have the anatomical knowledge that you have
Put your knowledge to good use and don’t be afraid to help out, even when things are a little unsettling
Always keep your first responder license up to date

At most emergency scenes paramedics are in charge but in this case, when it comes to your players, you are the first line of care.

You have probably noticed at most big sporting events, the team trainers and doctors rush out onto the field, ice or track before any ambulance is there.

This is your scene and you pass it off to the paramedics or first aid team after your assessment and treatment, or when you need more help.

Remember to always be respectful when you’re dealing with first responders at these kind of events, it’s best to work together for the safety and outcome of your patients.

Knowledge is a powerful thing. Using your anatomical knowledge will make for greater success in any emergency medical situation. However there should always be one person in charge of a scene. Usually whoever is most experienced should take control and direct the other medical team members what to do. Or whoever’s license is higher (I’m not about to tell one of the team Doctors what to do) since they will have far more training and experience. If you’re dealing with people who are less experienced, don’t be afraid to respectfully take control.

Looking at them and saying “who the hell is in charge here?” may not win you any points with them, but sometimes you just need to get your point across!