Nearly half of all injuries in high school sports occur during practice when no athletic trainer or emergency medical personnel are present. In these instances, coaches are the first responders. As a coach, are you prepared to take action in a medical emergency? Sport First Aid-5th Edition, a book written by Melinda Flegel and published by Human Kinetics, provides high school and club coaches with action steps for the care and prevention of more than 110 sport-related injuries and illnesses. This section of the book details how coaches should respond to the occurrence of a head injury when there is no athletic trainer or medical staff around.

If an athlete has suffered a blow to the head or a whipping of the head and neck, immediately evaluate for symptoms and signs of injury.
Causes

Direct blow to the head
Sudden, forceful jarring or whipping of the head
Ask if Experiencing Symptoms

Headache
Dizziness
Ringing in the ears
Grogginess
Nausea
Blurred or double vision
Check for Signs

Confusion
Unsteadiness
Inability to multitask (unable to do several athletic skills at once or do a skill correctly when distracted)
Short-term memory loss
Emotional changes such as a short temper or depression
Unresponsiveness to touch or voice (call out the athlete’s name and tap on the shoulder)
Irregular breathing
Bleeding or a wound at the point of the blow
Blood or fluid leaking from the mouth, nose, or ears
Arm or leg weakness or numbness
Neck pain with a decrease in motion
Bump or deformity at the point of the blow
Convulsions
Abnormalities in pupils (unequal in size or failure to constrict to light)
Vomiting
First Aid

If an athlete exhibits any of the previously listed signs or symptoms, pull the athlete out of activity. Symptoms such as headache or ringing in the ears may be the early signs of a more serious injury. In these cases, do the following:

Continue to monitor the athlete and alert emergency medical services if signs and symptoms worsen.
Immediately contact the parent or guardian and have them take the athlete to a physician.
Give the parent or guardian a checklist of signs and symptoms to monitor.
For injuries with more severe signs such as confusion, unsteadiness, vomiting, convulsions, increasing headaches, increasing irritability, unusual behavior, arm or leg weakness or numbness, neck pain with a decrease in motion, pupil abnormalities, or unconsciousness, do the following:

Immediately call emergency medical services.
Stabilize the head and neck until EMS takes over. Leave an athlete’s helmet on when stabilizing the head and neck. You don’t want to jar the head or neck unnecessarily. This is especially true if the athlete is also wearing shoulder pads.
Monitor the athlete for breathing difficulty and perform CPR if necessary.
Control any profuse bleeding but avoid applying excess pressure over a head wound.
Monitor for shock and treat as needed.
Immobilize any fractures or unstable injuries as long as it does not jostle the athlete, which may worsen his or her condition.
Playing Status

When can an athlete return to a sport after a brain injury? In most cases, this decision has already been decided for you. Check your state law or the regulations of the National Federation of State High School Associations (NFHS) to ensure that your athletes are receiving mandated care and supervision. The NFHS prohibits athletes from returning to activity until examined and released by a physician. Many states are enacting laws with similar or stricter guidelines. Check your state for specific laws regarding brain injuries in athletes.
Prevention

Educate yourself, your athletes, and their parents or guardians about concussions. Visit the CDC website atwww.cdc.gov.
During preseason physicals, screen for any history of head, spine, or nerve injuries. Have these athletes cleared by a physician, preferably a neurologist, before allowing them to participate.
Use preseason brain testing. Numerous software programs or testing contractors can assess each athlete’s normal brain function, including memory, cognitive functioning, motor (muscle and balance) control, and other functions before the beginning of a sport season. This information is then used as a baseline from which an athlete’s brain function can be compared when an injury is suspected or has occurred. Doctors and athletic trainers can monitor this information while the athlete recovers and determine when an athlete is ready to progressively return to activity. These tests can also be used to monitor the athlete for any signs of decreasing brain function as he or she progresses back into full participation. A decrease in function signals that the athlete is not ready to proceed further and may need to actually decrease activity. This type of testing can be an important tool for you, your athletes, and their physicians in helping to more objectively determine the seve

Book Notes by Bert DeSalvo

Each one of the concepts is like a game piece, and when we move them with a purpose, THE BIG TIME will suddenly appear. Just knowing about them has no real pay value. The key is in understanding and believing in them, for this is what motivates us to put them all together and use them.

**The BIG TIME is not a place; it’s the state of your heart.
**The BIG TIME is not something you get – it’s something you become.

The put-up game, just like a football game, takes practice – the right kind of practice. Put-ups, just like anything else, have to be learned; they have to become habit – they don’t just happen. Can be verbal, thumbs up, high five, hug, nod, smile, notes, etc. Put-downs are all around us and we can become involved in them just by association. This game actually reflects a person’s own self-centeredness and inadequacies without his even being aware of it. It can easily become a self-fulfilling prophecy: By putting others down, we end up putting ourselves down. Criticism and negative put-downs become steel habits which can turn into cynicism.

It starts with those innermost feeling in your heart that actually transforms your mind. This in turn affects your actions, and it makes all the difference in the world in the way you live each day of your life, regardless of your passion.

The BIG TIME is not a place; it’s the state of your heart. It’s not something you get; it’s something you become.

Many people in our society get caught up in “#1 or No One” mindset

“A mindset of this type sees only the outcome as important – the process has to be endured.”
– Compare themselves to others
– Always have to prove themselves superior to feel secure and successful
– Tension and pressure are often present
– Fear of failure is their primary motivator

If all we do is endure or tolerate the trip to a so-called destination, we’ve really missed the boat. A better way to put it is: We’re on the boat, but we are seasick most of the time.

Potential – ‘ I can be’ zone
Performance – ‘I am’ zone

DO THESE TO CLOSE THE “GAP”!
G = Goal-sets that motivate and challenge us
A = Attitude which is our self-fulfilling prophecy for whether we think we can or think we can’t, we’re usually right
P = Perseverance which develops mental toughness and builds our character

True fulfillment of the competitive experience: bringing out the best in ourselves and others. That’s what MTBTWYA is all about.

Three-Sided Coin
The EDGE is what makes the difference in your performance in any walk of life.

Side 1 – “Best”
– Being the best
– Comparison game,
– Lose ‘the edge’ on this side

Side 2 – “Doing our best”
– Focus on ourselves
– Not concerned with winning,
– “Aim before we fire”

Side 3 – “Giving it our best shot”

– When we concentrate on giving it our best shot, we just reload and keep aiming and firing, while adjusting and adapting ourselves to each changing situation. “When we really learn to enjoy the process of giving it our BEST SHOT in all that we do – we raise the chances of DOING OUR BEST more often. This can directly result in our BEING THE BEST some of the time. That’s what the three-sided coin is all about.

Success Road is based on the trip and the quality of living, not on the destination. It doesn’t focus on the regrets of yesterday or the fears of tomorrow but on the moment-by-moment, day-by-day trip that exposes the excitement and joy in the natural highs of many ordinary things in our daily life.

IMPORTANT TO HAVE GOALS, BUT CAN CHANGE THEM DURING THE TRIP

The goal is not at the end of the story: the goal is the road.

ADJUSTING – ADAPTING – ADVENTURING
HAVE A GOOD DAY – Thermometer – Affected by external changes no control
LEARN TO ‘MAKE IT A GOOD DAY – Thermostat – We set the dial We control it!

This shows what happens when you feel good about yourself – you are willing to take some risks and give it your best shot in all that you do.”

Baseball hitting percentage analogy:
.250 vs. .330 just a 1 hit difference per week for 162 games
The longer they play, the bigger that gap gets.

With concentrated focus we can get that one one extra effort, one extra struggle, one extra anything – and up goes our average.

Sharing pride vs. Selfish pride

Sharing pride – “It’s a special quality that brings out that inner drive and motivates us to give the extra effort to make things happen. This creates an atmosphere of confidence that is contagious.

MAGIC – “Make a Greater Individual Commitment”

Character: Our Best Piece of Equipment

3 forms of Motivation

1. Fear – “The floggings will continue until morale improves.”
a. Produces quick results but soon loses its effectiveness
b. Motivates from outside rather than from withing

2. Incentive – “Carrot on the stick”
a. Produces but eventually mediocrity will set in when people are doing
the right things for the wrong reasons

3. Love – Strongest form of motivation; Genuine unselfish love; No fear – Brings out the best in ourselves. The true joy of having is in SHARING.

When you do Make The Big Time Where You Are – IT’S NOT A PLACE, IT’S NOT THE STATE OF YOUR MIND – IT’S THE STATE OF YOUR HEART.”

You can find out more about the book by clicking on the image and link below: (The paperback version is $19)

Note: This is article was provided by Coaches Network and is an excerpt from Sports First Aid-5th Edition by Melinda Flegel

As a coach you are likely to be involved in each portion of the athletic health care relay—prevention, recognition and first aid care, assessment and treatment, and rehabilitation.

Your roles are defined by certain rules of the legal system and rules of your school administration, expectations of parents, and interactions with other athletic health care team members.

Legal Definitions of Your Role
Basically, the legal system supports the theory that a coach’s primary role is to minimize the risk of injury to the athletes under the coach’s supervision. This encompasses a variety of duties.

1. Properly plan the activity.

• Teach the skills of the sport in the correct progression.

• Consider each athlete’s developmental level and current physical condition. Evaluate your athletes’ physical capacity and skill level with preseason fitness tests, and develop practice plans accordingly.

• Keep written records of fitness test results and practice plans. Don’t deviate from your plans without good cause.

2. Provide proper instruction.

• Make sure that athletes are in proper condition to participate.

• Teach athletes the rules and the correct skills and strategies of the sport. For example, in football teach athletes that tackling with the head (spearing) is illegal and also a potentially dangerous technique.

• Teach athletes the sport skills and conditioning exercises in a progression so that the athletes are adequately prepared to handle more difficult skills or exercises.

• Keep up-to-date on better and safer ways of performing the techniques used in the sport.

• Provide competent and responsible assistants. If you have coaching assistants, make sure that they are knowledgeable in the skills and strategies of the sport and act in a mature and responsible manner.

3. Warn of inherent risks.

Provide parents and athletes with both oral and written statements of the inherent health risks of their particular sport.

Also warn athletes about potentially harmful conditions, such as playing conditions, dangerous or faulty equipment, and the like.

4. Provide a safe physical environment.

• Monitor current environmental conditions (i.e., windchill, temperature, humidity, and severe weather warnings).

• Periodically inspect the playing areas, the locker room, the weight room, and the dugout for hazards.

• Remove all hazards.

• Prevent improper or unsupervised use of facilities.

5. Provide adequate and proper equipment.

• Make sure athletes are using equipment that provides the maximum amount of protection against injury.

• Inspect equipment regularly.

• Teach athletes how to fit, use, and inspect their equipment.

6. Match your athletes appropriately.

• Match the athletes according to size, physical maturity, skill level, and experience.

• Do not pit physically immature or novice athletes against those who are in top condition and are highly skilled.

7. Evaluate athletes for injury or incapacity.

• Require all athletes to submit to preseason physicals and screenings to detect potential health problems.

• Withhold an athlete from practice and competition if the athlete is unable to compete without pain or loss of function (e.g., inability to walk, run, jump, throw, and so on without restriction).

8. Supervise the activity closely.

• Do not allow athletes to practice difficult or potentially dangerous skills without proper supervision.

• Forbid horseplay, such as “wrestling around.”

• Do not allow athletes to use sports facilities without supervision.

9. Provide appropriate emergency assistance.

• Learn sport first aid and cardiopulmonary resuscitation (CPR). (Take a course through the American Red Cross,American Heart Association, or the National Safety Council.)

• Take action when needed. The law assumes that you, as a coach, are responsible for providing first aid care for any injury or illness suffered by an athlete under your supervision. So, if no medical personnel are present when an injury occurs, you are responsible for providing emergency care.

• Use only the skills that you are qualified to administer and provide the specific standard of care that you are trained to provide through sport first aid, CPR, and other sports medicine courses.

• If athlete is a minor, obtain a signed written consent form from their parents before the season. For injured adult athletes, specifically ask if they want help. If they are unresponsive, consent is usually implied. If they refuse help, you are not required to provide it. In fact, if you still attempt to give care, they can sue you for assault.

• Some states expect coaches to meet additional standards of care. Check with your athletic director to find out if your state has specific guidelines for the quality of care to be provided by coaches.

Parental Expectations
Parents will look to you for direction when their child is injured. They may ask questions such as these:

• What do you think is wrong with my child’s knee?

• Will it get worse if my child continues playing?

• Should my child see a doctor?

• Does my child need to wear protective knee braces for football?

• Will taping help prevent my child from reinjuring the ankle?

• When can my child start competing again?

• While you can’t have all the answers, it helps to know those who can. That’s where the other athletic health care team members can help.

Click here for more information on Sports First Aid-5th Edition from Human Kinetics.