Medical Persons at the field

[jboulet4648]

Friday night I reffed a low division college match. Halfway into 2nd half, one of the players started haveing a seizure after being struck in the head in a ruck. Luckily the team had EMT's at the field who stabilized the player, and called paramedics. Follow-up, Player is okay, never had a seizure before, and has a sore head.

Found out that the colleges do not need actual medical personnel at the field, only a plan of action. Same with our club level. What is the requirements of such elsewhere?

 

[Robert Burns]

All Matches in England (should) have a first aid kit, blankets & a strether available. As well as someone that can use them.

 

[Simon Griffiths]

With plenty of emphasis on the should...

 

[Simon Thomas]

It is a bit more than that Robert ! For England (RFU juristiction) my understanding is as follows :

'Clinical Governance' as RFU now calls it, is a club responsibility NOT the referee's.
RFU defines First Aid care, and have RFU First Aid Kit Guidelines and a RFU First Aid course

We as referees have responsibilty for player safety and under our duty of care should check :
1) provision of stretcher / blankets
2) first aid kit
3) access - gates not padlocked (it has happened)
4) doctor or trained medical, first aid, and physios present
5 Hampshire's rural clubs have been asked to register postcode and directions with Hampshire Ambulance Service after a near death last season, when the ambulance couldn't find the ground in middle of countryside !
6) easy access to phone and contact number for emergency services clearly shown (or mobile on touchline with reliable individual

All clubs should have a good first aid kit and a first aider available on match days. Many clubs will have a physio present to. But I don't think it is mandatory ! At tournaments (especially for Youth) Clubs should have St Johns or similar paramedic service on site witrh ambulance fully equipped with CPR etc.

The whole issue of medical cover has changed in the last few years, and quite frankly becomea bit stupid. Most doctors and trained medical staff will now NOT get involved as they cannot get appropriate medical third party liability insurance cover at affordable premiums. However in life threatening situations they would of course get involved.

Gone are the days when you could be stitched up on the side of the pitch - as I was by the opposition scrum half when playing for the Old Boys v Guys Hospital (he was an ex-sChool and University pal !)

Club and Referee insurance is now handled centrally. A new funding scheme for all clubs at levels 5 and below was approved by the RFU Council at its 28 April 2006 meeting. This decision means that from season 2006/07 onwards, the RFU conditional funding scheme for clubs has been terminated and, in its place, the RFU centrally funds all player accident insurance, together with clubs' public liability and employer liability policies.

see RFU handbook for more regulations :

Rugby Injuries - Reporting, surveillance, support and pastoral care at http://www.rfu.com/microsites/handbooks/index.cfm?fuseaction=handbook.detail&storyid=8139

 

[Robert Burns]

Ok,

Let's be honest, how many of you check for these at any game? Let alone every game.

1) provision of stretcher / blankets
2) first aid kit
3) access - gates not padlocked (it has happened)
4) doctor or trained medical, first aid, and physios present

And what would happen if a club said they didn't have either a or b (one or both) and couldn't get them either. Should we be stopping the game from then taking place?

 

[mbkingsmill]

Having dealt with numerous serious injuries (both rugby and non-rugby related) my recomendation would be that a first aid kit and a blanket need to be available but that there is no need for a stretcher - if someone is seriously hurt then the only people who should be moving that player are professionally trained medical personel with the appropriate equipment to do so in a safe manner.

As referee's our primary responsibility is player safety and this, in my opinion, extends to the treatment of injured players. Moving a player before medical aid arrives to facilitate finishing a match is not appropriate with most serious injuries, as specialist equipment is required to stabalise those injuries and using only a stretcher and blankets (which is the only equipment specified as needing to be available) can cause more harm to the casualty. Therefore inorder to fullfill our duty of care to ALL players we must ensure that we don't permit anything to happen that can cause the condition of the casualty to deteriorate.

 

[Robert Burns]

I always generally thought that the Stretcher was for putting the casualty on to get them off the floor (quickest heat loss and all that) and not (in all cases) for getting them off the pitch.

 

[mbkingsmill]

if the casualty can move themselves (without assistance) onto the stretcher then yes fair enough you can put them on the stretcher to keep them off of the ground, but if you have got a spinal injury or a serious abdo problem or lower limb injury then you are best leaving the casualty as they are on the floor and just wrapping blankets/coats/tracksuits round them to keep them warm.

 

[Simon Thomas]

Robert

You should be ! And should be asked to do so by your Society. London Soc Refs certainly did when I was a team skipper back in the 1980s. If the worst ever happens, you as a referee could end up being asked some very difficult questions about what you checked before starting the match.
Your call as the referee on the day, but we recommend all the Hampshire Refs to ask the questions !

Last season we had three incidents in Hampshire which made us even more concerned than we were prevoiusly to get it right.

a) Southampton Medics player collapsed (no contact or anything) and CPR conducdeted by teamates. Ambulance took 50 minutes as they couldn't find the ground - middle of nowhere in country lanes. He would have died without one of his teamates who was fully qualified. Thankfully he recovered, and has a pacemaker to control a genetic inherited heart condition.

b) Guernsey player broke his neck on scrum engagement (no blame attached at all to referee - players' error). Home team physio took control, ambulance arrived, off to Southampton General - three hours later he was of to Stoke Mandeville at 15 mph in ambulance with police outriders up M3 and M25. It looked like he would be in a wheel-chair, but thankfully he has recovered and is now coach to Guernsey's Colts.

c) player with broken leg, in severe pain. Ambulance could not get access to pitch die to council jobs-worth not unlocking main gates (to prevent yobs on mpoeds getting in). The ambulance guys had a half mile walk and then back with stretcher over bumpy grass. Nasty ! Council got major b*ll*cking.

So I certainly ask all four questions during the hour before the match and talk to both physios / team managers to discuss when they can come on to the pitch - especially for players who have taken a head knock or are not moving, they don't wait for me - straight on !

If an injury does occur then always wait for professional help. If it is head and / or neck ensure the player does not move at all. Only trained paramedics / ambulance staff should move a player like that. A stretcher would only be used to move a player who can get himself onto it, and with a sprained ankle etc. If the player can't be moved, go to next door pitch, or if not available suspend the match - note the time, ensure the teams have the option of return to dressing room and a ten minute warm up before restart, or even abandon the match if necessary. Provision of a stretcher is an historical RFU and CB requirement.

We have a yellow card we ask our referees to fill in. This asks questions about stretcher and first aid kits, plus access / telephones. A negative submission is passed to our CB (County RFU) and they take it very seriously indeed and take action.

 

[madref]

On Saturday

There was a death on the field it was Eagle 2 v Leigh 6 (Vets) do not know what happened just found out this morning.

David

See http://www.zen57462.zen.co.uk/nowirul/

My heart goes out to any family or children of the deceased. Also must have been hard for the players and referee. I am for one going to have a minutes silence at my match on Saturday as a mark of respect.

 

[Simon Griffiths]

That's terrible. Thoughts with the family and friends.

 

[ex-lucy]

sat: i had a broken wrist for a winger (on 2 tries - just before try line for 3rd try he passed and fell on his wrist!! jug avoidance?). Doesnt seem much.
But after i whistled for the physio to come on and see to him and then, on her advice, phoned for an ambulance (always carry mobile phone in pitch side bag!!)... we waited 20 mins.
After 5mins or so attention, now in sling etc, the physio asked for 2 players to help him up to walk him to the edge of the field so the ambulance had easier access (muddy pitch etc).
Player collapsed/ feinted, i guess due to the shock. So we had to just leave him for teh ambulance.
i suppose the moral is .. you just dont know how serious the ramifications of a seemingly innocuous injury is for every player so be very very careful.
If i hadnt had the physio there, i dont know what i would have done.

 

[Robert Burns]

Robert

You should be ! And should be asked to do so by your Society. London Soc Refs certainly did when I was a team skipper back in the 1980s. If the worst ever happens, you as a referee could end up being asked some very difficult questions about what you checked before starting the match.
Your call as the referee on the day, but we recommend all the Hampshire Refs to ask the questions !

Last season we had three incidents in Hampshire which made us even more concerned than we were prevoiusly to get it right.

a) Southampton Medics player collapsed (no contact or anything) and CPR conducdeted by teamates. Ambulance took 50 minutes as they couldn't find the ground - middle of nowhere in country lanes. He would have died without one of his teamates who was fully qualified. Thankfully he recovered, and has a pacemaker to control a genetic inherited heart condition.

b) Guernsey player broke his neck on scrum engagement (no blame attached at all to referee - players' error). Home team physio took control, ambulance arrived, off to Southampton General - three hours later he was of to Stoke Mandeville at 15 mph in ambulance with police outriders up M3 and M25. It looked like he would be in a wheel-chair, but thankfully he has recovered and is now coach to Guernsey's Colts.

c) player with broken leg, in severe pain. Ambulance could not get access to pitch die to council jobs-worth not unlocking main gates (to prevent yobs on mpoeds getting in). The ambulance guys had a half mile walk and then back with stretcher over bumpy grass. Nasty ! Council got major b*ll*cking.

So I certainly ask all four questions during the hour before the match and talk to both physios / team managers to discuss when they can come on to the pitch - especially for players who have taken a head knock or are not moving, they don't wait for me - straight on !

If an injury does occur then always wait for professional help. If it is head and / or neck ensure the player does not move at all. Only trained paramedics / ambulance staff should move a player like that. A stretcher would only be used to move a player who can get himself onto it, and with a sprained ankle etc. If the player can't be moved, go to next door pitch, or if not available suspend the match - note the time, ensure the teams have the option of return to dressing room and a ten minute warm up before restart, or even abandon the match if necessary. Provision of a stretcher is an historical RFU and CB requirement.

We have a yellow card we ask our referees to fill in. This asks questions about stretcher and first aid kits, plus access / telephones. A negative submission is passed to our CB (County RFU) and they take it very seriously indeed and take action.

I'm quite glad to say we have a misunderstanding.

When you said the referee should check all that stuff I took it as a phsyical check, i.e. walking around checking gates in, asking to see first aider/kit and stretcher.

Now after the above post it is clear you mean ask if they have one and that seems to be sufficient, which we of course do do.

The magnicient world of words, lol.

 

[Chris Picard]

My prayers go out to his family.