FIRST AID for the Little League Volunteer

1. FIRST AID for the Little League Volunteer East Orange Little League 2013

2. The purpose of this learning module is to assist little league volunteers in preventing and treating illness and injury on the baseball field, during practice and games.

3. Objectives • Understand basic injury prevention techniques. • Differentiate between mild, moderate and severe injuries • Determine appropriate first aid techniques. • Design an injury plan to prepare for a severe injury. • Decide when an injured player is ready to practice and/or play. • Understand and implement the new Florida Concussion Law as applicable to youth sports.

4. Preventing Injuries - playing area • Always evaluate the playing area for any unsafe conditions. - foreign materials that don’t belong - unsafe base placement - large holes in ground/field - unlit fields

5. Preventing injuries - protective gear • Catcher 1. Catcher’s helmet with facemask and dangling throat guard 2. Shin Guards 3. Protective Cup (BB) 4. Long model chest protector (short model for SB) • Fielders Protective cup recommended for all male players • Batter/Runner Batters’ helmet with faceguard (mandatory at EOLL, except for Senior BB)

6. Preventing injuries - safe practices • Pre-game and practice warm up and stretches • Teach & Drill proper throwing mechanics • Teach & Drill proper running and sliding mechanics • Keep pitching rules in mind when practicing • Teach eye contact when throwing

7. Preventing injuries, miscellaneous • NO jewelry during games or practices, ONLY exception is medical alert bracelets.

8. General Recommendations • Always inform parents of an injury if they are not present when it occurs. • What to report the Safety Officer or BOD? Any incident that causes a player, manager, coach, umpire or volunteer to receive medical treatment and/or first aid must be reported. This includes passive treatments such as evaluation and diagnosis of the extent of the injury or periods of rest. • The injured player MUST provide a medical release to return to play. • Please fill out an Injury Tracking form any injury, even one that appears minor. • Please fill out an Injury Claim form for any injury that has a chance or is definitely going to require the patient to be seen by a medical professional.

9. Evaluating an injuryLISTEN > LOOK > FEEL > MOVE Listen .. How did the injury occur? .. What did the player feel/hear? .. What did observers see/hear? .. Specifically, where is the pain? .. Complaint of pain on movement? Look .. What do you see? Bleeding? Bruising, swelling, break in skin? Deformity in limb/bone? Feel .. Touch the injured area is there pain or only tenderness? Move .. Can the player move the injured area?

10. Injuries – Cuts & Scrapes • Clean the wound. Rinse out the wound with clear water. If debris remains embedded in the wound after cleaning, see your doctor. • Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If they don't, apply gentle pressure with a clean cloth or bandage. Hold the pressure continuously for up to 20 to 30 minutes. Don't keep checking to see if the bleeding has stopped because this may damage the fresh clot that's forming and cause bleeding to resume. If the blood spurts or continues to flow after continuous pressure, seek medical assistance. • Apply an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment such as Neosporin to help keep the surface moist

11. Injuries – Cuts & Scrapes, cont’d • Cover the wound. Exposure to air speeds healing, but bandages can help keep the wound clean and keep harmful bacteria out. • Get stitches for deep wounds. A wound that cuts deeply through the skin or is gaping or jagged-edged and has fat or muscle protruding requires stitches. A strip or two of surgical tape may hold a minor cut together, but if you can't easily close the mouth of the wound, see your doctor. Proper closure minimizes scarring and infection. • Check with your doctor so see if you are due for a tetanus shot within 48 hours of the injury

12. Sprains & Strains • These are common injuries. Most are minor and will respond well to rest and ice. If a player is not able to comfortably move the injured area within a few moments of an injury, they should be removed from the game. (i.e., if they aren’t able to “walk it off.)” • If a player is not able to voluntarily move an injured area, you should not attempt to move it for them. • If immediate swelling occurs or if a limb is obviously deformed, immobilize the site if you know how to do so safely. • Splint the area if possible. Have them get medical attention immediately. Call 911 or have the player’s parent do so. • If the player heard a popping sound when their joint was injured or they can't use the joint. This may mean the ligament was completely torn apart. They should have emergency evaluation. On the way to the doctor, apply a cold pack.

13. RICE Rest the injured limb. Ice the area. Using a cold pack, a slush bath or a compression sleeve filled with cold water all limit swelling after an injury. Try to apply ice as soon as possible after the injury. If you use ice, be careful not to use it for too long (20 minutes at a time is ok) as this could cause tissue damage. YOU HAVE TWO INSTANT ICE IN YOUR FIRST AID KIT THE SNACK BAR HAS ICE and REPLACEMENT INSTANT ICE. Compress the area with an elastic wrap or bandage. Parents may want to do this if they feel comfortable with this and know how to do so. Do not make the compress so tight it cuts off circulation. Elevate the injured limb whenever possible to help prevent or limit swelling. Instruct parents that if the injury is not better 24 hours or if they have ANY doubts or concerns it should be evaluated professionally.

14. Fractures • A fracture is a broken bone. It requires emergency medical attention. • Dial 911 or call emergency medical assistance if: – There is heavy bleeding. - Even gentle pressure or movement causes pain. – The limb or joint appears deformed. – The bone has pierced the skin. – The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.

15. Don’t • DO NOT move the person unless the broken bone is stable. • DO NOT move a person with an injured hip, pelvis, or upper leg. • DO NOT move a person who has a possible spine injury. • DO NOT attempt to straighten a bone or change its position unless blood circulation appears hampered. • DO NOT test a bone's ability to move.

16. Foreign Body in Eye • Use water to rinse the eye. • Run lukewarm tap water over the eye or splash the eye with clean water. Rinsing the eye may wash out the offending foreign body. There is irrigation solution in all first aid kits to use to rinse out the eye. • Have the person blink several times. This movement may remove small particles of dust or sand. • Pull the upper eyelid over the lower eyelid. The lashes of the lower eyelid can brush the foreign body from the undersurface of the upper eyelid. • Don't allow the person to rub their eye after an injury. This action can worsen a corneal abrasion.

17. If you think a severe head injury has occurred…. • CALL 911 • Until medical help arrives, keep the person who sustained the injury lying down and quiet, with the head and shoulders slightly elevated if possible. • DON’T MOVE AN UNCONSCIOUS PERSON unless you follow precautions for NECK AND SPINE INJURY!! • If the person stops breathing, do mouth-to-mouth rescue breathing if you know how! At this point, there is no need to do chest compression if the person's heart is still beating.

18. Head Injury cont’d Dial 911 or call for emergency medical assistance if any of the following signs are apparent: • Severe head or facial bleeding • Change in level of consciousness, even if temporary • Black-and-blue discoloration below the eyes or behind the ears (Raccoon Eyes) after injury • Cessation of breathing • Confusion • Loss of balance • Weakness or an inability to use an arm or leg

19. Heat Related Illnesses • Heat emergencies fall into three categories of increasing severity: heat cramps, heat exhaustion, and heatstroke • Heat illnesses are easily preventable by taking precautions in hot weather. • Bring extra water to practice for kids who forget. • Children have a higher risk of developing heat illness. Even a top athlete in superb condition can succumb to heat illness if he or she ignores the warning signs. • If the problem isn't addressed, heat cramps (caused by loss of salt from heavy sweating) can lead to heat exhaustion (caused by dehydration), which can progress to heatstroke. • Heatstroke, the most serious of the three, can cause shock, brain damage, organ failure, and even death.

20. SYMPTOMS Causes: Common causes of heat emergencies: High temperatures or humidity Dehydration Prolonged or excessive exercise Medications Symptoms: The early symptoms of heat illness include: Profuse sweating Fatigue Thirst Muscle cramps Kids sometimes just act tired or lazy! Watch for this when it starts to get hot. CAUSES

21. Symptoms HEAT STROKE Headache Dizziness and light-headedness Weakness Nausea and vomiting Cool, moist skin Dark urine The main sign of heatstroke is a markedly elevated body temperature Rapid heartbeat Rapid and shallow breathing Elevated or lowered blood pressure Cessation of sweating Irritability, confusion or unconsciousness Fainting HEAT EXHAUSTION

22. Treatment for Heat Related Illnesses • IF alert, give the person beverages to sip (such as Gatorade), or make a salted drink by adding a teaspoon of salt per quart of water. Give a half cup every 15 minutes. Cool water will do if salt beverages are not available. • For muscle cramps, give beverages as above and massage affected muscles gently, but firmly, until they relax. • If the person shows signs of shock (bluish lips and fingernails and decreased alertness ), starts having seizures, or loses consciousness, call 911 and administer first aid accordingly

23. Tooth Injury • Save any tooth for possible re-implantation. • Handle the tooth by the top only, not the roots. • Don't rub it or scrape it to remove dirt. • Gently rinse the tooth in a bowl of tap water. • Don't hold it under running water. • Try to replace the tooth in the socket. Then have the person bite down gently on moistened gauze or a moistened tea bag to help keep it in place. DO NOT try this if the injured person is at all sleepy or too young to cooperate. • If you can't replace your tooth in the socket, immediately place it in a bag with a wet paper towel or cloth and take to dentist. Milk is sometimes suggested to use to store the tooth. • This is an emergency and should have emergency evaluation

24. Nosebleed • Have the person sit upright. By remaining upright, you reduce blood pressure in the veins of the nose. This discourages further bleeding. • Pinch the nose. Use your thumb and index finger. Continue the pinch for 5 or 10 minutes. This maneuver sends pressure to the bleeding point on the nasal septum and often stops the flow of blood. • To prevent re-bleeding after bleeding has stopped, don't pick or blow nose and don't bend down until several hours after the bleeding episode. Keep head higher than the level of your heart. • If re-bleeding occurs, sniff in forcefully to clear your nose of blood clots. • Pinch nose again in the technique described above and have person contact their doctor. • Seek medical care immediately if: – The bleeding lasts for more than 15 to 30 minutes – The person feels weak or faint, which can result from the blood loss – The bleeding is rapid or if the amount of blood loss is great – Bleeding begins by trickling down the back of the throat

25. CommotioCordis – “agitation of the heart” • Everyone who is around youth baseball should be aware if this life threatening condition - Commotiocordis, literally concussion of the heart, can cause sudden cardiac death of a young person following a blunt impact to the chest. • Impact with items like a baseball, softball, or hockey puck or a collision between players, such as in lacrosse, or karate • While most people believe a high-energy impact is required to cause commotiocordis, that is not necessarily so. • Some victims had structurally normal hearts with no heart disease, the strikes occurred over the heart at a precise moment, resulting in ventricular fibrillation, cardiac arrest or cardiac sudden death.

26. CommotioCordis – “agitation of the heart”cont’d • A strike at the vulnerable time of the heart cycle, between beats, can trigger an abnormal rhythm. • Any blow to the chest, regardless of its intensity, velocity or force is capable of producing cardiac arrest. Unfortunately, commotiocordis can be 84% fatal. Early recognition of the arrest, CPR, and early defibrillation seem to offer the best chance of survival. • The 16% of patients who survive a commotiocordis event have three things in common: 1. Early recognition of the arrest 2. Treatment with CPR and early defibrillation 3. Survival rates rapidly drop to zero when interventions are delayed. THERE IS A DEFIBRILLATOR IN THE SNACK SHACK!

27. Contents of First Aid Kit & Managers Manual • First Aid Prevention, Identification & Treatment information flyers. • Injury Tracking Form & Injury Claim Form • CDC Concussion Reference Card • Ace Wraps • Ziploc bag • Athletic Tape • 4x4, 6x8 and assorted gauze pads • Bandage Scissors, tweezers • Please inform the safety officer if any of these materials are used so they can be replaced. • If you don’t know how to use these materials, • please don’t use them. • Ice and additional First Aid kit supplies are available in the snack bar.

28. Notes • Always tell parents what happened. • Always tell the parents they should get professional medical attention for injuries –don’t pretend to know more than you do. • Report injuries and events • If you don’t know what to do, ask for help. • Don’t do things you are not fully trained to do!

29. Thank you for your commitment to the children of East Orange Little League. Please email safety@eoll.org with any questions. Please open and complete the attached document so that we can track our volunteer training. This First Aid Training will be good for 2 years, and kept on file by the Safety Officer. Once you complete the form below click the SUBMIT button in the upper right-hand corner and it will open your email software for submission. (just type your name in the signature box)