SPORTS MEDICAL CARE AND FACILITIES REVIEW PROTOCOL FOR MAJOR CHAMPIONSHIPS. Dr. Ezequiel R. Rodríguez Rey

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1 SPORTS MEDICAL CARE AND FACILITIES REVIEW PROTOCOL FOR MAJOR CHAMPIONSHIPS Dr. Ezequiel R. Rodríguez Rey Fédération internationale d escrime- International Fencing Federation F.I.E. Medical Commission September 2003

2 Table of Contents Introduction 1) Pre-event Coordination 2) Sports venue inspection 3) Ambulances 4) Medical and auxiliary personnel 5) Reference hospitals 6) Venue communications and Transportation 7) Medical Delegate Report

3 INTRODUCTION The strategic objective of Sports Medicine is the prevention of injury among the athletes, their medical care and the surveillance of clean sports practice and equal chance for all through the enforcement of the Anti- Doping Code. Once this objective has been established, the next step in the organizational engineering process is to set the framework, the tools, with which to work towards achieving this main objective. This basic protocol is aimed at giving the Medical Delegate at major sports events a guide with which to oversee the infrastructure, proceedings and manpower available for that particular event. All data leading to valid approximation of the operational resources should be made known to the Medical Delegate before arriving at the site of the sports event: such is the goal of preliminary contacts between Organization Committees and the Medical Delegate. After arrival, the Medical Delegate should proceed to a systematic check of the sports compound, manpower and material means available to ensure a safe and professional medical care and doping control during the event. Although each event has its own particular characteristics and every location must develop a sound medical care design under often very varying circumstances, a concerted method of planning and verification should aid in reducing risk factors as a whole in major sports events. This protocol aims at helping bridge that gap and aiding the Medical Delegate verify the objective circumstances under which the sports event will develop. Dr. Ezequiel R. Rodríguez Rey Medical Commission Fédération internationale d escrime (F.I.E.) September 2003

4 1) PRE-EVENT COORDINATION The Medical Delegate should establish contact with the Organizing Committee a minimum of two months before the starting date of the sports event. This margin should allow ample time for coordination between the two parties and for evaluating important aspects of the medical care and doping control. Beside the establishing of a liaison officer at the event and the exchange of telephone, faxes and s, the Medical Delegate should ask for information concerning the following points: - Sports venue location, main characteristics, medical room and doping-control room, signals. - Medical staff and auxiliary personnel - Ambulances, access routes and evacuation time to the reference hospital. - Reference hospital(s) - Other circumstances (drinking water, climate, humidity, etc.) All doubts and possible improvements and suggestions should be pointed out, so as to be solved upon arrival. 2) SPORTS VENUE INSPECTION A) Sports Venue: description of the venue, location in the city; access and exit routes for ambulances and fire-fighters. Lighting, ventilation, emergency exits, drinking water supply, showers and lavatories. Proper signaling of medical room, doping-control room. Spectator, Technical Directory, Press, athlete and training areas. B) Medical care room(s): light, water, ice and oxygen supply, WC. Location and identification (signals throughout venue). Chairs and tables, examination couch. Medical material: manometer, stethoscope, oto-ophtalmoscope, lights, latex gloves etc. Minor surgical material, swathes and dressings, bandages, cotton, tapes, Guedel tubes, laryngoscope and intubation material, C.P.R. equipment. Wheelchair, stretcher, collars. Oral and parenteral drugs: NSAIDs, anti-histaminc agents, anti-hypertensive agents, adrenaline, nitroglycerin, A.A.S., acetaminophen, etc. C) Doping Control Room: a separate locked room for exclusive use of the doping-control team. Provided with WC and separate questioning and waiting areas. Tables and chairs; freezer or refrigerator for storing samples and another for keeping non-alcoholic beverages. 3) AMBULANCES One fully medicalized ambulance; a second transport ambulance should me available if the competition is held at separate venues. Trained paramedical personnel should man the vehicles. The equipment checklist includes: - Cardiopulmonary Resuscitation (CPR) equipment and defibrillator - Intravenous fluids and emergency medication; oxygen supply and masks. - Rescue apparatus, scoop-stretcher, immobilization equipment. - Pre-hospital communication protocol and radio. The ambulances should be located near the medical care room, with a cleared exit route and in starting position. The crew should be located at all times. 4) MEDICAL AND AUXILIARY PERSONNEL A) Medical care team: depending on the status of the federations rules, it should include one Trauma team and one General Medicine team; if possible, one Advanced Life Vital Support team should be present for severe acute injury cases. The day prior to start of competition a meeting should be held to establish contact between the parties and to inform about each one s responsibilities: - Standard case presentation - Organization within the championship, communication and identification. - Case register: date and time, name of patient, diagnosis and treatment. Hospital evacuations. - Parceling of the competition area and observation schedules.

5 B) Doping Control Team: protocol review with the team, male and female physicians and escorts, identification. -Identification of the athletes with Championship Identification Number. - Collection, conservation, custody and transportation of the samples to the laboratory. 5) REFERENCE HOSPITAL A Level III hospital should be designated for cases requiring urgent treatment of clinically serious conditions or injuries. Pre-hospital communication should be standard and the mean evacuation time should be known and communicated to the Medical Delegate. 6) VENUE COMMUNICATIONS AND MEDICAL DELEGATE TRANSPORTATION A means of communication (walkie-talkies, cell phone, radio) should be established between the Medical Delegate and the Organizing Committee, the Technical Directory and the medical teams. At the beginning of competition an information sheet should be handed out to the chiefs of delegations and team physicians concerning the medical care during the championships. As the Medical Delegate should have available transportation from his lodging to the venue before the start of competition until after the closing of the Doping Control, a transportation service should be established beforehand. 7) REPORT The Medical Delegate s report should be the summary of the medically-oriented organizational, operative and data-gathering activity during the championship. A comprehensive report valuable information on the degree of excellence achieved by the Organizing Committee in regard to the medical prevention, safety and operative procedures with the means at its reach. It should help evaluate the role of the Medical Delegate in helping to overcome the encountered difficulties and in the adjustment of future needs in material and manpower for each event. It should also help in eliminating flaws and mistakes to provide for a continuing improvement of sports medical care. The following aspects should be included: - Pre-event communication - Sports facilities and infrastructure - Medical and auxiliary personnel - Reference hospitals - Medical care during competition, including case description - Doping control - Incidents - Conclusions Although this protocol is basically oriented towards fencing, it can be suitably adjusted for other combat sports, given the specific laesion pattern for a particular sport. Following that reasoning, the adaptation should fit a sport-specific profile for other competitions.

Athletes have the right to refuse treatment, but not the right to compete with injuries that may be undetected.

Athletes have the right to refuse treatment, but not the right to compete with injuries that may be undetected. Annex D Medical Services Recommendations for Medical Services at FEI Competitions 1 Medical Attendance at Event The on-site provision of medical care must be available during the hours of the Competition