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Each injury situation is unique, requiring the medical team to have an array of psychomotor skills and a cognitive ability to determine what management strategy is most appropriate for any given scenario.  Conditional protocols in this document represent an organizational approach to common emergency conditions/illnesses in athletics that provides for autonomous medical decision-making regarding appropriate strategies for ensuring safe handling of injured/ill athletes.  Although certain medical conditions require specific management, emergencies in general require that the medical team consider, first and foremost, the Primary Objectives, which include the athlete’s cardiac, airway, breathing, and neurological status.

If an athlete collapses or is found unconscious, it will be assumed that they are in cardiac arrest until the medical team can establish otherwise. If an injured athlete is found to be without a carotid pulse, the medical team will immediately activate the EMS system using the team’s designated emergency response radio call and backup hand signal. The medical team will immediately implement CPR/AED protocols.  When managing a critically injured equipment-laden athlete, the most appropriate equipment removal procedures detailed in the the Safe Handling Protocols and Techniques section of this document will be implemented. Simultaneously, the medical team will establish a patent airway using the most appropriate Airway Management Protocol.

Upon establishing a patent airway, the medical team will provide on-going care in accordance with regional policies and established advanced cardiac life support (ACLS) procedures. The athletic training staff shall continue to provide care in accordance with professional practice standards until too exhausted to continue or until more qualified medical professionals arrive to take over scene management. When a team paramedic is available, the medical team shall continue to provide on-going care until the team paramedic deems the athlete stable enough for transport, at which time the medical team shall remove the protective equipment from the athlete using the most appropriate Equipment Removal Protocol. The athlete shall then be transferred and packaged for transport using the most appropriate protocol. Once properly packaged for transport the athlete will be transported to an appropriate medical facility with a designated athletic training, paramedic, and EMT escort.

The equipment required to carry out all ACLS procedures, equipment preparation and removal, transfer, and package for transport protocols shall be kept with the team’s advanced life support (ALS) equipment as indicated in the Emergency Response Equipment section of this document.