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PREAMBLE

Best practice emergency action plans (EAP) must represents a collaborative agreement between the athletic trainers, team physicians, local emergency medical services, administrative officials, and other appropriate medical professionals, referred to from here as “The Medical Team”.  The TeamEMSoft© Comprehensive EAP Document has been developed as a general emergency response reference guide, organized as resource medical teams may use to enhance cognitive understanding of emergency procedures, to aid in on-going development of emergency response psychomotor skills, and reflect on when developing specific protocols and procedures.

The policies and procedures detailed in this EAP document are intended to serve only as guidelines.  These guidelines are not intended to be a substitution for prudent autonomous medical decision-making required during actual emergency management.  This EAP details policies and procedures as they pertain to communication, on-field response, activation/coordination of BLS and ALS, and development of training along the entire continuum of care.  Implementation of any should be provided for in all physician standing orders.

The policies and procedures are presented using an evidence-based review that is based on the Strength of Recommendation Taxonomy (SORT) criterion scale proposed by the American Academy of Family Physicians (Table 1).¹ Each recommendation is awarded a grade of A, B, or C based upon patient-oriented or disease-oriented outcomes. The SORT emphasizes outcomes-based treatments (ie, randomized controlled clinical trials).   With respect to emergency management recommendations, good-quality outcomes-based research is limited by the ethical constraints of implementing an experimental design that would preclude an at-risk group from being exposed to various treatment measures. The medical team should recognize and consider these limitations when assessing specific recommendations related to planning considerations, education, and emergency management throughout the entire continuum of care.  Clinically relevant works referenced in this document are provided in the reference section which has been organized to correspond works cited in each section of this document.

Table 1.

Strength of Recommendation / Evidence Category Definition
Category A Recommendation based on consistent and good-quality patient-oriented evidence. a
Category B Recommendation based on inconsistent or limited-quality patient-oriented evidence. a
Category C Recommendation based on consensus, usual practice, opinion, disease-oriented evidence, or case series for studies of diagnosis, treatment, prevention, or screening. b
a Patient-oriented evidence measures outcomes that matter to patients: morbidity, mortality, symptom improvement, cost reduction, and quality of life.
Disease-oriented evidence measures intermediate, physiologic, or surrogate end points that may or may not reflect improvements in patient outcomes (eg. Blood pressure, blood chemistry, physiologic function, pathologic findings).