section nine safety issues - afl community club · 2014-06-19 · section nine safety issues risk...

IN THIS SECTION

SECTION NINE

SAFETY ISSUES

Risk management ...........................................188Health and safety checklists .....................188A checklist for providing a safe environment ........................................................ 189Safety considerations ...................................189Environmental conditions ..........................192

First-aid for sports injuries ........................193When an injury occurs, remember S.T.O.P. ............................................194Soft tissue injury management (R.I.C.E.R) ................................195The management of concussion in Australian football .........................................196

SAFETY ISSUES

188 AFL Junior Coaching Manual

RISK MANAGEMENTRisk management is concerned with ensuring that thought has been given to what might go wrong and taking action to prevent possible accidents and undesirable events. It is about being alert to danger and taking preventative action by establishing risk management processes to avert danger as far as possible.

The law requires people with a duty of care over others, as coaches have over children they are coaching, to take reasonable steps to avoid risk of harm or injury to those in their charge. Generally the younger the person in care the greater the duty of care that is owed.

To help establish those ‘reasonable steps’ to avoid injury or harm a risk management plan should be developed. Some potential hazard areas that a risk management plan or checklist should address are:

Pre-training• Warm-up equipment.• Facilities/change rooms.• General environment.

During training• Training equipment.• General environment.• Ground surface.• Children’s physical condition.• Children’s inexperience.• Children’s attire/adornments.• Climate.

Post training• Children’s physical condition.• General environment.

Please note that various State Legislation should be complied with at all times when working with children.

It is also our strong recommendation that multiple parents/volunteers be nominated to assist children in a non-open environment (ie. assisting children to toilets, pre-presentation nights, overnight camps etc). Under no circumstances should an adult be allowed a one-on-one oppurtunity with a child in a non-open environment.

HEALTH AND SAFETY CHECKLISTSPlayers• Health (check for medical conditions, medication needs.

Ensure full recuperation before resuming activity).• Instruct (highlight risks to avoid and stress safety

practices with children).• Approved dress (ensure children are appropriately

dressed. Check boots and for jewellery that could cause injury).

• Correct protection (e.g. insist on a mouthguard and encourage use of shin guards).

• Warm up (provide adequate warm-up exercise).• Supervision (provide adequate supervision at all times).• Activities (activities should be appropriate for skill levels).• Injury management (have a process for managing

injuries).• Group management (appropriate strategies are

needed to manage large groups of children).• Grading (match players of similar size, strength

and skill levels).• Rehydrate (encourage regular drinking to ensure

children do not become dehydrated).• Warm-down (provide adequate warm-down exercise).• Physical conditioning (don’t over-tire children).• Food handling (please refer to food handling website –

www.safefood.net.au).

Activities• Intensity (avoid stressful and high intensity activities.

Avoid over training).• Appropriateness (avoid activities which may cause

injury).• Procedures (stay within recommended procedures

and conform to all rules. Quickly intervene if children engage in potentially harmful behaviour).

Responding to injuries or emergencies• First aid (have a trained first aid person and

appropriate first aid equipment).• Contacts (have emergency telephone numbers

in a prominent location).• Communication (have a telephone handy).• Transport (have emergency use transport available).

TrainersTrainers are a key element of safety and player welfare in football clubs In accordance with AFL Policy, and the interests of meeting community expectations for the provision of first aid and trainers services, all matches should have a qualified first aider in attendance. Clubs should always have an appropriately and adequately stocked first aid kit and appropriate emergency transport equipment on hand and someone quailified to use them.

SAFETY ISSUES

189AFL Junior Coaching Manual

A CHECKLIST FOR PROVIDING A SAFE ENVIRONMENTPlaying/training equipment• Approved equipment (use only approved equipment).• Training aids (ensure markers and other training aids

are safe - e.g. mats are non-slip).• Equipment in good condition (keep equipment in good

condition).• Training (train children in the use of all equipment

and where necessary monitor equipment use).

Playing field• Correct marking (is there sufficient distance between

the boundary and the fence? Is there ample area for the numbers involved to play safely?).

• Safe surface (check for holes, protrusions, debris. Is the surface level of appropriate firmness? If training at night, is the ground adequately lit?).

• Safe perimeter (e.g. ensure goal posts and light poles are highly visible and padded. Ensure all equipment is removed from near the boundary).

• Zones (use zone markings to increase safety).

Weather• Extremes (e.g. avoid training or playing in lightning,

severe cold and heat, thick fog or dust).• Sun (protect children from sunburn. Move into shade

where available).• Heat (ensure players drink plenty of water before,

during and after activity).• Cold (warm up after breaks. Wear warm clothing

when not active).

General environment• Spectators (e.g. ensure all spectators are outside

the boundary/fence).• Car park (is it well controlled? Are child pick-up

areas safe?).• Busy roadways (is there a need to escort children

across roads?).• Change rooms (e.g. are they clean, tidy and safe?

Is furniture safe?).• Strangers (be alert to strangers around young

children. Warn children about approaching strangers).

SAFETY CONSIDERATIONSResearch has shown that junior football is very safe. The incidence of injury in junior football is very low, and serious injury is extremely rare. To maintain this position, leagues and clubs should prepare adequately to deal with injuries or medical problems should they occur.

Risk management procedures include the provision of first aid support, safety equipment, and having policies in place for environmental and medical issues. These improve the safety of junior players.

Dealing with emergenciesPlanning what to do when an emergency occurs is an essential part of risk management. Junior leagues must be conversant with procedures and able to deal with emergencies so young people are well cared for.

Junior leagues should ensure a person with current first aid qualifications is available at all junior games and seek medical opinion when:• the health of a participant is questionable;• recovery from illness/injury is uncertain; and• a participant is injured during training/competition.

When medical advice cannot be obtained, the junior league and/or club should not allow the young person to participate.

A first aid kit must be available at training and competition venues. Sport-specific rescue equipment should also be accessible. Emergencies should be formally reported, discussed, and changes made to procedures if needed.

First Aid OfficerFor the safety of all junior players the following minimum levels of accreditation for providing first aid and trainer services will apply:• AFL Auskick / AFL Junior (5-12 years) – basic first aid

course;• Community Youth (13-14 years) – sports first aid

course/basic first aid course; and• Community Youth (15-18 years) – Level 1 trainer/basic

trainers course (must include current emergency first aid qualification).

SAFETY ISSUES


MEDICAL CONDITIONSSpecial medical conditionsSome medical conditions may create concern for coaches and parents. Generally, active sports are beneficial to most people with medical conditions. However, a medical certificate should be provided if there is potential for the condition interfering with participation, or playing football could adversely influence the condition.

Some conditions may require coaches to be informed if specific medical assistance could be necessary. Common conditions such as asthma, epilepsy and diabetes require an emergency management plan to be provided. Players with heart problems or who have lost one of a paired organ system (e.g. eye, kidney, testicle) need a specific medical clearance to play.

ConcussionConcussion occurs when, after a blow to the head, there is a brain injury with some immediate disturbance of brain function. Any player showing the signs or symptoms of concussion should be removed from the field immediately and referred to a medical practitioner.

A player, who has suffered concussion with or without losing consciousness, should not participate in any match or training session until he or she is fully recovered and has been cleared by a thorough medical examination. Junior clubs must cite a medical clearance before allowing a player who has suffered concussion to resume playing.

Infectious diseasesPlaying football, as with all team sports, involves players living and training in close contact with others. While this increases the risk of contracting common illnesses such as respiratory infections, skin infections or gastroenteritis. The following simple measures can reduce the chances of transmission of these infections:• avoiding sharing drink bottles;• washing hands regularly;• avoiding spitting;• a generally clean environment in change rooms.

These specific rules apply to players with acute bleeding during a game: • they should be removed from the ground immediately

and the bleeding controlled;• they may require medical attention;• all open wounds should be covered before returning

to play;• all clothing contaminated with blood should be

removed and washed.

These measures reduce the risk of transmission of blood-borne viruses.

NUTRITIONAppropriate nutrition in athletic children is essential to enhance their overall health, growth, development, and their sporting performance. The well-nourished junior football player will have plenty of energy for the entire game, be mentally alert, and recover more quickly from training and competition. The child who is not consuming enough total energy however will become tired and lethargic more quickly and may even lose enjoyment from participating in football.

Variety is the KeyTotal amounts of food required each day vary from child to child, however all young football players should be encouraged to consume foods from a wide variety of sources. Children should consume foods from the following groups each day:• Breads/cereals/pasta/rice/noodles• Vegetables/legumes• Fruit• Milk/yoghurt/cheese• Meat/fish/poultry/eggs/nuts/legumes

SnacksSnacking is a very important part of an active child’s day. Nutritious options provide extra fuel for exercise, play, concentration and growth. Good choices include:• Fruit flavoured yoghurts• Creamed rice• Fresh or tinned fruit and custard• Sushi rolls• Fruit buns and raisin bread• Crackers and cheese• Sandwiches with lean ham, chicken, tuna or salmon

fillings• Breakfast cereals • Pikelets with jam or honey

Snacking 1-2 hours before training and games, and again shortly afterwards, will help to ensure a child has fuelled up ready to play and then re-fuelled afterwards for their recovery. Foods and drinks sold at competition venues tend to be ‘hit and miss’ from a nutrition perspective. It is a good idea for parents to be encouraged to pack snacks for their child from home

SAFETY ISSUES


Hydration for Junior PlayersChildren are unable to regulate their body temperature in the same way that adults and teenagers can. Therefore extra attention to the provision of adequate, cool fluids is needed before, during and after training sessions and games, especially in warm weather. Coaches should provide regular drink breaks for their players and encourage each child to bring their own drink bottle to training.

Active children should also drink with their meals and snacks and carry a drink bottle with them throughout the day to ensure ongoing hydration.

Extra InformationIf parents or coaches are concerned about a child’s nutrition, seek professional advice from an Accredited Sports Dietitian or Sports Physician.

Sports Dietitians Australia has fact sheets on junior athlete nutrition http://www.sportsdietitians.com.au/factsheets/

FACILITIES AND EQUIPMENTBoundary lineIn order to prevent injuries to players, officials and spectators, the distance between the boundary line and oval fencing should be a minimum of 3 metres.

Goal-post paddingIn order to prevent injuries to players, officials and spectators, all fixed goal and behind posts must be padded as follows:• a minimum of 35 millimetres thick foam padding,

covered in canvas or painted;• a minimum height of 2.5 metres from the bottom

of each goal and behind post; • a suitable width to allow the padding to be fixed

around each goal and behind post; and• The padding must be securely attached around

each goal and behind post.

MouthguardsA mouthguard is essential for all players for both training and games. • Mouthguards have a definite role in preventing injuries

to the teeth and face and for this reason they are strongly recommended at all levels of football.

• Dentally fitted laminated mouthguards offer the best protection. ‘Boil and bite’ type mouthguards are not recommended for any level of play as they can dislodge during play and block the airway.

• There is no definitive scientific evidence that mouthguards prevent concussion or other brain injuries in Australian Football.

Helmets• There is no definitive scientific evidence that helmets

prevent concussion or other brain injuries in Australian football.

• There is some evidence that younger players who wear a helmet may change their playing style, and receive more head impacts as a result. Accordingly, helmets are not recommended for the prevention of concussion.

• Helmets may have a role in the protection of players on return toplay following specific injuries (e.g. face or skull fractures).

SpectaclesJunior footballers who wish to wear spectacles during matches and training sessions should wear spectacles with plastic frames and plastic lenses. A band must also hold the spectacles on securely. This will minimise the risk of injury to the player, teammates and opposition players.

SAFETY ISSUES


ENVIRONMENTAL CONDITIONSIn managing risk, consideration must be given to environmental factors and their impact on participants. Sometimes extreme weather conditions (e.g. heat, cold, rain or wind) make it best to postpone training or competition. Different regions of Australia vary in the weather conditions considered extreme, due to their residents’ acclimatisation to the local environment. When scheduling junior matches, junior leagues and schools must always consider the player’s health, giving careful consideration to the following environmental conditions.

HEAT Vigorous exercise in sport places some people at risk of heat illness. Even in cool weather, heat illness may occur in people exercising at high intensity for more than 45 minutes. The risk of heat illness is obviously greater in hot and humid weather because:• during high-intensity exercise in hot weather people

may not be able to produce enough perspiration to adequately cool themselves; and

• high humidity may prevent adequate evaporation of sweat.

Children perspire less and get less evaporative cooling than adults. In warm and hot weather, they have greater difficulty in cooling themselves; they look flushed, and feel hotter and more stressed than adults. Overweight children are particularly disadvantaged exercising in warm weather. Children should always be allowed to exercise at their preferred intensity, they should never be urged to exercise harder or compelled to play strenuous sport in warm weather. If children appear distressed or complain of feeling unwell, they should stop the activity.

In high temperatures and humid conditions, junior leagues and schools should consider postponing scheduled matches to a cooler part of the day or cancelling them. It is recommend junior football providers follow the Sports Medicine Australia guidelines available on their website sma.org.au.

COLDIn extremely cold temperatures, junior leagues and schools should consider postponing or cancelling scheduled matches. The AFL recommends junior leagues and schools apply common sense guidelines to climatic conditions that exist within their respective regions. Sports Medicine Australia (SMA) has state and territory branches and should be consulted when developing appropriate local policies to manage environmental conditions.

FLUID BALANCESubstantial amounts of water are lost through perspiration when exercising vigorously in the heat, so fluid balance is important at any time but needs more attention in some weather conditions. Junior participants do not instinctively drink enough to replace fluid lost during activity. Junior participants must be reminded to drink before, during and after training and competition. • Water is the most appropriate drink for re-hydration.

However, diluted cordial or sports drinks may be supplied. Flavoured drinks may be more palatable to children who have consistently poor drinking habits during exercise.

• Players should be encouraged to have their own drink bottles. This ensures that each player has access to an adequate level of replacement fluids and reduces the risk of contamination and passing on of viruses.

• Where cups and a large container are supplied, cups should not be dipped into the container. Used cups should be washed or disposed of after use.

• Cups should not be shared.

SUN PROTECTIONJunior leagues and clubs have a responsibility to protect junior participants, to the greatest extent practical, from the dangers of sun exposure. Junior participants should be encouraged to protect themselves against sun exposure by applying a 30+ sunscreen in warm weather.

Junior leagues and clubs should also maximise the provision of shaded areas at venues and events, and/or erect artificial shade.

Sports Medicine Australia has developed a policy related to preventing heat illness in sport. These general safety guidelines, which are specific to geographical locations, are available on the SMA website at sma.org.au.

LIGHTNING The AFL has produced a lightning policy for adoption by junior leagues and clubs. The policy provides a step-by-step process to assist volunteers when making the difficult decision to postpone matches and or remove participants from the playing surface. The full policy can be found at afl.com.au/policies.

SAFETY ISSUES


FIRST-AID FOR SPORTS INJURIESEveryone involved in sport has a responsibility to manage the risk of injury, keep it to a minimum and appropriately manage injuries that do occur. Inadequate first aid may aggravate the injury. The ‘golden rule’ in managing an injury is “do no further damage”.

The following diagram outlines an effective procedure in the first-aid management of sports injuries.

UNCONSCIOUS PLAYERIf the player is unconscious it is a life threatening situation and the DRABC of first aid should be used by an accredited sports trainer.

D DANGER• Check for danger to:• You.• Others.• The injured player.

R RESPONSE• Is the player conscious?:• Can you hear me?• Open your eyes.• What is your name?

S SEND FOR HELPCall triple zero (000) for an ambulance.

A AIRWAY• Make sure the airway is:• Clear of objects.• Open.

B BREATHING• Check if the player is breathing by

observing chest movements and/or air passing in or out of the mouth.

• If not, give 2 initial breaths and begin CPR.

C CPR• CPR involves giving 30 compressions at

a rate of around 100 per minute followed by 2 breaths.

• Continue CPR until the patient recovers or professional help arrives.

• Stop any bleeding by placing firm pressure over the injury site.

D DEFIBRILLATION• Attach a defibrillator (if available).• Follow voice prompts.

SAFETY ISSUES


TALKTALK to the injured athlete.• What happened?• How did it happen?• What did you feel?• Where does it hurt?• Does it hurt anywhere

else?• Have you injured this

part before?

OBSERVEOBSERVE while talking to the athlete. GENERAL • Is the athlete distressed?• Is the athlete lying in

an unusual position/posture?

INJURY SITE • Is there any swelling?• Is there any difference

when compared to the other side/limb?

• Is there tenderness when touched?

• Can the athlete move the injured part?

DO NOT TOUCH OR ASSIST THE ATHLETE IN ANY WAY.(Only move the injured part to the point of pain)• If yes,- does it hurt to move?- is the range of

movement restricted?- how does it feel,

compared to normal?- how does it feel,

compared to other side/limb?

PREVENT FURTHER INJURY

3 OPTIONS

3. MINOR INJURY Bumps and bruises which do not impair performance.

Play onA FEW WORDS OF ENCOURAGEMENT WILL HELP• Monitor any such injuries.• Minor injuries should also be

managed using the RICER regime.

2. LESS SEVERESoft-tissue injuries such as sprains, strains and muscle bruises

RICER regimeTHE FIRST 48 HOURS ARE VITAL IN THE EFFECTIVE MANAGEMENT OF SOFT TISSUE INJURIES• Rest.• Ice.• Compression.• Elevation.• Referral.

1. SEVERE INJURYSuspected head, facial, spinal, chest, abdomen injuries, fractures or major bleeding.

Get helpGET PROFESSIONAL HELP DON’T MOVE THE ATHLETE.• Keep onlookers away.• Comfort the athlete until

professional help arrives.• Immobilise and support.

STOPSTOP the athlete from participating or moving.

STOP the game if necessary.

PROVIDE A FEW WORDS of ENCOURAGEMENT

PROVIDE A FEW WORDS of ENCOURAGEMENT

WHEN AN INJURY OCCURS, REMEMBER S.T.O.P.

SAFETY ISSUES


HOW WHY

R REST Place the athlete in a comfortable position, preferably lying down. The injured part should be immoblisied and supported.

Activity will promote bleeding by increasing blood flow.

I ICE The conventional methods are:• Crushed ice in a wet towel/

plastic bag.• Immersion in icy water.• Commercial cold packs wrapped

in wet towel.• Cold water from the tap is better

than nothing.

Apply for 20 minutes every two hours for the first 48 hours.

CAUTION:• Do not apply ice directly to skin

as ice burns can occur.• Do not apply ice to people who

are sensitive to cold or have ciculatory problems.

• Children have a lower tolerance to ice.

Ice reduces: • Swelling.• Pain.• Muscle spasm.• Secondary damage to the

injured area.

C COMPRESSION Apply a firm wide compression bandage over a large area covering the injured part, as well as above and below the injured part.

Compression:• Reduces bleeding and swelling.• Provides support for the injured

part.

E ELEVATION Raise injured area above the level of the heart at all possible times.

Elevation:• Reduces bleeding and swelling.• Reduces pain.

R REFERRAL Refer to a suitably qualified professional such as a doctor or physiotherapist for a definitive diagnosis and ongoing care.

Early referral for a definitive diagnosis to ascertain the exact nature of the injury and to gain expert advice on the rehabilitation program required.

This regime should be used for all ligament sprains, muscle strains and bruises.

Remember with injuries of this kind, you should avoid:

Heat – increases bleeding. Running – exercise too soon can make the injury worse. Massage – increases swelling and bleeding in the first 48-72 hours.

SOFT TISSUE INJURY MANAGEMENT (R.I.C.E.R)

SAFETY ISSUES


THE MANAGEMENT OF CONCUSSION IN AUSTRALIAN FOOTBALL• In the best practice management of concussion,

player welfare is the critical element, both in the short and long-term.

• Concussion refers to a disturbance in brain function that results from trauma to the brain. The changes are temporary and the majority of players recover spontaneously and completely if managed correctly. Complications can occur if the player is returned to play before they have recovered from concussion.

• Any player who has suffered a concussion or is suspected of having concussion must be IMMEDIATELY REMOVED FROM PLAY and medically assessed as soon as possible after the injury. They must not be allowed to return to play in the same game or practice session.

• There should be a trained first aider at every game and the principles of first aid, including management of the cervical spine, should be used when dealing with any player who is unconscious or injured.

• Management of a head injury is difficult for non-medical personnel. In the early stages it is often not clear whether you are dealing with concussion or there is a more severe underlying structural head injury.

• Therefore, ALL players with concussion or suspected concussion need an urgent medical assessment.

• A concussed player must not return to school or to training or playing before having formal medical clearance. A graduated return to training, limited by symptoms, should be followed.

The key components of management of concussion include: a) Recognising the injury: Suspecting concussion

in any player with one or more of the symptoms or signs after a knock to the head;

b) Immediately removing the player from the game

c) Referring the player for medical evaluation; and

d) Ensuring the player has received medical clearance before allowing them to return to a graded training program.

In the case of children, a concussed player must not be allowed to return to school or play before being medically cleared. The child is not to return to play or sport until they have successfully returned to school/learning without worsening symptoms.

MANAGEMENT GUIDELINES FOR A SUSPECTED CONCUSSIONAn outline of the overall management approach is summarised in the figure below.

Presence of any concussion symptoms or signs (e.g. stunned, confusion, memory problems, balance problems, headache, dizziness, not feeling right)

YES NO

Implement first aid management protocol, including cervical spine immobilisation

Remove from the ground Assess using pocket CRT (Concussion Recognition Tool)

Presence of any factors for urgent hospital referral (e.g. confusion, vomiting, worsening headache)

Call for ambulance and refer to hospitalDo not allow player to return to play. Refer to medical

doctor for assessment (at venue, local general practice or hospital emergency department)

Figure 1. Summary of the management of concussion in Australian football.*Note: for any player with loss of consciousness, basic first aid principles should be used (i.e. Airways, Breathing, CPR...). Care must also be taken with the player’s neck, which may have also been injured in the collision. An ambulance should

be called, and these players transported to hospital immediately for further assessment and management.

A. GAME-DAY MANAGEMENTThe most important steps in the initial management of concussion include:• Recognising the injury;• Removing the player from the game• Referring the player to a medical doctor for assessment.

1. Recognising the injuryVisible clues of suspected concussion Any one or more of the following visual clues can indicate a possible concussion:• Loss of consciousness or responsiveness • Lying motionless on ground/Slow to get up • Unsteady on feet/Balance problems or falling over/

Incoordination • Grabbing/Clutching of head• Dazed, blank or vacant look• Confused/Not aware of plays or event• Loss of consciousness, confusion and memory

disturbance are classical features of concussion. The problem with relying on these features is that they are not present in every case.

• Other symptoms that should raise suspicion of concussion include: headache, blurred vision, balance problems, dizziness, feeling “dinged” or “dazed”, “don’t feel right”, drowsiness, fatigue, difficulty concentrating or difficulty remembering.

2. Removing the player from the game• Initial management must adhere to the first aid

rules, including airway, breathing, circulation, and spinal immobilisation.

• Any player with a suspected concussion must be removed from the game.

3. Referring the player to a medical doctor for assessment

• Management of head injury is difficult for non-medical personnel. In the early stages of injury, it is often not clear whether you are dealing with a concussion or there is a more severe underlying structural head injury.

• or this reason, ALL players with concussion or a suspected concussion need an urgent medical assessment (with a registered medical doctor). This assessment can be provided by a medical doctor present at the venue, local general practice or hospital emergency department.

MANAGEMENT OF AN UNCONSCIOUS PLAYER AND WHEN TO REFER TO HOSPITAL• Basic first aid principles should be used when dealing

with any unconscious player (i.e. Airway, Breathing, CPR…). Care must be taken with the player’s neck, which may have also been injured in the collision.

• In unconscious players, the player must only be moved (on to the stretcher) by qualified health professionals, trained in spinal immobilisation techniques. If no qualified health professional is on site, then do not move the player – await arrival of the ambulance. If the unconscious player is wearing a helmet, do not remove the helmet, unless trained to do so.

• Urgent hospital referral is necessary if there is any concern regarding the risk of a structural head or neck injury.

• Urgent transfer to hospital is required if the player displays any of the following: a) Loss of consciousness or seizuresb) Confusion c) Deterioration after their injury (e.g. increased

drowsiness, headache or vomiting)d) Neck pain or spinal cord symptoms (e.g. player

reports numbness, tingling, weakness in arms or legs)

• Overall, if there is any doubt, the player should be referred to hospital.

SAFETY ISSUES


B. FOLLOW-UP MANAGEMENT• A concussed player must not be allowed to return

to school or return to play before having a medical clearance.

• Return to learning and school school take precedence over return to sport.

• In every case, the decision regarding the timing of return to training should be made by a medical doctor with experience in managing concussion.

• In general, a more conservative approach (i.e. longer time to return to sport) is used in cases where there is any uncertainty about the player’s recovery. (“If in doubt, sit them out”).

Return to playPlayers should not return to play until they have returned to school/learning without worsening of symptoms.

Players should be returned to play in a graduated fashion.

The “concussion rehabilitation” program should be supervised by the treating medical practitioner and should follow a step-wise symptom limited progression, for example:

1. Rest until symptoms recover (includes physical and mental rest)

2. Light aerobic activity (e.g. walking, swimming or stationary cycling) – can be commenced 24-48 hours after symptoms have recovered

3. Light, non-contact training drills (e.g. running, ball work)

4. Non-contact training drills (i.e. progression to more complex training drills, may start light resistance training. Resistance training should only be added in the later stages)

5. Full contact training – only after medical clearance6. Return to competition (game play)

• There should be approximately 24 hours (or longer) for each stage.

• Players should be symptom-free during their rehabilitation program. If they develop symptoms at any stage, then they should drop back to the previously symptom-free level and try to progress again after a further 24 hour period of rest.

• If the player is symptomatic for more than 10 days, then review by a medical practitioner, expert in the management of concussion, is recommended.

THE MANAGEMENT OF CONCUSSION IN CHILDREN(PLAYERS AGED 5-17)As part of the 2012 meeting, specific recommendations were made for the management of children. Children require a different approach from adults because their brains are developing, and they need to continue learning and acquiring knowledge. As such, the priority is not just player welfare and return to play, but a critical element is return to school and learning.

As well as all of the principles of management outlined above, the following advice must be followed in any instance of a child being concussed or suspected of concussion.

Concussion symptoms can cause problems with memory and information processing, which interferes with the child’s ability to learn in the classroom. It is for this reason that a child is not to return to school until medically cleared to do so.

RETURN TO SCHOOL• Concussion may impact on the child‘s cognitive

ability to learn at school. This must be considered, and medical clearance is required before the child may return to school.

• It is reasonable for a child to miss a day or two of school after concussion, but extended absence is uncommon.

• In some children, a graduated return to school program will need to be developed for the child. Additional management by a paediatric neuropsychologist may assist in more difficult cases.

• Symptom assessment in the child often requires the addition of parent and/or teacher input

• The child will progress through the return to school program provided that there is no worsening of symptoms. If any particular activity worsens symptoms, the child will abstain from that activity until it no longer causes symptom worsening. Use of computers and internet should follow a similar graduated program, provided that it does not worsen symptoms. This program should include communication between the parents, teachers, and health professionals and will vary from child to child. The return to school program should consider:

SAFETY ISSUES


– Extra time to complete assignments and tests– Quiet room to complete assignments and tests– Avoidance of noisy areas such as cafeterias,

assembly halls, sporting events, music classes– Frequent breaks during class, homework, tests– No more than one exam per day– Shorter assignments– Repetition/memory cues– Use of peer helper/tutor– Reassurance from teachers that the student

will be supported through recovery through accommodations, workload reduction, alternate forms of testing

– Later start times, half days, only certain classes• Children are not to return to play or sport until

they have successfully returned to school/learning, without worsening of symptoms. Medical clearance should be given before return to play.

• If there are any doubts, management should be referred to a qualified health practitioner, expert in the management of concussion in children.

• Children should return to play in the same graduated fashion as adult players (see page 118)

SAFETY ISSUES


CONCUSSIONFor further up-to-date and comprehensive information about concussion management, go to the AFL Community Club website at www.aflcommunityclub.com.au/index.php?id=66

SAFETY ISSUES


The AFL acknowledges NAB for its support of the NAB AFL Auskick program

ACKNOWLEDGEMENTAustralian Government

The AFL gratefully acknowledges the support of the Australian

Government for AFL Development programs, through the Australian

Sports Commission

section nine safety issues - afl community club · 2014-06-19 · section nine safety issues risk...

Documents