CPR, Concussions, and overall player health.

[PlayOn]

I am considering getting certified in CPR because not only is it good to know but I've been reffing AYSO soccer where there are often no health professionals around and also I felt it would be good to have that skill available in case there was not a trainer present at a game I was working. Despite the fact that there should be a trainer at all games sometimes they may be working multiple events, or even busy carting a kid back to the locker room. I was wondering if there are any guidelines for game officials who may find themselves in a time critical health crisis on the field.

Although I would hope that this never arises and hope even more that the coaches would take control of the situation there comes a point where saving a life becomes more important than anything else.

Also with the added emphasis that has been put on concussion awareness in football and other full contact sports what is Lacrosse doing to make sure players are aware of the importance to report concussion symptoms? Are we as officials allowed to remove a kid from play who may look "out of it" even though a trainer or coach may give the OK for him to go back in to a game after a brutal hit?

Have any of you been in a life threatening situation during a game? Are there any guidelines for these types of situations?

[LaxRef]

I am considering getting certified in CPR because not only is it good to know but I've been reffing AYSO soccer where there are often no health professionals around and also I felt it would be good to have that skill available in case there was not a trainer present at a game I was working. Despite the fact that there should be a trainer at all games sometimes they may be working multiple events, or even busy carting a kid back to the locker room. I was wondering if there are any guidelines for game officials who may find themselves in a time critical health crisis on the field.

Although I would hope that this never arises and hope even more that the coaches would take control of the situation there comes a point where saving a life becomes more important than anything else.

In general, you have much more liability if you try to help an injured player than if you simply do your job and manage the field and the players. If you're trying to help players and something else happens on the field you could have prevented, you can be held liable, as you can if someone thinks you made the injured player's situation worse.

Of course, if the player is having a heart attack, if you are certified in CPR, and if no one else is qualified to help, I think you take your chances, but only in a situation like that.

Also with the added emphasis that has been put on concussion awareness in football and other full contact sports what is Lacrosse doing to make sure players are aware of the importance to report concussion symptoms? Are we as officials allowed to remove a kid from play who may look "out of it" even though a trainer or coach may give the OK for him to go back in to a game after a brutal hit?

Under NFHS rules, if a player has been "apparently unconscious," they must be removed from the game unless they get approval from an MD or DO. Get it in writing, and make sure the person giving it to you is really an MD or DO.

US Lacrosse has instituted the "ImPACT Concussion Management Program." See www.uslacrosse.org/safety/concussion.phtml

Have any of you been in a life threatening situation during a game? Are there any guidelines for these types of situations

As above, call the trainer or coaches in and let them take care of it. Do not pressure them to get the player off the field; let them take as long as they need. Be sure to file a report with the league about the injury as soon as the game is over. Do not even think about trying to help unless you are qualified, the injury is very serious, and there are no other options.

[NCLAXREF]

Let me say I agree with everything Laxref said.

That being said this is real life and there are laws in place to protect you when you are helping someone.

See this link and ask the kid today if he cared a that a ref saved his life!
http://www.youthlacrosseusa.com/hsnews/adam_part1_100203.html

Chuck is a good friend and I for one am glad he was at this game!

[LaxRef]

Let me say I agree with everything Laxref said.

That being said this is real life and there are laws in place to protect you when you are helping someone.

You're probably referring to "Good Samaratin" laws. These may not apply; I know when I worked as an ocean lifeguard they didn't because I was being paid to be there and had to have a certain level of medical training. As an official being paid to be there and do a specific job, those laws may or may not apply.

See this link and ask the kid today if he cared a that a ref saved his life!
http://www.youthlacrosseusa.com/hsnews/adam_part1_100203.html

Chuck is a good friend and I for one am glad he was at this game!

Well, this is what I was talking about: life-threatening emergency and a trained professional (he didn't have time to assess the medical training of the sideline personnel in this situation). In that case, help if you can (knowing that you can get sued if things go wrong).

BTW, if you are medically trained, it makes sense to assess the medical training of the sideline personnel before the game so you know whether you should try to help or get out of the way in a situation like this one. It also may save precious seconds if you know there's no one trained so your first call to the sidelines is "Call 911!" rather than "Trainer!"

[Beacher]

You're probably referring to "Good Samaratin" laws. These may not apply; I know when I worked as an ocean lifeguard they didn't because I was being paid to be there and had to have a certain level of medical training. As an official being paid to be there and do a specific job, those laws may or may not apply.


Good Samaritan laws apply to nearly anyone who provides assistance at the level to which they've been trained. As a lifeguard or any paid healthcare/first aid provider you are held to a different standard under these laws because of your training and position as an on duty first aid/healthcare provider, not just because you're being paid. You have to be paid for medical services to be exempt from Good Samaritan laws. Being paid to work at a game as a referee wouldn't change your standing under the law - to the best of my knowledge as a first aid trainer.

[laxzeeb]

Lawyer who is also official here, or the reverse, take your pick. It is important to note that good samaritan laws can vary state by state so if there is concern about that issue the specific one in your state should be considered. For example, what Beacher says about being held to a different standard is not true in my state and may not be true in others. Having a varying standard like that would invite lawsuits which is directly contrary to the intent of the statute. The level of care would be a potential factual question for the jury, which is what a good trial lawyer wants. The whole point of these statutes is to prevent the case from ever getting that far. Still it wouldn't surprise me if some of the more litigious states the statute may be written that way due to pressure from the plaintiff's trial bar or other interests. Typically as Beacher says the payment exception does refer to specifically being paid for providing the medical services, not because you are there getting paid to do something else, such as officiate.

Some states also have immunity protection that pertains specifically to application of CPR by those formally trained and up to date with certification. Any of laws can have exceptions for efforts that are made in a reckless fashion, sometimes the term willful or wanton is used. That would seem rare but that language can be present. It typically is in most immunity statutes.

Bear in mind these statutes do not protect someone from being sued, they act as a defense to a lawsuit if filed. Your hope is no attorney would find it financially worthwhile to pursue a case if the statute clearly applied.

Here is a reference link that appears to refer to the various state statutes:
http://www.momsteam.com/alpha/features/cardiac_awareness_center/good_samaritan_laws.shtml

All this being said, I generally agree with Laxref, leave the first aid to the coaches, hopefully trainers are present, spectators with medical training. Lacrosse being the type of sport it is it is not uncommon to have a doctor in the house. One day I hope AED's will be nearby every athletic field or stadium to aid in these situations.

[inblack]

I have my first aid as well. When it comes to Refereeing i have it more to help me determine the seriousness of an injury. How far should I allow the trainer to go, should an ambulance be called, can this player be safely moved? (yes i have stopped trainers from moving a player off the field untill the ambulance arrived)

In Canada we do not have the same litigation concerns that are present in the U.S. bet we are getting closer to your levels very quickly.
I am not touching that player unless his life is in immediate jepordy. That is too much risk for me.

We have AED's in just about every hockey arena now, (box lacrosse) most high school boards have them in thier schools now as well. Our university league has taken it upon themselves to make trainers manditory for the teams.

But I say leave it to the pros.