S.E.R.I.O.U.S. method for dealing with Injuries.
INTRODUCTION:
The Powers and Duties of the Referee listed in Law 5, state that the Referee is responsible, and has a duty to stop the match if, in his opinion, a player is seriously injured and ensures that he is removed from the field of play. An injured player may only return to the field of play after the match has restarted.
The Referee can also allow play to continue until the ball is out of play if a player is, in his opinion, only slightly injured. It is his duty to ensure that any player bleeding from a wound leaves the field of play. The player may only return on receiving a signal from the Referee, who must be satisfied that the bleeding has stopped.
One development area surprisingly deficient in many football/soccer Referees' capabilities, is a standard process for dealing with injury situations on the field of play. Invariably, the Referee (in good faith) deals with each situation with the health and safety of the injured player paramount. But very often, there is little (or no) thought given, to proactively preventing eager trainers from rushing onto the field of play. Sensible positioning by the Referee (whilst inspecting the injury) is also sometimes missing. The Referee has a duty to monitor all of the players, and not just the one who is injured. Another worrying aspect is the amount of times that the Referee wanders away from the injury location, to have friendly conversation with the other players whilst the injury is being dealt with. Without a set process to consider, it is also not surprising, that on some occasions, the Referee forgets to ask the treated player to leave the field of play, and to await a signal to re-enter at a suitable time after play has been restarted. The advice shown here, encourages Referees to use a set process for managing injuries. Whilst the advice may differ from that used in other countries, it is not meant as a definitive guide, but as a basis for improving the process used when dealing with injury situations. Also included, is a selection of relevant information included in official publications.
Making contact with the trainers/medical staff before the game starts:
Prior to kick-off, the Referee (and Assistant Referees) should try and make contact with the team trainers (or medical staff) and remind them to await the Referee's signal before entering the field of play when an injury occurs. The Referee should demonstrate the outstretched beckoning arm/palm signal that he will be using to summon the trainers/medical staff onto the field of play to assess an injury. The trainers/medical staff should be reminded that if it is possible to safely remove an injured player, treatment should not be applied on the field of play. But that the players' health and safety must always be paramount.
The S.ER.I.O.U.S. (a standard process for dealing with injuries in the field of play.)
Serious?(The first consideration is to decide if an injury is serious or not.)
Evaluate? (Evaluate each injury situation as it arises. Does play need to be stopped?)
Race. (Sprinting to the scene of the injury).
Inspect. (Taking up a position that allows inspection of the injury and monitoring the remaining players).
Organise. (Taking charge, positioning and seeking medical assistance if it is required).
Usher. (Overseeing the safe removal of injured players).
Start. (Starting the game again after the injury has been seen to).
Serious? (The first consideration is to decide if an injury is serious or not.)
o (ii) when a goalkeeper and an outfield player have collided and need immediate attention;
o (iii) when a severe injury has occurred e.g. swallowed tongue, concussion, broken leg etc.
If the injury is serious: For example, if the injury is to the head or neck or is a serious bleeding injury, broken bones, concussion, torn ligaments, or involves breathing difficulties, the Referee should stop play and summon the trainer/medical staff immediately.
What is serious injury?
Some examples of serious injury that can occur to a player in a game of football/soccer are:
Why is a head injury so serious?
Immediately after a head injury occurs, it can be difficult to tell the difference between a mild concussion and a more serious injury. A brain bruise (contusion) or bleeding within the skull at first may cause only mild symptoms.
Players who have experienced a head injury should be watched carefully for 24 hours.
If serious head injury is suspected, an immediate visit to the hospital or to a Doctor is essential. Players who have suffered from concussion should be advised not to play any further part in the game.
What is concussion?
CONCUSSION is an internal head injury. Of all the head injuries, this is the most insidious, and many casualties have succumbed several hours after the incident.
The Referee should be especially observant when contact involves children - the myth that you can 'run off' concussion by 'playing on', is a dangerous attitude, and has caused grief and embarrassment to many players, parents and coaches when the player eventually collapses.
Concussion is potentially very serious, and an indifferent attitude is to be discouraged.
What are the signs and symptoms of fractured bones?
Some, or all, of the following:
· pale, cool, clammy skin
· rapid, weak pulse
· pain at the site
· tenderness
· loss of power to limb
· associated wound and blood loss
· associated organ damage
· nausea
· deformity
· crepitus
Are damaged ligaments more serious than a broken bone?
Bones are connected to each other in joints by ligaments. When excessive force is applied to joint, ligaments may be torn or damaged. This type of injury is a sprain.
The seriousness of a sprain depends on how badly ligaments are damaged. Sprains can occur in any joint, but they occur most commonly in the ankle, knee, and finger.
INTRODUCTION:
The Powers and Duties of the Referee listed in Law 5, state that the Referee is responsible, and has a duty to stop the match if, in his opinion, a player is seriously injured and ensures that he is removed from the field of play. An injured player may only return to the field of play after the match has restarted.
The Referee can also allow play to continue until the ball is out of play if a player is, in his opinion, only slightly injured. It is his duty to ensure that any player bleeding from a wound leaves the field of play. The player may only return on receiving a signal from the Referee, who must be satisfied that the bleeding has stopped.
One development area surprisingly deficient in many football/soccer Referees' capabilities, is a standard process for dealing with injury situations on the field of play. Invariably, the Referee (in good faith) deals with each situation with the health and safety of the injured player paramount. But very often, there is little (or no) thought given, to proactively preventing eager trainers from rushing onto the field of play. Sensible positioning by the Referee (whilst inspecting the injury) is also sometimes missing. The Referee has a duty to monitor all of the players, and not just the one who is injured. Another worrying aspect is the amount of times that the Referee wanders away from the injury location, to have friendly conversation with the other players whilst the injury is being dealt with. Without a set process to consider, it is also not surprising, that on some occasions, the Referee forgets to ask the treated player to leave the field of play, and to await a signal to re-enter at a suitable time after play has been restarted. The advice shown here, encourages Referees to use a set process for managing injuries. Whilst the advice may differ from that used in other countries, it is not meant as a definitive guide, but as a basis for improving the process used when dealing with injury situations. Also included, is a selection of relevant information included in official publications.
Making contact with the trainers/medical staff before the game starts:
Prior to kick-off, the Referee (and Assistant Referees) should try and make contact with the team trainers (or medical staff) and remind them to await the Referee's signal before entering the field of play when an injury occurs. The Referee should demonstrate the outstretched beckoning arm/palm signal that he will be using to summon the trainers/medical staff onto the field of play to assess an injury. The trainers/medical staff should be reminded that if it is possible to safely remove an injured player, treatment should not be applied on the field of play. But that the players' health and safety must always be paramount.
The S.ER.I.O.U.S. (a standard process for dealing with injuries in the field of play.)
Serious?(The first consideration is to decide if an injury is serious or not.)
Evaluate? (Evaluate each injury situation as it arises. Does play need to be stopped?)
Race. (Sprinting to the scene of the injury).
Inspect. (Taking up a position that allows inspection of the injury and monitoring the remaining players).
Organise. (Taking charge, positioning and seeking medical assistance if it is required).
Usher. (Overseeing the safe removal of injured players).
Start. (Starting the game again after the injury has been seen to).
Serious? (The first consideration is to decide if an injury is serious or not.)
- When an injury situation occurs, the first consideration for the Referee - is to decide if the injury is serious or not.
As soon as the Referee has authorised the trainer/medical staff to enter the field, the injured player must leave the field, whether he receives treatment or not. If the player does nor comply, he should be cautioned.
Exceptions to this ruling are made only for:
o (ii) when a goalkeeper and an outfield player have collided and need immediate attention;
o (iii) when a severe injury has occurred e.g. swallowed tongue, concussion, broken leg etc.
- The Referee should note the position of the ball if the game has to be stopped, so that the correct restart can be applied once the injury has been dealt with. It is very easy to forget the type of restart, or the location of the restart when focusing on the injury. In the pre-match brief to the Assistant Referees, the Referee should instruct the Assistants to make a note of the required restart. This will aid the Referee if he forgets!
- If there is any discipline action to be taken as a result of the injury, the Referee should firstly organise any treatment for the injured player, before taking any discipline action.
- There may be occasions when the Referee will need to fend off angry players crowding around the injury scene. This must be done assertively and in conjunction with help from the Assistant Referees if required. The Assistant Referees must be briefed as to their role in such circumstances.
- If the delay for dealing with the injury, is likely to be long, the Referee can stop his watch.
- Referees are instructed to add the full amount of time lost for injury delays at the end of each period of play.
If the injury is serious: For example, if the injury is to the head or neck or is a serious bleeding injury, broken bones, concussion, torn ligaments, or involves breathing difficulties, the Referee should stop play and summon the trainer/medical staff immediately.
- Referees should certainly always stop play immediately and summon medical aid if a serious head injury is suspected.
- The Referee should try and recognise serious injuries by looking out for body signs such as an inert unconscious body, or obvious pain, or genuine concern expressed by other players near the scene. If there is any doubt as to the seriousness of an injury, (especially if a young child is involved), the Referee must always err on the side of caution by summoning medical aid immediately.
- A player's health is far more important than a game of football/soccer.
- Summoning the trainer/medical staff, can be done immediately by using a loud whistle, vocal instructions and by waving a beckoning arm/palm towards the Technical Area, or towards the vicinity of where the team’s trainer/medical staff is located.
- If there are players injured from both teams, then waving two beckoning arms will clearly show that both of the competing team’s trainers are urgently required.
- Assistant Referees should also play their part in summoning on trainers/medical staff in cases of urgency.
- In local Park level football, when there are no medically qualified personnel in attendance, professional assistance should be quickly obtained for serious injuries, and the advice offered, acted upon.
What is serious injury?
- A serious injury cannot be easily defined in just a few words; but should be fairly obvious to spot.
- A serious injury can have a major impact upon the life of the player and warrant possible compensation if caused by wilful misconduct or negligent treatment or movement of the player.
- Referees must be particularly vigilant when young players are concerned – a serious injury can have a significant impact on the development of a child.
- Another factor in considering the seriousness of an injury is the impact on the victim's earnings and lifestyle. An injury that causes a substantial loss of earnings or earning capacity would be termed "serious". Also, an injury that requires a player to make major accommodations to their lifestyle is also serious.
- Serious injury is when there is harm done to the body that causes severe, permanent or protracted loss of or impairment to the health or to the function of any part of the body.
- Serious injury can have devastating consequences for the player and their family.
- Serious injury affects the whole person, from physical abilities to changes in the quality of life.
- The Referee should never sanction the movement of a player who has possible internal injuries without seeking the authority of the trainer/medical staff.
Some examples of serious injury that can occur to a player in a game of football/soccer are:
- becomes unconscious.
- has trouble breathing or is breathing in a strange way.
- has swallowed his tongue
- has chest pain or pressure.
- is bleeding severely.
- has pressure or pain in the abdomen that does not go away.
- is vomiting or passing blood.
- has seizures, a severe headache, or slurred speech or blurred vision.
- has injuries to the head, neck, or back.
- has possible broken bones.
- disfigurement (significant scarring or burns)
- spinal cord injuries
- heart attack
Why is a head injury so serious?
- A head injury may cause serious injury to the brain, even when there is no visible bleeding or injury visible on the outside of the skull.
- The impact of a hard blow to the head may jar or shake the brain within the skull (closed head injury).
- The rapid movement of the brain within the skull can cause bruising, swelling, or tearing of the brain tissue. It can also stretch, pull apart, or tear nerves or blood vessels within or around the brain.
- Head injuries can sometimes be more complex when players have been taking alcohol or drugs, which can make injury evaluation and recognition difficult. Do not assume any altered behaviour is only from alcohol or drug use.
- Where serious head, neck or back injuries are suspected, any movement by untrained hands has the greatest consequences. The player should be immobilized pending arrival of medical personnel.
- A severe headache or a headache that continues to get worse.
- Confusion or abnormal behaviour.
- A young player with a head injury may be extremely irritable or fretful or may cry constantly.
- Difficulty with staying awake.
- Slurred speech.
- Numbness, weakness, or loss of movement in the arms or legs.
- Vision changes and changes in the pupils' size, shape, and reaction to light.
- Dizziness, nausea, vertigo, or unsteadiness that prevents standing or walking.
- Bleeding from the ears or elsewhere on the head.
- May have unequal pupils
- Altered level of consciousness
Immediately after a head injury occurs, it can be difficult to tell the difference between a mild concussion and a more serious injury. A brain bruise (contusion) or bleeding within the skull at first may cause only mild symptoms.
Players who have experienced a head injury should be watched carefully for 24 hours.
If serious head injury is suspected, an immediate visit to the hospital or to a Doctor is essential. Players who have suffered from concussion should be advised not to play any further part in the game.
What is concussion?
CONCUSSION is an internal head injury. Of all the head injuries, this is the most insidious, and many casualties have succumbed several hours after the incident.
The Referee should be especially observant when contact involves children - the myth that you can 'run off' concussion by 'playing on', is a dangerous attitude, and has caused grief and embarrassment to many players, parents and coaches when the player eventually collapses.
Concussion is potentially very serious, and an indifferent attitude is to be discouraged.
What are the signs and symptoms of fractured bones?
Some, or all, of the following:
· pale, cool, clammy skin
· rapid, weak pulse
· pain at the site
· tenderness
· loss of power to limb
· associated wound and blood loss
· associated organ damage
· nausea
· deformity
· crepitus
Are damaged ligaments more serious than a broken bone?
Bones are connected to each other in joints by ligaments. When excessive force is applied to joint, ligaments may be torn or damaged. This type of injury is a sprain.
The seriousness of a sprain depends on how badly ligaments are damaged. Sprains can occur in any joint, but they occur most commonly in the ankle, knee, and finger.
- Damaged ligaments can be more serious than a broken bone.
- Great care must be taken to isolate the injury.
- Moving unsupported and properly bandaged injuries can have a devastating effect in causing further injury and pain to the injured player.
- Where serious neck or back injuries are suspected, any movement by untrained hands has the greatest consequences. The player should be immobilized pending arrival of medical personnel.
- Precautions for reducing the potential for transmission of infectious diseases must be considered.
- Whilst the Referee is not responsible for administering treatment, he should advise against dirty (or previously used) water from a bucket being used to treat an injury - particularly if the injury is an open wound.
- Dirty water is a carrier of disease, and players can become contaminated as a result of negligent treatment.
- The soccer community is like all other segments of society. Some participants may have infectious diseases including HIV/AIDS and Hepatitis B (blood borne pathogens). Treat every person on the field, as in any area of society, with the assumption they could be HIV positive.
- Contaminated towels, dressings, and other articles containing body fluids should be properly disposed of or disinfected.
