Reality Training: Severe head wound behind home plate

How would you treat a baseball umpire's significant head laceration as players, fans and television viewers watch your every move?

Incident Date: June 23, 2016

Department: Athletic trainers and Paramedics Plus, the standby medical service for the Oakland A's

What happened: Home plate umpire Paul Emmel was hit in the head when Angels’ pinch-hitter Jefry Marte lost control of his bat. Emmel immediately fell to the ground. When he removed his hat, blood cascaded into the sand. The sound of the bat hitting Emmel's head was startling to players, and the blood streaming out of a laceration was surely just as frightening for television viewers.

Read more about the incident and watch the video of the injury.

Discussion points: Control of severe bleeding, patient assessment and working in a high-visibility venue

As you watch the video ask yourself or discuss with your partner, company or squad the following questions:

1. Many EMS agencies provide standby services for athletes at all levels of competition. What are some of the challenges unique to athletic event standby and how are you specifically prepared to meet those challenges?

2. What is your treatment plan for controlling severe bleeding from a significant head laceration? Does your agency stock hemostatic gauze? Could it have been used on this patient?

3. What other injuries should you consider after an official or athlete has sustained a significant blow to the head, such as contact from the swing of a baseball bat? How do those potential injuries change your treatment plan for the patient, including your transport destination?

4. How has your department prepared to cooperate with athletic trainers? Have you completed joint training sessions and agreed upon protocols for athletic-specific injuries such as spinal cord injury, traumatic brain injury, and head, face or neck injuries sustained from contact with bats, balls and skate blades?

Athlete standby, especially at professional sporting events, is one of the most coveted assignments for EMS crews. Paramedics are rarely called upon for assistance, but when they are, it is because a significant, potentially life-threatening injury has halted play. In these critical moments, with thousands of fans in the stadium and perhaps millions more watching on television or online, paramedics must be prepared to respond with the highest level of competence and professionalism.

This article, originally published in July 2016, has been updated.

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