The Use of Oxygen in Sports Trauma Management

When and why Oxygen administration can be used within Sport

Oxygen is a treatment for hypoxaemia (lack of oxygen in the blood), not for breathlessness. Oxygen has not been shown to have any effect on the sensation of breathlessness in non-hypoxaemic patients (Driscoll et al British Thoracic Society guidelines for emergency oxygen use in adult patients 2008).

All seriously traumatised players, Head injury, Spinal injury, Chest injury, Unconsciousness, serious bleeding etc. should be given high flow oxygen as an initial, on-field treatment.

Trauma can affect the respiratory system’s ability to adequately provide oxygen and eliminate carbon dioxide in 3 main ways:-

(Information from the PHTLS, Prehospital Trauma Life Support, seventh edition 2011)

The upper airway should be checked first and any visible foreign objects removed, suction can be used to remove any blood or vomit in the mouth. The head tilt/chin lift should be used to remove the tongue from the back of the airway (or jaw thrust if a spinal injury is suspected).

High flow oxygen should be initially applied, for all seriously traumatised players/patients, using a non-rebreather oxygen mask (see image below).

Good first aid and/or Sports Trauma Management training combined with the correct use of oxygen can increase the chances of survival following a traumatic injury. An example of this is the recent injury to Tommy Smith of Huddersfield Town who suffered a head injury during a recent game. He was “in and out of consciousness for 10 minutes” and was eventually airlifted to the hospital. Follow the link below for the full story.

http://www.bbc.co.uk/sport/0/football/31074323

Oxygen should be used for all seriously traumatised sports competitors or patients. It can also be used to treat some chronic and acute medical conditions such as Asthma, COPD, emphysema, Anaphylaxis, Angina and Heart attacks. Ideally, Oxygen should be administered and titrated to a therapeutic level using a pulse oximeter (as shown below).

The oxygen saturation levels and pulse rate can then be monitored whilst waiting for an ambulance to arrive. Reducing the flow rate, to a therapeutic level, also helps to extend the length of time the oxygen cylinder will last. Click on the link below for more information on pulse oximetry.
 
http://www.patient.co.uk/doctor/pulse-oximetry

Oxygen is indicated following all serious traumatic injuries to players or patients. It can also be used to treat many other chronic and/or acute medical conditions. It must be used correctly with the appropriate equipment and training to be effective.

On our medical gases courses, we cover Oxygen administration and the points raised above. Medical gas administration is also included in our Sports Trauma Management Course.  For more information visit our course page Medical Gases Course.

Further reading on the pre-hospital use of oxygen in Adults is available below:

https://www.brit-thoracic.org.uk/document-library/clinical-information/oxygen/emergency-oxygen-use-in-adult-patients-guideline/appendix-1-summary-of-recommendations-emergency-oxygen-use-in-adult-patients-guideline/