Pitch-Side Wound Management and Suturing.

A guest blog by Gareth Davies. 

Since 2004, I have been involved as a pitch-side sports therapist in rugby, ranging from grassroots to the professional level. This season, I moved into football, working with Pen-y-Bont F.C. who are in the Welsh Premier League. 

While I was setting up all the stations during my first game with the football team (a force of habit having worked in rugby), I was told “you will never need that", the reference being to the suturing box, but I set it up ready just in case.

After a few games of being called onto the field for fairly minor injuries, such as stubbed toes, sprains and strains, bruising and swelling, the last three games had been somewhat eventful. I had to deal with three players who all suffered cuts to the head and face which have all required suturing.

Suturing is a very specific skill that was taught to me by Lubas Medical on their Wound Management and Suturing course. This is one hundred percent a fantastic skill to have and I highly recommend to anyone who is involved with a contact sport to have these specific skills. 

"This is one hundred percent a fantastic skill to have and I highly recommend to anyone who is involved with a contact sport to have these specific skills."

Having these skills enables managers to lose a player for a short space of time, as opposed to the remainder of the fixture. This is unless the player needs to be removed from the game and sent to the hospital for medical attention! 

Two of the players I sutured had fairly deep cuts on the scalp to the top of the head, both of which were bleeding quite a lot. It would have been impossible to put a dressing on this area and therefore the player would have had to been removed from the game and sent to A&E for treatment. 

This would have caused more issues as in one of the games we were away in North Wales and either the coach would have had to wait for us or we would have had to find alternative transport home!

The other player had a nasty cut just below the eye and this player did get sent to A&E, as I remembered the instructor on the suturing course saying that this is a very delicate area of the face that has lots of blood vessels and nerves, so you need to be highly trained to suture in this area. 

There are also cosmetic issues to think about. For this reason, I cleaned the wound and put a dressing over it. The player was taken to A&E who was then seen by a Maxillofacial surgeon who sutured the wound.

All of these experiences show that as pitch-side sports therapists, we need to be prepared for any situation. By learning key Wound Management and Suturing skills, I am now able to assess, manage and select the appropriate wound closure technique for a variety of traumatic wounds.

Behind the Scenes at Cardiff City FC

Pitch side medical team assisting an injured player at Cardiff city football club.
Lubas Medical pitch side team assisting an injured player at Cardiff City.

How elite players are kept safe

The Medical Team at Cardiff City regularly receive praise & recognition from visiting teams for the quality of their set up.

Here's how Lubas fit in with the team, & how you can prepare in any sport, at any level...

1. The Medical Team

The Lubas pitch side medical team consists of 4 medics & an ambulance crew, all with professional qualifications & trained in Lubas Sports Trauma Management. Our purpose is to support all medical staff & manage any traumatic injuries to players of both teams & officials.

Each member of the team has a specific role in dealing with an injured player depending on the type of injury.

To function safely & efficiently, we work closely with Cardiff City's full time medical staff, led by the team physio & head of medical (Matthew May) and team doctor (Professor Len Noakes).

Everyone understands their role & responsibility within the set up. The visiting medical team are brought up to speed during a pre-match medical meeting before every game. Medical teams clarify the support that's available & the plan in the event of a serious (or multi-player) injury.

It's vital for player safety to run through these plans pre-match so both teams fully understand & clarify the procedures.

2. Planning & Communication

In addition to pre-match briefings, the Cardiff City medical staff & Lubas pitch side team run through monthly practical training together.

We run through various scenarios including spinal injury, lower limb fractures & cardiac arrest. We practice the management of injury & transfer to the medical room.

Scenarios ensure everyone in both the Lubas pitch-side team & Cardiff's medical staff fully understand their role during the management of a serious injury.

There is also a set procedure in place for our ambulance crew to quickly & efficiently transfer a player to hospital in an emergency. This has been utilised on several occasions.

3. Equipment

The Lubas team & the medical staff at Cardiff City work together to ensure all medical equipment required is available & fit for purpose.

There are 3 areas that require fully stocked medical equipment:

Individuals from the medical team share responsibility for checking the medical kit.

The kit includes emergency drugs & life saving equipment (such as defibrillators, airways, oxygen, fluids etc) & immediate trauma management kit (Entonox, splints, spinal immobilisation & extraction equipment etc).

The emergency kit must always be available, in the place it's needed, when required. All equipment is regularly checked between games to ensure working order & check expiries & stock levels.

4. Teamwork

Football is a team game both on & off the pitch. We've been very lucky to work within such a supportive & inclusive medical team at Cardiff City.

The team fully understands the importance of both player safety & staff welfare. The camaraderie created at Cardiff City only helps to develop trust & confidence in the medical staff to do their jobs.

There aren't many teams that offer the players, & their families basic first aid training. But we're fortunate to work with a group of players at Cardiff that understand the importance of the medical team.

We provide basic first aid training for players, coaches & their families to help enhance this understanding. This also give them the basic knowledge required if they ever need to deal with an emergency.

The togetherness & family spirit at Cardiff City was truly evident this year. The support shown for team Dr, Professor Len Noakes, in his learn CPR campaign following the tragic death of his daughter, was incredible.

It was a privilege to contribute & take part of the film he created. You can watch it below, but we encourage everyone to watch & share it here: https://www.facebook.com/OnlyTimeBook/

All of these elements are relevant in all sports at all levels. We transfer the same mindset into grassroots, local & amateur sports as we do at elite level.

The key is remembering that player safety is the most important element of pitch side medical care at all levels.

This blog will help you to analyse your own planning, communication, preparation & teamwork skills. Is there anything you can do to improve these skills in your medical team?

If you are qualified in Lubas Sports Trauma Management, FASE 1 or FASE 2, join our "Medics for Sport" Facebook group for jobs, experience & more information.

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