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.

How to treat shock after an accident.

The term “shock” is often misunderstood. It can conjure up images of someone dealing with a traumatic experience being “cured” or comforted with a cup of sugary tea! But shock in medical terms relates to a physiological and potentially life-threatening condition.

To help you understand what type of shock we are talking about, here are some pointers for understanding, recognising & managing shock.

What is Shock?

Shock is the reduction of blood & oxygen to the organs and tissues of the body due to a problem with circulation. If untreated, shock can be fatal.

What causes Shock?

Shock is usually caused by a drop in blood pressure. This reduces the amount of oxygen to your vital organs and tissues.

The drop in blood pressure can be commonly caused by high volume blood loss (hypovolaemic shock), problems with the heart (cardiogenic shock) and severe allergic reactions (anaphylactic shock) among other things

What are the signs & symptoms of shock?

Someone suffering from shock will likely show the following symptoms:

What is the treatment for shock?

If you suspect someone is suffering from shock, you should do the following:

Conclusion

Shock is always brought on by an underlying problem or condition. Recognising the symptoms and acting quickly to get further help is vitally important if you suspect shock.

We provide more in-depth information and training regarding shock on our First Aid for Sport & Exercise (FASE 1) course (link to FASE 1). We also offer further online content at www.lubasonline.com

Related articles

https://www.nhs.uk/conditions/first-aid/ (Shock section)

https://www.mayoclinic.org/first-aid/first-aid-shock/basics/art-20056620

https://www.webmd.com/first-aid/shock-treatment

Ceri Q&A answers!

Here are the Answers to the Ceri Q&A. We would like to thank everyone for taking part. We hope you enjoy the answers and be on the look out for more Q&A'S in the future!

Q: My husband does a lot of running but gets bad shin splints. What’s the best way to treat this?

A: Shin splints is the term used to describe shin pain usually brought on by exercise. It is thought that the pain originates from the tissues around the bone swelling but can also be a sign of a stress fracture. 

They usually occur when people weight bare through their legs for an excessive amount of time or for example run on a hard surface with inappropriate footwear. 

They are easily treated with rest from the activity for up to 3 weeks, ice to the affected area for 10 minute periods every few hours for the first day or 2 and over the counter pain medication. If symptoms do not resolve, then seek help from your GP as this may indicate small stress fractures in the tibia. They may be prevented if your husband stretches well before exercise and ensures he is wearing the correct footwear.

Q: What are the most valuable skills you learnt while being a nurse?

A: I would have to say that although learning vital lifesaving skills were important it was learning how to communicate with people, especially those in pain or receiving bad news that was most valuable.

Q: How do you apply for work with Lubas?

A: If we require full time staff, we usually advertise the post on our social media. If you want to work with us on an ad hoc basis providing First Aid or medical cover at sporting or filming events then you can email a C.V to info@lubasmedical.com.   We will invite you in for an informal interview and then if successful add you to our database.

Q: Hi Ceri, what is the minimum age children can learn CPR?

A: Whilst there is no minimum age set for children to learn CPR, research has shown that children under the age of 11 lack the physical strength to administer quality compressions to adults. However, it is possible to teach children about CPR and defibrillators from a younger age.  CPR is now being brought into the high school curriculum which will allow 11-16 to learn CPR. The resuscitation council U.K also runs restart a heart day each year in October to encourage young people to learn CPR.  We have taught year 6 students CPR on these days and have been impressed with their willingness to learn the skill.

Q: What do you love most about doing event and film cover?

A: For me it’s covering the construction of the sets, it always amazes me how an empty wooden room becomes a house from the 40’s or a room in a mythical castle.  The set builders are truly gifted people.

Q: I’m looking to become a nurse, is there any advice you’d give for someone just starting out?

A: I would recommend nursing as a career to anyone as it is such a diverse job that can take you in many directions.  I would advise you to learn from your mentors and never forget the patient should always be your priority.

Q: It’s cool that you have worked in the premier league, do you feel there is more pressure working at that level?

A: Yeah, it was pretty cool, especially as I got to do it with Cardiff City.  There is pressure at any level you are working at.  In the premier league, you are conscious that there are cameras watching you, but you have support from a medical team.  At lower levels, the pressure comes from there being a lack of support.  In all situations, I follow the same structured approach to ensure the injured player always receives the correct care.

Q: Hello Ceri, I’m still a medical student but want to get into working pitchside, what courses & qualifications would I need to help me reach this goal?

A: There are a variety of courses we offer to help you reach your goal.  Our FASE1 course teaches the basic first aid skills required for working pitchside.  Our FASE2 course concentrates on more advanced first aid skills and how to assist a healthcare professional in the pitchside team. Our Sports Trauma Management course is aimed at healthcare professionals who would be team leader pitch side and offers instruction in advanced techniques.  It is always a good idea to gain experience too so maybe once you have completed a course you could volunteer to offer assistance at university events.