# Knockouts and EMS



## kittybreed (Apr 29, 2008)

I'm working on a medical care rubric for tournaments. At what point after a knockout do you need to call EMS? If the person regains consciousness after 1 minute, do you need to call? I am trying to write guidelines and want input from those with more experience than I have. Thanks!


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## jks9199 (Apr 29, 2008)

I'd suggest you get the guidelines from medical experts.  We martial artists sometimes have a tendency to do things that are, at best, ill advised. 

My personal guideline is that ANY knockout should be assessed by appropriate medical experts.  A brief knockout or near-knockout might wait till the following morning, but if there's any delay in return to consciousness, that should be sped up.  If they don't come to within a few minutes, it's time for EMS.  If there are any indications of severe brain trauma (confusion of time/space/memory, balance disruption, dizziness, eyes that aren't tracking smoothly, nausea or vomiting, etc.), call EMS or transport the person yourself to the ER.  In short -- if there's any question at all, call the experts.  Few of us have the real expertise to do more than initial crude assessments, especially as we come to understand more and more how much damage is done by a "little" concusion.


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## kittybreed (Apr 30, 2008)

I fully agree with you. Although I don't practice, I have an active nursing license. I am looking for some "hands-on" guidelines of those who have been there. I think we would agree that many poeple who are momentarily stunned at tournaments do not seek care, at least not right away. 

I am also pursuing this at a medical angle and will use medical recommendiations to write my paper.


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## IcemanSK (Apr 30, 2008)

I'm with JKS on this one. As soon as the fight is called due to KO, get the medics in to look in on the KO'ed fighter.


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## punisher73 (Apr 30, 2008)

kittybreed said:


> I'm working on a medical care rubric for tournaments. At what point after a knockout do you need to call EMS? If the person regains consciousness after 1 minute, do you need to call? I am trying to write guidelines and want input from those with more experience than I have. Thanks!


 

It seems as if you should have medical personal on stand by at the tournament and every fighter should be examined if they are ko'd.  If it is full contact, with MMA style gloves even a quick work up on the hands, face, ribs etc to check for small bones that might be broke.


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## kittybreed (Apr 30, 2008)

Actually, I am developing this rubric as part of a paper to judge the effectiveness of the medics at tournaments. Just because a medic is there, it may not be enough. The advice I got from paramedics today is that EMS should be called EVEN IF A MEDIC IS THERE if the person does not respond in 60 seconds and they are breathing. If the person has a seizure, or vomits, they sould be called immediately.

Thanks to all who responded.


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## Tez3 (Apr 30, 2008)

We run MMA fight nights and we spend a lot of money on getting very good medics, we have two paramedics who bring an ambulance with them. As soon as someone is knocked out the ref is usually the first to put the fighter in recovery position and removes his gumshield, the medics are in as fast as they can.(they aren't called in they come in automatically when any fighter is KOd.) _From that point on the medics are in charge_. the fighter has no choice as to whether he receives care, we as promoters have a duty of care to make sure they receive the best medical care. I will keep an eye on all the fighters afterwards too and have often called a medic to check one out if I feel any concerns.
In MMA of course there is no standing count so even if a fighter isn't fully KOd the fight will still be stopped. 
I'm not sure how our paramedics correspond with yours as in qualifications  but while they are expensive to hire they are worth their weight in gold, we wouldn't use first aiders for this. They also do the medicals for the fighters before hand. Some shows use doctors but to be honest your average family doctor knows little about emergency work.

http://www.nhscareers.nhs.uk/details/Default.aspx?Id=905


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## kittybreed (Apr 30, 2008)

For competeness, of course you would call STAT if the fighter was not breathing. I appreciated the advice about checking the bones of the hand in the assessment.


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## Tez3 (Apr 30, 2008)

kittybreed said:


> Actually, I am developing this rubric as part of a paper to judge the effectiveness of the medics at tournaments. Just because a medic is there, it may not be enough. The advice I got from paramedics today is that EMS should be called EVEN IF A MEDIC IS THERE if the person does not respond in 60 seconds and they are breathing. If the person has a seizure, or vomits, they sould be called immediately.
> 
> Thanks to all who responded.


 
Not sure what an EMS is or what you define as a medic, sorry! The medics we use are exactly the same as the people who would come if we dialled 999 (our equivelant of 911).


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## Tez3 (Apr 30, 2008)

Sorry don't know what STAT is either!


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## kittybreed (Apr 30, 2008)

Sorry. STAT is medical speak for "immediately." My TKD master always had paramedics with an ambulance. I don't know if all tournaments do though.


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## kittybreed (Apr 30, 2008)

Tez3 said:


> We run MMA fight nights and we spend a lot of money on getting very good medics, we have two paramedics who bring an ambulance with them. As soon as someone is knocked out the ref is usually the first to put the fighter in recovery position and removes his gumshield, the medics are in as fast as they can.(they aren't called in they come in automatically when any fighter is KOd.) _From that point on the medics are in charge_. the fighter has no choice as to whether he receives care, we as promoters have a duty of care to make sure they receive the best medical care. I will keep an eye on all the fighters afterwards too and have often called a medic to check one out if I feel any concerns.
> In MMA of course there is no standing count so even if a fighter isn't fully KOd the fight will still be stopped.
> I'm not sure how our paramedics correspond with yours as in qualifications but while they are expensive to hire they are worth their weight in gold, we wouldn't use first aiders for this. They also do the medicals for the fighters before hand. Some shows use doctors but to be honest your average family doctor knows little about emergency work.
> 
> http://www.nhscareers.nhs.uk/details/Default.aspx?Id=905


 
What is the "recovery position?"


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## Tez3 (Apr 30, 2008)

kittybreed said:


> Sorry. STAT is medical speak for "immediately." My TKD master always had paramedics with an ambulance. I don't know if all tournaments do though.


 
Cheers! All the karate tournaments I've been to had at least St. Johns Ambulance people in attendance. I don't know if you have them, they are an organisation of trained first aiders who attend sports events, anywhere where first aid maybe needed but for MMA we feel we need paramedics, first aid alone isn't enough.  
Interestingly our paramedics also attend things like motor racing and motorbike racing, horse shows etc and they say our shows are the most 'restful' for them as they have little to do! We rarely have injuries and KOs aren't that common. However all injuries even ones regarded as minor are checked out. Fighters may not want it but I put my mother look on and they agree lol!


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## BrandiJo (Apr 30, 2008)

http://en.wikipedia.org/wiki/Recovery_position

I have never been to a toury with out paramedics on standby. They are the ones who reply to your 911 calls


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## jks9199 (Apr 30, 2008)

kittybreed said:


> Actually, I am developing this rubric as part of a paper to judge the effectiveness of the medics at tournaments. Just because a medic is there, it may not be enough. The advice I got from paramedics today is that EMS should be called EVEN IF A MEDIC IS THERE if the person does not respond in 60 seconds and they are breathing. If the person has a seizure, or vomits, they sould be called immediately.
> 
> Thanks to all who responded.


If you have medics ringside or otherwise in PROFESSIONAL attendance at the tournament or event, you should be guided by their training as to whether or not to call for EMS.  For full contact events, you should have both a doctor (lots of "fight doctors" are NOT trauma specialists; they're fight fans who have an MD, and can advise) and EMTs who ARE specialists in immediate response to traumatic injury, in my opinion.  Docs and EMTs are not interchangeable; they each do different things, in different situations.

In the case of a serious injury at a tournament, I'd also agree with activating the EMS system, not merely using your event medics.  The Emergency Medical System includes paramedics/EMTs (and other first responders), the ER, and the ambulance (or other) transport that gets them there.  When you call 911, along the chain of events is information being sent to each component to allow them to be ready.  Also, by activating the EMS, you allow them to transport keeping your site medics free to handle other events.  (I was once at a tournament that had to stop for about an hour, because we ran out of medics...  Yeah, we were playing a little rough.  Seven people went to the hospital out of one ring alone.)  And, your site medics may not have all the equipment that the responding EMTs carry; I've noticed that many times the medics on site have a very basic kit while you can send and advanced life support unit, if appropriate.


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## Tez3 (May 1, 2008)

Recovery position is where you first check someone's airway and breathing then move them onto their side, injuries to neck/spine permitting. there is a specific way to do it, different first aid instructors teach different ways to do it but basically the patient is on their side ie left side with right arm moved over so hand flat on floor under chin and right leg bent over to stop them rolling. 
http://www.bbc.co.uk/health/first_aid/procedures_index/recoveryposition.shtml


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