Important Notice: This First Aid Guide has been prepared for ABLL coaches, managers and staff to be helpful and assist in the early detection / treatment of certain medical conditions that may occur at baseball / softball games and practices. This Guide is NOT to be considered comprehensive. Users are encouraged to refer all questions to qualified medical personnel. ABLL adheres to a policy of "safety first" and requires all staff to call 911 Medical Emergency if there is any question as to the proper treatment of a serious medical matter at an ABLL practice or game.

1. If the foot or hand at the end of the injured extremity is cold or blue, call 911 immediately!
2. Do NOT straighten the extremity if it is deformed - keep it in the position found.
3. Stabilize the extremity. Use padding to keep it immobile.
4. Put ice on the injury. Never put the ice directly on the skin - put it in a bag first. After holding ice on the injury for about 20 minutes, take it off for 20 minutes.
5. Anti-inflammatory drugs like ibuprofen or naproxen will help with pain.
6. Elevate the extremity to reduce swelling.
7. If 911 was not called, seek medical assistance for additional pain relief and further evaluation of the injury. The use of an ambulance is probably not necessary, but ambulances in many areas are capable of providing additional pain relief.

Tips:

1. A little water in the ice bag will help it conform to the shape of the injury.
2. Compression wraps may also help reduce swelling, although the evidence is not compelling. Wrap the extremity about 4-6 inches above and below the injury. The wrap should be snug, but loose enough to fit one finger under the elastic bandage.

Facial Cuts

Cuts on the face can bleed much more than their size suggest. Once bleeding stops, it's important to dress a cut correctly to avoid scars. If cut is large or bleeding does not stop, victim should see a doctor for possible sutures.

1. Skull Fracture - Head injuries typically come from blunt or penetrating trauma the head.. If the skull is soft when touched, or the victim has an open or depressed skull fracture. Other signs of a skull fracture include blood or clear fluid draining from the ears or nose, and bruising around both eyes or behind the ears.

2. Closed Head Injury - A closed head injury is an injury to the brain inside an intact skull. Injury to the brain causes swelling, which quickly increases the pressure within the skull. The increased pressure causes more damage to the brain, which causes more swelling, and so on. Some types of closed head injury stop the cycle automatically (concussion), while others will continue to get worse until the victim dies (epidural hematoma). The only way to tell the difference is through a CT scan, which looks at the brain and the skull using x-rays.

A victim struck with a blunt object should be watched for signs and symptoms of a closed head injury. I:

- confusion - vomiting - dizziness - very high blood pressure - very slow pulse

- loss of consciousness at the time of the injury (getting knocked out)

- short-term memory loss (victim keeps repeating questions)

3. Head Injury First Aid - In all cases of injury to the head and neck, it's vital not to move the victim's neck. Support his or her head in the position you found it. Bones of the spine can be injured from movement of the head during trauma. Broken or displaced spinal bones can cut or put pressure on the nerves of the spinal cord, causing temporary or permanent paralysis and loss of feeling.

If skull fracture or serious closed head injury is suspected, call 911 immediately.

Heat Exhaustion

Heat exhaustion is caused by an increase in core body temperature often coupled with fluid loss (dehydration). It's important to recognize heat exhaustion early and seek treatment as quickly as possible. It does not need to be hot outside for heat exhaustion to occur. Many victims develop heat exhaustion just from exertion.

Heat exhaustion can lead to heat stroke if not treated in time.

Signs and symptoms of heat exhaustion:

• weakness
• dizziness
• warm, moist, pale skin
• nausea and vomiting.

Initial Treatment

1. Make sure the patient has an airway and is breathing.
2. Move the victim to a cooler environment immediately. Shade is better than sun, air conditioning is better than outside, etc. The cooler the better.
3. Remove the victim's clothing to encourage heat loss.
4. If the victim is conscious and able to follow commands, he or she should drink fluids to rehydrate.
5. If the victim is unable to follow commands or is vomiting, do not encourage drinking as it may lead to choking and immediately call 911!

Knocked Out Tooth

If you keep a knocked out tooth, there is a possibility that it can be re-implanted -- if you move fast and get medical attention.

NOTE Treatment for nose bleeds has changed in recent year especially with No. 1:

1. Lean forward, not back. Don't try to protect a favorite shirt by leaning back. The blood needs to go somewhere and will most likely go down the throat. If the victim leans back, blood could get in the windpipe causing a blocked airway, or go into the stomach. Blood may irritate the stomach lining and cause the victim to vomit.
2. Pinch the victim's nose just below the bony bridge. Your fingers should be on the soft tissue as well as the bone. If there is still blood flowing, adjust your grip. There should not be visible bleeding while you are holding the nose. Blood vessels that supply the nasal membrane can be pinched against the bony
3.  
4. bridge (the hard part) to slow blood flow and create a clot. Hold the nose for at least 5 minutes. Do not let go to check bleeding until the 5 minutes is up.
5. After 5 minutes, release the pressure to see if the bleeding has stopped. If not, repeat Step 3 for 10 minutes this time. Remember: don't let go to check bleeding until the 10 minutes is up. Repeat for another 10 minutes if necessary.
6. If a nosebleed doesn't stop after the second or third try, it's time to see a doctor. If at any time, the victim feels lightheaded, dizzy, or weak, call 911. If left uncontrolled, nosebleeds can lead to shock.

The symptoms of a sprain are almost exactly the same as that of a broken bone. When in doubt, sprains should be treated the same as broken bones. The most common symptoms are:

pain - swelling - bruising - inability to move - inability to bear weight on the joint

It is not necessary to have all of the symptoms of a sprain in order for the joint to be injured.

1. Do not call 911 for a sprain. Visiting a doctor for a sprained joint if:

• Use the "RICE" method to treat the sprain.
  • Rest the sprained joint by not placing weight on it. Use a cane or crutch on the uninjured side to lean away from the injury.
  • Ice the sprain with an ice pack.
  • Compress the sprain with a compression bandage. Ask a healthcare provider to show you how to properly apply a compression bandage.
  • Elevate the sprain above the level of the heart as often as possible during the first 48 hours.

1. Open unprotected exposure to the suns rays can cause serious short and long term skin and eye problems. ABLL encourages all staff, players and spectators to use sunglasses and sun screen whenever appropriate. Note significant ultra violet rays can still be a major health risk even on cloudy days.
2. Sunburns should be treated with aloe or other ointments specifically designed for this purpose. Pain may be mitigated via the proper doses of ibuprofen or acetaminophen.
3. Severe sunburn should be referred to a doctor’s care.