Organizing First Aid Response at a Game

Hosts take on a lot of responsibility at an airsoft game.  Airsoft games are complex simulations involving player enforced rules and, for a period of time, suspend the social rules about pointing guns (even toy ones), there are pursuits, hiding, ambushes and adrenalin runs high.  In amongst this fun, its very possible to have injuries, or, for pre-existing medical conditions to overcome a player to the point where they need medical assistance.  This is where a First Aid Plan comes into play.

Responding to another person's aid in the event of injury, trauma or a pre-existing condition does not happen by accident.  Many members of the public hold first aid credentials, and are as well members of the emergency response community.  This short paper discusses how to organize volunteers in a pre-determined way at a game to get first aid to a player, or, to evacuate that player to an accessible location for EMS access and transport (and when NOT to).

About Me

I am a paid-on-call firefighter and a qualified first responder, so I am not speaking out of my hat in discussing this topic, and its because of this I bring this topic up for hosts who are unaware of the potiential medical emergencies they might face in their game.

Before we start... you're not going to get Sued.

Many of the questions that are most frequently asked by people about first aid have to do with legal considerations when providing emergency care and first aid. Many people are afraid to care for someone they don't know because they're worried about being sued. In this day and age when lawsuits are prevalent, it's a justified concern. However, Canada maintains specific laws, called "Good Samaritan" laws, that protect people who administer first aid from being sued. These are general guidelines followed by Canadian law:

- The person providing first aid must not deliberately cause further harm to the victim. Breaking ribs during CPR is NOT deliberately causing further harm.
- The person providing first aid must offer and provide care only up to the level and extent he/she is trained and qualified.
- The person providing first aid must obtain consent from the victim before giving care.
- An injured person has the right to refuse care, no matter how seriously he/she is injured.
- In the event of a minor child, consent for care must be obtained from the child's parent or guardian. This is another reason why I recommend games be restricted to age of consent (18 and over).

There are only two exceptions where obtaining consent is not necessary. In the event that the victim is unconscious, consent is implied, meaning if the victim knew his/her condition, he/she would want you to provide care. In the case of a minor child, conscious or unconscious, without a parent or guardian present, consent from the absent parent or guardian is implied.

It's important to remember that, in Canada, no bystander is required to provide care in an emergency.  However, if you do decide to provide emergency care, you do have a responsibility to continue caring for the victim until:

- the victim no longer requires care.
- someone else arrives on the scene that is qualified to provide emergency care.
- you are physically unable to continue providing care.

As long as you stay within the level of training you've received and you do not abandon the patient, you cannot be sued.

Before the Game Starts

Before the game begins I ask for a show of hands of people who have a current First Aid and CPR certificate or are EMS/Fire.  I take the 3 (because I am one, if you are not, take 4) top trained and designate those players as my First Aid Response Team.  I then ask for four more people, people who are in good shape and physically strong and I assign that as my Lift Assist Team.  Both the First Aid Response Team and the Lift Assist Team pick one leader.  In the case of the First Aid Response Team, it should be the person with the highest medical authority and training.  I myself have a backboard and a first aid kit at games I host as a rule.  If you host a lot, you should probably consider doing the same and also getting First Aid training if you don't already have it.  I include a C-Spine kit, as spinal injuries are a possibility in this game.  If you do not carry a cell phone, one should be included in the kit.  But remember you can only give care to the level you are trained.  Don't use a piece of equipment you are not trained to use, but, don't rule out the possibility that you may have a trained paramedic or firefighter stepping forward to volunteer, and they will have that training.

I then designate a radio channel which the host always operates on.  Sometimes this is a separate channel from the game channel, sometimes it is not.  If it is, when you report an injury, it is important to get the channel clear first.  Toggle the mike and speak clearly saying "NODUFF, NODUFF, NODUFF Player Injured".  Anyone hearing this should IMMEDIATELY CEASE all communications and keep the channel clear for the Host and/or First Aid Response Team leader.  The First Aid Response Team Leader will reply with. "NODUFF Acknowledge, please state your location, identity and nature of injury." All gaming activity should cease at this time and all players should return to the safe area.

While this information is being communicated, the First Aid Response Team should immediately response to the patient's location.  The Lift Assist Team reports to the safe area and obtains the backboard and first aid kit(s) and then responds to the patient's location.  Comms should stay clear but the two team leaders and the patient or witness can communicate until the teams arrive at the patient's location.

Standard first aid activities will proceed from there, which those who are on the First Aid Response Team should be familiar with.

If the patient requires emergency care, at the first aid team leaders discretion, the patient should be transported off the field to where EMS can easily access the patient.  If there is a spinal injury, there may be the decision to leave the patient in place.  Again, this is a decision that has to be made based on the mechanism of injury and the patient state.

If cell service is available, the cell phone being carried or the cell phone in the kit, use it to call 911.  If cell service is not available, you should pre-plan your access to emergency services.  Among the methods I've used have included radio relay to a house phone in the area or taking the patient directly to the emergency room of the nearest hospital.  Preplanning your route to the hospital is advisable especially if you are playing in a rural or wilderness area.

Additional Measures

At larger events, particularly multiday events that are held in remote areas, as part of my game waiver, I also ask the player if they have an medical conditions of concern.  I'll direct those players to the First Aid Team Leader for a quick one-on-one.  The First Aid Team Leader can then record anything significant that the player may wish to share or instructions on current medical concerns and possible responses to issues.  In remote areas we pay particular attention to allergies to plants and insects.

It Could Never Happen

I've been at games where the following things have happened:

- Heatstroke
- Epilepsy
- Diabetic Reaction/Coma
- Allergic Reactions
- Serious Fall from Heights with head and back injuries
- Concussion
- Broken Arm
- Torn ligaments
- Shattered teeth
- Player knocked unconscious
- Deep cut wound
- Eye Injuries

Are you prepared to deal with this?  This all happened in a 5 year period over the course of perhaps 200 games.