125 Emergency medical response to US sports injuries: patients, places, and procedures

Statement of Purpose Emergency medical services (EMS) often respond to injuries sustained during sports. Characterizing such incidents can help schools/organizations and EMS agencies anticipate sports-related pre-hospital care needs, and coordinate their responses. Methods/Approach We identified EMS runs associated with team sports (ICD-10 activity code Y93.6x), to a school, athletic field, or another athletic facility, using National Emergency Medical Services Information System 2017 data. We characterized incidents by patient characteristics, incident location, and pre-hospital medical procedures; we used ICD-10 diagnosis codes and SNOMED procedure codes. Results Of 1107 EMS runs identified, the median patient age was 17 years (interquartile range 14–29), 29.5% of patients were female, and 46.7% were white. The most common locations were athletic fields (517 incidents, 46.7%) and schools (330, 29.8%). Initial diagnoses were non-specific: the most common primary symptom was ‘pain, unspecified’ (34.7%), and the most common primary impression was ‘injury, unspecified’ (53.7%). Of 1656 procedures recorded, 287 (17.3%) were conducted prior to EMS arrival. The most common pre-EMS procedure was splinting (32.4% of pre-EMS procedures), and the most common EMS procedures were gaining intravenous access (33.7%) and electrocardiographic monitoring (22.6%). Conclusions The vast majority of sports-related EMS responses were for teens and young adults, at known athletic venues, for musculoskeletal injuries and pain. Pre-EMS care often focused on stabilizing the injury, while EMS care often involved advanced assessment and pain relief/fluid administration. National EMS data, while informative, often lacked diagnostic detail, and the specific type of athletic facility; combining EMS data with hospital diagnoses, when available, would enable greater precision. Significance and Contributions to Injury and Violence Prevention Science Characterizing sports-related EMS responses allows organizations with responsibility for athlete health and safety to train and equip on-scene responders, and to coordinate responses to take advantage of the complementary skill sets of on-scene and EMS responders.