EMT's at comps?

[cantskiforlife]

I am constantly amazed and curious as to the lack of medical staff at ballroom competitions. I have seen people pass out, have asthma attacks, dislocate limbs, break bones, cut themselves, etc... yet I don't ever recall seeing an official medic at any competition (NDCA, USA Dance, Collegiate, etc...).

I wanted to start this post as a place for people to discuss this and see if people thought competitions should have some sort of medical personnel, supplies on hand.

My vote is to hire an EMT or two for the length of the competition, even if this increased the cost of the event. What are your thoughts?

[QPO]

Interesting, concept, I know a lot of sporting events must have first aid on duty, I would have thought a big comp would have to have it available, I will find out what the rules are in Australia.

[Laura]

On the one hand I see where you are coming from, and could have benefitted from it myself once a few years ago :( . On the other hand, for a small club-level competition that runs in a single day, this could be a budget problem for non-profit groups trying to put on low-cost events.

I've seen this done on a volunteer basis at some events, and think that's a great place to start. There are so many doctors etc. in the ballroom community that it could be possible to tap that resource.

[wooh]

The problem with set volunteers, they're now opening themselves to liability that someone that just happens to be there is somewhat protected from based on Good Samaritan Laws. Even with paying people, they won't be able to offer more than basic first aid at the site, which you should be able to find without a formal first aid station, and thus I think the costs would outweigh the benefits. Having an AED available would be a good idea, and people planning ahead and packing themselves a small first aid kit would be a good idea though.

[White Chacha]

I'm pretty sure the BU folks have had an EMT on site during their comp. Universities holding on-campus competitions can leverage off their infrastructure. Most have a campus security force with trained EMTs on call.

[Stillharbor]

I know we've all seen freak accidents (broken bones, dislocated shoulders, etc) but the majority that we see are sprains, strains, and cuts. I think most organizers are of the opinion that most dancers can deal with the minor injuries that we see in eachday practice. Any worse injuries, then you need actual medical personnel, so you might as well go to the hospital instead of spending money on EMTs that may or may not be needed.

[dancepro]

I am constantly amazed and curious as to the lack of medical staff at ballroom competitions. I have seen people pass out, have asthma attacks, dislocate limbs, break bones, cut themselves, etc... yet I don't ever recall seeing an official medic at any competition (NDCA, USA Dance, Collegiate, etc...).

I wanted to start this post as a place for people to discuss this and see if people thought competitions should have some sort of medical personnel, supplies on hand.

My vote is to hire an EMT or two for the length of the competition, even if this increased the cost of the event. What are your thoughts?

I must say I am surprised about this as well, when I first moved here. In many European competitions there is a medical personnel for the duration of the competition. The British Open has a fairly large EMT as they are there from early morning to late night for seven+ days.
In some counties it is the laws that there has to be medics around as it is a sporting event. Also in some countries they include basic CPR and med-care in their professional exams for two main reasons. One, they are teaching a sport and/or form of exercises. Second they (the professionals) are dealing with the public and they (the government) are not expecting the public to know basic CPR.

I taught a class a while back where one man had a heart attack right there in class. Luckily I knew some basics CPR and med-care. I was also lucky that a doctor, that was to participate in the next class, came in early. I sure was glad that I had some basics down.

In the counties that have the professional exam include CPR and basic med-care, the professionals are required to take a bush up course every 2 years to renew their license. It had been many years since I have done my exam and any brush up courses. After this incident I realized that I really needed to go back and get my brush up course as I didn't feel as confident in what I should do as I could have been.

Dancepro

[dancepro]

A few years back on competitor sprained her foot. There was nobody in the ballroom able to help her. I called my chiropractor to get help. He is on the EMT at many sporting events like bike races and triathlon competitions all over the world. He is actually very well known for his ability in this field. He helped me over the phone as much as he could. He was chocked to find out that there was no EMT present at the competition.

Dancepro

[tanya_the_dancer]

I know we've all seen freak accidents (broken bones, dislocated shoulders, etc) but the majority that we see are sprains, strains, and cuts. I think most organizers are of the opinion that most dancers can deal with the minor injuries that we see in eachday practice. Any worse injuries, then you need actual medical personnel, so you might as well go to the hospital instead of spending money on EMTs that may or may not be needed.

I think that's a good point. Also, I think a lot of hotels nowadays have to have some basic first-aid equipment as well (like a defibrillator), so that's covered as well.

[Another Elizabeth]

I taught a class a while back where one man had a heart attack right there in class. Luckily I knew some basics CPR and med-care. I was also lucky that a doctor, that was to participate in the next class, came in early. I sure was glad that I had some basics down.
I think one reason that comps get away with it is that since dancing as an adult amateur in the US requires money (especially for pro-am), there are a fair number of doctors who dance. I suspect that there is usually a doctor somewhere in the room for the duration of most comps. Of course, they have no obligation to help anyone with a medical difficulty, but my experience is that they usually do.

I do remember that Amy Cousins used to serve as "official doctor" for some competitions. I think I heard through the grapevine that she got discounted (free?) entries in exchange, but I don't know that for a fact.

[wooh]

I know we've all seen freak accidents (broken bones, dislocated shoulders, etc) but the majority that we see are sprains, strains, and cuts. I think most organizers are of the opinion that most dancers can deal with the minor injuries that we see in eachday practice. Any worse injuries, then you need actual medical personnel, so you might as well go to the hospital instead of spending money on EMTs that may or may not be needed.

Absolutely, totally agree!

[wooh]

It had been many years since I have done my exam and any brush up courses. After this incident I realized that I really needed to go back and get my brush up course as I didn't feel as confident in what I should do as I could have been.

You could have done the class the day before, you never feel prepared for that kind of thing! I'm great in a hospital, but get me away from the safety of all my equipment and CPR is the absolute last thing I want to do. :)

[dancepro]

You could have done the class the day before, you never feel prepared for that kind of thing! I'm great in a hospital, but get me away from the safety of all my equipment and CPR is the absolute last thing I want to do. :)

I know that I will never be prepared for something like that. I am not a doctor and don't claim to know anything about medicine. Even if I was I am sure a situation like that would not be pleasant.
I just felt it was irresponsible of me not to have brushed up on my CPR in more then 10 years. I had just talked to a friend of mine about that and BAM there the situation was.

Please if we are both at a competition together and something happens to me, come and take care of me. Will you????:);)

Dancepro

[elisedance]

While we're on the medical subject has there ever been illegal drug tests at ballroom comps? Its everywhere else....

[SDsalsaguy]

While we're on the medical subject has there ever been illegal drug tests at ballroom comps? Its everywhere else....
A. a totally different topic, so please feel free to start a new thread.
B. yes, IDSF events must respect the IOC rules on doping (a topic that has been discussed several times here on DF)

[dancepro]

While we're on the medical subject has there ever been illegal drug tests at ballroom comps? Its everywhere else....

Yes, in the US too....

Dancepro

[SDsalsaguy]

Yes, in the US too....

Dancepro
Again, seperate topic for a seperate thread please.

[elisedance]

:oops:
BOT

Perhaps we need some stats on the frequency of injuries to see if this is really overkill. I've actually never seen an accident serious enough to warrant ambulance service. Also, each competition should assess how long it would take for an EMT to get there if there was an injury.

[DL]

My vote is to hire an EMT or two for the length of the competition, even if this increased the cost of the event. What are your thoughts?

Every nontrivial judo competition I've ever seen has had EMTs present for the duration. I asked about this, and the apparent reason was that it's cheaper to schedule their time in advance, than it is to call for an ambulance on demand.

I learned that a long time ago and didn't go into details, which may vary by region in any event.

Putting aside bloody noses, I don't think there's a big difference in injury rates for large events, between the two sports. (I mean that both rates are fairly low, but dramatic moments are indeed dramatic, and unconsciousness is not unheard-of at either.)

So I think I agree that having EMTs on hand would be a Good Thing (TM).

[Larinda McRaven]

:oops:
BOT

Perhaps we need some stats on the frequency of injuries to see if this is really overkill. I've actually never seen an accident serious enough to warrant ambulance service. Also, each competition should assess how long it would take for an EMT to get there if there was an injury.

In the past 6 months I have seen a heart attack, a woman pass out in the pro rounds and have to be carried off the floor still unconcious, know of someone got a huge gashy flesh wound, and someone suffer a sudden attack of bells palsy. Each of these people, except the flesh wound, was assesed by a doctore on site (competitor student) and then advised to take a trip to the emergency room.

Over the years on the comp floor I have seen probably 5 heart attacks, numerous concusions when someone gets knocked down, lacerations from rhinestone encrusted bracelets smacking someone elses face, torn ligiments, dislocated shoulders, people passing out, people having asthma attacks and panic attacks, ladies heels coming down and creating a puncture wound in the achilles of another lady.... the list goes on and on.

If you are hurt enough to go to the emergency room than doesn't it also make sense to have someone attending you the moment the accident happens, instead of people wandering around wondering what they shoud do, and staring at you wishing they could help, while you writhe in pain or are convulsing.

And you are not hurt enough to go to the emergency room shouldn't there at least be an emeregency medical kit with peroxide, bandages, ice packs, ace bandages, neosporin, butterfly band-aids...

When you are at 35+ comps a year you realize how frequently this stuff happens. If you only do 5 a year, and are only in the ballroom for one style, instead of the entire week, you may go your entire dance life without seeing an emergency.

[elisedance]

wow - well I suppose would see a lot more than us in the trenches ...

Maybe they should have a field hospital unit :)

[DL]

And you are not hurt enough to go to the emergency room shouldn't there at least be an emeregency medical kit with peroxide, bandages, ice packs, ace bandages, neosporin, butterfly band-aids...


Handling this stuff is not least of the duties of EMTs at judo matches, especially because, say, a bloody nose that can't be stoppered in < 1 minute is an automatic forfeit. Are there similar rules regarding such injuries and disqualifications at ballroom competitions?

[Larinda McRaven]

If you are hurt or bleeding, and I have seen bloody noses in mid round, they will stop and give you a moment to collect yourself. If you can't get up and dance within a reasonable moment and have to leave, then you are out. But there are no rules. The chairman uses his discrection.

[BM]

I'm pretty sure the BU folks have had an EMT on site during their comp.

That is correct. I also think that Holy Cross has someone on-board at their comp, but I'm not sure if it's an EMT, athletic trainer, or what.

[cantskiforlife]

First, I do not think it is appropriate to place the responsibility of medical care on any potential doctor that happens to be at the competition. It is not why they came there and not something they should have to deal with. Plus, although many doctors may be great at surgery, etc... many of them are not trained in the same manner as an EMT who can assess and treat a wider variety of issues.

Second, I do not think it is enough to simply have a $30-50 First Aid kit on hand. These contain some products that can help but tend not to include items that a personal trainer/ EMT would have on hand. Nothing to properly sterilize a large wound, nothing to properly brace a fracture, sprain, etc...

When a pro collapsed last year at a competition no medical personnel assisted the competition staff. Then at a collegiate comp last year, when one of the competitors passed out, the photographer and a few dancers ended up assisting. Luckily the photographer was an EMT.

I bring this up because I recently obtained first-hand experience with the frustration of not having an EMT, medical support or supplies at a competition

Short version of the story:
Loose screw in practice floor finds its way into big toe of foot. Staff is less than helpful. Two Band-Aids are provided within the first 45 minutes. A first-aid kit arrives an hour later. 3 hours after incident occurs, I finish treating my own injury with my own medical supplies and no assistance.

My point is that injuries do happen at competitions and most competitors do not have the skills, ability to to take care of their own injuries. With a medical presence at the competitions, competitors could be reassured that any injuries would receive sufficient care.

[dancepro]

In the past 6 months I have seen a heart attack, a woman pass out in the pro rounds and have to be carried off the floor still unconcious, know of someone got a huge gashy flesh wound, and someone suffer a sudden attack of bells palsy. Each of these people, except the flesh wound, was assesed by a doctore on site (competitor student) and then advised to take a trip to the emergency room.

Over the years on the comp floor I have seen probably 5 heart attacks, numerous concusions when someone gets knocked down, lacerations from rhinestone encrusted bracelets smacking someone elses face, torn ligiments, dislocated shoulders, people passing out, people having asthma attacks and panic attacks, ladies heels coming down and creating a puncture wound in the achilles of another lady.... the list goes on and on.

If you are hurt enough to go to the emergency room than doesn't it also make sense to have someone attending you the moment the accident happens, instead of people wandering around wondering what they shoud do, and staring at you wishing they could help, while you writhe in pain or are convulsing.

And you are not hurt enough to go to the emergency room shouldn't there at least be an emeregency medical kit with peroxide, bandages, ice packs, ace bandages, neosporin, butterfly band-aids...

When you are at 35+ comps a year you realize how frequently this stuff happens. If you only do 5 a year, and are only in the ballroom for one style, instead of the entire week, you may go your entire dance life without seeing an emergency.

I totally agree here. I have seen a lot of the same things in all the years I have been going to competitions. I myself was knocked unconscious in one competition. The list that Larinda started could go on and on.....

Dancepro

[dancepro]

First, I do not think it is appropriate to place the responsibility of medical care on any potential doctor that happens to be at the competition. It is not why they came there and not something they should have to deal with. Plus, although many doctors may be great at surgery, etc... many of them are not trained in the same manner as an EMT who can assess and treat a wider variety of issues.

Second, I do not think it is enough to simply have a $30-50 First Aid kit on hand. These contain some products that can help but tend not to include items that a personal trainer/ EMT would have on hand. Nothing to properly sterilize a large wound, nothing to properly brace a fracture, sprain, etc...

When a pro collapsed last year at a competition no medical personnel assisted the competition staff. Then at a collegiate comp last year, when one of the competitors passed out, the photographer and a few dancers ended up assisting. Luckily the photographer was an EMT.


I totally understand your frustration. I also agree with all the valid point that you are bringing up.
I do however not think the organizers are going to do anything until it is either a rule from the NDCA, the hotel requirement, some government requirement or they get sued and learn from that experience. I am sorry but it is an expense, that I don't think, organizers would welcome. They would only do it if they absolutely had to.

Dancepro

[elisedance]

Here its not even a rule to provide free water for the competitors - I don't think they are going to spring for an EMT...

[wooh]

Well if I was around, I'd be glad to help. But a paramedic or nurse or MD can only do so much, and they WILL send you to a hospital if you actually needed their presence. Cantski, you needed a trip to to the ER if you couldn't treat it yourself. Nobody in the field is going to tell you otherwise, because it opens them up to liability issues. So again, call for an ambulance or get someone to drive you to the ER if your own first aid kit doesn't work. If you have a heart attack or such, you want the ambulance on the way anyway, whoever might be there.

[cantskiforlife]

So if I understand you correctly, by not providing the services of a trained EMT whose job it is to deal with these situations and assess them, a competition opens itself to lawsuits, etc? Can you expand on this? I would have thought of it a protection against lawsuits.

Let me also try to follow your logic here:

A patron at the competition hurts his ankle. He cannot tell if it is sprained, broken, torn achilles, etc... We could call an ambulance and wait for it to show up (give it 30+ min or so at a cost of $500+). Or we could an EMT at the event who could immediately diagnose the ankle and determine if an ambulance is indeed needed or if its simply a sprain and needs to be splinted.

A patron has a seizure. An ambulance is called and the patient who is badly damaged from his seizure is taken away. Or An EMT who understand what to do in the case of a seizure removes any obstacles and supports the patron's neck/ head so that the seizure can proceed without the risk of neck/head injury.

In more than say 90% of the cases, immediate treatment can and usually does prevent further damage. EMT's are trained for these situations and as first responders can provide much more support than your off-duty (or on-duty) neurosurgeon or pediatrician.

[cantskiforlife]

Having participated in many contact & non-contact sports throughout my life, I know that at almost every single competition, event, there was ALWAYS a medical presence...

And having been on the receiving end of treatment many times (broken noses, toes, wrists, torn ligaments, sprained neck and back, etc...) as well as having treated many sprained ankles, wrists, etc... I am quite familiar with these situations. You are 100% wrong when you say:

Cantski, you needed a trip to to the ER if you couldn't treat it yourself.

[wooh]

So if I understand you correctly, by not providing the services of a trained EMT whose job it is to deal with these situations and assess them, a competition opens itself to lawsuits, etc? Can you expand on this? I would have thought of it a protection against lawsuits.

Let me also try to follow your logic here:

A patron at the competition hurts his ankle. He cannot tell if it is sprained, broken, torn achilles, etc... We could call an ambulance and wait for it to show up (give it 30+ min or so at a cost of $500+). Or we could an EMT at the event who could immediately diagnose the ankle and determine if an ambulance is indeed needed or if its simply a sprain and needs to be splinted.

A patron has a seizure. An ambulance is called and the patient who is badly damaged from his seizure is taken away. Or An EMT who understand what to do in the case of a seizure removes any obstacles and supports the patron's neck/ head so that the seizure can proceed without the risk of neck/head injury.

In more than say 90% of the cases, immediate treatment can and usually does prevent further damage. EMT's are trained for these situations and as first responders can provide much more support than your off-duty (or on-duty) neurosurgeon or pediatrician.

Problem: EMT absolutely CANNOT diagnose. Outside their scope of practice. They will always (if smart) send you to the hospital. If not smart, you don't want them anyway. Not talking liability as a comp, talking liability as a provider. EMT says, "It's a sprain," they'll lose their license.
ETA: they might say, "probably a sprain." But they should be sending you for further treatment.

[wooh]

And having been on the receiving end of treatment many times (broken noses, toes, wrists, torn ligaments, sprained neck and back, etc...) as well as having treated many sprained ankles, wrists, etc... I am quite familiar with these situations. You are 100% wrong when you say:

Urgent Care then or your PCP. They should be advising follow up. If they are, and you aren't following up, you're playing with fire. If they aren't, then they're putting their license and your health at risk.

[wooh]

In more than say 90% of the cases, immediate treatment can and usually does prevent further damage. EMT's are trained for these situations and as first responders can provide much more support than your off-duty (or on-duty) neurosurgeon or pediatrician.
Actually I'd argue unless someone is in cardiac arrest, getting treatment immediately or an hour later won't make a difference. In cardiac arrest, treatment 90% of the time won't make a difference anyway.

[cantskiforlife]

I'll agree that it always makes sense for a follow-up. Where we seem to disagree is about the benefit of staffing an EMT at competitions.

[GJB]

About how much would it cost to hire an EMT (or two working shifts) for a three day event?

[danceronice]

Problem: EMT absolutely CANNOT diagnose. Outside their scope of practice. They will always (if smart) send you to the hospital. If not smart, you don't want them anyway. Not talking liability as a comp, talking liability as a provider. EMT says, "It's a sprain," they'll lose their license.
ETA: they might say, "probably a sprain." But they should be sending you for further treatment.

This. This is why I'm sometimes reluctant to involve EMTs when I'm injured or unwell, because then I *know* a trip to the hospital's coming. They can't do much more than stabilize and transport.

I'm not saying an EMT presence is a bad idea, just that if you're hurt so badly you can't tell if it's a sprain or a break (I never see a doctor over a sprain) you're going to the ER anyway. Though possibly an on-site EMT could determine if you need an ambulance or are stable enough you can be taken by car.

[wooh]

I'll agree that it always makes sense for a follow-up. Where we seem to disagree is about the benefit of staffing an EMT at competitions.

Cost-Benefit.:) Where's the tipping point?:)

[DL]

I do however not think the organizers are going to do anything until it is either a rule from the NDCA, the hotel requirement, some government requirement or they get sued and learn from that experience. I am sorry but it is an expense, that I don't think, organizers would welcome. They would only do it if they absolutely had to.

Dancepro

I got curious about what this would cost. I tried a couple of city web sites and didn't find the service listed for public emergency services. I saw a posting from a college in the NE US with an event planning guide indicating a $25/hour (4-hour minimum) fee for "stand by" service from a particular private ambulance company. Cursory further research yielded other quotes up to $1k for a whole day. Generally the ambulance companies seem not to list their fees for this and say only that the service and its cost can be discussed on the phone.

Services on college campuses might be quite cheap indeed. In a big city for a major event, $1k seems a bit stiff but not outlandish.

I suspect prices may vary with type of service, too. I saw some service offerings for a stand by service that was not a guaranteed presence -- if somebody had an actual emergency elsewhere, the stand by EMTs might be dispatched from the event to go handle it. Dedicated service might cost more.

If event organizers were able to find an option on the $25/hour side of the spectrum, then IMO they would have no excuse not to take it.

I did not spend much time on this, nor make any phone calls to find out details. Does anybody have a firmer grasp on the actual costs?

[cantskiforlife]

Cost-Benefit.:) Where's the tipping point?:)

Do you include potential for lawsuit in the analysis?

[elisedance]

Cost-Benefit.:) Where's the tipping point?:)
...which is where I was at...
However, if dancesport really is a 'disaster in the making' consistent with some people's impression then I think the responsible thing is to have an expert at hand.

[wooh]

Do you include potential for lawsuit in the analysis?

Every entry form I've seen has the entrant sign a waiver. What are you going to sue for anyway? Treatment took 15-20 minutes for the EMTs to arrive instead of "immediate"? What are the damages there?

[Yippy4Skippy]

Another idea would be to utilize resident physicians in the area. Residents generally don't get paid much, (Believe me I know!) and they are often responsible for running codes, etc. in their day-to-day lives. As a family practice resident, I see a huge variety of medical problems. I run codes during most of my calls and I see other less serious injuries in the office all the time. I would love to work a comp just for the free admission! Just a thought...

[wooh]

...which is where I was at...
However, if dancesport really is a 'disaster in the making' consistent with some people's impression then I think the responsible thing is to have an expert at hand.

I've yet to see a "disaster" that's more likely at a comp than elsewhere that IMMEDIATE treatment rather than urgent treatment will make a difference. Make you feel warm and fuzzy and cared for? Maybe. But nothing that will change the outcome.

[DL]

Cost-Benefit.:) Where's the tipping point?:)

I also wonder whether the cost would need to be borne by the organizer.

Suppose I plan an event. Local ambulance service charges $500 for an emergency call and ER trip. Even at a high-end cost of $1,000, I hire them to be on site for a whole day.

Somebody at the event is injured. The on-site EMTs and ambulance make the ER run. Can I pass $500 to the injured person, who in turn would pass it to a health insurance provider?

[wooh]

I also wonder whether the cost would need to be borne by the organizer.

Suppose I plan an event. Local ambulance service charges $500 for an emergency call and ER trip. Even at a high-end cost of $1,000, I hire them to be on site for a whole day.

Somebody at the event is injured. The on-site EMTs and ambulance make the ER run. Can I pass $500 to the injured person, who in turn would pass it to a health insurance provider?

You gonna throw some powder in a corner of the floor at the end of the day if they haven't been used yet?;)

[elisedance]

Another idea would be to utilize resident physicians in the area. Residents generally don't get paid much, (Believe me I know!) and they are often responsible for running codes, etc. in their day-to-day lives. As a family practice resident, I see a huge variety of medical problems. I run codes during most of my calls and I see other less serious injuries in the office all the time. I would love to work a comp just for the free admission! Just a thought...

Its a great thought - but I'm afraid an insurance nightmare. I believe that residents are covered by a blanket hospital policy and not individually - thus, they can not practise off site.

[Yippy4Skippy]

Actually, you can work it out so that you'd be covered but it would just require some administrative work before the comp. It used to be a lot easier before they instituted the new moonlighting rules. (Our malpractice insurance used to cover us wherever we went.) It could still be done, just more paperwork.

[DL]

You gonna throw some powder in a corner of the floor at the end of the day if they haven't been used yet?;)

Well, the idea is that I wouldn't hire them in the first place if I didn't think they'd be used. Yes, somebody has to make a risk assessment and a judgment about a health care expense (whoa, there's fodder for a whole other thread). Also, I suspect that the numbers wouldn't work out quite so harshly.

In any case it seems reasonable that the beneficiaries of nontrivial emergency services -- and their insurance providers -- should bear similar cost whether or not I've arranged for the services to be on-hand.

[etp777]

A rather pertinent question would be whether anyone has ever known an organizer that was sued for an injury and not providing care at the comp?

[Another Elizabeth]

Do you include potential for lawsuit in the analysis?

You are far more likely to get a lawsuit if you provide the EMT and he screws up treating something (or even doesn't screw up, but there is an unavoidable bad outcome, or the competitor decides to try to keep dancing even if the EMT advises against it, etc.) than you are by not providing the service at all. Also, talking about saving the cost of the ambulance isn't really an incentive because the organizer does not pay that cost if they're not providing any service.

[Yippy4Skippy]

You are far more likely to get a lawsuit if you provide the EMT and he screws up treating something (or even doesn't screw up, but there is an unavoidable bad outcome, or the competitor decides to try to keep dancing even if the EMT advises against it, etc.) than you are by not providing the service at all. Also, talking about saving the cost of the ambulance isn't really an incentive because the organizer does not pay that cost if they're not providing any service.


It's likely in that situation that the EMT would bear the brunt of the lawsuit, (and a dancer that chose to keep dancing despite injury would have had to sign a waiver for refusing treatment.) The organizer would probably not be held liable because they do not have a legal duty to that patient as the EMT would, (one of the necessary elements in a successful malpractice case).

[waltzguy]

Perhaps a disclaimer has to be signed by all competitors saying you will not sue in the event of an accident or injury.

[Yippy4Skippy]

Perhaps a disclaimer has to be signed by all competitors saying you will not sue in the event of an accident or injury.

Do you think anyone would sign it?

[Larinda McRaven]

It is in your NDCA entry forms. Even if you don't sign it states that when you show up your release the organizer from liabilty.

The problem seems to be whether or not you are injured due to gross negligence on the part of the organizer. That is often why they refuse to acknowledge or try to fix slippery floors. If they acknowledge there is something wrong with the floor they acknowedge their responsibilty.

If you have a heart attack, well, thats your own doing.

[elisedance]

If it was on the entry form you would not have any choice. Besides, I think most people would sign, relying on their own insurance (assuming they have it that is of course).

[elisedance]

['Snap' larinda :)]

[etp777]

I'd say most people sign b ecause most people don't actually read what they sign. :)

[waltzguy]

I'd say most people sign b ecause most people don't actually read what they sign. :)

I'll sign that. :p

[waltzguy]

Do you think anyone would sign it?

Sure. Sign or don't enter the comp.

[wooh]

A rather pertinent question would be whether anyone has ever known an organizer that was SUCCESSFULLY sued for an injury and not providing care at the comp?

Fixed that for ya.:)

[etp777]

haha, true, true. :) Thanks wooh.

[wooh]

It's likely in that situation that the EMT would bear the brunt of the lawsuit, (and a dancer that chose to keep dancing despite injury would have had to sign a waiver for refusing treatment.) The organizer would probably not be held liable because they do not have a legal duty to that patient as the EMT would, (one of the necessary elements in a successful malpractice case).
Organizer has bigger pockets and hired the EMT, thus in my non-lawyer opinion theoretically making the organizer liable just like a hospital is liable for what its employees do. There's definitely some potential for legal risk there for the organizer, would need an actual attorney to tell us just how much. Might be negated if they went through and just had an ambulance hang around outside, which really wouldn't do much more than shorten response time and isn't the first-aid station some are wanting. Organizer would definitely want to consult an attorney to determine which has more liability potential.

[etp777]

I admit to having a pretty good knowledge of medicine, particularly emergency medicine, but will fall into camp giving all credit to EMts, and glad I'm not one. :) Had some good training from EMts, nurses and doctors, plus the training they gave us at ft benning, and still give huge amounts of credit to EMTs. That being said, still not sure it's a good idea for comp organizers to have an EMT on staff in this particujlar world

[cantskiforlife]

is the resistance primarily due to the risk of lawsuits? Sad world...

[etp777]

haven't seen a need for it at our comps cantski. plus tend to treat myself for most medical issues. But not at all saying you're wrong, hope you won't take my responses that way. Hate the letigious society we live in and definitely try not to give in to it though.

But I know worst I've seen was at last comp, and was just a bad cramp. mom actually helped the dancer, as she's been an RN longer than I've been alive. :)

[wooh]

For me, it's mainly because I like to focus on the ouctomes, and I just don't see it actually making a difference in outcomes.

[DL]

is the resistance primarily due to the risk of lawsuits? Sad world...

Well, if so, not only is it sad, but I don't get it. As you and I have each pointed out, non-dance events often have EMTs on hand. Is there anything inherently more palatable about the risks elsewhere, than in the world of dancing?

Incidentally, on the subject of waivers, I noticed both last year and this year that the EUSDC has a waiver on its entry form. In non-dance events, I have often found it to be standard practice to require a signature on an entry form waiver in addition to a general waiver signed to gain required membership in national governing bodies.

[tanya_the_dancer]

Do you think anyone would sign it?

You usually have a waiver like this for pretty much any physical activity. When we went on a 3-hour whitewater run, we had to sign a waiver, my gym contract has a waiver, when we were buying a lesson package from a studio, that contract had a waiver in it, too. Same for competition entry forms. If you don't sign it, you can't participate. Simple as that.

I wonder how that works for spectators though. They usually don't sign any forms, so if they get on the floor during general dancing and get hurt, then who's responsible?

[Laura]

If it was on the entry form you would not have any choice. Besides, I think most people would sign, relying on their own insurance (assuming they have it that is of course).
It is very often part of the entry form packet and I very often see it left unsigned. Heck, if people can't even find the right ticket order form don't even ask them to try to get the wavier signed and turned in. Which, it was pointed out to me by several people when I was dealing with them for Nationals in 2006, isn't worth the paper it's printed on anyway.

[Laura]

is the resistance primarily due to the risk of lawsuits? Sad world...
Unfortunately a lot of stuff in our society is messed up due to risk of lawsuits -- monkey bars removed from playgrounds, ski areas and swimming pools closed, lack of skateboarding parks, and so on.

[wooh]

Which, it was pointed out to me by several people when I was dealing with them for Nationals in 2006, isn't worth the paper it's printed on anyway.

True, much like the confidentiality warnings at the bottom of emails.:)

[Indiana_Jay]

I have to agree with Wooh's position here.

I'm a former EMT. I've been out of the EMS world for several years, but I doubt that much has changed since then.

I'm a social ballroom dancer. I've attended a few competitions as a spectator and as a volunteer, but never as a competitor.

One thing I note in this thread is an apparent confusion of the difference between first aid and pre-hospital emergency care. In my experience, the role of an EMT is pre-hospital emergency care. That's just what it sounds like -- care of people who have injuries and/or illnesses that can be classified as emergencies until they can be cared for at a hospital.

Wooh is correct when she says it is not within the domain of an EMT to diagnose whether an ankle injury is a strain, sprain or fracture. In fact, although some fractures are fairly obvious because of the deformity involved, other fractures can only be diagnosed with the aid of an X-ray. I never developed X-ray vision while I was an EMT!

It is generally not the role of an EMT to provide care for non-emergency injuries or illnesses that do not require hospital care. Many times during my career, friends and family have asked questions along the lines of "what would you do about condition X or Y." My answer was often, "I don't know. That's not the kind of thing for which you'd call an ambulance, so it's not in my training."

Wooh is also correct when she says the only reason to have an ambulance crew standing by at an event it to shorten the response time should someone at that event require pre-hospital emergency care. There are, of course, situations in which minutes can make the difference between life or death. These include cardiac arrest, difficulty breathing, stroke, loss of consciousness (primarily because it can be a sign of cardiac arrest and/or stroke) and uncontrolled severe bleeding (including internal bleeding resulting from trauma). Patients who have most other pre-hospital emergency injuries and illnesses will not be significantly affected by waiting for an ambulance to arrive from the nearest station.

So the risk/benefit question becomes, "Are the life threatening situations sufficiently more likely during a ballroom dance competition to justify having an ambulance (or EMT) on standby so as to shorten the response time should they occur?" I doubt the answer is affirmative.

This bring us to the issue of first aid. First aid can include putting an adhesive bandage on a small finger laceration and it can include administering CPR to a person in cardiac arrest. In my opinion, first aid is everyone's responsibility. If you don't know how to administer CPR or how to stop severe external bleeding by applying direct pressure, you are not fulfilling your responsibility as a citizen and should avail yourself of training provided to members of the general public by organizations like the American Red Cross. I believe first aid is called "first aid" because it is the aid we all are to provide to each other, first, before the "pros" arrive.

Toward that end, competitors should all travel with the first aid supplies they are most likely to need for themselves, including bandages, over-the-counter medicines, etc. I don't think competitors should expect competition organizers to provide anything more than prompt access to the local EMS. It is fair, however, to expect venues to provide automatic defibrillators.

Because first aid is not really the scope of the EMT and because one need not be an EMT to provide first aid, I agree that it is unreasonable to expect a competition to pay an EMT to be on site. Competition organizers might find, however, that their local American Red Cross chapter has the ability to set up on-site first aid stations at events and might be willing to do so during a competition, if the number of competitors and spectators present will be large enough. One might find, however, that such organizations reserve such service for huge outdoor events attended by 10 times the number of people present at even the largest ballroom competition. If so, that would be an indication of an evaluation of the risk/benefit issue.

One final thought. As an EMT, I have staffed first aid stations at air shows attended by thousands of people. The real reasons my team was there were to shorten the response time in the event of an aircraft incident (particularly one that injured spectators) and to gain practice in the deployment of human and physical resources in preparation for possible future disaster responses. We also, of course, were prepared to provide pre-hospital emergency care to spectators as needed until the local EMS could transport such patients to the nearest hospital.

What was interesting was the expectations of the spectators. Countless times, people came in asking for things like aspirin (sorry, we don't have any, as common headaches are not pre-hospital emergencies) (Note: Since then ambulances have, in fact, starting carrying aspirin, but not for headaches. It's used as a blood thinner in heart cases), and sunscreen (not a treatment supply the average ambulance carries). What these people really wanted was a pharmacy, not EMS. We were not equipped to compensate for their own poor planning (especially with regard to the sunscreen).

I suspect that if a competition opens a first aid station, those present will have similar expectations, in addition to services one should only reasonably expect from an athletic trainer ("Can you wrap my ankle for me?")

Which brings me back to my main point: Bring your own stuff. If your illness or injury is too great for what you can bring, patronize the nearest pharmacy. If it's too great for that, patronize the nearest urgent care clinic. If you have pre-hospital emergency, access the local EMS. That should be sufficient.

[etp777]

"Pre hospital emergency care"

Heh, have my pre hospital trauma life support book upstairs. feel like eI should review that before next comp. :)

[wooh]

Thanks IJ. The "expectations" part especially, as I remember in a previous thread, that's really what a lot of people wanted, was someone to help with the injuries they came TO the comp with.:)

[Larinda McRaven]

Thank you.

[SDsalsaguy]

Some excellent information there IJ, thanks.

[etp777]

Err, yeah, and after my poiintless comment, thanks for a great, and detailed, rundown of the subject IJ. :)

[elisedance]

IJ and Wooh - thats whats great about DF, there seems to be an expert on everything :) thanks...

I have a comp this weekend, and I will definitely take some first aid supplies. Maybe we should have a list of what.

Of course that raises another problem - what if someone else is injured and you have a first aid bag, can you help without also running into liability issues? I mean is a good samaritan a potential law suit victim?

[Indiana_Jay]

... what if someone else is injured and you have a first aid bag, can you help without also running into liability issues? I mean is a good samaritan a potential law suit victim?

It is an unfortunate truth that (at least here in the United States) anyone can sue anyone anytime for anything. A court might dismiss a frivolous lawsuit quickly, but the defendant might still incur expenses associated with hiring a defense lawyer to file a motion for dismissal.

As to whether there's any protection for a "good Samaritan" who provides first aid to another person, many states have laws that would protect such a person from losing a lawsuit (as long as the care provided was not grossly inappropriate in some way). But the law is different in each state, so YMMV.

-IJ

[Joe]

In my opinion, the job of the EMT is to stabilize the patient so they can be transported to the ER, hence the "E" part of EMT.

is the resistance primarily due to the risk of lawsuits? Sad world...
Where have you been for the last 20 years?

[Indiana_Jay]

As to weather there's any protection...


I just hate coming back later to find typos in my messages, but too late to fix them! :(

[dancepro]

IJ and Wooh - thats whats great about DF, there seems to be an expert on everything :) thanks...

Of course that raises another problem - what if someone else is injured and you have a first aid bag, can you help without also running into liability issues? I mean is a good samaritan a potential law suit victim?


Thank you to both wooh and ij for all your great information.

When I had my "big" injured (knocked unconscious) I sure appreciated the help I got from some "good Samaritan", actually one of them was a doctor. I had a concussion and was told to pull out of the competition, which I did as I saw their expertise to be greater then mine on that subject.

It is sad that we are in a society where you can loose your shirt for helping others in need. Oh well, that is just the way it is.

Once again, thank you to both wooh and ij.:) It is great to have people like yourselves here on DF to help us that just don't know.

Dancepro

[Larinda McRaven]

I just hate coming back later to find typos in my messages, but too late to fix them! :(

taadaa!

[Indiana_Jay]

taadaa!

:) What a doll!

[cornutt]

So the risk/benefit question becomes, "Are the life threatening situations sufficiently more likely during a ballroom dance competition to justify having an ambulance (or EMT) on standby so as to shorten the response time should they occur?" I doubt the answer is affirmative.


This is a good point too. Ambulances and EMT crews are on station at auto races because there are non-trivial odds of a participant suffering a serious injury. (Here, "non-trivial" is defined as meaningfully higher odds as opposed to, say, walking around town.) Is that true of dance competitions? I doubt it.

I do think that venues ought to have an AED handy, but not because it's a dance competition specifically, but because I think every public building should have one. I've been trying to get one put in at work.

[Indiana_Jay]

I do think that venues ought to have an AED handy, but not because it's a dance competition specifically, but because I think every public building should have one.

My point, exactly. There's not much a competition organizer can do about this, except to choose only venues that are so equipped.

[DL]

Here's a question: "When serious injury occurs at a comp with no EMTs on hand, what level of disruption to the event does it typically cause?"

My thinking is that having pros on hand to deal with injuries immediately would cut down on delays, distraction, and, bluntly, gawking/rubbernecking.

[tanya_the_dancer]

Nothing will cut down on rubbernecking. That's human nature. :)

[elisedance]

Hey: a fatal heart attack in the middle of a high kick in foxtrot - that would be the perfect and poetic way 'out'.

If anyone makes that a non-fatal don't expect a thankyou...

[cantskiforlife]

Just thought I would post an update....

Boston University did have an EMT stationed at the event this year. The woman had a decent amount of stuff with her including a wheelchair that she was using to transport stuff. She was clearly bored out of her mind but it was nice to see her there, especially considering how slick the floor was...

[PretzelsAndBeer]

At last year's Twin Cities Open, one poor woman had a heart attack. She was a spectator, but a member of the studio I dance at and friends with many of us. My teacher was on the scene and, quick thinker that she is, grabbed one of her other students who happens to be a surgeon. He did CPR with the assistence of another dancer who was a nurse. The paramedics came with an ambulence and, long story short, she was fine and back at the studio a few weeks later.

Strange thing, apparently there wasn't an external defibrillator anywhere in that hotel. She was pretty lucky a doctor was standing literally fifteen feet away.

Actually, competitions seem to draw a pretty educated crowd so it's likely that there would have been a doctor or a nurse or someone with first aid experience somewhere nearby.

[Indiana_Jay]

At last year's Twin Cities Open, one poor woman had a heart attack. She was a spectator, but a member of the studio I dance at and friends with many of us. My teacher was on the scene and, quick thinker that she is, grabbed one of her other students who happens to be a surgeon. He did CPR with the assistence of another dancer who was a nurse.

<soapbox>
P&B's story provides an opportunity for me to again campaign for the concept of everyone, even you, learning CPR. This important life-saving technique is not just for physicians and nurses (although they have no choice about learning it). I consider knowing CPR and basic first aid and using them when needed to be a citizenship issue. Let's all be good citizens and take a few hours out of our dancing to learn them!

Further, when possible, let's all encourage competition organizers to book only venues equipped with automatic defibrillators. There's no excuse for any place that often hosts crowds to not have one!
</soapbox>

-IJ

[3wishes]

Here's also another suggestion, as I've experienced that golden opportunity to administer CPR to a person (a toddler) and yes he did fine by the time the paramedics arrived. Many of the "bigger" hotels have a doctor on staff or on-call. Contact the hotel where the event is being held and see what the cost of the doctor would be to attend or at least be on the premise of the venue during. Some will actually barter for entertainment tickets to bring their significant others or family to watch. I'm all for - having medical services available during these competitions. Even the most basic.

[tanya_the_dancer]

Just thought I would post an update....

Boston University did have an EMT stationed at the event this year. The woman had a decent amount of stuff with her including a wheelchair that she was using to transport stuff. She was clearly bored out of her mind but it was nice to see her there, especially considering how slick the floor was...

I think a university is in better position to provide that, considering all the campus infrastructure they have.

[elisedance]

There were two EMTs at the Ontario Closed today...