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   S.E.R.I.O.U.S. method for dealing with Injuries.
continued.............
  

Evaluate? (Evaluate each injury situation as it arises. Does play need to be stopped?)

The Referee will need to quickly evaluate each injury situation as it arises. Initial evaluation can sometimes be done from a distance, but on other occasions, the Referee will need to evaluate the seriousness of an injury from close quarters. Whether to stop play or not, depends on a number of factors which will need to be taken into consideration. Some of these are listed below:
 
  • The first consideration as mentioned above, is for the Referee to evaluate whether the injury is serious or not, and to subsequently decide if play should be stopped or not.
  • Is the injured player in the way of ensuing play, which constitutes a further danger to himself or to other players; or is he in a safe location that does not involve the development of the current phase of play?
  • Is the injury to a goalkeeper?
  • Is blood leakage involved?
  • Does it look like one of the teams are about to kick the ball out of play to allow the injury to be dealt with?
  • In general terms for non-serious injuries, the Referee should encourage play to continue. The decision for stopping play or not, is for the Referee to make in accordance with Law 5.
  • If a team purposefully kicks the ball out to allow treatment, then the Referee should be sympathetic to the gesture. Nevertheless, problems have occurred, when following the restart, the ball is not returned to the team who kicked it out of play. The Referee must therefore be vigilant and deal with the restart assertively, to ensure that the players do not abuse ‘The Spirit of this Gesture’.
  • Does the injury involve a young child?
  • Is the injury being simulated?
  • Is the injury likely to result in retaliation?
  • Does it look like the player may make a quick recovery?
  • Has the player lain himself down on the ground, thereby indicating that he requires treatment?
  • Has the manager instructed the player to drop to the ground?
  • Is there an element of time wasting involved? There are occasions when the Referee stops a game in order that an injured player might be attended to, and the player will not be as seriously injured as first thought. In fact, at the first squirt of magic water, the player is ready to play on. If players are wasting time, the Referee will need to deal with this in accordance with the Laws.
  • Is the tempo of the game such, that a forced stoppage by the Referee will provide an opportunity that allows tempers to cool?
  • Does the injury occur just as a goal scoring opportunity is developing?
  • Does the injury involve the need for disciplinary action to be taken?
  •  Can the injured player make his own way off the field to receive treatment? (Including being near enough to the touchline/goal line to roll himself off).
  • Will the weather have an adverse effect, if treatment is delayed?
  •  Does the injury involve a vulnerable player? For example, someone who suffers from asthma or is recovering from a previous injury. 

If the player is only slightly injured.

 

  • If the player is only slightly injured (for example, a thigh strain or cramp), the Referee will need to decide if play can be allowed to continue until a natural stoppage.
  • The Referee should allow play to continue until the ball naturally goes out of play if a player is, in his opinion, only slightly injured.
  • On some occasions, the ball may be purposefully kicked out of play by a sympathetic player, thus allowing the Referee to temporarily suspend the game to allow the injury situation to be dealt with.
  • If an injured player is able to safely leave the field of play without help, then he should be encouraged to do so. 
  • If the player is bleeding slightly, the Referee can instruct the player to leave the field of play. The player may only return when authorised by the Referee who must check that bleeding has stopped and is suitably covered. The Fourth Official or an Assistant Referee may assist the Referee in checking the player, before they return to the field of play. 
  • A player cannot wear clothing with blood on it, or clothing that has been contaminated with blood.
  • Players uniforms contaminated with blood should be changed. They should NOT be rinsed out and re-worn. Referees should never allow the player back onto the field without a clean jersey, shorts, shoes, etc., whatever has had the blood on it. 

  
Race. (Sprinting to the scene of the injury).

  • When a natural stoppage in play occurs (or if play has been subsequently stopped for a serious injury) the Referee should RACE towards the injured player.
  • A Referee who ambles towards an injury location, emits a signal that says, "I don't care for the well-being" of the players under my charge today", whereas a Referee who RACES towards the scene, shows that he is genuinely concerned, and eager to seek medical help if required.
  • Prior to summoning on the trainers/medical staff, the Referee needs to make an initial assessment before he can get to the scene. Does the injured player immediately require the trainer/medical staff assistance?
  • If the Referee is some distance away from the scene, he should look out for the body language of any players near the scene. Any signs of distress from them should be used as a trigger to seeking help immediately.
  • For non-serious injuries, whilst RACING towards the injured player, the Referee should use an outstretched palm to delay the entry of any over-eager trainers/medical staff. This is important, for as soon as the Referee has authorised the trainers/medical staff to enter the field, the player must leave the field whether he has received treatment on the field or not. In other words, the player should at least be evaluated by the Referee, and given the option by the Referee to request help from the trainer/medical staff if required.
  • When young children are involved, parents very often rush onto the field of play when their child gets injured. The Referee must be sympathetic to the parent's concerns, and manage each circumstance carefully (without antagonising the situation). In these situations, it's more a case of educating the parents, rather than strictly adhering to the duties and responsibilities as laid out in the Laws.


  
Inspect. (Taking up a position that allows inspection of the injury and monitoring the remaining players).

Inspecting and assessing the injury:

 

  • On arrival at the injury scene, and after correctly positioning himself, the Referee should ask the injured player if he requires a trainer/medical staff; using words to the effect of, "Do you want your trainer". 
  • The Referee should not say, "Do you require treatment?" Otherwise the player will assume that the Referee will allow treatment on the field of play.
  • If on arrival at the scene, it is apparent that the player is in obvious need of prompt medical assistance, the Referee should summon aid immediately (there is no need to ask a severely distressed player if he needs treatment).
  • After questioning the injured player, the Referee authorises one, or at most two trainers/medical staff, to enter the field to ascertain the type of injury and to arrange the player’s safe and swift removal from the field by the shortest route or by stretcher or by walking.
  • Important Note: It is imperative, that the Referee does not make the decision to remove a player with a serious injury from the field of play, or to make a decision to call for a stretcher to be provided.  The Referee must first seek this advice and authority for removal from the trainer/medical staff. He can do this by engaging with the trainer/medical staff by asking them if it is possible to remove the player without incurring further injury or distress. Once this has been achieved, the Referee can summon a stretcher. If a Referee calls for the stretcher, or insists that a player be removed without recourse to the trainer/medical staff, it could have dire consequences for the Referee, if the injury involves damage to the spine, head or is a serious fracture (and the hasty removal on the Referee's sole authority causes further trauma to the injured player).
  • The bottom line is, that when a serious injury is suspected, the Referee MUST seek advice from the trainer/medical staff before sanctioning the removal of an injured player.


Organise.  (Taking charge, positioning and seeking medical assistance if it is required).

  • When the Referee arrives at the scene, he should position himself such that he can still keep an eye on the rest of the players. In other words, the Referee should not place his back to the rest of the players when he is dealing with the injury. This is the most common fault when Referees deal with an injury situation. 
  • In moments of tension, the Referee should also position himself so that he can monitor the technical area occupants.  This is doubly important if the injury location is near to the technical areas.
  • The Referee should position himself near the injury location, so that he has the majority of the rest of the players, in front of him.
  • When it is safe to do so, the emphasis should always be on the injured players receiving treatment after they have left the field of play, rather than whilst they are on it.
  • Whist an injured player is being assessed, or receiving any immediately required emergency treatment, the Referee should stand a couple of paces back from the scene, in a position so that he can communicate clearly with the participants, and in such a way that you can also keep an eye on the rest of the players whilst overseeing the assessment of the injury. 
  • The Referee should allow the trainer/medical staff a reasonable amount of time to make a diagnosis/verification of the injury, but they must be reminded that no (non-emergency) treatment is allowed on the field of play.
  • When an injury occurs, tempers can be at a heightened state. The Referee should allow a reasonable space between himself and the medical staff. Close attendance by the Referee may on some occasions, inflame tempers.
  • Whilst monitoring the injury assessment, the Referee may also have to simultaneously deal with indiscipline. The priority must always be in seeking help for the injured player. Once this has been achieved, the Referee can deal with any misconduct.
  • Some trainers/medical staff when dealing with an injured player cannot refrain from berating the Referee. The Referee must allow the injured player to be sorted out, before taking any action against misbehaving trainers/medical staff.


 

Usher. (Overseeing the safe removal of injured players). 

 

  • If the player does not require treatment, and is able to walk to the touchline unaided, the Referee should encourage the player do so by the shortest route. In such cases, the Referee should provide a signal towards the trainer/medical staff, to indicate that their medical assistance on the field of play is not required on this occasion.
  • If an injured player is able to remove himself from the field of play, the Referee should prevent any trainers/medical staff from rushing across the field of play, rather than making their way around the boundaries to reach the injured player as play resumes.
  • If the player is unable to make his way to the touchline unaided, or if he requires a trainer's presence, the Referee should signal for help with a clear one arm-beckoning wave, vocal instructions and if necessary, use of the whistle to attract attention.
  • Once the (one or two permitted) medical staff have arrived, the Referee should allow a reasonable amount of time for them to assess the extent of the injury. 
  • If the injured player does not require a trainer/medical staff, and intends to remain on the field of play to recover, the Referee should allow a reasonable amount of time for recovery, prior to recommencing the game.
  • If the Referee is advised by a Doctor or other medically qualified person that a player's injury is so bad, that it would be harmful for that player to continue playing, the Referee should ask the Doctor (or other medically qualified person) to decide whether the player can be moved or not, or whether the player is able to leave the field of play.
  • If the trainer/medical staff considers that the player cannot walk off, they will advise the Referee, who will use the two-handed signal for a stretcher. A seriously injured player should only be moved from the field of play on the trainer/medical staff's authority. A Referee is not medically qualified to make this decision.
  • Referees MUST stay with the injured player to ensure whatever action is required is completed as quickly possible and that the trainers/medical staff leave the field as quickly as possible, taking the shortest practical direction from the field even if this is in the opposite direction to the technical area.

 


  
Start.  (Starting the game again after the injury has been seen to).
  • Play can be restarted once the injured player and any trainer/medical staff have completely left the field of play.
  • The Referee can use a combination of arm and vocal communications, to signal to the injured player that he can re-enter the field of play.
  • An injured player may only return to the field of play after the match has started
  • An injured player may only re-enter the field from the touchline when the ball is in play.
  • When the ball is out of play, the injured player may re-enter from any of the boundary lines.
  • If play has not otherwise been stopped for another reason, or if an injury suffered by a player is not the result of a breach of the Laws of the Game, the Referee restarts play with a dropped ball
  • The Referee alone (or if nominated, the Assistant Referee or Fourth Official) is authorised to allow an injured player to re-enter the field whether the ball is in play or not.
  • When play has been restarted, the Referee must be very careful when he allows the injured player to return onto the field of play. The Referee should wait until the play action is away from the vicinity of the waiting player before signalling him to enter.  The oncoming player should not become immediately involved in active play, as this may generate problems.
  • The Referee (or if nominated, the Assistant Referee or Fourth Official) must check that any bleeding players have been treated properly before they are allowed to enter the field of play. A player cannot wear clothing with blood on it, and players uniforms contaminated with blood should be changed. The player's equipment should NOT be rinsed out and re-worn.
  • The Referee should always read the Competition Rules. In some competitions, the Rules forbid the Referee from adding on time at the end of either half of the game for injuries or any other cause because of the tight schedule of games being played on many grounds.
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