An article for those involved in sport at grassroots level. 

Head injuries (particularly concussion) continue to be a major talking point at all levels of medical care in sport.


But how can we expect head injuries to be taken seriously or fully understood in professional sport, when most people at grassroots don't know the basic considerations?


It seems coaches, parents, players, managers (and some first aiders!) think head injuries are an area that only medical professionals need to worry about.


But a small amount of basic knowledge and understanding can help us all deal with head injuries.


Take a look at the recent picture below of James Milner clashing heads during a pre-season game v Napoli:



From a first aid perspective, think about which of the following you would be able to assess and manage:


1. Concussion or a serious head injury


Would you be able to assess for signs of concussion?


Could you assess for signs of other types of head injury like a fractured skull or compression?


Would you know when to remove the player and when to let them carry on?


2. Unconscious casualty



If the casualty collapsed and became unconscious, how would you manage them?


Should you move the casualty?


When would you consider calling 999?


3. Open wound



If the player has an open wound, could you control the bleeding?


Should the player carry on?


Are you prepared for the potential risk of infection to both you and the player?


If player welfare really is the number one priority, coaches, players, officials, parents and players should all be able to answer the above questions as a minimum.

Just this week, Newport County manager Mike Flynn questioned the reasoning behind an enforced extended period of rest for Antoine Semenyo following a concussion against Oxford United. As Semenyo is under 19, the F.A's rules dictate an additional 6 days' recovery. Rather than publicly suggest this is unnecessary and potentially undermine the ruling, it would be more helpful for Flynn to find out why this is the case.


Increased awareness and understanding of head injuries at grassroots football would only serve to help medical professionals and player welfare at all levels.


Click here for further information about Lubas Medical First Aid for Sport & Exercise (FASE) courses,



*We are currently offering a discount if you purchase a 'Wound Management Kit' in conjunction with any Wound Management & Suturing course, you will get them both at the discounted price of £387+VAT* 

Normal cost of Wound Management kit = £198+VAT

Normal cost of Wound Management Course = £231+VAT

Normal Combined Price = £429+VAT

Special Offer: £387 +VAT 

*We are also offering a discount of the total price if you book onto the Sports trauma management on the 26/10/18 and Wound Management & Suturing on the 28/10/18 both of which are held at our premises in Cardiff.*

Normal Cost of Sports Trauma Management course = £363 + VAT

Normal cost of Wound Management Course = £231+VAT

Normal Combined Price = £594+VAT

Special Offer = £537+VAT 

**Please can contact the office if you wish to book any of these offers**  


Kit Content


The kit includes;

·        3 x Suture removal kit

·        2 x Staple gun + remover

·        2 x Small/medium/large latex medical gloves

·        2 x Anchored skin closure kit

·        2 x Topical skin adhesive 0.5 g

·        3 x Standard suture pack (containing; 1 x Treves forceps 13cm, 1 x Iris stitch scissors 11.5 cm, 1 x Kilner needle holder cm, 1 x T.O.E dissecting forceps 13 cm)

·       1 x 20 ml Normal Saline solution

·       1 x Sharps box

·       1 x Clinical waste bag

·       3 x 18 mm Sutures

·       3 x 27 mm Sutures

·       A training kit to practice your suturing skills. (contains; 2 x 4-0 18mm sutures, 1 x 3-0 27 mm suture, Soft leather sponge.)

     The training kit also includes a fine suturing pack plus containing; 1 x Kilner holder 14cm, 1 Iris stitch scissors 11.5cm, 1 x Toothed forceps 10 cm, 1 x Iris Non-toothed forceps 10cm, 1 x Crepe sterile paper, 1 x Tray with 2 integral pots, 2 x Dressing towels 43cm x 38 cm, 5 x Swabs 4 ply 7.5cmx7.5cm.



Are you a medical professional looking to update your suturing skills or perhaps learn a new skill altogether? Why not attend one of our wound management course’s, follow the link to visit the website or call the office on 02921 304 101.


What is CPR? (FAQS)

Posted by chris



What is CPR?

CPR (Cardio Pulmonary Resuscitation) is an emergency life saving procedure that is carried out when somebody is in cardiac or respiratory arrest. We combine rescue breaths and chest compressions to try and circulate oxygen around a casualty’s body to the major organs in preparation for defibrillation.

What is a cardiac arrest?

Cardiac – relating to the heart. Arrest – To stop.

Cardiac arrest is when the heart stops pumping blood (and therefor oxygen) around the body. This is often caused by an electrical or mechanical malfunction of the heart, an underlying heart condition, or following a medical emergency. During cardiac arrest, the vital organs are starved of oxygen and the casualty becomes unconscious and stops breathing.

Is a heart attack the same as cardiac arrest?

No. A heart attack is caused by a blockage in the arteries supplying blood and oxygen to the heart tissue. As the heart is a muscle, it requires oxygen to function correctly. If untreated, this can develop into a cardiac arrest as outlined above. Therefore, a heart attack could be the cause of a cardiac arrest

How effective is CPR at restarting the heart?

A common misconception is that CPR is designed to “re-start” the casualty’s heart. CPR is effective in circulating blood and oxygen to the vital organs until a defibrillator becomes available to shock the casualty (and theoretically restart the heart). Effective CPR within the first few minutes of cardiac arrest can more than double the chances of survival.

What is a ‘defibrillator’?

A defibrillator (or AED, which stands for Automated External Defibrillator) is a device that can deliver an electric shock to the heart of a casualty in cardiac arrest. The shock provides enough electricity to help “re-start” the heart under the right circumstances.

AED’s assess the casualties heart rhythm and “decide” if a shock is required. This makes them very safe and simple pieces of equipment for bystanders to use.


Can I use a defibrillator?

The simple answer is yes. Though it is highly preferred and recommended you have training before using a defibrillator, it isn’t a requirement. A defibrillator is a vital piece of life saving equipment that can be used by any bystander during cardiac arrest.

Defibrillators are becoming much more common in public places like supermarkets, train stations, public gyms, airports etc. These are referred to as PAD’s (Public Access Defibrillators). They are very effective at guiding the operator through the process of potentially shocking a casualty and will not allow you to shock someone who doesn’t need it.

There is no reason to be afraid to use a defibrillator if you suspect a casualty is in cardiac arrest.

Is CPR effective without mouth to mouth or rescue breaths?

Chest compressions combined with rescue breaths is still the recommended and most effective form of CPR.

However, if you have reason not to give mouth to mouth/rescue breaths e.g. the casualty has blood or vomit around their mouth, or you don’t know the casualty and are unsure as to the risks of infection, “hands-only” CPR is an acceptable alternative.

In casualty’s that have suffered cardiac arrest through a lack of oxygen (caused by drowning, asthma, anaphylaxis or in most children), “hands only” CPR is much less effective.

Chest compression's without rescue breaths are always still more effective than doing nothing at all!

How do I know if someone is in cardiac arrest?

Without an appropriate supply of blood & oxygen, the brain cannot function and shuts down. During cardiac arrest, the lack of oxygen to the brain will cause the casualty to become unresponsive or unconscious.

The casualty may make noisy, infrequent gasps or may show no signs of breathing. This is not normal breathing and would indicate the casualty is in cardiac arrest.

If the casualty is unconscious and has stopped breathing normally, they are in cardiac arrest. Call 999 and start CPR!

Will the casualty survive a cardiac arrest?

In the UK, fewer than 10% of people that suffer cardiac arrest, with an attempt of CPR outside of hospital, survive.

Where a cardiac arrest is recognised immediately, CPR is performed, and a defibrillator is used prior to medical professionals (Paramedics) arriving, survival rates of higher than 50% have been reported. This really highlights the importance of the recognition of signs and symptoms and importance of immediate CPR and defibrillation.

Can you be sued for doing CPR?

Nobody in the UK has ever been sued for attempting CPR. In 2015, the government introduced the ‘Social Action, Responsibility and Heroism (SARAH)’ act to protect those performing “acts of heroism”.

The link to this law is as follows:

Is adult CPR different from child CPR?

The ratio of compressions to rescue breaths in children is the same as the adult sequence, however, there are some modifications that make it more appropriate for children as follows:

·         Begin with 5 rescue breaths before the first 30 compressions.

·         Use one hand for compressions (or 2 if you find it difficult to compress with one hand) as children are smaller than adults.

·         Use two fingers to compress the chest of a baby (under the age of 1).

It is important to know that these modifications are not essential, and it is far more important that some form of CPR is given rather than nothing at all. There is a general fear that the “wrong” form of CPR given in children could make the situation worse. This is not the case and any attempts at CPR will have more benefit that doing nothing.

How effective is CPR at restarting the heart?

A common misconception is that CPR is designed to “re-start” the casualty’s heart. CPR is effective in circulating blood and oxygen to the vital organs until a defibrillator becomes available to shock the casualty (and theoretically restart the heart). Effective CPR within the first few minutes of cardiac arrest can more than double the chances of survival.


Combat Concussion


Whilst working as a medic covering a Taekwondo tournament in December 2017 I dealt with an incident of concussion. The competitor returned this year and I caught up with her to find out what happened after the event. I was not expecting the story that followed.

Carla, a black belt in Taekwondo, was competing in a sparring contest. She was wearing the appropriate safety equipment including head guard and gloves.

I became concerned about the competitor after she received a blow to her head. She became unsteady on her feet and so the bout was stopped. I removed her from the ring, and she began to complain of nausea and photosensitivity. We moved to a quieter area as the noise levels were beginning to become a problem for her. Following a full assessment my immediate impression was that she was concussed and should not continue in the tournament. 

The assessment revealed that it was difficult for her to answer certain questions. She answered Maddocks questions with no problems, it was when I began filling in her details on my treatment record that she struggled. She was unable to recall her phone number and revealed that she hadn’t been able to remember things for a few days after hitting her head on a concrete archway in a friend’s house.

She began to drop her level of consciousness and I became increasingly concerned, especially as this was her second head injury in the space of a week. Although haemodynamically stable I felt her dropping level of consciousness, nausea and photosensitivity meant I needed to refer Carla to a Doctor as a matter of urgency. I was concerned that this could be a serious head injury, possibly an intracranial bleed. I called 999 and unusually a doctor, nurse and paramedic were on the ambulance that was sent. 

A concussion was diagnosed by the doctor, with the advice to see her own GP on her return to Devon. She left Cardiff that evening with somebody keeping a close eye on her during the long car journey home.

I contacted her in the days following and she said she was feeling tired but generally better. When I caught up with her she told me of her difficult year since.

It was a few weeks after the initial diagnosis of concussion that her symptoms began to worsen. Whilst attending another Taekwondo tournament, as an observer, her friends became concerned when she became vacant and began slurring her words. They quickly took her to hospital.

Numerous scans were performed and thankfully there was no evidence of a life threatening bleed. Following a detailed examination of Carla and her ongoing symptoms a diagnosis of post-concussion syndrome was made. She continued to experience impaired vision finding herself unable to focus for any length of time. 

The extreme tiredness that she encountered restricted her everyday life including her ability to return to work. Concentrating for any length of time lead to exhaustion, even the simplest tasks became difficult. The making of simple decisions such as what to eat for tea were now a challenge. Reading and listening to music became impossible. It took four months before she was back at work as a classroom assistant. This was facilitated by her occupational health department who developed an activity/sleep schedule to aid her rehabilitation. 

Her mental health suffered, experiencing emotional discomfort the year since her injury. Thankfully she has been supported through this with counselling sessions and is now taking medication to ease her depression.

Although some symptoms remain, especially travel sickness and tiredness, things are improving and for the first time in over a year she has returned to exercise. Her involvement with Taekwondo continues, and whilst she has been advised not to spar again, working as an instructor Carla continues to inspire young people to take up the sport. 

When teaching on our First Aid for Sports and Exercise (FASE) and Sports Trauma Management Courses, we stress the importance of recognition and correct management of concussion.

Keeping up to date on any change in guidelines and published research allows us to keep our information current. Hearing directly from someone who has experienced a serious concussion has helped us to understand it’s long-term effects and the impact it can have. 

Kind thanks to Carla Dunne for allowing us to share her story.  

Hi guys, we'd just like to provide you with some links regarding current guidelines 2017.

Firstly this is the new SCAT5 assessment tool 2017;

Here is the child SCAT5 assessment tool 2017;

Also here is the consensus statement on concussion in sport from the Berlin conference november 2016;

We have updated our Sports trauma management course to comply with the latest guidelines. 

There has also been updates from the British Thoracic Society

Here are the all guidelines;

Here are the guidelines for emergency oxygen use in ambulances, community and preā€hospital settings;

We hope this has been useful for you and we're happy to answer any questions you may have regarding these guidelines.

All Lubas course's are up to date with all current guidelines at the time of the course. 

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