No point in chasing the impossible
in any event
The MDU recently conducted a survey and found that GPs attended a wide number of sporting events in a professional capacity as crowd doctors. The events were as diverse as strongman competitions, car rallying, scuba diving, pop concerts, Gaelic football, rugby football and horse racing.
The survey1 found the most common event for GPs to attend was rugby matches, with 30 per cent in attendance. This was followed by 25 per cent who attended soccer matches, 23 per cent who attended boxing bouts and 16 per cent who attended equestrian events. Clearly all these events involve an element of risk to the participants.
Any event that expects to attract a crowd of 2,000 or more should have a crowd doctor present, according to the Football
Licensing Authority's Guide to Safety at Sports Grounds and the Health and Safety Executive's Event Safety Guide, which provide guidance on the safety of spectators and medical provision. As
well as sporting events, doctors may also
be asked to attend other crowd events, such as concerts.
Being a doctor at a large event is an excellent way of using your professional skills and with the added bonus of a grandstand seat at the spectacle on offer.
But if you are planning to attend an event in your professional capacity you need to consider if you have the appropriate qualifications, skills, experience and support and to check your indemnity arrangements.
In the MDU's experience it is rare for a GP to receive a complaint or claim if it is thought that he or she did not deal properly with an injury to a spectator or participant. Some professional sports organisations provide indemnity for doctors attending events and you will need to check whether this applies.
If the event organiser will not provide indemnity, it is advisable to check your indemnity position with your medical defence organisation before undertaking any official duties as a crowd doctor to ensure you have appropriate cover. This type of activity is distinct from acting as a Good Samaritan.
In the event of a claim a court would consider a doctor's competence, specialty, training and relevant experience. The GP would need to be able to show the standard of care provided was that of a reasonably skilled and experienced practitioner professing to have that skill.
He or she needs to demonstrate that there is a reasonable body of medical opinion prepared to support his or her actions in a particular case.
Doctors may offer their services, either on a paid or voluntary basis. GPs who attend sporting events are expected to have appropriate qualifications, skills, experience, equipment and support as well as expertise in areas
like cardiopulmonary resuscitation, airway maintenance and spinal fracture immobilisation, and must be able to treat anaphylaxis.
Some doctors have also completed courses in advance trauma life support and paediatric life support, or have a diploma in immediate medical care. Some organisations, such as the Football Association, run specific training for crowd doctors.
Equipment levels and clinical protocols used should conform to guidelines published by the relevant professional and/or sporting body. Check with the specific sport or other governing body running the event about the level of qualifications you need.
Always allow time to check that equipment complies with current best practice guidance and that any drugs are properly stored and in-date.
Crowd doctors may be working by themselves, but for larger events they may often be part of a team including paramedics, St John's ambulance volunteers and stadium staff, for example.
If you are working as part of a team, communication is important. Make sure you discuss your responsibilities with colleagues, as well as how to obtain a second opinion. Arrangements for transfer to hospital and documentation of clinical involvement should be understood by everyone in the team in advance of the event.
Occasionally doctors may be attending an event as a spectator and be called on to help an injured person in an emergency. As a bystander any clinical assistance provided in an emergency, accident or disaster is referred to as a Good Samaritan act.
Doctors have an ethical duty, laid down by the GMC, to 'offer anyone at risk the assistance you could reasonably expect to provide' in an emergency, wherever it may arise. Faced with a call of 'is there a doctor at the event' you will need to do what you reasonably can given the injury, the equipment available (or even if there is no equipment) and your training.
Your help may be limited to ensuring
no one moves the injured person inappropriately.
If you do help out in such circumstances, make a clinical note as soon as you can and ensure the patient or those close to them are aware of your identity.
While it is very unusual for complaints or claims to result from Good Samaritan acts, it is a good idea to inform your medical defence organisation.