Matching the density of the rugby playing population to the medical services available in the Eastern Cape, South Africa
Master Thesis
2017
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University of Cape Town
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Abstract
Background: Rugby Union is a popular contact sport played worldwide. The physical demands of the game are characterized by short duration, high intensity bouts of activity, with collisions between players, often while running fast. The head, neck, upper limb and lower limb are common sites for injury. Although catastrophic injuries are rare in rugby, they do occur. Immediate action (4-hour window) must occur after the injury to minimise the damage incurred from a catastrophic injury. This infers that a well-functioning medical infrastructure should be available to anticipate injuries of this nature and provide treatment for the best possible outcome. Currently there is no system information/map in South Africa describing the medical infrastructure in relation to places where clubs and schools practice and play matches. Such a system may assist providing early and immediate transfer of injured players to the appropriate treatment facility. This would minimise the damaging effects caused by delays in medical treatment. Therefore the aim of this study was to; (i) investigate and report on the location, distance and travel time from rugby playing/training venues in the Eastern Cape to the nearest specialist hospital where a player may be able to receive adequate treatment for a catastrophic injury, and ii) report on safety equipment available at these playing venues to facilitate this transport in a safe manner. Methods: All the clubs (n=403) and schools (n =264) that played rugby in the Eastern Cape were accounted for in the study. However, only 15 clubs and 35 schools were included in the analysis as they had their own facilities for training and playing matches. Distances between clubs/schools and the nearest public, private and specialized hospital (able to treat catastrophic injuries) were measured. In addition driving time was also estimated between the clubs/schools and nearest specialized hospital to determine if an injured player could be transported within four hours to receive medical treatment for a catastrophic injury. In addition medical safety equipment was audited (according to information provided by SA RUGBY)) for each club and school to identify if they were meeting the minimum safety standards as set by SA RUGBY. Results: Twenty schools were identified as being less than one hour away from the nearest hospital equipped to deal with catastrophic rugby injuries; nine schools were between 1-2 hours away and six schools were between 2-3 hours away. All schools were within 100 km driving distance of the nearest public hospital; 28 schools were within 100km driving distance to the nearest private hospital. For seven schools, the nearest private hospital was between 100 and 150 km away. Fourteen schools had spinal boards, eleven had neck braces, ten had harnesses, nine had change rooms, five had floodlights, and twenty-two had trained first aiders. Six schools were located 2-3 hours away and were at higher risk due to a lack of first aid equipment. Ten clubs were less than an hour away from the nearest hospital equipped to treat catastrophic injuries; two clubs were between 1-2 hours away, two were between 2-3 hours away and one was between 3-4 hours away. All clubs were within 100 km driving distance of the nearest public hospital. Nine clubs were within 100km driving distance to the nearest private hospital, three clubs were based between 100 and 150 km from the nearest private hospital and three were based over 150km away from the nearest private hospital. Twelve clubs had a spinal board, eleven clubs had neck braces, ten clubs had harnesses, ten clubs had change rooms, seven clubs had floodlights and twelve clubs had first aid trainers. One club was classified as high risk as it was located 2-3 hours away from the nearest hospital equipped to manage a catastrophic injury and had no first aid equipment. Discussion/Conclusion: No clubs or schools included in the study were more than four hours away from a hospital that was equipped to deal with a catastrophic rugby injury. Therefore, any player who suffers a catastrophic injury should be able to get to treatment within the 4-hour window period. Another finding was that not all clubs or schools possessed the minimum equipment required to host training or a rugby match. SA RUGBY can take appropriate action towards these clubs and schools to ensure that they maintain the safest possible practice to not put their own players at increased risk.
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Reference:
Moore, S. 2017. Matching the density of the rugby playing population to the medical services available in the Eastern Cape, South Africa. University of Cape Town.