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Gymnastics Foam Pit Extraction:

Care of the Injured athlete

Safety equipment is designed to protect the athlete; however in some cases, it can become a hindrance

to providing care in the event an athlete is seriously injured. The gymnastics foam pit, which is designed to

provide a safe “crash landing spot” for athletes, can pose a significant challenge in providing prompt

emergency care. FOAM PIT ExTrAcTIOn - sPEcIAl nOTEs

1. A foam pit extraction is labor intensive, requiring a lot of manpower. The typical EMs ambulance has two medical professionals on board. To safely remove a pediatric athlete weighing approximately 60 pounds requires 5- 6 people. For a mature, collegiate athlete, 6-8 medical personnel are necessary for safe extraction. If there is a gymnastics foam pit extraction emergency, be sure to notify additional emergency units and get assistance.

2. The foam pit is deeper than it looks and may be over your head.

3. remove shoes and socks before entering the foam pit for increased maneuverability. The foam pit acts like quicksand and will pull at shoes making moving in the pit difficult, thus increasing unnecessary movement of the athlete.

4. A foam pit extraction is slow and time intensive. If there is immediate respiratory or cardiac compromise where life-saving interventions are

required, then rapid extraction by staff on hand while maintaining alignment as best as possible is recommended.

5. The more mature and developed the athlete, the deeper that athlete will land and be buried in the pit.

PHOTO 1: A gymnastics foam pit is a landing area filled with soft foam blocks that can be 10 feet wide x 20 feet long and can vary from 4-8 feet deep. Foam pits are surrounded by concrete walls with a trampoline style frame and suspension foundation; creating a “self-fluffing” mechanism. The soft foam blocks in combination with the trampoline creates a forgiving landing site, but also produces an unstable platform for medical personnel to access the athlete. Because of the trampoline foundation, any sudden movement by emergency medical personnel or staff entering the foam pit will transfer to the athlete.

PHOTO 2 & 2A: Due to the nature of the sport and

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the high level of acrobatic skill, gymnasts can land in a variety of positions; supine, prone, side-ways (twisting motions), or head down (due to under-rotation).

PHOTO 3: Using equipment available in the facility, such as landing mats (thicker mats provide more stability), the ATc or EMs personnel can safely contact the athlete. By placing the mat near the athlete’s head, the ATc needs to create a wide base of support to minimize movement and slowly crawl towards the athlete to access the cervical spine and provide stabilization. Foam blocks may be providing appropriate support, so they should not be moved until the ATc has assessed the cervical injury and block positioning.

PHOTO 4: Once the cervical spine is stabilized, additional ATc or EMs can slowly and very carefully enter the pit. Additional mats or a second spine board should be placed around the athlete to give the additional ATc and EMs a more stable surface from which to work. A minimal number of foam blocks should be adjusted. As more blocks are moved, even if only on the surface, the deeper the athlete will sink in the pit. Additionally, as more people enter the pit the trampoline foundation will be stretched and everyone will begin to sink.

PHOTO 5: The c-collar should be placed on the athlete before being moved onto the spine board. Foam blocks may be providing stabilization, so move, compress or adjust the minimal number of blocks possible. (next page)

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PHOTO 6: Once the c-collar is on and the ATc at the head is in position, the spine board can be brought into the pit and the area around the athlete can be prepared for the log roll. Foam blocks on the side opposite of the spine board will need to be leveled out to maintain spinal alignment during the log roll. Be sure to level the space the entire length of the spine board. DO nOT rEMOVE BlOcKs FrOM UnDErnEATH THE ATHlETE. This will cause the athlete to sink; so move as few foam blocks as possible. (nOTE: if the athlete is twisted and is partially buried, make sure all extremities are located, so the spine board does not cause further injury.)

PHOTO 7: At the head ATc’s count, the athlete will be log rolled and the spine board will be brought into position. Angle the spine board slightly and a large amount of force will be necessary to compress the foam blocks and get the spine board deep enough under the athlete. You cannot “come-up from underneath” the athlete like you would in a swimming pool, as the foam blocks are an obstruction.

PHOTO 8: To help maintain alignment, foam blocks can be used as stabilization devices. (next page) PHOTO 9 - 12: Once the athlete has been

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securely strapped onto the spine board, extraction from the pit can begin. Be sure to have an adequate number of people on the edge of the pit to pull the spine board onto a stable surface. lifting the spine board overhead is dangerous to both the athlete and medical personnel because of the unstable foundation. sliding the spine board on a mat to the edge and then lifted out onto a stable surface is effective.

PHOTO 13: ADDITIOnAl AccEss METHODs: cervical stabilization via ladder. The majority of fire trucks have a standard 16 foot ladder onboard. The ladder can be used to span the width/length of the pit and provide an initial stable surface to work from for the ATcs or EMs personnel. The ladder should be placed near the athlete’s head, so the cervical spine can be stabilized. Once the c-spine is stabilized and a c-collar is placed on the athlete and additional medical personnel enter the pit, the ladder should be removed. The athlete will begin to sink as people enter the pit. The person on the ladder stabilizing the head, can have a fall risk onto the injured athlete as their arm length has to compensate for the distance between the edge of the pit, the ladder height and how far the athlete sinks.

PHOTO 14 - 15: ADDITIOnAl AccEss METHODs: spine Board Extraction via ladder. In some cases where there are a limited number of medical personnel to assist with a pit extraction, a ladder can be of assistance to extract the athlete from the pit. Hoist the spine board onto the ladder and then slide it up or across the ladder onto a stable surface.

In cOnclUsIOn: A foam pit extraction is unlike any “athletic environment” that ATcs or EMs personnel encounter or are routinely trained on and practice. It is imperative to collaborate with local EMs as they will most likely be the first responders on-site to most gymnastic facilities; particularly outside of the collegiate level. It is important to practice

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different methods of extraction, direct entry into the pit, the use of different mats and the ladder, as each emergency situation will require thinking “outside of the box.” If you are an ATc working with gymnastics at any level, a gymnastics facility owner or gymnastics coach at the professional, collegiate, high school, or recreational club level, it is highly recommended to develop a Foam Pit Extraction Emergency Action Plan (EAP) to include all community Fire and rescue and EMs personnel who would be responding to a foam pit emergency.

special Thanks to: Gymnastics Inc, Myrtle Beach, South CarolinaJazmin Kimber, Level 7 Gymnast, Horry County Fire and Emergency Rescue Crews, South Carolina, The Certified Athletic Trainers with McLeod Regional Medical Center Sports Medicine: Joe Cauble, Jon Ekhoff, Anita Fleming, Paul John, Jessica Kendall, Brian Lowe, Jessica Lowe, Heidi Mehlman, Adam Ploeg, Valencia Oxendine-Rose, Andrea Rubalcaba, Lisa Wood-Sanders, Dave Stoklosa

USA Gymnastics sells a Guide to Safety & Training in the Gym (2-disc DVD set).

This 2-disc DVD set includes Olympians Shannon Miller and John Macready, along with 2007 National Champion David Durante, and American Gladiator Beth Horn, taking you through the sections of useful information for clubs, parents and athletes. Information includes safety orientation videos, parent tips, the benefits of gymnastics, communication tips, safety posters and handouts, and much more. Disc two shows various examples of extricating an injured athlete from a foam pit. Use the first DVD in your lobby to promote your program and use the second one for educational purposes with staff. Provided complimentary to USA Gymnastics Member Clubs.

Item Number: 6111Price: $25.00www.usagym.org/safetyeducation

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