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Procedures for dealing with injuries


karl

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I'm trying (and so far failing) to find out about policies and procedures surrounding injuries that may occur.

 

Let me give an example based on an actual event:

 

An amateur run venue is hosting a show by an amateur society. A cast member trips on some steps and injures their ankle. A first aider recommends they go to casualty but the person in questions says they want to stay and finish the show. Should they be allowed to continue in the performance? Is there a duty of care to prevent them possibly aggravating the injury out of a feeling that the show must go on / adrenalin overriding the pain, etc.

 

After the show the cast member visits A&E who say there is no serious damage but recommend they keep their weight off it as much as possible. The cast member is adamant that they want to complete the run (say four more performances) even though the part requires a lot of standing/walking/physical activity. Should they be allowed to perform.

 

In many cases the course of action will be fairly obvious (e.g. call an ambulance) but should the venue have a policy in place for cases where it is less clear cut?

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I actually drive an ambulance for a living, It's totally impossible to have a procedure for all eventualities. Most things come down to how bad it feels. If talent says they will continue you can't cosh them and drag them into A&E. With an amateur society HSWA doesn't apply BUT it often shows good methods of working safely.
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Most things come down to how bad it feels. If talent says they will continue you can't cosh them and drag them into A&E.

I wouldn't want to be dragging people to A&E against their will but the SM or suitable person could refuse to allow them on stage. A bit draconian I know but we had a case a few years ago where somebody took a nasty tumble (we had to pause the show) but once they'd got up and dusted them selves down they said they were fine to continue. It was only after the curtain fell that they admitted how much pain they were in and requested an ambulance. The fact that they had continued to perform had actually caused additional damage.

 

Now you could say that if somebody is foolish enough to carry on when they know they've damaged themselves that it's their own look out. But it's not always that simple - people get fixated with the old "show must go on" mantra and adrenalin can mask all manner of problems.

 

So I was just wondering if there isn't a case for having a policy that if a first aider feels it is inadvisable to continue that they shouldn't be allowed to go on. I wonder what others do in such cases.

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Tricky issue. You have a common law duty of care even to amateurs but I would warn against putting anything down in writing for two reasons. It would be a legal "hostage to fortune" and is always open to interpretation in implementation.

 

As Jive says you can't just hijack people to A&E but to be perfectly safe from repercussions extra care is required.

Example; People with "drink taken" have been ordered not to climb, ignored that instruction, fallen and died and their relatives have successfully sued for partial compensation. The court apportioned blame with the view that the "employer" ought to have taken action to ensure they could not climb.

 

In most cases as you describe it is not that critical but erring on the conservative side would be best. I certainly would not allow repetitive stress on an injury such as "seeing out the run" least of all because the "show must go on". It just doesn't.

 

Once you know of an injury then the duty of care is reinforced simply because you are aware of pre-conditions. Just as you would not allow an infectious person to contaminate the rest of the cast then you should not allow further or subsequent injury to occur to an individual.

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At the very least write everything down in a book set aside for the purpose. I was at a venue last year when an amateur cast member was injured and insisted on being patched up and going on. This was quite properly refused - they were clearly in shock. Had they insisted and something else happened a record of this with witnesses' names could have been quite valuable down the line. IMO the decision to carry on in any performance should never be solely down to the person injured.
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Somebody has to be in charge - doesn't matter if it's amateur or professional, and that person makes the decision if somebody can work (in this example, meaning go on and do what they do). My own way of doing it is to advise them with other people present - and offer them choices. "Are you ok, or would you rather go to hospital now?" They make a decision, and their response is what I write down. X declined the offer to go to A&E, and continued with the show. I always offer choices. The only time, as mentioned above, where I decide unilaterally is when somebody is clearly not able to make that decision properly, and I make it for them. Oddly, I tend to document things as close to the event as I can, unlike Kerry's system. I've been a witness in court too many times now, and reading back what I wrote close to the incident often conflicts slightly from my memory months afterwards - I've never been good at remembering, so for me, writing down dates, times and what happened in pretty decent detail work well. The duty to complete a record of accidents is part of many venues systems, but not all - some not even having an accident book at all!

 

In the example Karl gave, the person got proper advice, chose to ignore it and wanted to go on. I would have let them. The advice to keep weight off it received the next day was also ignored, and they wanted to keep performing. Assuming no pressure had been applied by the company, I would have gone along with it again. An adult is perfectly capable of making these decisions. I'd be happy to justify allowing them to go on in these circumstances, feeling happy that if they did in fact injury themselves further by doing it, I had enough evidence to mitigate any claim.

 

We are not their mothers, they're adults perfectly capable of deciding what is best for them. I would of course investigate what my plan B was - is there an understudy, how competent would they be? I'd also look at the performance being given by the injured party. I'd look at the two choices and put the best person on - best for the production, not the person. If I decided the understudy was the best solution, sadly, I'd probably up-play the injury and take them out because the risk was too high, when the real reason was the understudy wasn't hopping around looking awful.

 

I've been doing this in panto at the moment. A dancer hurts herself - do I take her out permanently till she's better, which spoils the look for the entire show, or do I let her perform the routines and scenes where her injury isn't an issue? I then have a full complement for 75% of the show, with her out for the routines that would aggravate the injury. I just had a chat, and we worked out what she could do and what she couldn't. Another one broke his finger (after a show) - A&E between shows, comes back with two strapped together. Very painful to do a couple of lifts, so we took him out for a couple of days from those scenes. Another fell down a flight of stairs, again , after a show. A bit more serious with a CAT scan. He wanted to be in the show next day - despite looking a mess. This, I said no to, and sent him home. Next day he asked to come back again, and I stuck him back in the light duty scenes. I am not a medical expert, but I know enough about head injuries to not want to take chances. Three days later, with no further signs of problems, he's back in properly.

 

My point is that somebody makes a call, and there is no rule book for it - no plan you can follow, no list of examples to match up to.

 

If this means, as it did, that I end up as the back end of an elephant, that's life!

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You also have to consider that the (any) "Accident Book" is a controlled document under the Data Protection regulations (of the moment whenever) because it has several people's names and home addresses and details pertinent to their health. -One of the reasons why some places don't have the book.
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