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Sunday, January 27, 2019

Basketball: Fast Five: What's on Your Crash Cart?


Urban Legend? The Chief Resident in Surgery was called to the ER to see a patient with back pain. Short on decorum, he said, "Look, I'm super busy. I hope you're not wasting my time." He then looked at the patient's back, with a hatchet embedded. "That'll do." 

Maybe it's a stretch (okay, it is), but doctoring and coaching overlap. Really. 

At life threatening events called "codes" the Code Team has a hierarchy of options and treatments. ABC means airway, breathing, circulation. En route, I'd think, first MAKE THE DIAGNOSIS

You're also part of a team - person 'running' the code, Anesthesia (airway management and breathing), nursing (Crash Cart, supplies and drugs), aides (perform CPR), nursing documentation (who did what and when), phlebotomy (blood drawing), runners (to take specimens to lab), and so forth. LEAD

As an instructor (coach), I'd tell players (students, younger doctors) to identify urgent situations, initial assessment, and management. A lot of training teaches recognition and treatment when the situation goes south. Here were my Big 6:

Confusion (change in mental status)
Hypotension (low blood pressure)
Dyspnea (shortness of breath)
Chest pain 
Bleeding 
Sepsis (overwhelming infection)

You don't need total collapse of the patient to initiate resuscitation, just serious instability. And during a basketball game, critical situations often arise. What's your approach?

Kevin Eastman says, "Do it harder, do it better, change personnel, $#7* it ain't working.

Timeouts. "Stops make runs." No stops, no runs. You know them when you see them. Timeouts don't carry over or arrive in your Christmas stocking. Timeouts definitely belong on the cart. 

Energy and Urgency. Transition defense fails from unawareness, effort, organization (responsibilities), personnel, and more. Did we have floor balance? Did we lack a plan or the speed, athleticism, or will to stop transition? 

Discipline. Foul trouble often occurs from poor technique. Reaching in, bodying ballhandlers, lack of verticality, pushing on rebounds, and allowing post entry are sure ways to get into foul trouble. 



Warming Blanket. "The Microwave."  Hypothermia is relatively rare but warming blankets aren't. Exposure and sometimes surgery cool the body to risky levels. Inserting "instant offense" makes coaches smarter. Cultivate a bench scorer.  

Best Four Actions. Need a hoop? What's your "go to" BOB, SLOB, offensive set, zone offense action? These may arise in ATO (after timeout) situations. 

These are just a few "emergency" remedies. We need more...during turnover crises, for 
stopping the star, stopping points in the paint and inability to control penetration, 
offensive stagnation, and comebacks (presses and personnel). 

Knowing when to intervene and having the remedies give us a chance to survive to fight another day. Who and what's on your crash cart? 

Lagniappe: "Staggering" actions from MoraBanc and FastModel Sports with both diagrams and video. Good stuff.