Responding to Sports Injuries: First Aid (SALTAPS & PRICE)
Why First Aid Matters in Sport
Every sports session carries some risk of injury. When something goes wrong, a coach, referee or first aider must act quickly and correctly. Knowing the right assessment and treatment protocols can prevent a minor injury from becoming a serious one, and could even save a life. Two of the most important tools in sport first aid are the SALTAPS protocol and the PRICE therapy framework.
SALTAPS: The On-Field Assessment
SALTAPS is a seven-step routine for assessing an injured performer on the pitch or court. It helps the first responder gather information systematically before deciding whether the athlete can continue, needs to be removed, or requires emergency help. The steps are as follows.
See — observe the incident as it happens or arrive on the scene and look for obvious signs of injury such as unusual posture, swelling or deformity. Ask — question the performer about what happened, where it hurts and what the pain feels like; this gives subjective information that cannot be seen. Look — carry out a visual inspection of the injured area, comparing it to the uninjured side; look for swelling, bruising, redness or deformity. Touch — with the performer’s permission, gently palpate (feel) the area to identify specific points of tenderness or crepitus (a grinding sensation that may indicate a fracture).
Active movement — ask the performer to move the injured part themselves (without assistance) through their pain-free range; this tests whether the muscles and tendons are working. Passive movement — the first aider gently moves the injured joint while the performer’s muscles remain relaxed; this tests the integrity of ligaments and joint structures. Strength testing — the performer resists gentle pressure applied by the first aider; if this is pain-free and strength is maintained, return to play may be considered. If any step reveals a significant problem, the performer should be removed and further assessment arranged.
SALTAPS stands for See, Ask, Look, Touch, Active movement, Passive movement, Strength testing. It is the standard on-field assessment routine used to decide whether an injured performer can continue or must be removed from play.
DRABC: Emergency First Aid
If a performer is unconscious or you suspect a life-threatening emergency, SALTAPS is set aside and the DRABC protocol takes over. Danger — ensure the scene is safe for you, the performer and bystanders before approaching. Response — check for consciousness by calling the performer’s name and tapping their shoulders firmly. Airway — if unresponsive, open the airway by tilting the head back and lifting the chin. Breathing — look, listen and feel for normal breathing for up to 10 seconds. Circulation — if the performer is not breathing normally, call emergency services immediately and begin CPR at 30 chest compressions to 2 rescue breaths.
If a performer is unconscious but breathing normally and has no life-threatening conditions, place them in the recovery position: roll them onto their side, support the head and tilt it back slightly to keep the airway clear, and ensure the top knee is bent to prevent rolling forward. Monitor their breathing continuously until emergency services arrive.
SALTAPS is for alert, conscious performers who have sustained a musculoskeletal injury such as a sprain or strain. The moment a performer is unresponsive, unconscious, not breathing normally, or you suspect cardiac arrest, DRABC must be applied immediately. Never delay DRABC to complete a SALTAPS assessment. The priority order in any emergency is always: safety first, then airway, then circulation. Calling 999 (or 112) early is critical — a defibrillator should be retrieved while CPR begins.
PRICE Therapy: Immediate Soft-Tissue Management
Once a conscious performer with a soft-tissue injury (sprain, strain or contusion) has been assessed and removed from play, PRICE therapy guides the immediate treatment. Applied within the first 24–72 hours, it limits swelling, reduces pain and creates the best conditions for healing.
Protection — protect the injury from further damage, for example by using a splint, sling or by simply stopping the performer from weight-bearing. Rest — stop physical activity to prevent aggravation; this does not mean total bed rest but avoidance of the activity that caused the injury. Ice — apply a cold pack or ice wrapped in a damp cloth for 15–20 minutes every two hours; never apply ice directly to skin as this risks an ice burn. Compression — apply a firm (but not tight) bandage to reduce swelling and provide support. Elevation — raise the injured limb above the level of the heart to reduce blood pooling and oedema.
PRICE stands for Protection, Rest, Ice, Compression, Elevation. Each step targets a different aspect of the inflammatory response: protection prevents further damage, ice and compression reduce swelling, and elevation drains excess fluid away from the injury site.
X-rays and Specialist Assessment
When a fracture is suspected following the SALTAPS assessment — for example, if there is point tenderness over bone, obvious deformity or the performer cannot bear weight — the performer must be referred for an X-ray. X-rays show whether a bone is broken. An open fracture is identified by a wound that reaches the broken bone. You do not need to understand the technical process of how X-rays work, but you must know that they are the primary imaging tool used to diagnose skeletal injury in sport.
A very common error both in practice and in exam answers is stating that ice should be applied directly to the skin. This causes an ice burn (frostbite injury to the superficial tissues) and is incorrect. Ice must always be wrapped in a damp cloth or placed in an ice bag with a cloth barrier. Similarly, do not state that compression should be applied as tightly as possible — a bandage that is too tight can restrict circulation. If a performer’s fingers or toes become pale, cold or numb after bandaging, the bandage is too tight and must be loosened immediately.