1. UEFA EUROPEAN U-21 CHAMPIONSHIP UEFA European U-21 Championship ISRAEL 2013 Israel 2013 Liran Lifshitz, MSc PT Medical Department Director Israel Football Association liranl@football.org.il Liran Lifshitz, MSc PT Medical Department Director Israel Football Association liranl@football.org.il

2. Post Tournament Summary & Recommendations Pre Tournament Preparation Tournament

3. Pre Tournament Preparation Duration: the Pre-tournament stage lasted nearly a year.

4. First stage preparation: Composition of the medical plan after examining the program we received from Denmark. Establishment of the steering committee.

5. Stadium and Training Ground Preparation OCTOBER 2012- UEFA MMR medical equipment guide was sent to the stadiums and training facilities. Anti doping room was designed according to UEFA regulations. JANUARY 2013- LOC pre inspection was preformed by the tournament doctor and tournament medical coordinator. FEBRUARY 2012- UEFA inspection took place: 3 days tour to all stadiums and training ground facilities. APRIL 2012- LOC final inspection was preformed by the tournament doctor, tournament medical coordinator and a representative of First Aid Service. Pre Tournament Preparation

6. Hospital Preparation Tournament Hospitals Setting: Main hospital : Tel Aviv Sourasky Medical Center Secondary hospitals : Hadassah Medical Center – Jerusalem Rabin Medical center Beilinson- Petah Tikva Meir Medical Center –Kfar Saba Hillel Yaffe Medical Center - Hedera Sanz Medical Center Laniado- Netanya Wolfson Medical Center- Holon Pre Tournament Preparation

7. Hospital preparation In each local hospital a coordinator was appointed to accompany the preparation and tournament. In the tournament main hospital a number of representatives were appointed on several key departments: emergency room, imaging. Each team received a file with the relevant hospital information, located near their training ground and hotel. FEBRUARY 2012- UEFA inspection took place also at the tournament main hospital. Pre Tournament Preparation

8. Medical Staff Preparation First Aid Service (FAS) The service was provided by MDA (Magen David Adom In Israel), the national first aid service, and the largest in the country. A MDA representative was appointed to accompany the preparation and tournament. UEFA MMR Medical equipment guide was sent to MDA. Pre Tournament Preparation

9. Medical Staff Preparation Pitch-side and Spectator Doctors 7 doctors Participated in the tournament. All of them participated in “UEFA football doctors education program” which took place in Israel August 2012. The doctors functioned as Pitch-side and Spectator Doctors alternately: - For each match was appointed 1 pitch-side doctor who was responsible on MD-1 and MD. - For each match was appointed 1 spectator doctor. Anti doping staff 5 (4 +1 standby) Anti doping volunteer chaperons were trained and appointed for each stadium. Most of the chaperons were local medical students.. Pre Tournament Preparation

10. TournamentTournament

11. Medical Meeting The meeting took place on 4/6/2013, a day before the opening of the tournament. 27 people participated in the meeting: UEFA doctor, each teams’ medical staff, tournament medical coordinator, pitch side and spectator Doctors.

12. Medical Meeting goals Professional and personal acquaintance. Presentation of the local medical administrative part. Presentation of anti doping regulations. On field evaluation & treatment: professional discussion & debate based on video case studies

13. First Aid Service (FAS) During the training, MDA provided an ambulance at each training ground. During the matches, MDA provided wide medical support including fully equipped advanced life support (ALS) ambulance, paramedics, first aid providers and a stretcher team. Prior to each match, the medical coordinator and the MDA representative gave a prep talk to all MDA personnel. The prep talk included information about the set up of the FAS, the work protocol etc.

14. First Aid Service (FAS) Stadium 32000 seats (final match) Stadium 11000 seats 63Ambulances 3618First aid medical staff 21Spectators doctor

15. Medical Incidence Management Any medical application was directed to the tournament medical coordinator (TMC). During a match, the application to the TMC was through the Pitch-side Doctor. During other times, the application to the TMC was through the Team Liaison Officers TLO (the Israeli representative).

16. Evacuation to a Hospital Procedure In any evacuation to the Hospital, a special form was filled with the player/staff name. The form was filed in Hebrew by the Team Liaison Officers (TLO). The IFA was responsible for treatment at the hospital. The teams did not need to deal with the payment upon arrival to the hospital. The hospital bills were taken care of after the tournament, via the insurance companies representing the groups.

17. The hospital application form is being filled by the Team Liaison Officers (TLO). Medical examination by the team medical staff Medical evacuation by MDA accompanied by an Israeli guide and a team medical personal. Imaging The interaction between pitch side doctor and the team doctor An example of an event during a match

18. Doping Doping testing was conducted in 8 out of 15 matches. The tests were conducted randomly and directed by UEFA Doping Officer. Anti-doping volunteer chaperons attended each match, in order to conduct testing if necessary.

19. Final Match

20. Dealing with the warm Israeli weather Weather forecast for the tournament period was sent to the participating teams prior to their arrival. Weather updates were given every other day. In the event that a match was held in extremely hot weather, a container with crashed ice and sponges was supplied to each team.

21. Recovery Ice Bath AFTER PRACTICE AFTER A MATCH TEAM Israel Netherlands Norway Germany Italy Russia England Partially Spain Because of the increasing use of ice, we have to consider improving the efficiency of ice supply and use in the stadiums.

22. Germany ice bath England ice bath

23. PLAYERS INJURY LOCATION During the tournament there were total of 15 injuries among players who reported to the tournament medical coordinator (TMC) and was treated in hospitals. Post Tournament Summary & Recommendations

24. PLAYERS INJURY TIMING Questions raising from the stats: Injuries training ratio was relatively high. Post Tournament Summary & Recommendations

25. Players imaging Most imaging was preformed on the same day of injury. During the tournament MRI was the preferred examination by the teams. Post Tournament Summary & Recommendations

26. Spectators Medical service At each match there was a minimum of one doctor and two first aid staff that included paramedics and first aid provider who were responsible for any spectator injuries. There was a total of 19 spectator Injuries during the tournament. Injury types: Minor injuries, cuts and bruises, burns, contusions, dyspnea, abdominal pains. Post Tournament Summary & Recommendations

27. Team doctors Medical feedback (6 of 7 teams completed the questionnaire) A medical feedback form was sent to all team doctors at the end of the tournament. Answers ranged from 1 (very unsatisfied) to 5 (very satisfied). Post Tournament Summary & Recommendations

28. Summary- Local tournament medical staff AmountTask 1(TD)Tournament Doctor 7Pitch-side and Spectator Doctors 1Tournament Medical coordinator (TMC) 18-36First Aid Service (MDA) 20Anti Doping Chaperons Post Tournament Summary & Recommendations

29. Positive feedback Pre tournament UEFA inspection – the inspection contributed greatly to the smooth and professional conduction of the tournament. in addition, we would like to mention the great contribution of UEFA Doctor Mr. Jens Kleinefeld, which brought with him experience, professional knowledge and a great desire to share them with us. Post Tournament Summary & Recommendations

30. Recommendation The MMR should be wider and include the following points: 1. Spectators medical room and content. 2. Ratio between the number of spectators and medical staff. Accreditation difficulty for first aid staff: The problem- daily changes in the medical staff created difficulties in the identification process, and made it impossible to complete the accreditation ahead of time. Therefor, the accreditation process was done before each match, demanding a lot of time and resources from the accreditation staff (at each match there were 18-36 first aid staff members). Recommendations- the accreditation should be applied by job definition and not by name. the first aid staff can be recognized by their unique uniforms. Post Tournament Summary & Recommendations

31. UEFA EUROPEAN U-21 CHAMPIONSHIP Israel 2013 Our goal- Providing quality professional medical service at the highest availability. service at the highest availability. Our goal- Providing quality professional medical service at the highest availability. service at the highest availability.