This question comes from a NSW first aider who says:

I have a question regarding event first aid. It is common in this setting, especially within sport, for people to request ice for injuries. This is often wanted without a patient assessment conducted. I am often met with a negative response when I ask to have a look at the injury, as is often the case when the patient is some distance away from the medical centre.

On numerous occasions I have been asked for ice, but on patient assessment found that had I provided ice it would have been inappropriate treatment eg concussion. Also is a concern is returning to play immediately after a short ice application time, which risks further injury.

My question I guess comes down to what are the legal risks to provide ice without a patient assessment, and if ice is not given is that negligent?

Presumably your agency is contracted to provide professional first aid services, not to supply an esky.   The old days of running onto the field with the magic sponge or trying to strap an injury are surely long past. If the team want a physiotherapist or sports specialist they should get one. If they want first aiders they need to allow first aiders to do their job.

You should not be issuing ice without doing a patient assessment because, as you have noted, ice may not be the appropriate treatment and you are there to give the appropriate treatment.  If you simply handed over ice without doing a patient assessment and there was say a concussion or fracture then there could indeed be legal repercussions. Later the player may well allege that you were there to provide first aid, by issuing the ice you provided some care but clearly did not do what a reasonable first aider would do which is actually examine the patient.   If the patient is some distance from the medical centre, your obligation may well be to go to them but I would not be handing out ice without seeing the patient.

As for players going on early, they are of course entitled to reject your treatment and your advice, but if that becomes a practice you should raise that with the team or organisers that engage you. If they don’t want your services then you don’t need to be there. If what they want is a sports physio to ‘strap the injury’ or do whatever they do, they should engage them.

Not giving out ice without assessing the patient could not be negligent.

If you are going to provide a professional service you have to act as a professional. That means expecting that you will be allowed to provide the service your agency has agreed to provide – ie a first aid service where first aid is given in accordance with best practice standards. If they want some other service, they should get another service provider. If they want to buy an esky and ice they can do that without your cooperation.