Clinical Applications Exercises Flashcards
How does the role of the athletic trainer working in the clinic differ from the responsibilities of the athletic trainer working in a university setting?
How does the role of the athletic trainer working in the clinic differ from the responsibilities of the athletic trainer working in a university setting?
The role of an athletic trainer is dictated by that state’s regulation of the practice of athletic training
The athletic trainer should treat only those who have sustained injury due to physical activity & not patients w/ neurologic or orthopedic conditions
What actions can the athletic trainer take to reduce the number of injuries and to minimize the risk of injury in the competitive athletes at that high school?
- physical exams & preparticipation screenings
- ensure appropriate training & conditioning of the athletes
- monitor environmental conditions
- select & maintain properly fitting protective equipment
- educate parents, coaches & athletes about the risks of sports
A second-semester college sophomore has decided that she is interested in becoming an AT. Her college has a masters degree in AT yet does not offer an entry level CAATE approved curriculum.
How can she most effectively achieve her goal of becoming an AT?
Everyone must graduate from a CAATE-accredited program to take the BOC exam.
Therefore she must transfer schools
What considerations are important for inclusion in a risk management plan for an athletic program?
Security Issues
Fire safety
Electrical and equipment safety
Emergency injury management
How can the athletic trainer most efficiently set up the preparticipation exams to clear 200 athletes for competition in the fall sports?
The preparticipation exam should consist of:
Medical hx
A physical examination
Brief orthopedic examination
May be effectively administered using a station examination system w/ a team of examiners
A collegiate athletic trainer is approached by the school administration to determine the potential risk of injury to their football team.
What approach is best suited to gather this information?
The NCAA Injury Surveillance System
If a patient brings a lawsuit against the athletic trainer, what must the patient prove if he is to win a judgement?
If an AT fails to provide an acceptable standard of care, there is a breach of duty on part of the AT
The athlete must then prove that this breach caused the injury or made the injury worse.
What is the statue of limitations for an adult patient to file suit?
In personal injury cases, the individual would typically have btwn 1 & 5 years to file a suit for negligence
What type of insurance policy should the meet organizers carry to cover medical costs?
Low cost accident insurance
Often covers accidents on school grounds while athletes are competing
A marathon runner comes into the sports medicine clinic, complaining of feeling tightness in her lower extremity during workouts.
What should the AT recommend as a specific warm up routine that this patient should consistently perform before her workout?
5-7 min slow jog, breaking into a light sweat
Stretch: either static or PNF technique
Each stretch performed 4 times, held 15 to 20 secs
Cool down period: stretch
Following the competitive season, a football player took the months of Dec & Jan off from intense training. It is now time for him to begin the preparatory phase of training.
What activities should he begin with & how should these activities progress over the next several months?
Early part of preparatory phase: training should be low intensity with a high volume of repetitions. This phase should last several weeks to 2 months.
Just before preseason: the athlete should train at a high intensity, and volume should decrease to allow full recovery btwn sessions
An ice skater falls and hits the back of her head on the ice, incurring a possible cerebral concussion.
Initially what observational signs may indicate a cerebral injury?
Signs of a cerebral injury: Pale face color Moist skin Rapid pulse Shallow breathing Pupils may become dilated
A football player sustains a cerebral concussion while making a tackle during a game.
How should the AT determine the athlete’s level of orientation and memory
Assessing orientation and memory: Current date Name of last week’s opponent Who won that game Who scored this games last goal
An ice hockey player is checked hard into the boards head first and sustains a concussion. It is his second concussion this season.
What guidelines should be followed regarding his return to play?
The patient should be held out of all activity until he is completely asymptomatic and can perform at baseline levels on neuropsychological tests and balance tests
The physician may consider keeping the player out the rest of the season
A 40 year old former professional football player with a history of numerous concussions begin to complain of memory difficulty, difficulty in concentrating and on occasion some irritability and problems in visual focusing.
What problem foes this patient have? How should his condition be managed?
Post concussion syndrome
Cannot return to play until cleared by a thorough neurological examination
A high-school lacrosse player experienced a concussion with a brief loss of consciousness.
One week later, the patient is symptom free except for a headache.
Should the athletic trainer allow the patient to resume normal contact activity at this point?
No
Due to the patient’s young age & possibility of second impact syndrome
In order to return to play need to have:
Absence of post concussive symptoms
Clearance by a physician
A professional firefighter falls from a ladder, striking his head on the pavement, and develops a subdural hematoma.
How can an AT distinguish the symptoms of a subdural hematoma from the symptoms of an epidural hematoma?
A subdural hematoma is due to venous bleeding
Symptoms appear gradually over hours or even days
A epidural hematoma results from arterial bleeding
Symptoms appear rapidly
A field hockey player sustains a severe blow to her cheek by a stick. The blow fractures her maxilla but does not knock her unconscious.
How should the patient be transported to the hospital and why?
The conscious patient with a fractured maxilla is transported to the hospital in a forward-leaning position. This position allows external drainage of salvia and blood
A basketball player is elbowed in the mouth while fighting for a rebound. He goes to the sidelines w/ blood in his mouth, saying he thinks he chipped a tooth. On examination, the AT determines the blood is coming from a cut in the lip and that a small portion of one of his upper front teeth is broken, but there is no bleeding from the fracture and it does not appear that the pulp chamber has been exposed.
What type of tooth fracture does this patient have and how should this incident be managed?
Uncomplicated crown fracture
If the fractured piece of tooth is found it can be placed in a plastic bag
The patient can finish the game
Should be seen by a dentist within 24 to 48 hours
A wrestler is hit in the nose, which injures the lateral nasal wall and causes epistaxis
How should this nosebleed be managed?
Patient should sit up with a cold compress placed over the nose and ipsilateral carotid artery.
Digital pressure should also be applied to the affected nostril for 5 minutes
A 30 year old male is accidently poked in the eye while playing basketball with a few friends in his driveway.
What symptoms indicate that this may be a serious eye injury?
Blurred vision
Loss in the visual field
Major Pain
Double Vision
A racquetball player who is not wearing protective goggles is hit in his eye with a ball and develops a collection of blood in the anterior chamber.
What type of eye injury is this and what complications may follow?
Hyphema
Could lead to major lens, choroid or retinal problems
Immediate referral to physician
A patient develops an eyelash follicle infection.
What is the cause of this condition, and how should it be treated?
Caused by a staphylococcal organism
Managed:
Hot, moist compresses
1 % yellow oxide or mercury ointment
While carrying the ball, a football back is clotheslined and seriously injures his throat.
What should the AT be concerned with in such an injury?
Could produce a blood clot in the carotid artery
Fracture to the larynx - rare
Could cause a breathing crisis
A soccer player is kicked in the abdomen above the umbilicus. Initially, she had the wind knocked out of her. Now she is complaining of pain and her abdomen is tight on palpation.
What should the athletic trainer be most concerned about, and what organs may be involved?
Injury to an organ that can lead to internal blood loss
Can lead to shock
Could injure: spleen, liver, stomach, small intestine, pancreas & gallbladder
Could also be a contusion to the muscles of the abdominal wall causing guarding
An aerobics instructor complains that when she takes a deep breath, she feels some funny cracking sensations in her lungs. The patient’s athletic trainer wants to listen to her chest with a stethoscope.
What sound should the athletic trainer listen for?
Be able to identify abnormal breathe sounds
Adventitious breath sounds are not normally heard
Wheezes or Rhonchi (musiclike sounds w/ a high pitch)
Rales (crackling or bubbling sounds)
An ice hockey player is checked into the boards by an opponent. He has the wind knocked out of him and, on recovery, says that he feels pain when he tries to take a deep breath. The AT suspects an injury to the thoracic cage.
How can the athletic trainer differentiate between a rib fracture and a costochondral injury?
AT should palpate at along the rib, the intercostal space btwn the ribs, and at the costochondral junction to locate a specific point of tenderness
Apply AP compression to the thoracic cage
Costochondral injury:
More pain w/ transverse compression applied laterally to the rib cage
A lacrosse player is hit in the thorax with an opponent’s stick. He has immediate, localized pain over his ribs and within minutes begins to develop some respiratory difficulty. The athletic trainer suspects that the player has likely fractured a rib and is extremely concerned that the fracture has damaged the lungs.
What lung injuries are possible, and how should this injury be managed?
Injuries severe enough to fracture a rib may cause: Pneumothorax Tension Pneumothorax Hemothorax Traumatic asphyxia
All conditions should be considered LIFE THREATHING
Access rescue squad
Be prepared to initiate CPR
A Football player is running 60 yard sprints during a conditioning workout with the rest of the team. Even before beginning the first practice, the athlete knew that he was not very fit and was worried about how he would do. On the 5th sprint, he called for the AT and said he felt as if he could no breathe. He appeared to be gasping for air.
What might the athletic trainer suspect is wrong with this patient, and what is the immediate treatment?
Hyperventilating
Likely caused due to anxiety that existed over having to do these sprints
Treatment:
Increase level of carbon dioxide in the lung
Breathe slowly through one nostril or Breathe into a paper bag