Emergency, Concussion, Imaging, Med Conditions, Integ Flashcards
Areas of brain
Frontal
Occipital
Parietal
Temporal
Areas of brain:
Frontal:
- Personality changes
Occipital:
- center for vision
Parietal:
- proprioception, sensory processing & speech
Temporal:
- memory & word understanding
Concussion outcome for child
13+
SCAT 3
Child SCAT ages 5-12
Cardiovascular adaptations during pregnancy:
Inc blood volume
Inc heart rate
Inc stroke volume
Inc cardiac output
Dec in systemic vascular resistance
Levels of consciousness
AVPU
Alert; able to respond
Verbal; responds only to verbal commands
Painful; responds only to painful stimuli
Unresponsive
Types of football pads (3)
non cantilever pads- QB/WR. more freedom of movement. some OL who use hands more
-inside cantilever - fits under the arch of the shoulder pads and rests against the shoulder. It is more common because it is less bulky than the outside cantilever.
-Outside cantilever - sits on top of the pad, outside of the arch. It provides a larger blocking surface and affords more protection to those who are in constant contact, such as linemen.
-Double cantilever - combination
of both the inside and the outside cantilever,
affords a player the greatest amount of protection but is not feasible for all positions because of its bulk.
proper preactivity hydration
17–20 oz three hours prior to the event and 7–10 oz every 10–20 minutes during the event
WBGT - when to start being alert
85 deg- begin staying alert to changes
stop training if 99 degrees or higher.
heat stroke
core temp >105
cold immersion
get to <102 before transport
shock
moist clammy skin
increased RR
decreased BP
weak, rapid pulse- tachycardia
hypothermia
mild: 95-98.6
moderate: 90-94, cessation of shivering
severe: temp <90, brady, hypotension
death at core temp 77-85
lightning times
lightning–>thunder time
divide by 5
= miles away
Ottawa Ankle Rules
-pain in malleolar/midfoot
-unable to WB after / in ED
-TTP at posterior tip of fibula/tibia
TTP at med/lateral malleolus
TTP at navicular or 5th MT base
Ottawa Knee Rules
age >55
unable to WB
TTP at fibular head
isolated TTP at patellar
unable to flex to 90
Pittsburgh knee rules
fall/blunt trauma
+ EITHER:
-age <12 or >50
-cant WB 4 steps
Canadian C spine rules
*High risk factors
-age >65
-dangerous MOI
-extremeity paresthesias
*Low risk to allow safe ROM assessment:
-simple rear end
-normal sitting in ED
-ambulatory since injury
-delayed onset, no midline tenderness
*IF you can assess, can they rotate >45 deg?
*If so, NO radiograph
*If 1 high risk- need xrays
*If 2 low risk + can’t rotate to 45 = need rays
Salter Harris classifications
SALTR
I: slipped, through growth plate but NOT bone involved, cannot happen if growth plate fused
II: above (most common), through most of growth plate and metaphysis
III: lower, some distance through growth plate and through epiphysis (poorer px)
IV: through/transverse/together: fracture through metaphysis, growth plate & epiphysis
V: ruined, does not displace growth plate but crush type injury, poor px
Canadian CT rules - is CT needed after head trauma
-minor injury + ONE of following:
-GCS 13-15 after LOC, amnesia
-open fx
-high risk- GCS <15 2 hours after
-2+ episodes vomiting
-65+ y/o
-medium risk- amnesia before impact 30+ min
New Orleans Criteria for imaging after head injury
with minor injury + ONE of following:
-HA
-vomit
->60
-intoxicated
-amnesia
-visible trauma above clavicle
-seizure
HTN definition
140/90 on 2 different occasions
marfan syndrome testing rules
echo every 6 months
no collision sports or static strenuous like weightlifting
ehlers danlos
collagen tissue impacts
liver referral
RUQ to shoulder/neck
spleen
LUQ
Cullen sign
bluish tint at umbilicus
mcburneys point
1/3 distance from ASIS to umbilicus - near appendix
MRSA 5 Cs
-Contact (frequent skin to skin)
-Contaminated item/surface
-Crowding
-Compromise of skin integrity
-Cleanliness
erythasma
Red-brown plaques involving skin folds.
Erythrasma is caused by the bacteria
Corynebacterium minutissimum
may compete with lesion if well covered
abx for 2-4 wks
impetigo
-bullous on trunk/extremities with blisters that rupture easily
-non bollus - thin walled vesicles that rupture into honey colored crust
topical
-No new skin lesions for at least 48 hours.
-Complete 72 hr directed abx
-No further drainage/exudate
-ctive infections may not be covered to compete
follicitulus
faruncles - return to sport rule
No new skin lesions for at least 48 hours.
Complete 72 hr directed abx
No further drainage/exudate
active infections may not be covered to compete
MRSA
systemic abx used on case by case
same rts rules as impetigo: No new skin lesions for at least 48 hours.
-Complete 72 hr directed abx
-No further drainage/exudate
-active infections may not be covered to compete
-initially presents similar to other bacteria infections. similar to abscess/furuncle
-often confused with spider bite
-lesion may start as small pustule that develop into larger abcess/pustule with area of erythema & some tissue necrosi
miliaria
Fine red- or skin-colored papules
caused by blockage of eccrine glands
due to sweating
chillblain/pernio
Blotchy red or purple lesions that
present several hours after
cold exposure
fungal infections
intertrigo
tinea capitis
tinea coporis
tinea cruris
tinea pedis
tinea versicolor
intertrigo
Chronic, erythematous plaques found
in skin folds. Can involve scrotum
safe to return to play, keep area dry/clean
tinea captitis
Scaly, gray patches with mild hair loss
oral antifungal
2 wks min of systemic treatment
tinea captitis
Scaly, gray patches with mild hair loss
toral antifungal
2 wks min of systemic treatment
tinea corporis
Round, well-defined, erythematous,
scaly plaque with raised borders. Tinea
corporis gladiatorum (tinea corporis
found in wrestlers) frequently has a
more irregular lesion
topical for at least 72 hours, lesion covered with gas permeable membrane
tinea pedis
Erythematous, pruritic scales between
the toes, on the plantar aspects, and
sides of the feet
may compete if lesion well covered
tinea cruris
Well-defined boarder with erythematous
pruritic scaly plaque in skin folds of
groin. Scrotum usually not involved
may compete if well covered
tinea versicolor
topical 2-4 wks, can play
Asymptomatic, hypopigmented or
hyperpigmented macules, commonly
found on trunk.
corn, callus
Calluses are hyperkeratotic, nonpainful
lesions caused by friction. Corns also
are caused by friction, but contain a
painful central core.
piezogenic
papules
Fatty herniations through fascial tissue
in the heels. Can be painful or asymptomatic
viral infections
Molluscum contagiosum
HSV
HSV RTS criteria
- free of systemic symptoms such as fever, malaise
-no new blisters developed for 72 hours
-all lesion surmounted with firm adherent crust
-completed min 120 hours of systemic antiviral
-active lesions cannot be covered to participate
Molluscum contagiosum
Typically presents as umbilicated, or
delled, flesh-colored to light-pink pearly
papules, measuring 1 to 10 mm in
diameter
can cover with gas permeable membrane
What to do if Type I DM is less than 100 mg/dL?
Specifically NATA recommends; Administer 10 g to 15 g of fast-acting carbohydrate: eg, 4 to 8 glucose tablets, 2 T honey. Measure blood glucose level. Wait approximately 15 min and remeasure blood glucose.
If blood glucose level remains low, administer another 10 g to 15 g of fast-acting carbohydrate. Recheck blood glucose level in approximately 15 min.
If blood glucose level does not return to the normal range after second dosage of carbohydrate, activate emergency medical system. Once blood glucose level is in the normal range, athlete may wish to consume a snack (eg, sandwich, bagel)
2 requirements to diagnosis EIA?
-Symptoms
-Obstructed Airways
dec by 10-15 % in FEV
Both with exercise
Rescue inhaler medication
rapid acting inhaled B2-agonists
Classification of Asthma:
Step 1: mild: FEV in 1 sec or PEF >80%
Step 4: severe FEV or PEF <60%
If PEF is < 80% of best or predicited what is the initial treatment?
Inhale a rapid-acting B2 agonist
up to 3 tx in 1 hr
Volkmanns contracture
Ischemic contracture occurs when there is a lack of blood flow to the forearm
could be caused by increased pressure due to swelling or compartment syndrome
leads to contracture deformities of the fingers, hand and wrist
Major Risk Factors for Hypertrophic Cardiomyopathy?
Prior cardiac arrest*
Family Hx of SCD
Unexplained syncope
Left ventricular wall thickness > 30 mm
Abnormal blood pressure response to exercise
Nonsustained spontaneous ventricular tachycardia
When to RTS after liver injury
when enzymes have normalized
Severe hypoglycemia
Mental status changes
Autonomic Changes
Collapse
Treat w/ glucagon
1 mg subcutaneous
Intramuscular injection
RR Emergency
> 25 breaths/min
EIA can be triggered by:
What will you see a dec in?
cooler & dryer air drawn into the lungs
Dec in FEV1
When should insulin dependent diabetics postpone exercise?
level is above 250 w/ presence of urine keytones
OR
above 300
Mono recovery time, RTS
spleen at risk first 21 days
initial recovery 7 days
but really 2-3 wks
asymptomatic to rts, 3 wks rest
Scoliosis:
What is the cut off score for the Adam’s forward bend test?
Difference in 8 mm side to side or 7 degrees (correlates to a COBB angle of 20 degrees)
Can be measured with a scoliometer
Y balance cut off
anterior reach- 4cm
posterior/lat-6cm
scoliosis- who should be referred to ortho
Skeletally immature children w/ curves >20 deg Cobb angle
OR fully mature adolescents with curves greater than 40 degrees
Types of football pads (3)
non cantilever pads- QB/WR< more freedom of movement. some OL who use hands more
nside cantilever - fits under the arch of the shoulder pads and rests against the shoulder. It is more common because it is less bulky than the outside cantilever.
Outside cantilever - sits on top of the pad, outside of the arch. It provides a larger blocking surface and affords more protection to those who are in constant contact, such as linemen.
Double cantilever - combination
of both the inside and the outside cantilever,
affords a player the greatest amount of protection but
is not feasible for all positions because of its bulk.
Types of football pads (3)
non cantilever pads- QB/WR< more freedom of movement. some OL who use hands more
nside cantilever - fits under the arch of the shoulder pads and rests against the shoulder. It is more common because it is less bulky than the outside cantilever.
Outside cantilever - sits on top of the pad, outside of the arch. It provides a larger blocking surface and affords more protection to those who are in constant contact, such as linemen.
Double cantilever - combination
of both the inside and the outside cantilever,
affords a player the greatest amount of protection but
is not feasible for all positions because of its bulk.
