Emergency Procedures:Exam 2 Flashcards
Emergency
Unexpected occurrence that requires immediate attention
What can a mistake in initial injury management lead to?
- longer recovery time
- life threatening situations
How many emergency action plans should there be?
Separate for every site and sport
What 3 things should an emergency action plan include?
- define personnel available and their role
- list equipment available
- consider practice vs game
How and where should the plan be posted?
Clearly posted and sometimes above a phone
Components of EAP (5)
- phone (location and number)
- keys for access
- all support personnel must be familiar
- someone to accompany athlete in ambulance
- folder/ electronic version of athlete emergency contacts, history, insurance, ect
What should the taker of the phone call be told? (7)
- exact location and address
- telephone number
- caller’s name
- what happened: mech of injury and events prior to injury
- number of people involved
- condition of victim
- care being given
When should consent be given?
Prior to the season
When should parents be notified?
ASAP
Implied consent
With no informed consent, consent implied on part of patient to save life
Where does the assessment begin?
On the playing field with the goal of determining the nature of the injury and the direction of care
Components of assessment
- primary survey
- secondary survey
components of primary survey
- LOC (level of consciousness)
- CAB
What should be done in the primary survey?
- assess level of consciousness
- determine potential life threatening injures/ conditions
Potential life threatening conditions (5)
- no circulation
- obstructed airway
- no breathing
- profuse bleeding
- shock
Secondary assessment
- no life threatening conditions
- specific info about injury
- head to toe assessment
- assess vital signs
- ID potential life threatening conditions
Vital signs
- temp
- pulse
- BP
- breathing
- Pulse ox
Overall goal of primary assessment
- circulation
- airway
- breathing
Goal of primary assessment:circulation
- pulse
- excessive bleeding
Goal of primary assessment: airway
What things might obstruct
Goal of primary assessment: breathing
- frequency
- quality
- adequate
4 life threatening conditions of which you should call 911
- unconscious
- trouble breathing
- no signs of life (normal breathing or movement)
- severe bleeding
What to do with an unconscious athlete? (4)
- note body position
- determine LOC and CAB
- stabilize spine
- activate EMS
What should you do with equipment of an unconscious athlete?
- leave helmets and pads
- remove face mask
What should you do if athlete is supine and breathing?
Monitor
Supine and not breathing
CAB
Prone and breathing
Monitor, log roll after
Prone and not breathing
Log roll; CAB
How many people are needed for log roll?
4 at least
Checking of a conscious victim
- obtain consent
- scene safety, LOC and CAB checked upon approach
- secondary survey begins
When to not transport victim (3)
- trip may aggravate injury or illness or cause additional injury
- when the victim may develop life threatening condition
- unsure of the nature of the injury
Equipment removal
- remove face mask
- cut away jersey, opening to chest protector to expose chest for CPR and AED
- remove both pads/helmet or neither
How to use an AED
- evaluate heart rhythm of victim experiencing cardiac arrest
- Can deliver electrical charge to heart if appropriate
- fully automated
How to asses LOC
- “are you ok”, calling name, tapping shoulder
- painful stimulus
4 levels of consciousness
- alert
- responsive to verbal stimulus
- responsive to painful stimulus
- Unresponsive
How to assess circulation
- check for severe bleeding
- check pulse @ carotid artery for 5-10 secs
- AED and CPR if needed
Airway assessment
-is airway open and clear?
How to open airway
- head tilt/ chin lift
- modified jaw thrust
- airway adjuncts (maintain airway)
What to consider when opening airway
- c-spine
- personnel
- equipment
How to do CPR
- 100 compressions a min for untrained
- 30:2 ratio for those trained
How to check for breathing
- look for chest rise
- listen for breath sounds
- feel for air movement
- Rate and quality
When to administer rescue breathing
If breathing is absent or inadequate
Rescue breathing
- bag valve mask
- supplemental oxygen
Hemorrhage
Abnormal discharge of blood
Types of external bleeding
- venous
- arterial
- capillary
Venous
Dark red with continuous flow
Arterial
Bright red and flow in spurt
Capillary
Exudes from tissue and is reddish
How to control external bleeding
- **protective equipment
- direct pressure (clean gauze and firm pressure)
- elevation of body part
- pressure points/ tourniquet
When does shock occur?
When less blood is available to the circulatory system because the vascular system is unable to hold the volume of blood (vasodilation)
When is there a high probability of shock?
- fractures
- Internal injuries
- severe bleeding
Is shock rapid or slower?
-either
What is shock a problem of?
- blood volume
- hemodynamics
Hypovolemic shock
Trauma and blood loss
Respiratory shock
Lung injury /
Neurogenic shock
Dilation of blood vessels
Psychogenic shock
Syncope
Cardiogenic shock
Heart can’t pump
Septic shock
Infection
Anaphylactic shock
Allergy
Metabolic shock
Severe illness
Skin symptom of shock
Pale cool and clammy
Pulse symptom of shock
Weak and rapid
Respiration symptom of shock
Quick and shallow
Blood pressure symptom of shock
Lower (systolic <90)
Conscious level symptom of shock
Drowsy and sluggish
Incontinence symptom of shock
Urinary and fecal
Other shock symptoms
Change in disposition and extreme thirst
How to manage shock
- maintain body temp
- elevate feet and legs
- psychological reaction
- no food or drink
When is secondary survey performed?
After primary survey and no life threatening conditions (stable)
Secondary survey
- musculoskeletal assessment
- decide to move or transport
- referral or secondary care
Musculoskeletal assessment adult v child
- adult: head to toe
- child: toe to head
Pulse
Radial or carotid in neck
- normal: 60-100 a min
- quality: rhythm and strength
Respiration
- at rest
- normal rate: 12-20/ min
- quality: difficulty/ sound
Blood pressure
- systolic
- diastolic
- normal: <120/<80 mmHg
Body temp
- oral rectal, auxiliary, ear, skin
- normal: 97.8-99 degree
Where to check skin color
Nail beds, lips, mouth, tongue
Where is a good place to look for skin color for dark skin people?
Inside mouth, lips, tongue, skin around nose and mouth
Red in color
Heat stroke, allergic, > BP
Ashen or pale
Shock, < BP, hemorrhage
Blue
Airway abstruction
Yellow
Liver disease
Pupils and vitals
- use a pin light
- PEARL: pupils equal and reactive to light
What do constricted pupils indicate
Use of depressant drug
What do dilated pupils indicate?
- head injury
- shock
- use of stimulant
What does pupils failure to accommodate indicate?
Brain injury, alcohol or drug poisoning
What is more important: response or size?
Response
What does the inability to move indicate?
Serious CNS deficits impacting motor control
Hemiplegia
Inability to move one side
What does hemiplegia indicate?
Brain trauma or stroke
Bilateral upper extremity sensory motor deficits indication
Cervical spine injury
What could pressure on the spine or injury below the neck result in?
Compromised function of lower limbs
Musculoskeletal assessment
- history
- observation
- palpating
- special tests
History in MA
Sounds, sensations, events leading up to injury, mechanism of injury
Observation MA
- inspection of injured and non-injured areas
- look for gross deformity, swelling, skin discoloration
Types of splints (5)
- rapid form vacuum splint
- air
- traction
- SAM
- spine and pelvis
What should be checked before and after splinting?
Circulation, sensation, motor function
Crutch instructions (up stairs)
- BW on crutches
- un injured leg up first
- pull crutches/ affected leg up
Crutches instructions down stairs
- BW on good leg
- injured leg and crutches down first
- good leg follows
