immediate and emergency care Flashcards
What drugs can be used with phonophoresis during the acute phase of treatment?
- Dexamethasone
- Hydrocortisone 1% and 10%
- Lidocaine
One of your athletes has been diagnosed with psoriasis. What medications are appropriate for treatment on this condition?
- Aristocort
- Kenalog
- Topicort
What are medications that are delivered via a meter-dosed inhaler for exercise induced asthma?
- Proventil
- Alupent
- Atrovent
- Ventolin
What medication is often used for anxiety or panic attacks?
Xanax
What is the primary mode of action of penicillin?
Inhibits the metabolism of bacteria
What is the appropriate treatment for an acute quadriceps contusion?
Apply ice to the injured area and put the knee into slight passive flexion to help maintain the flexibility of the quadriceps muscle
Deep frostbite is a medical emergency. What would be the proper course of treatment for this problem?
Rapid rewarming of the affected body part with warm water between 100 to 110 degrees
During which circumstances should an athlete by immediately referred to a dentist?
- The tooth is knocked out
- When a tooth is displaced 2 mm or more
- When a crown is fractured and the tooth is still alive
A male patient sustains a direct blow to the genital area. How can the athletic trainer immediately decrease the pain?
Have the patient lie supine with his knees bent to his chest to decrease the strain on the scrotum and apply ice to the affected area
Shock after a severe injury can result from __________ or _____________?
Hemorrhage or the stagnation of blood
A patient who has been diagnosed with infectious mononucleosis has just been cleared by the team physician to return to full activity. How long should the patient remain out of full contact participation from the time of onset to full recovery?
The patient can return to light activity after 3 weeks from the onset of the illness if the spleen is not enlarged or painful, the patient’s liver function studies are normal, and no fever is present
What the signs and symptoms of increasing intracerebral pressure that the athletic trainer should monitor after a player has sustained a head injury?
- Nausea and vomiting
- Pupil irregularity
- Increase in systolic blood pressure with a decrease in diastolic blood pressure
- Changes in cognition
If an athlete is unconscious from a blow to the head, he or she should be assumed to have a neck injury in addition to a possible head injury. If the airway appears to be impaired, what are the appropriate steps in management?
- Cut the facemask with an appropriate tool and move it out of the way
- Leave the helmet on
- Stabilize the head and neck
- Activate EMS
What are the appropriate steps in the management of an athlete who is experiencing a seizure?
- Keeps spectators out of the way
- Protect the athlete’s head and body from injury
- Turn the athlete on his or her side
- If the athlete is in status epilepticus or it is a first seizure, immediately seek further medical support
In what amount of time is brain damage likely to occur if the brain is deprived of oxygen?
4 to 6 minutes
Where is the carotid artery pulse palpated?
In the groove between the larynx and the sternocleidomastoid muscle
During CPR, the adult sternum must be compressed to what depth for compression to be effective?
1.5 to 2 inches
What signs and symptoms are characteristic of a tension pneumothorax?
- Tracheal deviation
- Distended neck veins
- Unilateral absence of the breath sounds
- Cyanosis
Where would the athlete complain of pain with acute appendicitis?
Lower right quadrant of the abdomen
When fitting an athlete for crutches, the elbow should be flexed to approximately what angle?
30 degrees
What is the appropriate treatment for an athlete who has sustained a rib fracture?
use of a rib belt
An athlete comes to the athletic trainer holding a tooth that has just been knocked out of his mouth. What would be the proper steps for the athletic trainer to take to allow for a successful reimplantation?
Place the tooth in a cloth soaked with saline or water and get the athlete to a dentist within 30 minutes
An athlete has sustained a fracture involving the knee. What areas should be splinted?
The lower limb joints and one side of the trunk
The acute phase of an injury lasts approximately 3 to 4 days. What occurs at the time of initial trauma?
Transitory vasoconstriction, followed by vasodilation and increased permeability
Where do primitive stem cells mature into red and white blood cells and platelets?
bone marrow
The athletic trainer notices an athlete is prone to abnormal bruising. After discussing the problem with the team doctor, he recommends what vitamin?
Vitamin K contributes to blood clotting because it imparts a calcium binding ability to certain blood proteins
A drug that is used to increase the effects of another, such as aspiring when used in combination with codeine, is known as what?
potentiating
Your patient is on a medication for a Staphylococcus aureus infection. What adverse reactions might you expect with antibiotic treatment?
- Abdominal cramping
- Diarrhea
- Nausea
- Vomiting
What is the normal dosage for one tablet of aspirin?
325 mg
Anabolic steroids are often abused by athletes. What result may occur in the female athlete after ingesting testosterone?
A female may develop a condition known as hirsutusm, which is the excessive growth of hair in unusual places, with the ingestion of testosterone
What tool has the Inter-Association Task Force recommended not be used as the primary tool for loop-strap removal on a football helmet after an injury?
a screwdriver
A predisposing condition such as spinal stenosis may mean an athlete is more likely to?
develop paralysis after a fracture-dislocation
What word means “the abnormal development of tissue”?
dysplasia
_______________ and ______________ are two conditions that will interfere with fracture healing.
Poor blood supply, poor immobilization
______________ and ______________ are both examples of histamine-2 blockers.
Tagamet, Zantac
What drug muse the athletic trainer determine the athlete is not allergic to prior to administering a NSAID?
aspirin
When transporting an athlete off the field by manual conveyance, it is most convenient to do this with how many athletic trainers?
2
What is the average respiratory rate for an adult (18 years of age or older)?
12 to 15 breaths/min
Orthostatic syncope is caused by what condition?
Sudden peripheral vasodilation
Which type of food should the athletic trainer recommend the patient avoid if a gallbladder pathology is suspected?
fatty foods
Your team physician sends a prescription to you for your athlete that reads “whirlpool treatments TID.” What does TID mean?
three times a day
If necessary, the removal of the helmet and shoulder pads from an athlete with a suspected spinal cord injury should be coordinated to avoid what?
cervical hyperextension
What is the primary reason an athletic trainer would perform pulmonary auscultation?
To identify potential abnormal breath sounds
One of your female patients presents with dysuria, a sense of urgency to urinate, decreased urine volume, nocturia, low back pain, and pyuria. What do you suspect this patient has?
Cystitis, or a bladder infection
When choosing a prophylactic knee brace, the brace should meet what criteria?
- It should not interfere with normal knee function
- It should not increase injuries to the lower extremity
- It should be cost effective and durable
When recommending a running sneaker the athletic trainer should recommend a sole that has what major qualities?
shock absorbing and durable
One of your patients presents with abnormal pain that he describes as burning. He states that it becomes worse when he lies in supine o consumes caffeine, spicy foods, or alcohol. What might you suspect is the problem?
Esophageal reflux or peptic ulcer
One of your patients presents with a sudden onset of chest pain, dyspnea, hemoptysis, and cyanosis. What do you suspect is the problem?
pneumothorax
How long should the abdomen be auscultated before the athletic trainer decides if the bowel sounds are absent?
2 to 3 minutes
One of your patients begins to complain of intense itching of the skin under the cold pack that you applied to his shoulder 5 minutes ago. When you remove the pack you notice that hives have developed on that area that has been cooled. What is this patient experiencing?
Cold urticaria is an allergic reaction to cold exposure
When treating an athlete who presents with undifferentiated somatoform disorder, the athletic trainer should do?
- Provide care for a bona fide injury
- Develop a sound relationship with the athlete to gain trust
- Avoid doing more hard by dismissing the athlete as a “symptom magnifier”
When using iontophoresis, the athletic trainer should be aware of possible _____________ and ____________ as a result of ion flux during treatment
Skin irritation and chemical burns
Why it is important that an athlete with an abdominal injury never be given anything to eat or drink?
It increases the risks of surgery if an operative procedure becomes necessary
One of your diabetic athletes appears confused and is dizzy, apprehensive, and diaphoretic. How should this athlete be treated?
This athlete should be treated for insulin shock and should be transported to the nearest hospital if he or she does not respond to sugar within 2 to 3 minutes
What is the proper protocol for administering Tylenol to an adult?
Initial dose: 2 tablets, 325 mg each, repeat every 4 to 6 hours, PRN
What is the proper protocol for administering Advil to an adult patient?
Initial dose: 1 to 2 tablets, 200 mg each, repeat every 4 to 6 hours, PRN. Do not exceed 6 tablets in a 24-hour period without consulting with a physician
What is the proper protocol for administering Pepcid AC to an adult patient?
Initial dose: 1 tablet, 10 mg each with water up to twice a day. Do not administer more than 2 tablets in a 24-hour period
One of your athletes is complaining of constipation related to dietary change. What would be the most appropriate recommendation for the athletic trainer to make?
Recommend increased fluid intake and increased intake of fruits, bulk vegetables, and cereal
What category of drugs does not have a synergistic effect to cryotherapy?
Systemic antibiotics
What category of drugs has an antagonist effect to superficial and deep heat therapy?
Systemic vasoconstricters
What are the three most common sites for avulsion fractures and apophysitis in the pelvic region?
- Ischial tuberosity
- AIIS
- ASIS
What is the possible consequence of a poorly managed shin contusion?
Osteomyelitis, which results in the destruction and deterioration of the bone
What is the appropriate treatment for a Bennett’s fracture?
RICE and analgesics followed by immobilization of the carpometacarpal joint; it is structurally unstable and the athlete should be immediately referred to an orthopedic surgeon
One of your athlete is having an anxiety attack. What process does rebreathing into a paper bag reverse?
respiratory alkalosis
What end feel is an abrupt, firm, springy resistance to motion?
muscle spasm
When symptoms are experienced distal to the pathology, this is known as what?
referred symptoms
What special test identifies ulnar nerve compression or transmission interference at the elbow?
tinel’s sign
What are the signs and symptoms of anaphylactic shock?
- Development of rash or hives
- Wheezing sounds coming from chest
- A decrease in blood pressure
- Rapid, weak pulse
What type of shock is commonly referred to as fainting?
Psychogenic shock is caused by a temporary dilation of blood vessels that reduces the normal amount of blood in the brain
What are the signs of a diabetic coma?
- Fast and weak pulse
- Deep and sighing respirations
- Livid, later pale, skin
- Fruity-smelling breath
What are the two most common sites to apply direct pressure to control bleeding of the upper and lower extremities?
brachial artery and femoral artery
What are the signs of hypovolemic shock?
- Low blood pressure
- Rapid and weak pulse
- Shallow and extremely rapid respiration
- Agitation
How long can the brain be deprived of oxygen until brain cells begin to die?
4 to 6 minutes
What carries impulses toward the central nervous system?
afferent pathways
Deep stroking during massage is known as what?
friction massage
__________ pupils indicate possible shock, hemorrhage, or cardiac arrest.
dilated
What occurs when an individual is in shock?
- Skin is pale and cool
- Pulse is rapid
- Blood pressure is low
- Respiration is shallow
How often should the athletic trainer monitor vital signs and level of consciousness after an athlete has sustained a concussion?
Every 5 minutes until the athlete’s condition clears completely
Cranial nerve dysfunction and altered breathing patterns are signs of pathology of what part of the brain?
midbrain and medulla
Diabetic ketoacidosis may result from what condition?
High blood glucose levels
What condition has a cardiac etiology as it relates to sudden death in the athlete?
wolff-parkinson-white syndrome
At what core body temperature does shivering cease, skeletal muscle stiffen, and cold diuresis occur?
below 90 degrees F
What is a normal reading for pulse oximetry?
95-100%
What is the normal systolic blood pressure range for a child between 6 to 10 years of age?
80 to 122 mm Hg
How is the correct size of an oropharyngeal airway measured and selected?
Measure the distance between the tip of the ear to the corner of the mouth
An indication for suctioning includes what?
Vomiting in an unresponsive individual
Athletic trainers are qualified to use emergency oxygen systems to care for an ill or injured athlete. What is true regarding emergency oxygen systems?
- They have pressure reading systems
- They deliver oxygen at a fixed flow rate
- It has a container holding medical-grade oxygen
- It delivers oxygen at a flow rate of at least 6 LPM for at least 15 minutes
What precautionary measures should be taken prior to transferring and securing an athlete with protective equipment to a rigid immobilization device such as a spine board?
Facemask removal and preparation of shoulder pads
What is the first step in treating an abrasion or laceration?
reduce wound contamination
When a bronchodilator is used more often than recommended, it can cause what?
tachycardia
Portable radios and land line telephones are preferred over personal cell phones when communicating in an emergency primarily because of what?
A cell phone may be unreliable in some areas due to weak cellular signals
A capillary refill of greater than ________________ seconds is a sign of inadequate perfusion.
2.0 seconds
Acute compartment syndrome is considered a medical emergency
true
During which circumstance should an athlete be immediately referred to a dentist?
- Tooth is knocked out
- When a tooth is displaced 2 mm or more
- When a crown is fx and tooth is still alive
A patient who has been dx with infectious mononucleosis has just been cleared by the team doctor to return to full activity. How long should the patient remain out of contact participation from the time of onset to the time of full recovery?
at least 3 weeks
If an athlete is unconscious from a blow to the head, they should be assumed to have a neck injury in addition to a possible head injury. If the airway appears to be impaired, what are the appropriate steps in management?
- Cut facemask with an appropriate tool and move it
- Leave helmet on
- Stabilize neck and head
- Activate EMS
What are characteristics of a tension pneumothorax?
- Tracheal deviation
- Distended neck muscles
- Unilateral absence of breath sounds
- Cyanosis
When evaluating an unconscious athlete, what should the AT do first?
Check athlete’s airway is open and they are breathing normally
An athlete has a suspected fx involving the knee. What areas should be splinted?
Lower limb joints and one side of the trunk
Which cells release histamine and serotonin during the cellular response phase of tissue healing?
Mast cells and platelets
One of your cross-country runners has an ongoing problem with tinea pedis. Which of the following actions should you take to assist this athlete in minimizing the problem?
-Use talcum powder daily and keep their feet dry after showers
A patient comes to the ATR with what appears to be a tick embedded in his lower leg. The AT should instruct the patient not to do what?
Pull the tick out with tweezers
Your patient is on mediation for Staphylococcus aureus infection. What adverse affects might you expect with the antibiotic?
abdominal cramping
A predisposing condition such as spinal stenosis may mean an athlete is more likely to?
develop paralysis after a fx-dx
Spinal immobilization is best achieved with the full body splint. What are examples of full body immobilization
- Rigid spine board
- Vacuum mattress
- Scoop stretcher
- Miller full-body splint
What means “the abnormal development of tissue”?
dysplasia
What is the primary reason an AT would perform pulmonary auscultation?
Identify abnormal breathing sounds
One of your athletes presents with rhinorrhea, rhinitis, sore throat, nonproductive cough, low grade fever, headache, chills, and malaise. What actions should be taken?
Limit activity until fever resolves, resume full activity as symptoms resolve
When choosing a prophylactic knee brace, the brace should meet all criteria of:
- Shouldn’t interfere with normal knee function
- Shouldn’t increase injury to LE
- Cost effective and durable
What materials can an AT use to construct a custom protective/supportive device
- Felt
- Gauze
- Cotton
- Foam
One of your patients presents with a sudden onset of chest pain, dyspnea, hemoptysis, and cyanosis. What do you suspect is the problem?
pneumothorax
How long should the abdomen be auscultated before the AT decides if the bowel sounds are absent?
2-3 minutes
Which of the following is not a good reason to refer an athlete to a psychiatrist or psychologist
Athlete is showing undue concern over minor injuries, but the concern is brief
An athlete receives a head injury during a soccer game. While performing the on-field eval, the AT notices the athlete has a hearing defect after testing for air and bone conduction using a tuning fork. What cranial nerve is injured?
vestibulocochlear (VIII)
What is the proper protocol for administering Pepcid AC to an adult patient?
- initial dose: 1 tablet; 10 mg each with water twice a day
- No more than 2 tablets in 24-hours
Which category of drugs do not have a synergistic effect to cryotherapy?
systemic antibiotics
What category of drugs has an antagonistic effects to superficial and deep heat therapy
systemic vasocontrictors
Inflammatory Response
characterized by redness, swelling, tenderness, pain, increased temperature, and loss of function
Occurs : injury day-day 4
Rubor
redness
tumor
swelling
dolor
tenderness & pain
calor
increased temperature
functio laesa
loss of function
phagocytes
neutrophils, macrophages, and leukocytes that ingest microorganisms, other cells, and foreign particles
exudate
accumulation of fluid that penetrates through vessel walls into and joining extravascular space
vasoconstriction
the immediate vascular response to tissue damage ; decreases in diameter of a blood vessel
chronic inflammation
occurs when the acute inflammatory response does not respond sufficiently to eliminate the injuring agent and restore tissue to its normal physiological state/ from repeated microtraumas and overuse
fibroblastic repair phase
proliferative and regenerative activity leading to scar formation and repair of the injured tissue
Occurs: Day 4 - Week 6
fibroplasia
period of scar formation
collagen
a strong, fibrous protein found in connective tissue
type 1 collagen
found in skin, fasciae, tendon, bone, ligaments, cartilage, and interstitial tissues
type II collagen
found in hyaline cartilage and vertebral disks
type III collagen
found in skin, smooth muscle, nerves, and blood vessels
Maturation-Remodeling Phase
long-term process; this phase features a realignment or remodeling of the collagen fibers that make up scar tissue
Occurs: Week 3-(2-3 yrs)
wolff’s law
bone and soft tissue will respond to the physical demands placed on them, causing them to remodel or realign along lines of tensile forces
microtears
overuse
macrotears
acute trauma
atrophy
wasting away of muscle tissue
factors that impede healing
Microtears Macrotears Edema Hemorrhage Poor Vascular Supply Separation of Tissue Muscle Spasm Atrophy Corticosteroids Keloids Hypertrophic Scars Infection Humimdity, Climate, & Oxygen Health, Age, Nutrition
metaplasia
conversion of one kind of tissue into a form that is not normal for that tissue
hyperplasia
excessive proliferation of normal cells in the normal tissue arrangement
Muscle Strain Healing
the time required for rehab is fairly lengthy; rehab time for this particular injury is usually longer than for a ligament strain
hamstring strain healing period
6-8 weeks
tendon healing period
4-5 weeks
nerve healing
cannot regenerate once the nerve cell dies
methods for soft-tissue healing
anti-inflammatory medications
therapeutic modalities
exercise rehabilitation
Avascular Necrosis
a portion of the bone degenerates due to a poor blood supply
Conditions that interfere with fracture healing:
poor blood supply
poor immobilization
infection
soft tissues between severed ends of bone
stress fracture
created by cyclic forces that adversely load a bone at a susceptible site; may be the result of axial compression or tension created by the pull of muscles.
pain
“an unpleasant sensory and emotional experience associated with actual or potential tissue damage: