Lecture 2 - Emergency Procedures (cont'd) Flashcards
CPR
- > 30 compressions - 2 breaths
- > 100bpm
- > 2 inch compression depth
- > make sure breath is actually going into chest cavity
- > may have to use AED
compression only CPR
- > keep blood circulating
- > suggested for non-healthcare professionals
- > not to be used if respiratory emergency (i.e. drowning)
after your primary scan what are the three avenues that would require further examination
- Head injury
- Spinal injury
- Peripheral joint injury
LODRFICARA
Location
Onset
Duration
Radiation
Frequency
Intensity
Character
Aggravating Factors
Relieving factors
Associated symptoms
Situations in which to activate EAP
- > unconscious athlete
- > non-normal ABCs
- > suspected spinal injury
- > major head injury
- > bone fracture (of humerus, pelvis, femur, facial, or cranial bone)
- > severe laceration to major circulatory system
- > inability to stand and bear weight
- > contusion to vial area (throat, eye, vital organ)
why is the weight bearing and ability to walk significant when someone is injured
- > if they can’t take 4 steps because pain is so severe then it’s probably a fracture - activate EAP
- > this helps remove the subjectivity of pain scales
Steps of a Head injury assessment
- > GCS
- > check for fluid coming out of eyes, ears, mouth, nose
- > mental state
- > symptom check (even one = concussion)
*headache, dizziness, nausea, vomiting (2+), ringing in ears, seeing stars - > personality change (hard to detect if you don’t know the athlete
- > PEARL
- > activate EAP?
- > monitor vitals
PEARL
pupils equal and reactive to light
signs and symptoms of expanding ICP
inter-cranial pressure
- > altered LOC
- > unequal pupils
- > irregular eye movements, not tracking
- > severe headache and vomiting 2+ times
- > increase body temp/ irregular respiration
- > persistent hypotension and bradycardia indicates severe brain damage
bradycardia
unusual slowing of HR, usually after lucid interval, indicates severe lower brain stem compression
eye examination (H pattern)
- > check for nerve damage
CN3 - > superior, inferior, medial rectur
CN3 - > inferior oblique
CN4 - > superior oblique
CN5 - > lateral rectus - > if eye is swollen shut assume that the globe is ruptured
Nystagmus
a condition of involuntary eye movement: horizontal, vertical, or rotary (can be bilateral or unilateral)
can be caused by
- > congenital
- > CNS disorder
- > drugs alcohol
- > rotational movement
pupillary light reflex
is a reflex that controls the pupils diameter in response to intensity of light
- > reflex pathway in CN2 (afferent) and CN3 (efferent)
- > useful in gauging brainstem function and tests motor and sensory function of the eye
- > dilate for dark environments or long local distances; constrick for light and short focal distances
- > reaction is brisk, slugish or flixed
how does the pupillary reflex come into play with the eye examination
normally both pupils will constrict with light, when one doesn’t then you call EMS as this means theres a neurological issue
- > if occulomoter nerve is damaged then pupils wont react to light
red flags when dealing with an injury
- > neck pain
- > confusion or irritability
- > repeated vomiting
- > weakness or tingling in extremities
- > seizure or convulsion
- > deteriorating consciousness
- > severe or increasing HA
- > double vision
- > unsual behaviour change
how to clear a head injury
- > stabilized head and neck if suspected
- > check for fluid in nose eyes, mouth, and ears
- > mental stays
- > eye exam (H-patterm, accomidation, PEARL)
- > symptom check and vital signs (constantly)
- > call EMS if not cleared
accommodation reflex
- > pupil changes size while focusing on near/far objects
Battle, racoon, and halo signs
SIGNS OF CRANIAL FRACTURE
Racoon - > around the eyes
Battle - > behind the ear
Halo - > drop of blood that is surrounded by CSF
LeFort Fracture
Type 1
- > straight across upper lip
Type 2
- > triangle (teeth up to bridge of nose)
Type 3
- > cheekbones upper like and outer border of eyes
sideline evaluation of head injury
- > administer SCAT 5
- > if symptoms are moderate and stable then refer to professional within 24-48hrs
- > if symptoms are severe and/or worsening refer to ER
subdural vs epidural hematoma
epidural hematoma
- > between skull and outer layer of brain/meninges
- > fast occurring, from large trauma
Subdural hematoma
- > occurs between dura mater and 2nd layer of meninges
- > slow, people can develop one days/weeks after injury
- > common spots are by temples (pterion) because this is the thinnest area of the skull
