Lecture 3 - Emergency Procedures (cont'd) Flashcards
steps in a spinal injury assessment
STABILIZE AND DO NOT MOVE THEM
- pain location
- body scan
- tingling and/or numbness into extremities
- sensation testing
- motor response (wiggle hands and toes then pump wrists and ankles)
- strength test
- activate EAP?
- monitor vitals until EMS comes
How to test myotomes of lower extremities
resisted holds with 5 second holds resistance
L4 - pull sole out
L5 - push foot into PF
S1 - push soles together
Testing dermatomes of the upper extremities
touch both sides at the same time if possible
C5 - lateral aspect of the upper arm
C6 - Lateral aspect of forearm, going down to thumb
C7 - Middle finger
C8 - medial hand and forearm
T1 - medial aspect of the arm
T2 - armpit
testing dermatomes of the lower extremities
L4 - Medial aspect of foot
L5 - Web of big toe
S1 - lateral aspect of foot
how to test myotomes in the upper extremity
C5 - resist bicep flexion or shoulder abduction
C6 - resist wrist extension
C7 - resist pulling fingers out
C8 - resist wrist flexion (limp wrist
what is a stinger/burner injury?
Burners and stingers are injuries that occur when nerves in the neck and shoulder are stretched or compressed (squeezed together) after an impact
Presents as…
- unilateral radiating pain, burning/parasthesia (burning and tingling) in upper extremity with possible weakness
- usually in C5-C6
- lasts seconds to minutes
Method of injury…
- traction
- impingement
how to distinguish a spinal injury from a stinger
see slide 56
what to do if the athlete is unconscious
- shake and shout
- do not move the athlete (control the athlete)
- ABCs
- always suspect a spinal and head injury
- CPR?
- AED?
if no pulse/breathing then you to do CPR with CAB, activate EMS and use the AED
what does CPR and CAB stand fore
CPR
- cardiopulmonary resuscitation
CAB
- Compressions
- airway
- breathing
what to do in the event of a fracture
- stabilize the athlete (control the athlete)
- support the injured limb or area
- split
- activate EAP
- monitor vitals signs, treat for shock
- Ottawa knee and ankle rules
- extreme boney tenderness
ottawa KNEE rules
determines the need for radiographs after acute knee injury; test is done after 7 days
get and X-Ray if any of these criteria are met
- if patient is 55 or older
- isolated tenderness of the patella
- tenderness at the head of the fibula
- unable to flex knee 90deg
- can’t weight bear (4 steps) both immediately and in the emergency department
ottawa ANKLE rules
determines the need for radiographs after acute knee injury
- can’t weight bear (malleolar pain)
- tenderness of the medial or lateral malleolus
what to do if theres a severe laceration
- control athlete
- apply direct pressure with gauze (DO NOT REPLACE BLOOD SOAKED GAUSE, add more on top)
- monitor vital signs
- treat for shock
- activate EAP
vital areas
- eyes
- ears
- abdomen (organs)
- major arterial supply
- airway
- reproductive area
what happens if theres a contusion to vital areas
- control athlete
- suspect internal bleeding
- signs of shock
- soft tissue tender, swollen or firm
- discolouration of the skin
- examine
- if severe then activate EAP immediately, if minor (i.e. in muscle) apply ice
characteristics of shock
shock is a life threatening medical condition from insufficient blood supply to the body
- can lead to hypoxia, tissue necrosis, heart attack, and organ damage
- requires immediate medical attention
S/S of Shock
Common symptoms
- rapid, shallow breathing
- cold, clammy skin
- rapid, weak pulse
- dizziness or fainting
- weakness
Other symtoms
- eyes appear to stare
- anxiety or agitation
- seizures
- confusion or unresponsiveness
- low or no urine output
- bluish lip and fingernails (cyanosis)
- sweating
- chest pain
list the types of shock
anaphylactic shock
- hypersensitivity or allergic reaction (allergy, insect bite, medicine, food)
septic shock
- bacteria in the blood and releasing toxins
- can be caused by many different infections
Cardiogenic
- heart is damaged and is unable to deliver sufficient amounts of blood to the heart and body
Neurogenic
- spinal cord injury, usually as a result of traumatic accident or injury
Hypovolemic shock
- severe loss of blood and fluid in the body
how to manage shock
- activate EAP
- stay with the athlete
- check ABC, administer CPR if compromised/not normal
- maintain normal body temp
- control athlete
- elevate feet
- do not give fluids even if the person is thirsty
- manage any additional injuries
S/S of HEAT related injuries/conditions
Heat cramps
- spasm of muscle due to fluid and electrolyte loss
- S/S muscle contractions, usually in legs and abdomen
Heat Exhaustion
- most common form of heat illness
- S/S normal to slightly increased temp, exhaustion, cool, MOIST, pale skin, headache
Heat Stroke
- S/S high temp, red, hot, DRY skin, LOC, rapid weak pulse and rapid shallow breathing
how to manage heat related injuries
- cool the body, give fluids, minimize shock, provide ongoing care
- heat stroke? Activate EMS
S/S of COLD related injuries/illness
Frostbite
- freezing of body tissue
- S/S lack of feeling, waxy skin, cold to the touch and discoloured
Hypothermia
- entire body cools, may result in death
- S/S shivering, slow, irregular pulse, numbness, glassy stare, apathy and declining LOC, changes in skin colour, slowly responding pupils
how to manage cold related injuries/illness
gradually warm the area/body, minimize shock
- hypothermia? activate EMS, provide ongoing care
peripheral joint Ax
- history of symptoms (what, where, how)
- active (ROM and pain levels)/ Passive (non contractile)/resisted (contractile
- activate EAP?
- ask athlete if they can get up (protect, support, control)
- help athlete off the feild
- re-assess
sideline peripheral joint Ax
- history (LODRFICARA)
- observations
*skin colour, bruising - temp
- deformities, swelling, atrophy, hypertrophy
- test ROM (ROM testing helps to narrow down structures are injured and you can isolate the structure that is suspected of being injured)
- Active
> athlete does movement without therapist
> assesses ROM and pain vs uninjured side - Passive
> therapist moves athletes joint through ROM
> stabilize above and below the joint in question
> assess ROM, quality of movement, apprehension to movement and pain - Resisted
> isometric contraction (hold 5 secs)
> test muscle strength and contractile tissues - special tests
*palpations
