Midterm Flashcards
Primary Prevention
reducing the incident of injury before they occur
Secondary Prevention
Addressing injuries in their early stage to prevent recurrence, severity and/or secondary complications
Examples of primary prevention
-looking at conditions
-equipment
-warm-uo
-nutrition/hydration
-looking for unfae technique
-injury patterns
-talking with coaches
-preventative bracing
examples of secondary prevention
-taping/wrapping
-education
-sufficent rehab
-early identification
-reconditioning
When to wear a brace instead of taping
-if sport doesnt allow
-ongoing conditions
-larger joints
-tape can sometimes wear off before game is over
what is the purpose of orthotics
-to adjust biomechanics to perform properly
what should orthotics also be given with
-proper, supportive rehab
What time period does an injury become chronic
over 6 weeks typically
Types of muscle and tendon injuries
-strain
-tendonitis/osis
-contusions
Types of ligament injuries
-sprain (overstretch, dislocations, subluxations)
Types of Bone injuries
-fracture/break
-bruise
Types of nerve injuries
-burner/stinger
-contusion/crash injury
Types of brain injuries
-concussion
-acquired brain injury
-direct trauma or indirect trauma
types of skin injuries
-lacerations, abrasions
-contusions
Sprain vs Strain
Strain is muscle or tendon and a sprain is ligament
Grade 1 sprain/strain
-tissues stretch/some fibres disrupted
-for sprains, integrity of joint is maintained
-for strains, contractions are strong but painful
Grade 2 sprain/strain
-partial tear/many fibres disrupted
-for sprains, results some instability/laxity in the joint
-for strains, contractions are weak and very painful
Grade 3 sprain/strain
-complete tear
-for sprains, results in significant instability/laxity in the joint
-for strains, unable to contract and often pain free
types of bone fractures
-transverse
-linear
-oblique (displaces and non-displaced)
-Spiral
-greenstick/bend
-comminuted
How does muscle respond to contusions
pain, swelling, discolouration, spasam, reflex inhibition
pain and swelling can stop
voluntary muscle contraction
difference between tendonitis and tendonosis
itis= inflammation (acute)
otis= tissue breakdown (chronic)
types of overuse injuries
-bursitis
-shin splints
-stress fractures
Role of student trainer
-EAP
-Primary and secondary intervention
-scene survey
-C spine
-Assess urgent vs non urgent
-Reassure
-support through rehab
What is an EAP
-organized system of managing servere injury
-allows for quick and efficent injury management
3 people included in EAP
Charge person, call person, control person
role of charge person
person in charge of delivering care
role of call person
-providing medical info and meeting/directing ambulance
role of control person
managing people and loacting supplies
what should be included on EAP
-Important numbers
-addresses
-location of medical records and AED
mechanism of injury
how it happened
sources of MOI
trauma and overuse
Onset of MOI
acute/traumatic or Insidious (gradual)
signs
something you see
symptoms
something the athlete feels/describes
examples of signs
-bruising
-swelling
-heat/cold
-sweating
-shivering
vomitting
examples of symptoms
-pain
-tingling
-numbness
-burning
-tight
-pressure
nausea
common measurement of pain
subjective scale of 1-10
essential role along with pain management
reassurance
how to help psychologicaly with injuries
-give injured athletes a job
-know when to refer
-listen a lot
-support
-mindful and sequential RTP
types of skin wounds
-lacertions
-abrasions
-punctures
-contusions
-blisters
steps of management of lacerations
step 1: control bleeding
step 2: clean the wound
step 3: steri-strips
controlling bleeding
-PPE
-pressure
-elevation
cleaning wounds
-soap and water
-cinder suds
*helps prevent infection
field considerations for when applying steri strips
-dry the area around laceration
-adhesive spray
-rub q tip on either side fo laceration
when do we send for stitches?
-only done effectively within 24hrs
-deep wounds affecting more than just skin
-unable to stop bleeding
-would to face
-wound is across joint
what to do for minor cuts and abrasions
non-stick gauze and cover roll
punctures
leave objects in and pad around, send for medical attention
what to avoid with contusions
-myositis ossificans
-deep tissue massage
what to do for contusions
-lymph drainage of effleurage
-protective padding
-ultrasound (pulse setting)
-interferential current
what to do for blisters
-skin lube
-second skin
-cover roll
*clean well
when to seek medical attention
-cant control bleeding
-dirty and cant clean
-deep wound/puncture
-object impaled
-changes in sensation
-human/animal bite
-rusty object
cartilage/meniscus healing
-limited capacity to healing
-little or no direct blood supply thereofore longer healing
ligament healing
-during repair phase, collagen or connective tissue fibres lay down randomly
-gradual scar is formed
-over following months collagen fibres align in response to joint stress/strain
skeletal muscle healing
-regeneration of new myofibres is minimal
-healing and repair follwos the same process of random collagen alignment and develops tensile strength in response to stress/strain
nerve healing
-regeneration can take place very slowly (3-4mm/day)
-peripheral nerves regenerate better than central NS
Wound healing stages
- Homeostasis
- inflammation
- Repair and regeneration
- Remodelling
wound healing: homeostasis
process leading to cessation of bleeding
wound healing: Inflammation
essential vascular and cellular response of proper tissue healing
would healing: repair and Regeneration
formation of granulation tissues
would healing: Remodelling
strengthening of tissues along lines of tension
what stage of wound healing to people often leave early
remodelling
length of inflammation
4-6 days
length of proliferation
4-24 days
when should advil not be taken
within first 24 hours of injury
how long is remodelling phase
21 days - 2 years
what stage does the matrix of collagen realign
remodelling
3 phases of musculoskeletal injuries
- Inflammatory
- Repair and regeneration
- remodelling
Musculoskeletal: Inflammatory response
-vasodilation of blood vessels
-while blood cells fight infection, break down and clean up damaged tissue to start healing
S&S inflammation
-redness
-swelling
-heat
-pain
-loss of function
Musculoskeletal: proliferation response
-collagen laid down in disorganized matrix
-revascularization brings O2 and nutrients
-edges of wound draw closer
Musculoskeletal: remodelling phase
-collagen reorganizes along lines of stress
-tissues increase in tensile strength
-important for avoiding chronic conditions
what is the best way to differentiate stages
timelines
Bone healing
-follows same 3 phases but more complex
-5 stages; avg 6-8 wks
5 stages of bone healing
- Hematoma formation
- Cellular proliferation (cells grow and divide)
- Callus formation (soft callus)
- Ossification (hard callus)
- Remodelling
Inflammatory phase aims of treatment
-decrease pain, swelling, inflammation, activity
-protect
-educate
Demolition phase (3-15 days) aims of treatment
-decrease residual swelling and pain
-increase ROM, flexability, strength, proprioception, CV fitness
-prevent complications
-educate
Healing phase (day 10 - 8wks) aims of treatment
-increase circulation, ROM, flexability, strength, CV fitness, proprioception
-decrease muscle spasam
long term goals aims of treatment
-maintain skin and connective tissue
-ensure full ROM, strength, flexibility, psych rediness
-optimal biomechanics
-correct habits
-proprioception
-protect injury site
guidelines for RTP
full ROM, 80% strength
-able to perform demands of sport
-psych rediness
tools trainers have
-hot/cold
-massage
-wound care
-taping and wrapping
-exercise
-educate
when to use heat
-healing phase and beyond
-relaxation
-promote flexability
tissue response to heat
-increase circulation, inflammation, metabolism, edema
-decrease spasam, pain
types of heat
-moist heat application
-eletric heat pads
-hot shower
-microwaveable bags
-sauna
-ultrasound
infrared vs traditional saunas
-heats your skin/body vs just the air around you
contraindications to heat
-inflammed tissues
-bleeding disorder
-blood clots
-impaired sensation
-metal implants
-infection
-open wounds
-pregnant
tissue response to cold
-decrease, inflammatory response, edema, pain, circulation, hematoma, muscle spasam, tissue metabolism, enzymatic activity, extensability
types of cryotherapy
-crushed ice or cubes
-gel packs
-frozen beanbag
-only keep on for 10-15 min
-ice cup massage
-cold immersion
-cryochamber
-gaseous therapy
liquid nitrogen
contrindications of electric cryochamber
-pregnant
-high BP
-Blood Clots
-Heart conditions
-Infection
raynauds phenomenon;
- decreased blood flow to finhers/toes due to vasospasam
“do fingers turn white in the cold”
contraindications to cold
-urticardia; hives from cold
-clotting disorder
-superficial nerves
-altered skin sensation
-CPRS
when to massage
-tight muscles
-injured msucles
injured muscles in inflammatory phase
lymph drainage or effleurage only
what to do for injured muscles in the healing phase
deeper forms of massage to increase circulation
contraindications to massage
-acute inflamm
-contusions
-acute spasam
-open wounds
-altered sensation
-possible clot
-bleeding disorders
-over varicose veins
-DVT
-cancer
four main principles of massage therapy
- general - specific - general
2 superficial - deep - superficial
3 proximal - distal - proximal - Peripheral - central peripheral
what should be in a players medical records
Conditions, allergies, previous injuries, emergency contact, level of experience
What are our key goals?
-provide care to manage conditions
-minimize secondary complications
-determine safe removal
questions to address when determining safe removal from play
-weight bearing
-non weight bearing
-assisted?
-advance care requires?
general hierarchy of conditions
- ABCs, Major bleeds
- Acquired brain injury/ concussion
- spinal
- fracture/dislocation
- sprains/strains
- abrasions
steps for on-field assessment
- Survey the scene
- block the head/control cspine
- determine LOC
- Assess Vitals (ABC)
- history (SAMPLE, PQRST)
- Identify any other injuries
Questions to ask yourself during the scene survey
-any safety concerns in the immediate environment
-any clues to MOI
-how many people injured
how to control the C-spine
-block the head
-place one hand on athletes forehead
-ask athlete to remain still
-as assistant to take over using in-line stabilization
Assessing LOC
-use AVPU scale
AVPU
Alert, Verbal, Painful, Unresponsive
types of airway assisted devices
oropharangeal airway, or nasopharangeal airway
how to check circulation
-check for carotid pulse
Summary of secondary survey
rapid body scan, history, decision on next steps
rapid body scans check for:
-major bleeds
-deformities
-anything indicating a life-threatening emergency
call ems for spinal if the have any 2:
-central pain on palpation
-tingling/numbness/unable to move extremeties
-MOI
-unwilling to move
how many head injury assessment symptoms are considered a concussion?
one- no RTP
observable signs of head injury
-CSF in ears/nose
-deformities
-black eyes
-brusing behind ears
-aggressive/emotional
-altered speech
-cant focus
-seizure
oculomotor screen for head injury
-PEARL
-tracking
-peripheral vision
cognitive screening
-orientation
-immediate memory
-delayed recall
-concentration
how to treat major fractures and dislocations
-stabilize
-treat for shock
-call 911
emergency medical conditions
-diabetic emergency
-epilepsy
-asthma
-anaphalactic shock
-heat/cold emergencies
-abdominal injuries