On-Field Acute Care and Emergency Procedures

Question 1

Emergency Action Plan goals

Answer 1

Primary concern is maintaining cardiovascular and CNS functioning

Key to emergency aid is the initial evaluation of the injured patient.

Must at all times act reasonably and prudently

Must have prearranged plan that can be quickly implemented.

Question 2

EAP guidlines

Answer 2

Seperate plans should be created for each venue

Establish equipment and helmet removal policies and procedures

Availability of phones and access to 911

Be familar with community based emergency health care delivery plan.

Question 3

When calling 911 relay information …..

Answer 3

Type of emergency

Suspected Injury

present condition of the patien t

assistance being given

Location of phone being used

Location of emergency

Building limitations

Question 4

Parent Notification

Answer 4

When patient is a minor, ATC should try to obtain consent from parent prior to emergency treatment

When unobtainable, predetermined wishes of parent (provided at start of school) are enacted

With no informed consent, consent implied on part of patient to save life.

Question 5

On - Field Assessmenrt

Answer 5

Determines the nature of the injury

provides information about the direction of treatment

Is divided into primary and secondary surveys

Question 6

Primary Survey

Answer 6

Performed initially to ewstablish presence of a life-threatening condition

Surveys for airway, breathing, circulation, shock and severe bleeding are included

Used to correct life-threatening conditions

Question 7

Secondary Survey

Answer 7

Performed after life-threatening condition is ruled out

gathers specific information about the injury

assess vital signs

perform more detailed evaluations of non life-threatening conditions

Question 8

Dealing with Unconscious Patient

Answer 8

Always considered to have life-threatening condition

Check ABC’s (airway, breathing, circulation)

Assume neck injury

Remove helmet only after neck injury has been ruled out.

Question 9

Shock

Answer 9

Result of decrease in blood available in circulatory system

Movement of blood cells slow, decreasing oxygen transport to the body

Question 10

Types of Shock (8)

Answer 10

Hypovolemic - Decreased blood volume resulting n poor oxygen transport

Respiratory - Lungs unable to supply enough oxygen to circulating blood

Neurogenic - Caused by general vessel dilation which does not allow typical 6 liters of blood to fill the sytem, decreasing oxygen transport

Cardiogenic - Inability of heart to pump enough blood

Psychogenic - Syncope or fainting casued by temporary dialation of vessels reducing blood flow to the brain.

Septic - Result of bacterial infection where toxins cause smaller vessels to dialate

Anaphylactic - Result of severe allergic reaction

Metabolic - occurs when illness goes untreated (diabetes) or when extensive fluid loss occurs.

Question 11

Shock Management

Answer 11

Maintain core body temperature

Elevate feet

Keep patient calm. psychological stress could negatively affect patient

limit onlookers and spectators

reassure the patient

do not give anything by mouth until instructed by physician

Question 12

Secondary Survey

Answer 12

Pulse

State of Consciousness

Respiration

Temperature

Skin color

Pupils

Movement

Abnormal Nerve Response

Question 13

Pulse

Answer 13

Normal = 60-80 beats per minute

Childs = 80-100bpm

rapid and weak could indicate shock, bleeding, diabetic coma or hest exhaustion

Rapid and strong could indicate heatstroke, fright

strong and slow indicates skull fracture or stroke

no pulse = cardiac arrest or death

Question 14

State of Consciousness

Answer 14

AVPU scale = Alertness, verbal (responding to voice), pain (responds to painful stimulus), unresponsive (no response to pain)

ACDU = Alert, Confused, Drowsy, Unresponsive

Question 15

Respiration

Answer 15

12 breaths per minute for adults

20-25 for children

Shallow - shock

irregular or gasping - cardiac compromise

frothy with blood - chest injury

Question 16

Blood Pressure

Answer 16

Measured with sphygmomanometer indicating arterial pressure.

systolic blood pressure is pressure created by ventricle contraction (normal 115-120mmHg

diastolic pressure is residual pressure present between beats 75-80mmHg

Question 17

Temperature

Answer 17

Normal is 98.6 degrees

Question 18

Skin color

Answer 18

Red - Elevated temp, heat stroke or high blood pressure

White = Insufficient circulation, shock, fright, hemmorage, heat exhaustion or insulin shock.

Blue = (cyanotic) airway obstruction or respiratory insufficiency

Question 19

Pupils

Answer 19

Extremely sensitive to any situation impacting the nervous system.

Constricted = indicate use of depressant drug

Dilated = indicate head injury, shock, use of a stimulant.

Failure to accomodate may indicate brain injury, alcohol or drug poisoning

pupil response is more important than size

Question 20

Movement

Answer 20

Inability to move may indicate serious CNS deficits impacting motor control.

Hemiplegia - Inability to move one side.

Bilateral upper extremity sensory motor deficits could indicate cervical spine injury

Pressure on spine or injury below the neck could result in compromised function of lower limbs

Question 21

Abnormal Nerve Response

Answer 21

Numbness and tingling in limb with or without movement could indicate nerve or cold damage.

Response to adverse stimuli can provide important information.

Total loss of pain sensation may be caused by hysteria, shock, drug use or spinal cord injury