On-Field Acute Care and Emergency Procedures Flashcards
Emergency Action Plan goals
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.
EAP guidlines
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.
When calling 911 relay information …..
Type of emergency
Suspected Injury
present condition of the patien t
assistance being given
Location of phone being used
Location of emergency
Building limitations
Parent Notification
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.
On - Field Assessmenrt
Determines the nature of the injury
provides information about the direction of treatment
Is divided into primary and secondary surveys
Primary Survey
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
Secondary Survey
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
Dealing with Unconscious Patient
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.
Shock
Result of decrease in blood available in circulatory system
Movement of blood cells slow, decreasing oxygen transport to the body
Types of Shock (8)
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.
Shock Management
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
Secondary Survey
Pulse
State of Consciousness
Respiration
Temperature
Skin color
Pupils
Movement
Abnormal Nerve Response
Pulse
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
State of Consciousness
AVPU scale = Alertness, verbal (responding to voice), pain (responds to painful stimulus), unresponsive (no response to pain)
ACDU = Alert, Confused, Drowsy, Unresponsive
Respiration
12 breaths per minute for adults
20-25 for children
Shallow - shock
irregular or gasping - cardiac compromise
frothy with blood - chest injury
Blood Pressure
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
Temperature
Normal is 98.6 degrees
Skin color
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
Pupils
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
Movement
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
Abnormal Nerve Response
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
