Remaining Exam 1 Material [CH 8 + 9] Flashcards
9 issues that should be addressed when developing an emergency action plan
- develop separate emergency action plans for each sports field or court
- establish specific policies + procedures for removing equipment, particularly helmets + shoulder pads
- make sure phones are readily available
- a member of the sports medicine team should be designated to make an emergency phone call
- make sure keys to gates or padlocks are easily accessible
- assign a member of the sports medicine team to accompany the injured athlete to the hospital
- carry contact information for all athletes, coaches, + other personnel at all times, particularly when traveling
- in certain situations, staff members may be called upon to provide emergency services to non-athletes including spectators, referees, + coaches
- it is recommended a “time out” be routinely included prior to the start of each athletic event
what information should the designated member of the sports medicine team provide during emergency phone call
-type of emergency situation
-suspected injury
-present condition of the athlete
-exact location of the emergency
during the recommended “time out” period before the athletic event, what occurs
anyone in involved in athletic health care can meet + go over a specific checklist of the venues EAP (emergency action plan)
individuals providing emergency care to an injured athlete must ____ + act ____
cooperate, act professionally
what occurs too often
medical personnel disagree over exactly how the injured athlete should be handled/transported
ex: EMS + ATs disputing when to transport an athlete suffering from heat stroke
what should be done to keep good relations
establish procedures + arrange practice sessions at least once per year
how frequently should practice sessions occur
at least once per year
primary survey
refers to the assessment of life-threatening problems including ABCSS
ABCSS
airway
breathing
circulation
severe bleeding
shock
what injuries take precedence over all other injuries sustained by an athlete
life threatening injuries
primary survey- what should be established immediately
-body position, level of consciousness, + responsiveness
-CAB (circulation, airway, + breathing)
primary survey- what decides if equipment is removed to expose airway
type of sport
primary survey- if the athlete is supine + breathing, what do you do
do nothing until consciousness returns
primary survey- if the athlete is prone + not breathing, what do you do
log roll them carefully to supine + begin CPR immediately
decision to log roll is determined by what
whether you are trained to or not
primary survey- if the athlete is prone + breathing, what do you do
monitor closely until they regain consciousness
primary survey- how long should life support be maintained
until emergency medical personnel arrive
when should the secondary survey begin
once the patient is stabilized
it is essential that a ____ but ____ evaluation is made to determine whether CPR is necessary
careful but quick
all individuals in any way associated with a sport program should be certified in what
CPR + AED
when should an AED be used
immediately after it has been determined the athlete is unresponsive
in 2010 how did American Heart Association change its acronym
from ABC to CAB to emphasize the importance of chest compressions in creating circulation
(circulation, airway, + breathing)
3 things to control bleeding
-direct pressure
-elevation
-pressure points
control bleeding- direct pressure
-pressure applied directly over a would with the hand over a sterile gauze pad is recommended
-additional pads should be placed on top of pads already in place
-do NOT use a towel to stop bleeding because opens door to infection
-should use sterile gauze pad, 1 time use
how do you slow the bleed via femoral artery
find area in groin + kneel to put pressure on that area
control bleeding- elevation
works against gravity to reduce BP + facilitate venous + lymphatic drainage
control bleeding- pressure points
-when other options fail to work, pressure points may be used
-the 2 most commonly used are the brachial + femoral artery
what is the last resort to stop bleeding
pressure points
2 most commonly used pressure points
brachial artery
femoral artery
hemorrhage
loss of blood
internal hemorrhage
invisible to the eye making diagnosis difficult
-needs imaging to see
signs of internal hemorrhage
-abdominal pain
-shortness of breath
-nausea + vomiting
detection of internal bleeding/hemorrhage is only able to be made through what
diagnostic testing
what must you do to any athlete suspected to have internal hemorrhage
must be taken to hospital immediately
all severe hemorrhaging eventually results in what
shock
-therefore, treat athletes as such
shock
occurs when a diminished amount of blood is available to the circulatory system, resulting in fewer oxygen carrying blood cells
what is the biggest key thing to detecting shock
decreased BP
signs/symptoms of shock
-moist, pale, cool, + clammy skin
-weak + rapid pulse
-increased + shallow respiratory rate
-decreased BP
steps to manage shock
-dial 911
-maintain body temperature as close to normal as possible
-elevate feet + legs 8-12 inches for most situations, but depends on injury
when managing shock, what is something you can do to help manage body temperature
cover athlete with a blanket
why do we elevate legs when managing shock
so we can ensure the brain is getting enough blood
2 specific injuries we wouldn’t elevate legs for
-brain bleed: this would push more blood out of the brain; the brain is a closed space so the blood wouldn’t leave but would just increase pressure in that area
-leg fractures: we don’t want to move the fractured leg, but you can still move the non-injured leg
if there is no life-threatening injury, what should be conducted
secondary survey/assessment
secondary survey- vital signs
-heart rate
-breathing rate
-BP
-temperature
-pupils
normal heart rate
adults: 60-80 bpm
children: 80-100 bpm
normal breathing rate
adults: 12-20 breaths per minute
children: 20-25 breaths per minute
normal BP
120/80 mmHg
normal temperature
98.6 F
normal pupils
should be equal in size
pupils that aren’t equal in size indicate
traumatic brain injury
on-field injury inspection FIRST PHASE
includes making decisions on the seriousness of the injury + how the injured athlete should be transported if needed
on-field injury inspection SECOND PHASE
includes:
-brief history
-visual observation
-initial visual assessment
-palpation of the injury site
after the brief on-field inspection is carried out, what decisions should be made
-seriousness of injury
-type of aid/immobilization necessary
-injury requiring immediate referral
-manner of transportation
off-field assessment- history
understanding the mechanism on injury, how the injury occurred, a previous history of the injury, + the complains of the athlete are key to diagnosis
off-field assessment- observation
should include looking for swelling + edema, deformity, discoloration + tissue temperature changes
off-field assessment- palpation
-should include both bones + soft tissues
-must be performed systematically with light pressure away to deeper pressure toward the injury
off-field assessment- special tests
used to determine ligament stability, impingement signs, muscle imbalance, + body alignment discrepancies
MSK
musculoskeletal
immediate treatment following acute MSK injury
acronym POLICE
-protection
-optimal loading
-ice
-compression
-elevation
POLICE- P
protection
-splint, boot, brace
POLICE- OL
optimal loading
-early functional activity encouraged
POLICE- I
ice
-decreases pain
-also helps with inflammation
how can ice slow the healing process
ice gets rid of inflammation, but sometimes you don’t want to get rid of this because it kickstarts healing
POLICE- C
compression
-assists in decreasing edema
POLICE- E
elevation
-eliminates blood pooling in the extremities
emergency splinting
if an athlete appears to have a fracture, dial 911 + splint the body part before the athlete is moved
3 major concepts of emergency splinting
- splint from 1 joint above the fracture + 1 joint below
- splint the injury in the position it is found
- always check pulse + motor sensation
how would you splint a forearm fracture
splint the elbow + wrist
how would you splint upper arm fracture
we can’t splint the shoulder, but we can immobilize
if no pulse after putting splint on…
creates risk for amputation
-should have pulse before + after splint
rapid form vacuum immobilizers
can be molded to the shape of any joint or angulated fracture
air splints
clear plastic splint that is inflated with air around the affected part
splinting lower limb fractures
fracture of the ankle/leg require immobilization of the foot + knee
splinting upper limb fractures
lower arm + wrist fractures should be splinted in forearm flexion + supported by a sling
fitting crutches- where should crutch tips (bottom of crutch) be placed
-6 inches from outer margins of the shoe
-2 inches in front of the shoe
fitting crutches- where should underarm crutch be positioned
1 inch below the anterior fold of the axilla (armpit)
-there should be a gap between crutch + armpit so that it doesn’t aggravate armpit
fitting crutches- where should hand brace be placed
evenly with the athlete’s hand
-elbow flexed to approximately 30 degrees
using crutches
-athlete stands on 1 foot with the affected foot completely elevated
-place the crutch tips 12-15 inches ahead of the feet
-athlete leans forward, straightens elbows, + swings between the stationary crutches
spinal motion restriction (SMR)
the most important principle to prevent further harm to the spinal cord
2 techniques used for spine injured athlete
-head-squeeze
-trap-squeeze
head-squeeze
cup hands around ears
-better used when ambulance is near
trap-squeeze
better used when it will take a while for ambulence to arrive
most current recommendation for spine injured athlete
-MUST HAVE AT LEAST 3 TRAINED PROFESSIONALS
-remove both helmets + shoulder pads prior to transport while continually maintaining cervical spine stabilization
when should a rigid cervical spine collar be applied
at the earliest + most appropriate time
moving + transporting the spine injured athlete
-current recommendation is to initially place the patient on a long spine board for extraction from the field or court + then transfer them to a less rigid stretcher for transport
moving spine injured athlete- patient is supine
6+ person lift should be used
moving spine injured athlete- patient is prone
they must be log rolled onto back then placed on a spine board or scoop stretcher
how many people should be used to lift spine board
-TRY to get at least 7
-8 is most ideal
-6 is okay if that is all that is available
-1 person at head, rest on the sides
spine board means
we are worried they are paralyzed or drastic injury
stretcher means
less serious spine case
stretcher carrying
the sports medicine team member at the head of the athlete will direct those assisting to stand + will then command carrying the patient off the field or to an emergency vehicle
ambulatory aid
support or assistance given to an injured athlete who can walk
-athlete is still walking, just with assistance
manual conveyance
fully carrying the athlete, multiple people make a chair for athlete
bloodborne pathogens
pathogenic microorganisms that can potentially cause disease
-may be present in human blood + other bodily fluids including semen, vaginal secretions, + cerebrospinal fluid
-basically anything in your blood
3 most significant bloodborne pathogens
-HBV (Hepatitis B)
-HCV (Hepatitis C)
-HIV
hepatitis
basically inflammation of the liver
-viral infection that causes swelling, soreness, + loss of normal function in the liver
signs of HBV
-similar to flu symptoms
-fatigue
-nausea
-abdominal pain
-headache
-fever
is it possible for an individual infected with HBV to exhibit no signs or symptoms + go undetected
yes
prevention of HBV
-good personal hygiene
-avoiding high-risk activities
how long can HBV survive in dried blood or on contaminated surfaces
at least a week
is there a vaccine for HBV
yes- it can prevent the contraction of HBV
-any heathcare professional should recieve the immunization
what is the most common chronic bloodborne pathogen in the US
hepatitis C (HCV)
what might HCV require
liver transplant
signs of HCV
-80% have no signs of symptoms
-may have jaundice
-mild abdominal pain
how is HCV most commonly spread
through sharing of needles
-rarely spread in any other way
is there a vaccine available for HCV
no
human immunodeficiency virus (HIV)
viral infection that has the potential to destroy the immune system
signs/symptoms of HIV
-fatigue
-weight loss
-joint/muscle pain
-fever
how is HIV spread
through exposure to infected blood or through intimate sexual contact
how long may HIV take before developing symptoms
8-10 years
those who test positive for HIV have a high likelihood of developing ____
AIDS (acquired immunodeficiency syndrome)
-with AIDS, the immune system is crushed + cannot protect you in the same way
-the person becomes extremely vulnerable to developing a variety of illnesses as the immune system can’t protect the body properly
what countries have big HIV prevalence
-Africa (20.6 million out of the 37.9 million cases in the entire world)
-Southeast Asia
is there a vaccine for HIV/AIDS
NO
how to prevent AIDS
safe sex practices
policy regulation for bloodborne pathogens in athletics
-several institutions including NCAA have established BBP policies to educate athletes
-all healthcare professionals must follow universal precautions including hand washing, using biohazard containers, proper disposal of needles, etc.
what does the Americans with Disabilities act state about an athlete with HIV
player cannot be discriminated against + may only be excluded based on a medically sound evaluation
does the NCAA or CDC recommend mandatory HIV testing for athletes
NO- neither do
how to prepare an athlete using precautions
all open skin wounds should be covered before practice/competitions
when bleeding occurs, what should you do as a precaution to BBPs
athletes with active bleeding must be removed from participation as soon as possible + returned only when deemed safe
personal precautions
one-time-use nonlatex gloves should be used in treating the athlete
what supplies must sports programs have available
-chlorine bleach
-antiseptics
-wound care bandages
-sharps container
what color are sharps containers in US
red
what ratio of bleach:water should disinfectant solutions have
1:10
1 part bleach to 10 parts water
what are sharps
sharp objects such as needles, razor blades, + scalpels
abrasions
skin is scraped against a rough surface such as grass
lacerations
irregular + jagged tearing of soft tissue
difference between abrasions + lacerations
-abrasions are smaller, more like a scrape, + reach the first level of dermis
-lacerations are a cut that is irregular + jagged
incisions
wounds with smooth edges
incisions examples
-kitchen knife
-glass
puncture
direct penetration of tissues by a pointed object
avulsion
occurs when the skin is torn from the body
is tap water better than not cleaning a wound
YES
immediate care of skin wounds
to minimize the chances of infection, the would must be cleaned as THOROUGHLY AS POSSIBLE
what should be applied to keep a fresh wound clean
sterile dressing
if a wound is discharging fluid, what should happen
the dressing should be changed often to minimize bacterial growth
what is recommended for cleaning wounds repeatedly, followed by what
saline solution, followed by antibiotic ointment
if the athlete has a wound that appears to be severe, what should happen
they should be sent to a physician who will make the decision if sutures are necessary to close the wound
how long can the decision for sutures be made
golden window is 12 hours, no longer
-after this point there is a decent chance it will get infected anyway so you might as well leave it open at that point
signs of wound infection
-pain
-heat
-redness
-pus
how can most infections be treated
with antibiotics
how often should one get the tetanus immunization
as a child + booster every 10 years
