Serious Injuries Flashcards
What are examples of equipment you might need to manage serious injuries?
Guedel's airway Spinal collar/spinal board Gloves DFib Masks for CPR
What does DRS ABCD stand for?
D - assess for DANGER in the env (power lines, fire, chemicals, glass etc)
R - check RESPONSE - if no response then no need to do ABCD obviously
S - SEND for help
A - check AIRWAY - clear if needed
B - check BREATHING
C - begin CPR
D - use DEFIBRILLATOR if needed
Which fractures are medical emergencies?
- Vertebra - d/t spinal cord damage risk; check for spinal cord signs if you suspect spinal
- Pelvis - bc potential for great blood loss
- Femur
- Others - eg. ribs if they perforate lungs or other organs
- Head - is there LOC? signs of concussion?
Descirbe the assessment of neck injuries
- Assess peripheral S+M (no R) W/OUT moving the head - wiggle fingers/toes/squeeze hand/ask if sensation on one side feels the same as the other
- Palpate for asymmetric spasm or tenderness at the spine; palpate deliberately for continuiity
- Assess isometric neck strength W/OUT moving the head
- Assess ROM of neck - test a nod - at anytime if you think something is a bit awry or the pt says something stop
- Perform axial compression (Jane says she’s never done this); if -ve then athlete can be moved
- Note the exact time of injury since Mx decisions can be based on duration of sx
How do you respond as a first responder to a neck injury?
- Prevent them from sitting up
- Restrain their head so they don’t move it too much
- DRS ABCD if needed
Whats more important - airway management or spinal cord injury?
Airway management!
How do you manage conscious vs unconscious neck injury?
Conscious - regimented exam and PE exam
Unconscious - immob + address airway/breathing
- if unconscious and prone - log roll over and ABCD
- if conscious can leave them there and monitor
What are the different ways a spinal cord may be injured?
- Compression (can result in temporary loss in function for hours/day)
- Distraction
- Bruising
- Haemorrhage
- Ischemia
- Transection
What are the S/Sx of spinal cord injury?
Sensation
Motor -
Reflexes
Loss of bowel/bladder
Loss of sweating
ICH
- length of time until onset of symptoms depends on type of bleeding and location of bleed relative to dura mater
- EDH = between dura mater and skull
- SDH - between arachnoid and dura
- SAH
- ICH
Descirbe EDH
MOI - blow to the head
S/Sx - might have brief concussion/these may quickly subside but it is a LUCID period
- size of haematoma increases and symptoms increase in proportion to the amount of bleeding
Describe the progression of symptoms for EDH
- LOC of signs of concussion
- lucid period
- confusion/drowsiness/disorientation
- headache increasing in severity
- cranial nerve s/sx
- coma
- death
SDH
- MAJORITY of deaths resulting from athletic related head trauma
- symptoms may occur HOURS/DAYS/WEEKS after initial trauma
- acute = 48hrs
- chronic = 30+ days
Whats the difference between simple vs complex SDH
simple = no cerebral damage complex = contusions on brain surface associated with swelling
Describe the progression of s/sx for SDH
- initial lucid period
- headaches/cloudiness
- cognitive/motor/CN impairment
*let the pt know what s/sx to look out for at home so they don’t ignore them!
