test2 Flashcards
-the initial evaluation -members of sports med team acting reasonably/prudently at all times -a prearranged plan that can be implemented on a moments notice(EAP)
proper emergency care of the injured athlete depends on these aspects
-outline personel and role (emergency team) -identify necessary equipment -availability of phones and access to 911/procedure for activating EMS -maps&directions for access to facility -procedure for documenting a medical emergency
components of EAP
-immediate care of the athlete -retrieval of emergency equip -activation of EMS -meet and direct EMS (roles determined by level of expertise)
roles within the emergency team
-spineboard -rigid cervical collars -face mask removal tools -CPR masks/ barriers -vacuum splints -crutches -blood borne pathogen kit -automated external defibrillator (AED) -emergency oxygen w/ mask
emergency equipment
1.name of caller 2.type of emergency; suspected injury 3.present condition 4.current care being provided 5.location of phone being used 6.location of emergency
activating/calling EMS
-athletic trainer generally first to arrive on scene of emergency -athletic trainer has more training and experience transporting athlete than physician -EMT has final say in transportation
cooperation btwn emergency care providers
-when unobtainable predetermined wishes of parent (provided at start of school yr) are enacted -with no informed consent, consent is implied on part of athlete to save their life
parent notification
- determines nature of injury
- provides info regarding direction of treatment
- divided into primary and secondary survey
principles on the field injury assessment
- note body position and level of consciousness
- check and establish ABC
- assume cervical sping injury until proven otherwise
dealing with unconscious athlete
with athlete supine and not breathing…..
ABCs should be established immediately
- if athlete supine and breathing…
nothing should be done until conciousness resumes/Monitor vitals
if prone and not breathing…
- nothing should be done until consciousness resumes– then carefully logroll and cont to monitor vitals
life support should be monitored and maintained until…
emergency personell arrive
- caregiver must be able to triage injuries
- life threatning injuries take precedents(CPR,profuse bleeding and shock)
- est responsiveness: gently shake and ask “are you ok” but if no response, EMS needs to be activated and postioning of body should be noted and adjusted in event CPR is necessary
primary survey
- equip may compromise lifesaving efforts but removal may compromise situation further
- facemask should be removed appropriate clip cutters (anvil pruner, trainers angel, fm extractor)
- use of pocket mask/barrier mandated by OSHA during CPR to avoid exposure to bloodborne pathogens
equipment considerations in primary survey
- A: airway opened
- B: breathing restored
- C: circulation restored
- D: defibrilator
reveiw of CPR
- performed once life threatening condition ruled out
- gathers specific information about injury
- assess vital signs and perform more detailed evaluation of conditions that don’t post life threatning consequences
secondary survey
- head tilt, chin lift method
- push down on the forehead and lifting the jaw mvoes the tongue from back of the throat
opening the airway (A of CPR)
- look, listen, and feel
- take deep breath, administer 2 slow breaths (raise chest 1.5-2 in)
- if breath doesnt go in, retilt and ventilate
- if breath still doesnt,30 chest compressions and lookf or object in airway
- OSHA requires the use of proteective barrier when adminstering CPR
establishing breathing (B of CPR)
- locate margin of ribs and xiphnoid process of sternum
- 2 fingers wdth above xiphoid process, place heel of hand on lower portion of sternum
- place other hand on top with fingers parallel of interlocked
- keep elbows locked with shoulders directly above patient
- compress chest 1.5-2” (30x per 2 breaths)
- after 4 cycles reassess the pulse(if not present continue cycle)
adminstering CPR
- When obstructed individual cannot breath, speak, or cough and may become cyanotic…__ ___ can be used to clear the airway
heimlich maneuver
- Stand behind athlete with one fist against the body and other over top just below the xiphoid process
- Provide forceful thrusts to abdomen (up and in) until obstruction is clear
heimlich maneuver
___ finger should be inserted in mouth along cheek, using hook maneuver, pull across to free impediment, and attempt to ventilate after each sweep until athelete is breathing
index
- Device that evaluates heart rhythms of victims experiencing cardiac arrest
- Electrodes are placed at the left apex and right base of chest - when turned on, machine indicates if and when defibrillation necessary
Maintenance is minimal for unit
using an automatic external defibrillator (AED)
- Venous - dark red with continuous flow
- Capillary - exudes from tissue and is reddish
- Arterial - flows in spurts and is bright red
hemorrhage types
- Direct pressure
- Firm pressure (hand and sterile gauze) placed directly over site of injury against the bone
- Elevation
- Reduces hydrostatic pressure and facilitates venous and lymphatic drainage - slows bleeding
external bleeding
Eleven points on either side of body where direct pressure is applied to slow bleeding
pressure points
- Can occur beneath skin (bruise) or contusion, intramuscularly or in joint with little danger
- Bleeding within body cavity could result in life and death situation
- Difficult to detect and must be hospitalized for treatment
- Could lead to shock if not treated accordingly
internal hemorrhage
- Generally occurs with severe bleeding, fracture, or internal injuries
- Result of decrease in blood available in circulatory system
- Movement of blood cells slows, decreasing oxygen transport to the body
shock
- Moist, pale, cold, clammy skin
- Weak rapid pulse, increasing shallow respiration decreased blood pressure
- Urinary retention and fecal incontinence
- Irritability or excitement, and potentially thirst
signs and symptoms of shock
- Maintain core body temperature
- Elevate feet and legs 8-12” above heart (positioning may need to be modified due to injury)
- Keep athlete calm as psychological factors could lead to or compound reaction to life threatening condition
management for shock
- Primary goal is to limit swelling and extent of hemorrhaging
- If controlled initially, rehabilitation time will be greatly reduced
- Control via RICE
REST
ICE
COMPRESSION
ELEVATION
immediate treatment
- Stresses and strains must be removed following injury as healing begins immediately
- Days of rest differ according to extent of injury
[rest] in immediate treatment
- Initial treatment of acute injuries
- Used for strains, sprains, contusions, and inflammatory conditions
- Ice should be applied initially for 20 minutes and then repeated every 1 - 1 1/2 hours and should continue for at least the first 48-72 hours of new injury
- Treatment must last at least 20 minutes to provide adequate tissue cooling.
- Ice shouldn’t be left on overnight because of THE HUNTING RESPONSE
[ice] in immediate treatment
- Decreases space allowed for swelling to accumulate
- Important adjunct to elevation and cryotherapy and may be most important component
- A number of means of compression can be utilized (Ace wraps, foam cut to fit specific areas for focal compression)
- maintained daily
[compression] in immediate care
- Reduces internal bleeding due to forces of gravity
- Prevents pooling of blood and aids in drainage
- Greater elevation = more effective reduction in swelling
[elevation] of immediate treatment
- SAM splint
- rapid form immobilizer
- lower/upper limb splinting
emergency splints types
- Styrofoam chips sealed in airtight sleeve
- Moldable with Velcro straps to secure
- Air can be removed to make splint rigid
rapid form immobilizer (emergecny splint)
- Fractures of foot and ankle require splinting of foot and knee
- Fractures involving knee, thigh, or hip require splinting of whole leg and one side of trunk
lower limb splinting
- Around shoulder, splinting is accomplished with a sling.
- Upper arm and elbow should be splinted with arm straight to lessen bone override
- Lower arm and wrist fractures should be splinted in position of forearm flexion and supported by sling
- Hand and finger fractures/dislocations should be splinted with tongue depressors, roller gauze and/or aluminum splints
upper limb splinting
- EMS should be contacted if this will be required
- Must maintain head and neck in alignment of long axis of the body
- One person must be responsible for head and neck at all times
- Primary emergency care must be provided to maintain breathing, treating for shock and maintaining position of athlete
placing athlete on spine board
- Perform primary survey
- Retrieve spine board
- with board close, captain gives command to roll onto board
- head and neck cont to be stabilized once on board
steps for sping boarding
- If athlete is a football player, helmet must stay in place with face mask removed
- Head and neck are stabilized by strapping
- Trunk and limbs are secured
moving and transporting injured athletes
- arms of athlete are draped over shoulders of assistants, with their arms encircling his/her back
- complete and even support provided on both sides by individs of equal height
ambulatory aid
- Used to move mildly injured athlete a greater distance than could be walked with ease
- Carrying the athlete can be used following a complete examination
- Convenient carry is performed by two assistants
manual conveyance
- Best and safest mode of transport
- With all segments supported athlete is lifted and placed gently on stretcher
- Careful examination is required is stretcher needed
- May be necessary if athlete can’t be transported comfortably in seated position
stretcher carrying
- When lower extremity ambulation is contraindicated a crutch or cane may be required
- Faulty mechanics or improper fitting can result in additional injury or potentially falls
proper fit and use of crutch or cane
- Athlete should stand with good posture, in flat soled shoes
- Crutches should be placed 6” from outer margin of shoe and 2” in front
- Crutch base should fall 1” below anterior fold of axilla
- Hand brace should be positioned to place elbow at 30 degrees of flexion
- Cane measurement should be taken from height of greater trochanter
fitting athlete for crutch
- Injured leg moves with the crutches
- Step with injured leg and crutches first, followed by uninjured leg
- Non-weight bearing (NWB) to touch down weight bearing(TDWB) partial (PWB) and full weight bearing (FWB)
- when using cane or one crutch, support should be held on uninvolved side
proper use of crutch
