The A-E approach of the injured player Flashcards
Items that may block a player’s airway on the field-of-play:
Loose and poor-fitting gum shield if the player wears one.
Blood in the mouth.
Broken and loose teeth.
Mud (especially if the ground is wet and the player falls face down).
Chewing gum.
ATOM FC is used by an emergency clinician to identify life-threatening thoracic conditions that will lead to loss of life if no intervention takes place.
Airway obstruction
Tension pnemothrax
Open pnemothrax
Massive heamothorax
Flail chest
Cardiac tamponate (+/- pulmonary contusion / pulmonary oedema)
A player is experiencing a seizure in the semi-prone position after an unseen incident on the field of play.
What is your next immediate action?
Protect the players head and neck in MILS. Ensure they have adequate airway and apply oxygen as soon as possible. Then continue with your A-E assessment
It’s Saturday, and you are part of the medical team covering a Championship game. During the match, the referee suddenly stops the game. She points frantically down the touchline and waves the medical team on. You spot the assistant referee lying on the floor in a prone position. As you approach him, you can see tonic posturing and hear noisy breathing.
What is your next immediate action?
MILS and immediate jaw thrust, followed by quick ABC
In the clinical setting, ‘normal’ breathing exists within a range of values. If an individual’s rate falls outside this range, intervention is required to maintain adequate respiration.
In an otherwise healthy player, which of the following answers outlines the lower and upper rates of breathing (RPM) that would/could instigate clinical support via bag valve-mask ventilation?
<10rpm and >30rpm
Which one of the following depicts the best initial and continued assessment process?
Complete a full prior to A-E assessment
Appreciate mechanism of injury
Safe approach
Address catastrophic bleed
Application of MILS
Assess response
Ascertain signs of life
ABCDE
Secondary survey
Reassess
After a hard training session with the U17s, you are alone with a player in the changing room. Suddenly, she collapses. On initial assessment, she is not breathing and does not have a pulse.
What is your next immediate action?
Call for help
Provide 5 rescue breaths
A player involved in an illegal tackle in the goal area, who you suspect may have a spinal injury, is prone and breathing normally on approach.
What is your next immediate course of action?
Apply MILS. Access A-E and deal with the signs that arise. When ready, remove safely with triple immobilisation from the field of play.
What methodical process (applied to all medical emergencies) is essential in providing the structured delivery of crucial interventions in the management of the critically ill or injured player?
A-E approach
Regarding the advanced life support (ALS) algorithm in cardiac arrest, when you are considering the presence of any reversible causes, which one of the following is not one of the established ‘four H’s’?
Hypo/hyperthermia
Hypovolemia
Hypoxia
Hypo/Hyperkalamia
Several players are in the gym using weights. They are high spirited, messing around and not taking as much care with the equipment as they should, and one player attempts a chest press without a partner, the bar slips and the weights come down, crushing the player’s chest. You are immediately called to respond to this incident and arrive after the bar and weights have been removed by the other players present. The injured player remains reclined on the weights bench. On assessing breathing as part of your A-E approach, you utilise the RIPPA assessment.
Which one of the following statements is correct when using the RIPPA assessment?
Assessing via inspection, the presence of surgical emphysema can indicate trauma to the chest and lungs
During a match, a player is struck on the head by the ball. She collapses to the ground in a prone position and immediately begins to fit. On approach, you immediately gain c-spine control.
What is your next immediate action?
Apply MILS. Complete a miniABC and apply oxygen immediately.
ABC are dealt with as a first priority and a mini ABC established immediately. If any problems are identified thereafter at each stage of the survey, the survey is stopped and the problem dealt with before moving on. Once the A-E assessment has been completed and the player is stabilised, distracting injuries may be dealt with and extrication can be considered from the field of play.
Is this statement correct or incorrect?
Correct
During a cup final match with maximum crowd capacity reached, a player suffers a direct collision to their head and chest. On presentation, they have an altered level of consciousness, but their airway is controlled. Your next step is the B assessment.
What actions are required to complete an adequate assessment of the chest – both on the field and afterwards in the medical room?
Ascertain whether the chest is moving
Assess the respiratory rate and depth
Assess bilateral and equal expansion, both high and wide
Feel for crepitus from ribs and surgical emphysema
Apply oxygen
After full extrication, reassess the above - plus auscultation and percussion
Expose to look for additional injuries
The DR AcxBCDE approach to assessment is the most appropriate primary survey to perform in the majority of incidents that occur in the football setting. However, it has one caveat that needs to be taken into consideration once danger and response have been established.
Which one of the following best describes that caveat?
Catastrophic bleed
