Week 3 Flashcards
What might be on player medical records?
- medical conditions
- allergies
- previous injuries
- emergency contact info
- level of experience/# of years playing
What are our key goals?
- provide care to manage conditions
- minimize secondary complications
- determine safe removal
Things to consider when ensuring safe removal from playing surface?
- weight bearing?
- non-weight bearing?
- assisted?
- is advanced care required?
How can you handle safe removal from playing field?
- ask more questions (athlete/coaches)
- ask for help (another student trainer, certified AT, sport physio?other team?, docs?
General hierarchy of conditions (most imp to least)
- ABCs (airway breathing conditions), major bleeds
- acquired brain injury/concussion
- spinal
- fracture/dislocation
- sprains/strains
- abrasions
Hierarchy of emergency on-field assessment (most imp to least)
- survey the scene
- control the C-spine
- assess LOC
- assess vitals
- secondary survey
- head to toe
Survey the scene
Make sure it is safe to approach
Control the C-spine
Block the head
Assess LOC
Level of consciousness
(AVPU)
Assess vitals
Airway, breathing, circulation (includes major bleeds)
Secondary survey
- rapid body survey
- history (SAMPLE, PQRT)
Head to toe
To identify and other injuries
Primary survey
- survey the scene
- C-spine control
- LOC
- vital checks (ABCs)- are they there
How to conduct a scene survey?
- safety concerns in immediate environment?
- any clues to indicate what happened?
- did anyone see anything happen?
- how many athletes injured (have to triage who needs care first)
How to control the cervical spine
Block the head
- place one hand on athlete’s forehead to minimize movement
- ask athlete to remain still
- ask assistant to take over c-spine control using in-line stabilization
How to assess LOC
- remove mouth guard or anything in mouth
- rate athlete’s LOC using AVPU scale
What does AVPU stand for?
Alert
Verbal
Painful
Unresponsive
AVPU- alert
-eyes open, able to verbalize
AVPU- verbal
-responds to command or questions
AVPU- painful
- facial grimace
- flexion, extension or withdrawal of body part
- moan por groan
AVPU- unresponsive
- no response
Vitals check- ABC’s
A-airway
B-breathing
C-circulation
Vitals check - Airway
- is it open?
- position of head (in alignment? collapsed forward?)
- speaking or crying?
- unconscious?
Airway- When to use jaw thrust?
Do this when you suspect a spinal, especially if unconscious
Airway management tools
- oropharyngeal airway
- nasopharyngeal airway (AT not certified to do this)
Vitals check- breathing
- look
- listen
- feel
Vitals check- circulation
- do they have carotid pulse?
- obvious major bleed
Secondary survey summary
- rapid body scan
- history
- decision on next steps
What are you checking for with rapid body scan?
- major bleeds
- deformities
- anything indicating life-threatening emergency
What should be included in history taking?
- what happened?
- do you have any pain in your head?
- do you have any pain in your neck?
- do you have any pain in your back?
- do you have any tingling or numbness in your arms or legs?
- can you wiggle your fingers?
- can you wiggle your toes?
- does anything else hurt?
Decision on next steps: #1 Red flags for suspected spinal (when to call an EMS)
Any 2 out of the 4 following:
- central pain on palpation of spinous processes
- tingling/numbness/unable to move extremities
- if MOI is related
- unwillingness to move
Decision on next steps: #2 Head injury
- trauma to head
- pain in head
What to do before moving on to head injury assessment
- clear cervical spine first
- clear red flags
- check active ROM: flexion, extension, side bending, rotation
Head injury assessment symptom check
- do you have any pain or pressure in your head?
- do you have any ringing in your ears?
- do you feel dizzy?
- do you feel nauseous?
- is anything blurry or seeing double?
How many head injury symptoms need to be present to consider it a concussion?
- one (no return to play)
Head injury assessment observable signs
- check ears/nose for blood and fluid
- deformities in head
- black eyes
- bruising behind ears (battle’s sign)
- aggressive/emotional behaviour
- not making sense
- altered speech
- unable to focus
- seizure
Head injury assessment ocular/motor screen
- PEARL
- tracking
- peripheral vision
- ability to focus
Ocular/motor screen- PEARL
Pupils Equal And Reacting to Light
- cover one eye what happens to the other?
Ocular/motor screen - Tracking
- follow my finger
Ocular/motor screen- ability to focus
- how many fingers
- near and far
Head injury assessment cognitive screening
- orientation
- immediate memory
- delayed recall
- concentration
Head injury cognitive screening- orientation
- what is today’s date
- which team are you playing
- etc.
Head injury cognitive screening- immediate memory
- remember these 3 words and repeat after me (unrelated words)
Head injury cognitive screening- delayed/recall
- recheck those 3 words a few min later
Head injury cognitive screening- concentration
- can you count backwards by 3, starting at 100
What to do after head assessment is complete
- head to toe exam and decide how to safely remove athlete from field
- complete full SCAT6 on sidelines
SCAT6
Sport concussion and assessment tool; includes balance and coordination
What is include to include in head to toe exam?
- head
- neck
- shoulders
- chest/sternum
- ribs
- abdomen
- back
- pelvis
- legs/feet
- arms/hands
What are we looking for in the head to toe exam?
- pain
- bleeding
- spasm
- deformities
- bruising/wounds
- distal circ in ankle/foot
- distal circ in fingers
What is considered a major fracture or dislocation?
- large bone
- unstable or displaced
- compound fracture
What to do if there is a major fracture or dislocation?
- stabilize
- treat for shock
- call 911
Emergency medical conditions
- diabetic emergency
- epilepsy/seizure
- asthma
- anaphylactic shock
- heat/cold emergencies
- abdominal injuries
Shock
- circulatory system fails to adequately circulate blood
- life threatening condition= medical emergency
Symptoms of shock
- pale, cool, clammy skin
- rapid breathing
- rapid and weak pulse
- changes in LOC/confused
- nausea
- decreasing blood pressure
Care for shock
- blanket to maintain body temp
- rest in comfortable position to minimize pain
- have athlete lie down to increase blood to organs/brain
- reassure
- oxygen
