2nd Quarter Notes

What is an athletic injury? A damage to the musculoskeletal structures brought about by forces (i.e. acute or repetitive) during athletic performance.

Compression Forces that act along the long axis of a structure which produces a crushing effect.

Tension A pulling force that acts along the long axis of the structure which stretches the tissue.

Shear Forces that act at opposite directions at different points causing one part of the structure to move away from another part of the structure.

Acute Injury Injury with a sudden onset brought about by large forces Overuse Injury Injury that developed over time as a result of repetitive microtrauma

Neurological Emergencies Concussion Temporary disturbance in brain function brought about by a blow or jolt to the head Symptoms include headache, balance problem, confusion, and dizzy Signs include unconsciousness, amnesia, and clumsy

Neurological Emergencies Skull Fracture Trauma to the bony structure that protects the brain Could be linear, comminuted, depressed, or basilar Watch out for complications!! Signs and symptoms include cushing’s triad, nausea, and CSF leak

Neurological Emergencies Intercranial Hematoma Symptoms include headache, dizziness, and vomiting Signs include HR decrease, BP increase, raccoon eyes, battle’s sign, and CSF leak

Neurological Emergencies Spinal Cord Injury Trauma to the spinal cord leading to temporary or permanent paralysis C1-C4 paralysis from neck C5-C7 paralysis from chest T1-T9 paralysis of lower extremities

Management Steps to Spinal Injury Management Check consciousness (AVPU) Manage airway Perform neurological tests Apply cervical collar Log roll into spine board

Fractures Disruption in the continuity of a bone Type of fracture depends on mechanical load and bone maturity Several types of fractures include . . . Simple Compound Greenstick Comminuted Spiral

Signs and Symptoms Signs Symptoms Deformity Pain Weakness Bruise Swelling Positive X-ray Symptoms Pain Grating sensation

Evaluation Palpation – deformity, tenderness, indentation Percussion – pain during tapping Compression – distal to proximal Distraction – apply traction

Cast? Internal Fixation? External Fixation? Treatment Cast? Internal Fixation? External Fixation?

Dislocations Bone is pushed out of the joint capsule Signs and symptoms are similar to fracture Treat like fracture!!!

Immobilization Anatomical – fingers Rigid - wood Soft - bandage

Guidelines for Splinting Support the injured area above and below the site of the injury, including the joints. If possible, splint the injury in the position that you find it. Don’t try to realign bones or joints unless . . . Before and after splinting, check for proper circulation (warmth, feeling, and color). Immobilize above and below the injury.

Triangle and Cravat Bandages Cotton cloth that can be substituted if roller bandages not available First aid device, due to ease and speed of application Primarily used for arm slings Cervical arm sling Shoulder arm sling Sling and swathe

SPRAINS vs. STRAINS NOT INTERCHANGEABLE!! Both injuries are caused by abnormally high tensile forces which tears the tissue but damaged tissues are different . . . Which is Which?!?

SPRAINS vs. STRAINS Shoulders Lower Back Elbow Hamstrings Wrist Knee Ankle Lower Back Hamstrings Gastrocnemius

SPRAINS vs. STRAINS 1st Degree (Mild) No loss of function 2nd Degree (Moderate) Unstable / Weak 3rd Degree (Severe) Loss of function Dependent on the number of torn fibers . . .

What is inflammation? Is it bad? Control Inflammation What is inflammation? Is it bad? P – protect R – rest I – ice C – compression E – elevation

Elastic Bandage Application Hold bandage in preferred hand with loose end extending from bottom of roll Back surface of loose end should lay on skin surface Pressure and tension should be standardized Anchor at the distal end

Elastic Bandage Application Body part should be wrapped in position of maximum circumference More turns with moderate tension Each turn should overlap by half to prevent separation Circulation should be monitored when limbs are wrapped

The Skin Epidermis Dermis Hypodermis Function?!? Proptection, sensation, thermoregulation Function?!?

Common Emergencies Wounds Break in the skin and underlying tissues Open Closed Burns Injury caused by heat, cold, chemical, electricity, etc.

Common Emergencies Bites Wound caused by teeth or mouth Stings Small puncture wounds with chemical injected

Wounds and Bleeding Types of Wounds Incision Clean, sharp edge Laceration Irregular, tearing Abrasion Friction, scrape Puncture Pointed object Avulsion Partially ripped

!DANGER! Hemorrhage 1 glass (250cc) – normal 2 to 3 glasses – casualty becomes anemic and predisposes to infection 4 to 6 glasses – fatal Infection – gangrene may develop, amputation may be necessary Shock – circulation is compromised and may lead to death

Kinds of Bleeding Capillary bleeding – oozing flow of blood Venous bleeding – even flow of blood, dull color Arterial bleeding – irregular spurting of blood, bright red color

Wounds and Bleeding Proper Care Protect self Control bleeding a. direct pressure** b. elevation c. pressure points Use sterile dressing Prevent shock a. raise legs b. prevent heat loss Irrigate wound Change dressing regularly

Interrupted or Subcuticular? SUTURES are needed for deep cuts as well as cuts more than an inch long. Interrupted or Subcuticular?