Sport First Aid

Aspects of Treating Injuries Injury and Illness Prevention Injury and Illness Prevention Injury and Illness Recognition and First Aid Injury and Illness Recognition and First Aid Assessment/Diagnosis and Treatment Assessment/Diagnosis and Treatment Rehabilitation Rehabilitation

Sports Medicine Team Many make up a successful Sports Medicine Team, each must know and stay within their role. Many make up a successful Sports Medicine Team, each must know and stay within their role. –Athlete –Coach –EMT/Paramedic –Physicians –Athletic Trainer –Physical Therapist –Dentist/Oral Surgeon –Optometrist –Strength and Conditioning Coach –Equipment Manager –And more….

Coaches Responsibility Proper planning and instruction Proper planning and instruction Warn of inherent risks Warn of inherent risks Provide a safe physical environment Provide a safe physical environment Proper equipment Proper equipment Match up appropriately Match up appropriately Recognize injuries or incapacity Recognize injuries or incapacity Supervise activity closely Supervise activity closely Provide appropriate medical care Provide appropriate medical care

Game Plan –Varies greatly depending on level of play. –PPE and Liability Forms See COC Athletics for example See COC Athletics for example –Weather –Facilities –Conditioning –Equipment/Bracing –Correct Skill Instruction –Nutrition

EMERGENCY PLAN Trained Personnel Trained Personnel –Credentials 1st Aide 1st Aide CPR CPR ATC ATC EMT EMT MD MD –Emergency Care Equipment Field Kits Field Kits Splint Bags Splint Bags Stretcher Stretcher Biohazard Biohazard

Emergency Transportation Emergency Transportation –Transportation Vehicles –Ambulance & Paramedics –School personnel Communication System Communication System –Equipment radios radios telephones telephones on-the-scene transfer of information on-the-scene transfer of information – Notification ER & Urgent Care ER & Urgent Care Parents Parents Administrators Administrators

Emergency Care Facility Emergency Care Facility –Hospitals Services Offered Services Offered Locations Locations –Legal Considerations Group Health Care Plan Facilities Group Health Care Plan Facilities Emergency Care Protocol Emergency Care Protocol –Chain of Command Assignments and responsibilities Assignments and responsibilities on the scene care on the scene care telephone emergency telephone emergency Map (directions) Map (directions)

–Mock Drills Be Prepared Be Prepared Record Keeping Record Keeping –Accident Report –Emergency Cards –Documentation

911 Calls... Must give dispatcher following information Must give dispatcher following information –Type of emergency situation –Type of suspected injury –Present condition of athlete –Current assistance being given (CPR, ect) –Location telephone telephone cross streets cross streets how to enter facility how to enter facility

Assessment Procedures On The Field On The Field –Primary Survey ABCs ABCs Bleeding/Shock Bleeding/Shock –Secondary Survey Vitals Vitals Signs & Symptoms Signs & Symptoms

Unconscious Athlete –Note Body Position –Determine level of consciousness –ABCs –Neck & Spine –Do not remove helmet (face mask o.k. –Establish Airway –If prone and no breathing, role over (supine) –If prone and breathing, do not role over –When consciousness gained, log roll to spine board –Maintain Vitals until EMS arrives –Athlete is stabilized, 2ndary survey

External Bleeding External Bleeding –Direct Pressure –Elevation –Pressure points Brachial/Femoral Brachial/Femoral

Shock Can occur with any injury Can occur with any injury Most likely in Most likely in –severe bleeding –internal injury –fractures Definition Definition –Not enough blood available to circulatory system

–Dilation of blood vessels & imbalance of osmotic pressure Shock if untreated can cause DEATH Shock if untreated can cause DEATH Risky Conditions Risky Conditions –extreme fatigue –extreme temperature –extreme dehydration –illness

Handling Shock Signs & Symptoms Signs & Symptoms –Skin Moist, pale, cool, clammy skin Moist, pale, cool, clammy skin Weak & rapid pulse Weak & rapid pulse Increased & shallow breathing Increased & shallow breathing decreased b.p. decreased b.p. extreme thirst extreme thirst

Treating Shock Treating Shock –Maintain body temperature –Elevate Feet Unless head & neck Unless head & neck –If psychogenic, do not allow athlete to see injury –Do not over react, but confident & in control.

VITALS Pulse Pulse –60-80 in adults –Account for activity – in children Respiration Respiration –12 in adults –20-25 in children Blood Pressure Blood Pressure Temperature Temperature Skin Color Skin Color

Blood Pressure Blood Pressure –Systolic over diastolic –120/80 Temperature Temperature –98.6 Skin Color Skin Color Pupils Pupils –shock, heatstroke, hemorrhage –stimulants

State of Consciousness State of Consciousness Movement Movement –Head Injury –Stroke (cerebrovascular accident) –Abnormal Nerve Response Nerve damage Nerve damage blocked artery blocked artery spinal cord injury spinal cord injury head injury head injury

Musculoskeletal System Bones Bones –Shape, support, protect Joints Joints –When 2 bones meet Ligaments Ligaments –Bone to bone Tendon Tendon –Muscle to bone Cartilage Cartilage –Absorb force and reduce friction in a joint Muscles Muscles –Shorten to cause movement Bursa Bursa –Small, fluid filled sacs for reduce friction

Other Systems Neurological Neurological –Body’s control center Digestive Digestive –Energy Supply Respiratory and Circulatory Systems Respiratory and Circulatory Systems –Oxygenated blood Urinary System Urinary System –Remove waste from blood.

23 The Physics of Injury Muscle/tendon injuries Muscle/tendon injuries –injured by excessive tension –muscle/fascia injuries occur during eccentric contraction –tendons are strong to 18,000 lb./sq. inch. –strains occur most often at the musculotendinous junction (MTJ) –MTJ strains -- most common soft tissue sports injuries

24 Critical Force Critical Force: Critical Force: –Defined: How much force can tissue withstand –Varies for each type of tissue –May vary within the same tissue, depending upon: age age temperature temperature skeletal maturity skeletal maturity gender gender body weight body weight

25 The Physiology of Injury The inflammatory process The inflammatory process –Whenever damaged, the body reacts with a predictable sequence of physiologic actions, commonly called “swelling.” –begins during the first few minutes following an injury

Acute and Chronic Injuries Acute injury - “injury characterized by rapid onset, resulting from a traumatic event” Acute injury - “injury characterized by rapid onset, resulting from a traumatic event” Acute injuries typically involve trauma followed by pain, swelling and loss of function. Acute injuries typically involve trauma followed by pain, swelling and loss of function. Critical force -- “magnitude of a single force for which the anatomical structure of interest is damaged” Critical force -- “magnitude of a single force for which the anatomical structure of interest is damaged”

Acute and Chronic Injuries Chronic injury - “injury characterized by a slow, insidious onset, implying a gradual development of structural damage” Chronic injury - “injury characterized by a slow, insidious onset, implying a gradual development of structural damage” Chronic injuries develop over time and are often associated with repetitive, cyclic activities, such as running. Chronic injuries develop over time and are often associated with repetitive, cyclic activities, such as running. These injuries are commonly called “overuse injuries.” Common sites include the Achilles tendon, patellar tendon and the rotator cuff. These injuries are commonly called “overuse injuries.” Common sites include the Achilles tendon, patellar tendon and the rotator cuff.

Types of Open Wounds

Care for Open Wound 1. Stop Bleeding 1. Stop Bleeding –Direct Pressure with gauze (if available) –Stack gauze, do not remove it. –Pressure points in severe cases (arteries) Clean with soap and water, irrigate with water, 5 min if possible Clean with soap and water, irrigate with water, 5 min if possible Ointment (neosporin, triple antibiotic, etc.) Ointment (neosporin, triple antibiotic, etc.) Cover with band aide or other non stick product. Cover with band aide or other non stick product. Stitches? Stitches? –½ inch long or skin does not naturally come together.

Sprains - injuries to ligaments (three levels) Sprains - injuries to ligaments (three levels) –1 st degree: Slightly torn ligament –2 nd degree: Significantly torn ligament –3 rd degree: Completely torn ligament Strains - injuries to tendon, muscle or musculotendinous junction (Same 3 levels as above) Strains - injuries to tendon, muscle or musculotendinous junction (Same 3 levels as above) Contusions - commonly called a bruise Contusions - commonly called a bruise Connective Tissue Injury

Fractures - break or crack in bone -- two types: closed and open Fractures - break or crack in bone -- two types: closed and open Stress fracture - break or crack in a bone which develops over a relatively long time period Stress fracture - break or crack in a bone which develops over a relatively long time period Dislocations - the displacement of contiguous surfaces of bones comprising a joint -- two types: Dislocations - the displacement of contiguous surfaces of bones comprising a joint -- two types: –subluxation - partial –Luxation or dislocation - total displacement

Chronic Injuries –Chronic Muscle Strain Repetitive straining Repetitive straining –Tendonitis Irritated tendon, inflamed Irritated tendon, inflamed –Bursitis Inflamed Bursa Inflamed Bursa With all chronic injuries, its important to discover what changed. With all chronic injuries, its important to discover what changed.