2.  Must have an Emergency Plan & Practice it › written down  Notification of parents  Principles of Emergency Care › Primary Assessment  The unconscious athlete  Lifesaving techniques (CPR)  Obstructed Airway

3.  Definition of shock  Types of shock  Signs & symptoms  Management of shock

4.  Pulse & Respiration  Blood Pressure  Temperature  Skin Color  Pupils  Consciousness  Movement Ability  Nerve Responses

5.  History – background information › Subjective information – feelings of patient › Previous injury  Mechanism of Injury › Anatomy and biomechanics  Observation  Palpation

6.  Seriousness of Injury › Life threatening??  Type of First Aid Required  Medical Referral Required  Transportation Necessary › Emergency immobilization techniques › Moving the athlete with a spinal injury  What to do  Spine board › Ambulatory Aided  Methods commonly used  Fitting crutches or cane

8.  Time is of the essence  Proper first aid & Treatment is important  Written plans of what to do › Life threatening or permanent well being  Loss of breathing  Cardiac arrest  Heat injury  Head injury  Cervical injury  Bleeding  Fractures  Severe sprains

9.  Phones – readily accessible & charged  Call 911 › Who makes the call › What information is given  Type of emergency  Type of injury suspected  Present condition of athlete  Current treatment given  Location of phone being used  Location of injured athlete & how to enter the facility

10.  Meeting to share plan with EVERYONE  Someone should accompany the athlete to the hospital  Communication between athletic trainer, EMT’s, and physicians  Parental notification and/or consent › Actual consent in writing or verbal › Implied consent  Keys

11.  Unconscious Athlete › Note body position › ABC’s must be established › Always suspect a neck or spine injury if athlete is lying in the prone position › NEVER remove the helmet › Supine & breathing – do nothing?? › Supine & not breathing – establish ABC’s

12.  Prone & breathing – do nothing until consciousness returns – log roll, monitor ABC’s  Prone & NOT breathing – log roll, establish ABC’s  Monitor/maintain life support  After stabilization of athlete – start secondary survey

13.  Determines the existence of life threatening emergencies › Airway › Breathing › Circulation › Severe bleeding › Shock  Treat life threatening injuries › No breathing or circulation – obstructed airway › Profuse bleeding › Shock

14.  Obstructed Airway Management › Heimlich maneuver  Control of Hemorrhage › Abnormal blood loss  Venous – dark red & even flow  Capillary – oozing and reddish  Arterial – spurts & bright red › External Bleeding  Direct pressure  Pressure points  Elevation  Ice  Tourniquet – last resort › Internal Bleeding

15.  Shock › Occurs when there is a diminished amount of blood in the circulatory system › Types of shock  Hypovolemic – results from trauma w/blood loss  Respiratory – lungs unable to supply enough O 2  Neurogenic – dilation of blood vessels, no O 2  Psychogenic – fainting  Cardiogenic – inability of heart to pump enough blood  Septic – results from a severe infection  Anaphylactic – allergic reaction  Metabolic – severe illness goes untreated

16.  Shock (cont’d) › Signs & Symptoms  Severe injury  Moist, pale, cool, clammy skin  Pulse is weak and rapid  Respiratory rate increases & is shallow  Blood pressure decreases (systolic is below 90)  Disinterested in their surroundings  Irritability  Restlessness  Excitement

17.  Shock (cont’d) › Treatment  Maintain body temperature  Elevate the feet  Head injury – elevate feet  Neck injury – lay flat  Leg injury – lay flat until splinted, then elevate

18.  Recognize Vital Signs › Pulse – 60-80 bpm › Respirations – 12-20 breaths/minute › Blood Pressure – systolic 120/diastolic 80  110/60 (low) to 140/90 (high) › Temperature – 98.6°F/37°C › Skin Color  Red – heat stroke, HBP, elevated body temp  White – insufficient circulation, fright, shock  Blue (cyanotic) – obstructed airway

19.  Pupils › Constricted – depressant drugs › Unequal - Head injury › Dilated -  Shock  Heat stroke  Hemorrhage  Stimulant drug › Fail to respond  Brain injury  Alcohol/drug poisoning  State of Consciousness  Movement  Abnormal Nerve Response

20.  Musculoskeletal Assessment › Ask questions › Palpate  Assessment Decisions › Seriousness of injury › Type of first aid required › Referral › Transportation

21.  Burning, tingling, or numbness that doesn’t resolve quickly  Burning, tingling, or numbness that is bilateral  Severe bleeding  Deformity  Deteriorating Vital Signs (VS)  Unconsciousness  Doubt

22.  Primary Goal = minimize injury damage › Control pain & swelling › RICE method  Rest  Ice  Compression  Elevation (above the heart)

23.  Splinting › Two major concepts of Splinting  Splint from one joint above the injury to one joint below the injury  Splint where athlete lies  Types of Splints › Air splints › Rapid Form Vacuum immobilizers

24.  Moving the Athlete › Take great Caution  Spine board  Ambulatory aid  Stretcher  Manual Conveyance (chair)  Pool Extraction - swimmers

25.  Acute phase – first 72 hours  Repair phase – 72 hours to 28 days  Remodeling phase – after the 28 th day

26.  Obtain HISTORY of athlete › Listen to athlete – describe exactly what happened  OBSERVE/INSPECT the injured part  PALPATE  Perform SPECIAL TESTS  HOPS/HIPS

27.  Determine appropriate course of action  Administer First Aid  Select and apply emergency equipment  Refer to appropriate medical personnel

28.  Primary Survey › Life threatening or serious injury  Evaluation of progress › Done periodically during treatment & rehab phases & recovery  Secondary Survey › Done to determine specific nature of injury, site and severity of injury

29.  Must know your Anatomy & Physiology to determine the exact structures involved  Must know terminology used in sports medicine so you can communicate with other professionals

30.  Symptoms – subjective in nature; reported to the evaluator; occur to the athlete  Signs – objective measurements which can be seen or felt by the evaluator

31.  Diagnosis – the name of a specific injury; can only be given by a physician  Prognosis – the prediction of the course of recovery based on the evaluation

32.  Primary complaint  Mechanism  Symptoms  Disability  Related medical history  MUST OBTAIN ENOUGH INFORMATION TO VISUALIZE HOW THE ATHLETE WAS LAYING ON THE COURT/FIELD, ETC

33.  Scan exam  Posture  Gait  Swelling  Discoloration  Cuts or scars  Skin & nail condition

34.  Deformity  Compression  Percussion  Distraction  Temperature  Swelling  Point tenderness  Pulses  Crepitus  Spasm #1 Rule – rule out a fracture

35.  Motion  Neurological  Stress Tests  Function Tests