Lesson 4

Emergency ProceduresTaken From Chapter 7 and 10 in book

The Emergency Action Plan

_____________________________________Should be written for each activity siteIndividual responsibilities and protocols should

be reviewedShould meet annually with EMS to review

procedures________________________________

The Emergency Action PlanContinuedEAP members should be certified in first

aid and CPREmergency medical supplies and

equipment should be easily accessible –___________________________

_________________________________________________________________

Emergency Situations

__________________________ Assess life threatening conditions A,B,CsTriage-assessing all injuries quickly and then

returning to the more serious injuries immediately - MASH

___________________________Detailed head to toe assessmentSigns = measurable objective findings-bleeding, fluidSymptoms = subjective info provided by person

Secondary SurveyHOPS

If the athlete is talking and moving, start your 2nd survey; if they are unconscious call 911; if they are unconscious and ABC’s are adequate begin 2nd survey

H__________O___________P__________S____________

History

History-gather subjective information via a series of questionsType of pain, Location of Pain, Mechanism of injury,

Nauseous or sick to stomach, any ringing in the ears, abnormal vision and sensations

Questions should be open ended

A person who is not fully responsive may have a head or neck injury

Diplopia – double vision

Observation

Survey the scene as you come on to itLook don’t touch; What to look for:

Bleeding, discoloration, swelling, obvious deformity, fluid from ears/nose, state of athlete (alert, lethargic, restless), pupil size, tracking, and reaction to light

Observe bilaterally

PalpationUsing your hands to feel for

abnormalities in bone or soft tissuePalpate bilaterally- good (uninjured)

then bad (injured); palpate for:Local heat, swelling, deformity, crepitus,

point tenderness, muscle spasm, pain, sensations or lack of at site of injury and below

Start away from the injury and move toward; start with light touches and increase pressure

Special Test

Limited in an emergency situation; main job is to determine if possible spinal cord injury

Avoid any unnecessary movementMotor test – ____________________

________________________________________________________________________

If athlete is unconscious, try painful stimulation- pinching the soft tissue in the armpit may make their eyelid flutter or involuntary movement away from the stimulus

If no response, do not move, wait for EMS, and monitor ABC

Unconscious Athlete

Call 911 for all unconscious athletesHead injuries are #1 cause for loss of

consciousnessSee guidelines to help an unconscious athlete-

p.17 1-10 (Handout).

Hemorrhage

Three types of bleeding:____________ = bright red, spurting__________ = dark bluish-red, steady flow___________ = red, oozing

TreatmentDirect pressureElevation (if no fracture)If continues - Pressure points (femoral/brachial

arteries)

Wound Cleansing – p.235-240

Wear gloves Clean wound with saline, mild soap

Don’t use alcohol or concentrated peroxide (water it down)

Soak wounds (if appropriate) in betadine solution

Apply ointments (neosporine etc) Apply dressing

Wound Dressing

Apply Occlusive dressingsSecond skinDuoderm

Covering wound to return to gameUse telfa pad/ ointment/prewrap/tape

Allow the wound to “breath” at night in a controlled environment-cover before sleeping in the beginning

Fractures

C/S-direct contact, fall, dynamic overload Signs: ___________________________

_______________________________________________________________________

Types-open (c),closed (s), transverse, epiphyseal, avulsion

Four ways of recognizing fracture: PalpationPercussionCompression (be careful)Distraction (be careful)

Treating Fractures

Splint before moving-Follow 1st Aid/Safety Rules; Apply Ice

Types of splints:AnatomicStiff/rigidSoftVacuum

Check skin color, temp, and capillary refill before and after splinting

Shock

Shock can occur with any injury involving pain, bleeding, internal trauma, fracture, or spinal injury

_____________________________________________________________________________________________________________

S/S- p. 204Treatment-Elevate legs, keep warm, monitor

ABC’s; p. 204

Environmental Conditions p.261-270

Ways of cooling body: ____________ (sweat)__________(coming in contact with cool object)____________ (air/water flow)

Dehydration increases chances for heat illness

Preventing Heat Illness

Identify at risk individuals-children; pre-season athletes

Acclimatize athletes – ___________________ Wear appropriate clothing-light weight, light-

colored, porousFluid hydration should be often and unlimited;

8-12 cups 24 hrs before; 5-10oz during every 15 mins; 24 oz after for every lb lost

Weight Charts

Preventing Heat Illness-Cont

Temperature/ humidity guide workouts - Heat Stress Indexhttp://www.srh.noaa.gov/epz/?n=wxcalc_heatindex

Allow humidity and temperature to guide workouts

Practice schedules____________________

Types of heat illness p.261-270

____________________Muscle spasms caused by electrolyte loss;

early in season

____________________More common early in seasonS/Sx (signs and symptoms): dizziness,

headache, profuse sweating, rapid breathing, gray skin, rapid weak pulse, uncoordinated gait, elevated temp, nausea

Types of Heat Illness (2)

_________________Body’s temp control mechanisms have shut

downMEDICAL EMERGENCY-CALL 911S/Sx: unconscious, sweating has stopped,

shallow breathing, hot dry red skin, rapid strong pulse (“bounding”), high body temp, convulsions, seizures, comma

Treating Heat Illness

Move person to cool placeRemove equipment/unnecessary clothesLie person on back, with feet elevatedGive cool fluids (unless unconscious)Specifics:

Heat cramps: stretch, ice, drink cool fluidsHeat exhaustion : call EMS (if necessary), rest

in cool room; utilize cool/wet towels Heat Stroke: call EMS, RAPID COOLING

Hypothermia

_______________________________S/Sx: intense shivering, inability to

perform tasks, speaking difficult, incoordination, in severe cases: unconscious

Treatment: Maintain ABCs, Activate EMS, remove wet clothing, jewelry, give warm fluids, re-warm person gradually

Frostbite

Most common in fingertips, toes, earlobes, tip of nose

Occurs when soft tissue freezesSuperficial: Involves skin and superficial tissueDeep: Involves subcutaneous layers, tissue

destructionS/Sx: red swollen skin diffuse numbness, skin

turns yellow-white/ blue with waxy lookTreatment: remove wet clothing re-warm area

immediately; cover with sterile dressing; transport to hospital

Vital Sign Assessment

Respirations - Normal (N) = 12(A) and 20(C)Skin Color

Rubor = red skinPallor = pale skin

Pupils (light reflex) and visionPulse (N=__________)Blood pressure (N) - ____________