Emergency Situations and Injury Assessment

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Emergency Situations and Injury Assessment

• Chapter 7

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The Emergency Plan

• Have an Emergency Plan Practice It!
• Pre determined actions in the event of an
  emergency
• who will take charge,
• who will control crowds,
• who will call ambulance
• Procedures need to be posted and a card in the
  kit with address of facility and directions to
  event.
• The plan must be reviewed and discussed with
  participants, parents, officials, coaches and
  facility staff.
•  

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The Emergency Plan

• Considerations in Development
• Parent Notification
• Principles of Emergency Care
• Primary Assessment ABCs
• The Unconscious Athlete
• Review of Life-saving Techniques (CPR)
• Equipment Considerations
• Obstructed Airway

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Emergency Action Plan (EAP)

• Charge Person
• Most qualified person available with appropriate
  emergency first response training.

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Charge Person

• Should be familiar with emergency equipment for
  the particular activity
• Should control the emergency until a medical
  authority arrives
• Assesses the injury status of the athlete

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Call Person

• Must know location of working emergency
  telephone.
• Must have emergency contact information
  available.
• Must know directions to nearest hospital.
• Must know address of event facility
• Must know ambulance access routs

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Information for Ambulance Dispatcher

• State that it is a medical emergency.
• State what the emergency is.
• Is the athlete conscious?
• Breathing normally?
• Bleeding?
• Give exact location of facility and access route.

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Information for Ambulance Dispatcher

• Give phone number of the phone used to place the
  call. Have someone stay by the phone
• Ask for estimated time of arrival.
• Report back to charge person.
• Go to meet ambulance.

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Control Person

• Manages crowd to ensure adequate room for charge
  person to work.
• Ensures clear route for ambulance onto playing
  surface.
• Seeks medical personnel if requested by charge
  person.

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On-Field Assessment

• Tell athlete not to move
• Determine level of consciousness
• Stimulate
• A. B. C.s / primary survey
• Reassure
• Secondary survey
• Monitor vital signs
• Consider treatment
• transportation

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Secondary survey

• Physical signs.
• Fluid from ears, nose, mouth.
• Bleeding
• Deformity
• Skin colour

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Significance of Vital Signs

• Pulse children 60-80 bpm, adults 80-100 bpm
• Respiration children breaths 20-25/m, adults 12
  Blood Pressure male systolic 115- 120 mm Hg,
  diastolic 75-80 mm Hg, females 8-10 mm Hg
  lower.
• Temperature 37 degrees C, 98.6 degrees F
• Skin Color Red, pale, ashen, white, blue

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Significance of Vital Signs

• Pupils response to light, equal in size
• Consciousness alert and responds quickly, slow,
  unresponsive
• Movement Ability ability to move normally,
  weakness, paralysis
• Nerve Responses numbness, tingling, loss of
  sensation

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Assessment Decisions to be Made

• Seriousness of Injury Life-threatening?
• Type of First Aid Required?
• Medical Referral Required?
• Transportation Necessary?

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Shock

• Definition of Shock
• Types of Shock
• Signs and Symptoms
• Management of Shock

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Definition of Shock
SHOCK is a generalized inadequacy of blood flow
throughout the body to the extent of minimal to
extreme tissue damage. The vascular system loses
its capacity to hold the fluid potion of the
blood due to dilation of blood vessels leading to
disruption of osmotic fluid balance. Thus, plasma
leaks into tissue spaces resulting in stagnation
and slowing of blood flow causing decreased
oxygen to tissues leading to eventual death.
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Predisposing Factors of Shock

• Extreme fatigue
• Extreme exposure to heat or cold
• Extreme dehydration
• Illness

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Types of Shock
Hypovolemic blood lost from trauma, internal or
external bleeding, or lost plasma as in crush or
burn injuries Respiratory lungs unable to
supply enough O2 to circulating blood,
pneumothorax Neurogenic general dilation of
blood vessels thus the normal six litres of blood
can no longer meet O2 demands Psychogenic
caused by fainting often from fear, sudden
dilation of blood vessels causes decreased O2 to
brain
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Types of Shock
Cardiogenic failure of heart to pump enough
blood to the body Septic occurs from sever
bacterial infection Anaphylactic results from
severe allergic reactions from food, insect
bites, drugs, inhalants such as dust, pollens or
other chemicals Metabolic untreated diabetes,
extreme loos of bodily fluids through diarrhea,
vomiting or urination
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Signs and Symptoms

• Skin is moist, pale, cool, clammy.
• Weak and rapid pulse.
• Respiratory rate becomes increased and
  shallow.
• Decreased blood pressure.
• In severe cases - urinary retention and
  faecal incontinence.
• Unconsciousness.
• If conscious may display disinterest in
  surrounding, irritability, restlessness,
  excitement.
• There may also be extreme thirst.

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Management of Shock

• Immediate Transportation to Medical facility
• Face is pale lift the tail, Face is red lift the
  head.
• Spinal leave in position found until on the
  board.
• Head injury the head should be elevated - may
  be on board.
• Fractures of lower extremity elevate after
  splinting.

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Controlling Bleeding

• Direct Pressure
• Elevation
• Pressure points
• Hospitalization for observation of internal
  bleeding with injuries to head, abdomen and
  thorax.

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Spinal Injury Evaluation

• Unconscious Athlete
• Activate EAP
• Assume spinal injury
• Follow on-field assessment
• Prepare to transport athlete

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Spinal Injury Evaluation

• Conscious Athlete
• Tell athlete not to move
• Determine level of consciousness
• A.B.C.s
• Take history from athlete/ secondary scan
• Test sensation
• Test movement and grip, dorsi flexion
• Determine method of splinting and transportation

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Spinal Injury Evaluation

• Assume a head injury when c-spine is injured
• Assume a c-spine injury when head injury occurs

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TRANSPORTATION REVIEW

• Emergency Immobilization Techniques
• Moving the Athlete With Spinal Injury
• What to do with spinal injuries
• Use of spine board
• Ambulatory Aided Transportation
• Methods commonly employed
• Fitting and using crutch or cane

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Summary

• Most important aspect of Emergency Care of the
  injured athlete is to have an Emergency Plan, and
  the second most important is to practice it.
• Expect the unexpected and always be prepared for
  breathing emergencies.
• Be prepared to provide emergency transportation.