Emergency Care

1
Emergency Care

• Chapter 12

2
Emergency Action Plan

• Most sports not life or death
• Time is critical in emergencies
• Mistakes and/or procrastination BAD
• 1 concern is CV and CNS function
• All sites must have a PLAN
• Where is the phone?
• Who calls 911 (or other emergency number)?
• What info to give the dispatcher?
• Facility logistics gates, best access route,
  meet greet
• Transportation minor vs. adult
• Who needs to know the plan?
• Avoid ego conflict annual training
• Parent notification

3
Assessment Principles

• Always assume unconsciousness life-threatening
  injury
• Check
• Scene for safety
• Victim for responsiveness
• Call 911
• Immediately for unresponsive adult
• After 1 minute of care for child/infant
• Care
• Primary survey
• Secondary survey

• Primary survey life threatening situations
• A airway
• B breathing
• C circulation
• Severe bleeding
• Shock
• Secondary survey look for other injuries
• Head to toe
• More detailed evaluation
• May uncover problems that could become deadly

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Primary survey

• Life-threatening injuries airway obstruction,
  no breathing, no pulse, hemorrhage, shock
• Establish unresponsiveness call 911
• To remove or not to remove the helmet?
• Open the airway (head tilt or jaw thrust)
• Establish breathing (look, listen, feel)
• Yes breathing ? recovery position
• No breathing ? give 2 rescue breaths
• Breaths dont go in, re-tilt and try again
• If they still dont go in, treat for airway
  obstruction
• Establish circulation (carotid or brachial pulse)
• No breathing, yes pulse rescue breathing
• No breathing, no pulse CPR

5
Equipment considerations

• Helmet
• Dont remove
• Cut facemask off
• Shoulder pads
• Dont remove
• Cut laces and jersey
• Use barrier device
• If you take off one, you MUST take off the other

6
Airway emergencies

• Rescue breathing
• Adult 1 breath every 5 seconds
• Child/infant 1 breath every 3 seconds
• Airway obstruction
• Conscious
• encourage them to keep coughing
• 5 back blows and 5 abdominal thrusts
• Unconscious
• Use chest thrusts (like CPR)
• Finger sweep of mouth
• Rescue breaths

7
Adult CPR

• Only do if No pulse and No breathing!
• Find your hand position
• Kneel beside victim
• Place heel of hand in middle of breastbone
• Lace fingers together
• Lock elbows and shoulders
• Compress chest 1½-2 inches
• Do cycles of 30 compressions and 2 breaths
• Rate of 80-100 per minute
• Dont stop!!

8
Heimlich and chest compressions
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Bleeding emergencies

• Hemorrhage uncontrolled
• Venous dark red with continuous flow
• Arterial bright red and spurting
• Capillary reddish and oozes
• Universal precautions
• Bleeding results in shock

• Internal bleeding subcutaneous, intramuscular,
  intra-articular, or within a body cavity
• External bleeding abrasions, incisions,
  lacerations, punctures, avulsions
• Direct pressure
• Elevation
• Pressure points
• Dont remove soaked dressings

10
Shock

• Shock occurs when a diminished amount of blood is
  available to the circulatory system (loss,
  pooling, psychological fright, etc.)
• Cause vascular system loses capacity to hold
  fluid portion of blood inside vessels
• Effect not enough oxygen gets to the cells
• Signs/symptoms low BP, weak/rapid pulse,
  shallow/rapid breathing, pale/cool/clammy skin,
  drowsiness
• Care maintain body temperature, elevate feet
  8-12 inches, give nothing by mouth, loosen
  restrictive clothing

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Types of shock

• hypovolemic
• Respiratory
• Neurogenic
• Psychogenic
• Cardiogenic
• Septic
• Anaphylactic
• Metabolic

12
Secondary survey

• Only if there are no life-threatening problems
• Head to toe assessment
• Take vital signs
• Pulse
• Respiration
• Body temperature
• Blood pressure
• Skin color (red, white, and blue)
• Pupil reaction
• Level of consciousness (AVPU)
• Strength/weakness/pain with movement
• Sensory changes

13
Injury assessment

• On-field brief determine injury severity and
  transportation options
• Off-field in-depth
• H history of the injury
• O observation/inspection of the area
• P palpation begin away from the injury and
  move towards it
• S special tests to determine specific
  pathologies

14
RICES

• Used to reduce the amount of pain and swelling
  after an injury
• Also used to facilitate rehabilitation
• R rest prevent further injury
• I ice
• first 72 hours
• 20-30 minutes on, 60-90 minutes off
• C compression
• External pressure mechanical space reduction to
  limit swelling
• E elevation above the heart
• Eliminate gravity pooling in the extremities
• S support
• Crutches and/or splinting

15
Splinting and transportation

• Splint before you move the victim
• Improper or no immobilization is BAD
• Splint from the bone/joint above the injury to
  the one below
• Splint in the position found
• Types of splints
• Rigid
• Soft
• Anatomical
• Vacuum
• Traction
• Spine board

• Only move a victim when necessary
• Suspected spinal injuries DONT MOVE
• Stretcher/Sport chair
• 2-man carry
• Walking assist
• Crutch fitting
• Outside tip 6 to the side and 2 in front of
  shoe
• Axilla pad 1 below hand brace with elbow at 30
• Cane fitting to greater trochanter

16
Using ambulatory aids

• Cane/one crutch hold in opposite hand cane and
  bad foot go forward together
• Tripod/Swing NWB swing leg through
• Three-point PWB to FWB bad foot and crutches
  go forward together
• Four-point FWB opposite crutch and foot move
  together
• Upstairs good foot goes up first then
  crutches and bad foot
• Downstairs bad foot and crutches go down
  first then good foot

17
Fractures
18
Fractures