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Emergency Situations and Injury Assessment

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					Assessment of Athletic Injuries

             Chapter 5
       Ms. Baker, ATC, AT/L
         Sports Medicine II
        Lincoln High School
    Values of acute injury assessment

   Provide necessary information to formulate a formal
    diagnosis
   Obtain information needed for the required
    documentation
   Establish a database of information pertaining to the
    MOI, specific athletic activity, time of injury, severity
    & location of injury
        Classification of acute injuries

1.   Life threatening injuries
2.   Injuries that are not currently life-threatening but require
     monitoring because of potential of becoming life-threatening
3.   Low-priority injuries or non-urgent injuries requiring proper
     first-aid procedures
                   Golden Period

   First 10-20 minutes post-injury
   If missed then valuable information may be masked
    by protective muscle spasm, swelling, ↑ pain, or other
    physiological events
   Desire for a quick post-injury assessment should not
    overtake the need for a complete, accurate &
    logically sequenced assessment
   1st of many evaluations throughout the course of the
    injury
               Parent Notification

   Actual consent may be given in writing either before
    or during an emergency if the athlete is a minor.

   Implied consent
                  Primary Survey

   Rule out Life-Threatening Emergencies
      A = airway

      B = breathing

      C = circulation

      S = severe bleeding

      S = shock



   What should an athletic trainer/coach do if a life
    threatening emergency arises?
                The Unconscious Athlete

    Unconsciousness – a state of insensibility in which
     there is a lack of conscious awareness.
    Steps to dealing with an unconscious athlete
    Note body position                If the athlete is supine and breathing, do
    Check airway, breathing, and      nothing until consciousness returns
    circulation (ABCs)                 If the athlete is prone and not breathing,
    Assume there is a neck or spine   logroll him or her carefully to supine
    injury                             position and establish ABC immediately.
    Do not remove helmet. Cut face    If the athlete is prone and breathing, do
    mask away.                         nothing until consciousness returns, and
    Is supine and not breathing,      wait for the rescue squad.
    establish ABC immediately          Maintain and monitor life support for the
                                       unconscious athlete until emergency
                                       medical personnel arrive.
                Secondary Survey

   Need to keep in mind awareness of vital signs: pulse,
    respiration, & skin color
   Assessment of S/S
      Sign = an objective finding

      Symptom = subjective finding

   Secondary assessment consists of:
      History

      Observation

      Palpation

      Special tests
           Recognizing Vital Signs

   Vital signs to observe
      Pulse

      Respiration

      Blood pressure

      Temperature

      Skin color

      Pupils

      State of consciousness

      Weakness of movement

      Sensory changes
               On-Field Inspection

   Decisions that can be made from the secondary
    survey
      Seriousness of injury

      Type of first aid required

      Whether injury warrants referral to a physician

      Type of transportation needed
              SOAP vs. HOPS

   S = Subjective      H =History
   O = Objective       O = Observation
   A = Assessment      P = Palpation
   P = Plan            S = Special Tests
                        History

   Helps to build a rapport with or gain confidence from
    the athlete
   Ask clear questions w/o leading the athlete
   Avoid making assumptions and directing questioning
    towards a certain outcome

   What questions would you ask?
                    Observation

   Starts the moment you come in contact with the
    athlete
   Be aware of physical and mental response to injury
   Use eyes only…no touching
                      Palpation

   Always check bilaterally…starting on non-injured side
   Start palpations furthest away from the injury site
    and work toward the injury
   Have a set sequence
   3 C’s
      Confidence

      Competence

      Compassion

   Begin gentle then ↑ pressure to firm
   Specific anatomical structures
                            Tests

   Injury specific
   ROM testing
      Active (AROM)

      Passive (PROM)

      Resistive (RROM)

   Ligament stress tests
   Special tests
                          Plan

   Determine management of injury
   Decision could include
      Obtain services of an advanced life support system

      Refer to another medical specialist

      Continue the assessment process

         Further technical testing

         Rehab program

      Permit athlete to RTP w/ appropriate medical
       approval
   AT does not diagnosis
     Immediate Treatment Following
             Acute Injury
   Primary goal of acute injury treatment

   Initial management of acute injuries
      PRICE method

          Protection

          Rest

          Ice

          Compression

          Elevation
Moving and Transporting The Injured
              Athlete
   Special Circumstances
      Suspected Spinal Injury



   Ambulation Techniques
      Spine Board

      Stretcher carrying

      Ambulatory Aid

      Manual Conveyance

      Crutch or cane