Lesson 4

1. Lesson 4 Emergency ProceduresTaken From Chapter 7 and 10 in book

2. The Emergency Action Plan • _____________________________________ • Should be written for each activity site • Individual responsibilities and protocols should be reviewed • Should meet annually with EMS to review procedures • ________________________________

3. The Emergency Action PlanContinued • EAP members should be certified in first aid and CPR • Emergency medical supplies and equipment should be easily accessible –___________________________ • _________________________________________________________________

4. Emergency Situations • __________________________ • Assess life threatening conditions • A,B,Cs • Triage-assessing all injuries quickly and then returning to the more serious injuries immediately - MASH • ___________________________ • Detailed head to toe assessment • Signs = measurable objective findings-bleeding, fluid • Symptoms = subjective info provided by person

5. 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____________

6. History • History-gather subjective information via a series of questions • Type 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

7. Observation • Survey the scene as you come on to it • Look 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

8. Palpation • Using your hands to feel for abnormalities in bone or soft tissue • Palpate 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

9. Special Test • Limited in an emergency situation; main job is to determine if possible spinal cord injury • Avoid any unnecessary movement • Motor 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

10. Unconscious Athlete • Call 911 for all unconscious athletes • Head injuries are #1 cause for loss of consciousness • See guidelines to help an unconscious athlete-p.17 1-10 (Handout).

11. Hemorrhage • Three types of bleeding: • ____________ = bright red, spurting • __________ = dark bluish-red, steady flow • ___________ = red, oozing • Treatment • Direct pressure • Elevation (if no fracture) • If continues - Pressure points (femoral/brachial arteries)

12. 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

13. Wound Dressing • Apply Occlusive dressings • Second skin • Duoderm • Covering wound to return to game • Use telfa pad/ ointment/prewrap/tape • Allow the wound to “breath” at night in a controlled environment-cover before sleeping in the beginning

14. Fractures • C/S-direct contact, fall, dynamic overload • Signs: __________________________________________________________________________________________________ • Types-open (c),closed (s), transverse, epiphyseal, avulsion • Four ways of recognizing fracture: • Palpation • Percussion • Compression (be careful) • Distraction (be careful)

15. Treating Fractures • Splint before moving-Follow 1st Aid/Safety Rules; Apply Ice • Types of splints: • Anatomic • Stiff/rigid • Soft • Vacuum • Check skin color, temp, and capillary refill before and after splinting

16. Shock • Shock can occur with any injury involving pain, bleeding, internal trauma, fracture, or spinal injury • _____________________________________________________________________________________________________________ • S/S- p. 204 • Treatment-Elevate legs, keep warm, monitor ABC’s; p. 204

17. 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

18. Preventing Heat Illness • Identify at risk individuals-children; pre-season athletes • Acclimatize athletes – ___________________ • Wear appropriate clothing-light weight, light-colored, porous • Fluid 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

19. 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 • ____________________

20. Types of heat illness p.261-270 • ____________________ • Muscle spasms caused by electrolyte loss; early in season • ____________________ • More common early in season • S/Sx (signs and symptoms): dizziness, headache, profuse sweating, rapid breathing, gray skin, rapid weak pulse, uncoordinated gait, elevated temp, nausea

21. Types of Heat Illness (2) • _________________ • Body’s temp control mechanisms have shut down • MEDICAL EMERGENCY-CALL 911 • S/Sx: unconscious, sweating has stopped, shallow breathing, hot dry red skin, rapid strong pulse (“bounding”), high body temp, convulsions, seizures, comma

22. Treating Heat Illness • Move person to cool place • Remove equipment/unnecessary clothes • Lie person on back, with feet elevated • Give cool fluids (unless unconscious) • Specifics: • Heat cramps: stretch, ice, drink cool fluids • Heat exhaustion : call EMS (if necessary), rest in cool room; utilize cool/wet towels • Heat Stroke: call EMS, RAPID COOLING

23. 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

24. Frostbite • Most common in fingertips, toes, earlobes, tip of nose • Occurs when soft tissue freezes • Superficial: Involves skin and superficial tissue • Deep: Involves subcutaneous layers, tissue destruction • S/Sx: red swollen skin diffuse numbness, skin turns yellow-white/ blue with waxy look • Treatment: remove wet clothing re-warm area immediately; cover with sterile dressing; transport to hospital

25. Vital Sign Assessment • Respirations - Normal (N) = 12(A) and 20(C) • Skin Color • Rubor = red skin • Pallor = pale skin • Pupils (light reflex) and vision • Pulse (N=__________) • Blood pressure (N) - ____________