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EMERGENCY PROCEDURES. Chapter 12. Prompt Care is Essential. Knowledge of what to do Knowledge of how to do it Being prepared to follow through There is no room for uncertainty There is no room for error. The Emergency Plan.
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EMERGENCY PROCEDURES Chapter 12
Prompt Care is Essential • Knowledge of what to do • Knowledge of how to do it • Being prepared to follow through • There is no room for uncertainty • There is no room for error
The Emergency Plan • The key to emergency aid in the sports setting is the initial evaluation of the injured athlete. • The prime concern is to maintain cardiovascular function (ABC’s) and central nervous system function.
The Emergency Plan • EMS communication • Telephones must be available • Designate someone to call 911 • The right information must be communicated • Type of emergency situation • Type of suspected injury • Present condition of the athlete • Current assistance being given • Location of telephone being used and location • Exact location of the emergency
The Emergency Plan • Emergency Action Plan • Transportation policies • Treatment policies • Keys to the appropriate gates • Separate emergency plans should be developed for each sport’s field, court etc. • Cooperation with emergency care providers • Parent notification
Principles of On-The-Field Injury Assessment • Primary Survey: determines the existence of potentially life-threatening situations. • Airway • Breathing • Circulation • Severe bleeding • Shock
Principles of On-The-Field Injury Assessment • Secondary Survey: systematically assesses vital signs and symptoms for a more detailed evaluation of the injury. • Observation • History • Inspection • Palpation • Range of motion • Special tests
Secondary Survey Recognizing the Vital Signs • Pulse: should be taken at the carotid artery or the radial artery with two fingers. • Adult resting pulse 60-80 • Child resting pulse 80-100 • Rapid and weak = shock, bleeding, diabetic coma, or heat exhaustion • Rapid and strong = heat stroke • Slow and strong = skull fracture or stroke • No pulse = cardiac arrest or death
Secondary Survey Recognizing the Vital Signs • Respiration: check airway and breathing • Look • Listen • Feel • Normal adult respirations = 12 a minute • Normal child respirations = 20 a minute • Shallow respirations = shock • Gasping respirations = cardiac involvement • Frothy blood in the mouth = lung injury
Secondary Survey Recognizing the Vital Signs • Blood Pressure: force of the blood against the arterial walls measured by a sphygmomanometer and stethascope. • Systolic / Diastolic • Adult males = 120 / 80 • Adult females = 110 / 70 • High blood pressure = cardiac involvement • Low blood pressure = hemorrhage, shock, heart attack or internal organ injury
Secondary Survey Recognizing the Vital Signs • Temperature: is measured by a thermometer under the tongue, armpit, or rectum but skin also reflects temperature. • Normal core temperature = 98.6 • Hot dry skin = disease, infection, heat stroke • Cool clammy skin = shock, heat exhaustion • Cool dry skin = over exposure to cold
Secondary Survey Recognizing the Vital Signs • Skin color: can quickly be used to identigy medical emergencies. • Red skin = heatstroke, high blood pressure • Pale skin = insufficient circulation, shock, hemorrage, heat exhaustion, or insulin shock • Blue skin = poorly oxygenated blood (airway obstruction or respiratory failure) • Dark skin = look at lips, mouth or nails
Secondary Survey Recognizing the Vital Signs • Pupils: are very sensitive to injury affecting the nervous system. • Constricted = depressant drug • Dilated = head injury, shock, heat stroke, hemorrhage, stimulant drug • Failed response to light = head injury, alcohol or drug poisoning
Secondary Survey Recognizing the Vital Signs • State of Consciousness: awareness • Normal (quickly responds to stimuli): alert • Unconscious (does not respond to stimuli): 3rd degree concussion • Groggy (responds slowly to stimuli): 2nd degree concussion • Conscious (full memory but responds slowly to stimuli): 1st degree concussion
Secondary Survey Recognizing the Vital Signs • The Unconscious Athlete • Check the ABC’s • Check for milky fluid from the ears or nose • Check for bumps, lacerations or deformity • NEVER move an unconscious athlete • NEVER remove the helmet
Secondary Survey Recognizing the Vital Signs • Nervous System • Check movement of extremities • Lack of movement = head or neck injury • Check sensation of body areas • Numbness = nerve injury • Lack of pain = shock or spinal cord injury
Response to The Primary Survey • Obstructed airway management • Rescue breathing • CPR / AED • Stop severe bleeding • Treat for shock • Stabilize the athlete until EMS arrives
Response to The Secondary Survey • Determine the seriousness of the injury • Determine the type of first aid necessary • Determine if referral is warranted • Determine where referral is warranted • Determine the manner of transportation • Determine the immediate treatment
Immediate Treatment • Bandaging • Splinting • Metal splints • Vacuum splints • Anatomical splints • Others • Immediate Transportation • Ambulatory aid • Manual conveyance • Stretcher / spine board • RICES