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Published byKhalil Ballance
Modified over 2 years ago
The neck is not designed to be a weight- bearing part of the body.
IT IS IN THE SPORT
MOBILITY Facet Joint (Controls mov’t.)
Spinous Process Facet Joint Vert. Body Disc
LATERAL C7 T1 Craniocervical Ligaments Spinous Process
MUSCLES Trapezius Scalenes Sterno- mastoid
TYPES OF NECK INJURIES Strains Sprains Fractures/ Disloc. Nerve
MECHANISMS OF CERVICAL INJURY
FLEXION FLEXION AND ROTATION (Most fractures)
BURNER OR STINGER
MECHANISM OF INJURY Head tilted away. Head rotated away. Shoulder depressed.
Posture of the arm after a burner. Pain is burning and it radiates down to the arm. Tenderness on Brachial Plexus
PINCHED NERVE Mechanism of Injury (M.O.I.) …. Axial loading to the extended, side-flexed neck.
LO AD STRETCH PINCH
ASSESSMENT OF THE HEAD-NECK INJURED ATHLETE ON THE PLAYING SURFACE
NEUROLOGICAL SIGNS Disruption of nerve function Weakness Reduced Sensation Reduced Reflexes Muscle Atrophy
PAIN IS NOT A NEUROLOGICAL SIGN!!!!!
Nerve Cover Touching Nerve
FIELD APPROACH TO THE INJURED ATHLETE
B LOCK THE HEAD
No Helmet Removal
C.P.R. Look Listen Feel
ANY UNCONSCIOUS ATHLETE MUST BE TREATED AS A POTENTIAL SPINAL CORD INJURY!!!
Athlete unconscious. Athlete conscious with loss of movement or sensation. Complains of central neck pain.
FIELD MONITORING Re-check vitals. Reassure athlete. Observe for Shock. Be prepared to treat for shock.
SHOCK Collapse of the c.v. system, or failure of the system to provide an adequate blood supply to all body tissues.
CAUSES OF SHOCK Blood vessels dilated so widely that there is a poor venous return. There is loss of blood. Heart fails to circulate the blood properly.
TYPES AND CAUSE OF SHOCK Hemorrhagic – Internal and/or External Bleeding Respiratory – reduce O 2 in blood. (sucking wound, airway obstruction, spinal cord injury).
Neurogenic – loss of control by the nervous system. Psychogenic – reaction of nervous system to fear, bad news etc. Cardiogenic – inadequate function of the heart
Septic – severe infection resulting in vasodilation. Metabolic – loss of fluids through diarrhea, or urination. Anaphylactic – caused by allergic reactions. Extreme emergency.
SIGNS AND SYMPTOMS Eyes dull, lackluster Pupils dilated Face pale Shallow, irregular respirations Pulse rapid and weak 2
… 2 Skin cool and clammy May have nausea, fainting, anxiety, thirst Blood pressure is low
TREATMENT FOR SHOCK Control bleeding. Elevate lower extremities if no chest or head injury. Prevent loss of body heat. Lie athlete down. N.P.O.
Primary Survey Initial scan done by the ‘at head’ person. Feeling for deformity etc. Secondary Survey Someone else holds head and you check lower ext.
Initial Questions What happen? Pain? Present or after accident. Feelings: burning/tingling Head pain/ache?
Orientation to time and place. Observations of pupils. Observe for any CSF or blood coming from nose or ears. Look for bruising.
Test motor and sensory of upper extremity. Do gross motor of feet. Test grip strength of the upper extremity. Continue to ask about headache and nausea.
Removal from Field Supine lying. Sitting. Four Point Kneeling. Three Point Kneeling. Standing (with support). Slowly walk to sideling. Sideline Testing.
SIDE LINE TESTING Subjective Question about their feelings (headache, tingling, nausea) Objective Motor skills, verbal skills
HEEL TO SHIN 1 2
EYE MOVEMENTS (Nystagmus)
BALANCE TANDEM WALK
GUIDELINES FOR CONTINUED MONITORING
Grade II should be sent to the hospital. Grade I monitored at home. We give instructions. No A.S.A. One drink!
MINOR NECK TRAUMA SIDELINE MANAGEMENT
Minor Neck Trauma is an injury that has no arm pain, no loss of neck motion and no central pain during movement. The following should be tested……
General test of the myotomes (specific nerves that innervate specific muscles) to determine if there is gross weakness. If weakness; no return.
SIDE LIGHT… ‘Motion Talk’..ors – muscles doing the movement...ion – direction of mov’t...ed – end position.
SHOULDER ELEVATION C 3,4 “Lift your shoulders up, hold and do not let me push them down”.
“ Don’t let me push your arms down”. SHOULDER ABDUCTORS C5C5
ELBOW FLEXION C6C6 “Bend your elbow”
ELBOW EXTENSION C7C7 “Straighten your elbow.”
THUMB EXTENSORS C8C8 “ Do not let me pull your thumb down”.
FINGER ABD/ADDUCTORS T1T1 “Do not let me push your fingers together”.
If the neck motion is good, there is no neck/arm pain and the strength in the extremities is good, it is decision time!
If in doubt, don’t! If the tests are good and you tested long and often enough, then do! RETURN
SHOCK. 2 What is Shock? A condition of insufficient supply of blood reaching body tissues Certain degree of shock is found in most illness or trauma.
1 Shock Terry White, RN. 2 SHOCK Inadequate perfusion (blood flow) leading to inadequate oxygen delivery to tissues.
Shock Part 3: Chapter 9.
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.
Bleeding and Shock Chapter 15.
SPINAL INJURIES Chapter 11.
Chapter 11 Bleeding Shock.
NEXT Soft-Tissue and Bleeding Shock Muscle and Bone Head and Spine Definitions Team One Team Two Team.
Injury Evaluation Process
1 Shock Pakistan ICITAP. Learning Objectives Learn how shock occurs Know different types of shock Identify signs and symptoms of shock Demonstrate.
First Aid for Shock By: Shayla Z. Matt S. Sara K. Allen M.
Chapter 7 Emergency Plan and Initial Injury Evaluation.
Bleeding and Shock Obj: I will identify types of bleeding
Chapter 7 Shock. Introduction to Shock Perfusion Adequate blood and oxygen are provided to all cells in the body. Hypoperfusion The cardiovascular system.
First Aid for Colleges and Universities 10 Edition Chapter 13 © 2012 Pearson Education, Inc. Head and Spine Injuries Slide Presentation prepared by Randall.
Pages LEQ: When caring for a shock victim, how does the type of shock determine the treatment?
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