Sports Medicine Unit 9, Part C The Unconscious Athlete
It is extremely important that you be careful when examining an unconscious athlete, due to the possibility of a head or neck injury Ideally, it is best not to move an unconscious athlete until they have regained consciousness This is not realistic in most cases Officials, coaches, and others should never be allowed to rush medical personnel
Musculoskeletal Injuries Of major importance in musculoskeletal injury is the initial control of hemorrhage (bleeding), early inflammation, muscle spasm, and pain. The easiest way to do this is through the use of REST, ICE, COMPRESSION, and ELEVATION or R.I.C.E.
ICE (Cold Application ) An effective first aid agent that reduces pain and spasm in the first 4-6 hours after an injury. There is much debate about how cold works physiologically. –It is the subject of on-going research. –It does constrict blood vessels, thicken the blood, and reduce blood flow. –Also reduces tissue demand for O 2 & reduces HYPOXIA (lack of O 2 in blood).
COMPRESSION While cold is placed on the injury intermittently, compression should be maintained throughout the day. The wrap should be applied distally to proximally, which prevents swelling from moving into more distant parts of an extremity. –This is usually the result of gravity. Care should be taken to not wrap too tightly. –It is important to caution athletes and also advise them that, if they start to experience numbness or tingling in the extremity, they should loosen or remove the wrap immediately.
ELEVATION Along with ice and compression, it is important that the injured body part be elevated above the level of the heart for the first 48- 72 hours after injury. This elevation will help reduce swelling and internal bleeding. It also enhances venous return, by making it easier for blood to get back to the heart.
REST Essential for musculoskeletal injuries. This can be achieved by telling the person not to move the body part, or by applying tape, wraps, splints, casts, or putting the person on crutches. Immobilization helps to insure proper healing without complications.
HEMORRHAGE Defined as an abnormal external or internal discharge of blood. May be venous, capillary, or arterial and the bleeding may by on the inside or outside of the body.
HEMORRHAGE Arterial bleeding is exhibited with the forceful spurting of bright, red blood.
HEMORRHAGE Venous bleeding is usually dark and flows continuously
HEMORRHAGE Capillary bleeding is usually exhibited by an oozing of bright, red blood.
External Bleeding Stems from an open skin wound such as abrasions, lacerations, incisions, punctures, avulsions, etc. There are several methods that can be used to control external bleeding, including…
External Bleeding Direct Pressure - applying direct pressure over the wound with your hand and sterile gauze. The pressure is firmly applied against the resistance of the bone. Elevation - in combination with direct pressure, you should elevate the body part above the heart. This reduces blood pressure to the area and slows bleeding.
External Bleeding Pressure Points - can be used when pressure and elevation do not work. There are 11 major pressure points on each side of the body. These are areas that have superficial arteries and veins that can be compressed. Most common are the brachial and femoral arteries.
External Bleeding Tourniquet - if all other attempts to stop bleeding fail, then your last resort is to apply a tourniquet. This is a method seldom used in sports. If you apply a tourniquet you must… Note the time you put the tourniquet on on the forehead of the patient. DO NOT release the tourniquet at any time unless told to do so by a doctor. Remember you are cutting off all circulation to that body part. Athlete may lose it because of this. 14:30
Internal Bleeding Invisible to the eye unless seen by x-ray or other means. The danger with internal bleeding is that it’s difficult to detect and can be overlooked. Can be as simple as a contusion under the skin to filling a body cavity like the thorax or skull. If you suspect severe internal bleeding, refer to the hospital immediately.