Sports Injuries T. Bray B. Bray

Types of sports injuries Traumatic Head Neck Chest Abdomen Pelvis Extremities Bone, joint, and soft tissue Environmental Underlying medical condition

Procedures Do not go onto field or bench until sports trainer or coach requests As soon as ambulance is committed, contact dispatch If parents are on scene, speak with them directly (they have the final say)

Assessment ABCs SAMPLE OPQRST

Assessment ABCs Remove mask or helmet ONLY if airway or breathing are compromised and we need to take steps requiring physical contact (OPA, combi, etc.) Four screws hold mask on…remove w/trainer tool or screw driver Removing helmet is last option

Assessment Complete head to toe assessment including lung sounds and CMS at all extremities Overlook nothing

Assessment S & S, allergies, medications, past medical history, last oral intake, events leading up to incident (attention to post-traumatic amnesia)

Assessment Concussion (head) ALOC, pupils, nausea and/or vomiting, irrational behavior, widening pulse points, reduced CMS at extremities, and retrograde or post-traumatic amnesia

Assessment Concussion (head) Three grades: I. No loss of consciousness (LOC), post-traumatic amnesia less than 30 minutes II. LOC up to four minutes, post traumatic amnesia more than 30 minutes III. LOC greater than five minutes, and post-traumatic amnesia 30 minutes to 24 hours

Assessment Concussion (head) On-field assessment should include: Facial expression Orientation to person, place, time, and purpose Post-traumatic and/or retrograde amnesia Gait (CMS at extremities)

Assessment If athlete has a second LOC incident in one season or LOC over one minute should be assessed by neurologist

Treatment Longboarding (neck) Leave helmet on if possible If helmet removed and shoulder pads left on, pad head into position

Treatment Chest Wheezing Pain on inhalation Equal expansion Administer O2 to make lungs more effective with less effort

Treatment Bone and joint injuries Probable fractures, dislocations, tears, sprains, strains, and hyperextensions Follow standard protocols After complete assessment, specific CMS distal to injury Immobilize (above and below) Recheck CMS distal to injury

Treatment Soft tissue injuries Lacerations, abrasions, and contusions Standard protocols Remind parents that we are not x-ray or CT machines, and cannot tell contusions from fractures

Treatment In all cases, prevent shock Keep warm O2 IV TKO or bolus Elevate feet

Environmental Cold emergencies Frost nip Frost bite Hypothermia Gently warm and dry (no rubbing), glucose if shivering and alert, warm O2, and warm IV (if possible). Handle with care (gently)

Environmental Official hypothermia scale (core temp) Mild: 98.6 down to 93 Moderate: 93 down to 86 Severe: Below 86

Environmental Heat emergencies Heat cramps Heat exhaustion Heat stroke (true medical emergency) Cool (water or ice packs), oral fluids only if A & O, O2, IV bolus (if possible), and transport if called for.

Environmental Official heat injury scale (core temp) Heat cramps: 99 up to 101.3 Heat exhaustion: 99 up to 104 Heat stroke 105 or higher

Environmental Differential: Heat cramps: Localized pain, normal vitals, and occur during strenuous activities Heat exhaustion: Weak, fatigued, decreased LOC, headache and anxiety, profuse sweating, elevated pulse and respiration, and normal or slightly decreased BP (compensated=normal BP). Heat stroke: Same as above, and altered LOC, decreased BP

Environmental If you cannot tell if it is heat exhaustion or heat stroke, treat as heat stroke. PC protocols indicate that skin moisture is not a reliable indicator when determining between heat exhaustion and heat stroke (other than hot and dry is definitely heat stroke).

Underlying medical conditions Can be found with thorough assessment Common are: Cardiac Respiratory Diabetic Poor diet and/or dehydration Previous or recent injury