Chapters 4,5,6 Primary Survey Secondary Procedures First Aid

Primary vs. Secondary Assessment Primary Assessment –Life-threatening Conditions –Determine Responsiveness –Check CAB C A B Secondary Assessment –You have ruled out Life-Threatening conditions –Begin HIT/HIPS H I /O P S/T

Primary Assessment This is the first thing that needs to be done when approaching a victim. Once a life-threatening condition has been ruled out, your evaluation can continue. Airway –Partial Airway Obstruction –Universal Choking Sign –Total Airway Obstruction Breathing Circulation

SO YOUR ATHLETE IS BLEEDING… External Bleeding –Ways to control it: Hemorrhage –More severe, heavy flow of bleeding –Emergency! If bleeding cannot be controlled, 911 needs to be called!!!

UNIVERSAL PRECAUTIONS Used to prevent the spread of blood-borne pathogens. –Barrier Protection –Sharps Disposal –Infectious Control –Hand Washing

HIT/HIPS History Inspection Palpation (Special) Testing

HISTORY Common Questions to Ask… What happened? How did it happen? When did it happen? Has this happened before? Where was the pain initially? Did you hear any sounds/ feel any sensations? Were you able to continue participating? How soon did it swell? Does it feel unstable? What relieves the pain? How severe is the pain? What does the pain feel like? Are you experiencing any numbness or tingling? Have you had any treatment for this yet? If so, what has been done? Have you injured this body part before?

Vital Signs These are taken during a secondary procedure. It could be part of the history or the inspection. Heart Rate (pulse) Breathing Rate (respirations) Breath Sounds/Odor Blood Pressure Body Temperature Skin Color Capillary Refill Pupillary Reaction Ability to Move Response to Pain

INSPECTION Inspect Look for Really observe the athlete –Watch how they are holding the body part –Watch them as they approach you –Have them walk/do a motion for you and watch their reaction

PALPATION Examining an injury through touch Compare bilaterally If something feels different, then you have probably found your point of injury.

SPECIAL TESTING Range of Motion (ROM) –Compare Bilaterally –Test all ROM at the joint Manual Muscle Testing (MMT) –Compare Bilaterally –Grade Scale 0-5 Table 5.1 pg 46 in book Neurological Testing –Can be tested through sensation or movement –Every body part is linked to a specific nerve Special Testing –Specific tests for the injury Ex) Lachman’s ACL test

SIGN vs. SYMPTOM Sign –Something that can be measured/observed –Something that the Athletic Trainer can see or test –Examples: Symptom –Something that cannot be measured by the caregiver. –Information is something that only the athlete will know (what they feel) –Examples

WHAT IS SHOCK? A condition in which inadequate blood and oxygen are supplied to vital organs. Inadequate blood supply to these organs will result in shock (5 organs necessary for life):

WHY DO WE GO INTO SHOCK? 1.Axial blood vessels dilate while appendicular blood vessels constrict. 2.Heart Stops 3.Significant loss of blood

RECOGNIZING SHOCK SIGNS –Agitation –Rapid, weak pulse –Decreased BP (100mm HG or lower systolic) –Cold, clammy skin –Sweating –Cyanosis –Increasing unconsciousness –Pale skin tone SYMPTOMS –Nausea –Dizziness –Thirst –Anxiety

TYPES OF SHOCK Table 5.2 pg 47 in book Psychogenic Septic Neurological Cardiogenic Hemorrhagic/Hypovolemic Metabolic Respiratory Anaphylactic

TREATING SHOCK Treat the original injury Keep the athlete warm Elevate arms and legs 10-12in above heart (as long as there is no fracture) Measure respirations and pulse every 5min Don’t give them anything to eat or drink If vomiting occurs, put them in recovery position Get them to hospital ASAP!!

ASSESSING FRACTURES Check: Do not ask the athlete to use the body part as it could cause further damage!

MANAGING FRACTURES Requires immediate attention from a Physician Splint the area whether the fracture is obvious or not (if you suspect a fracture, splint it) Once the athlete is splinted, they can be moved and should be monitored for signs/symptoms of shock

TYPES OF SPLINTS Types of splints: –Traction Splint –Rigid Splint –Semi-rigid Splint –Soft Splint

PRICE P R I C E Method used to treat most sprains, strains, contusions and splinted fractures.

HEAT-RELATED PROBLEMS Hyperthermia = Heat Cramps Heat Exhaustion: body temp Heat Stroke: body temp ≥ 105 degrees F –Medical emergency, 911 needs to be called

HOW TO PREVENT HEAT- RELATED ILLNESS Acclimatize Wear lightweight uniforms Frequent water breaks Weigh in before and after practice Check humidity and temperature Avoid saunas and hot-tubs for extended time Eat properly Get plenty of rest Replace fluids lost after practice STAY HYDRATED ALWAYS!!!!

COLD-RELATED PROBLEMS Hypothermia = Frostbite –Treat with gradual re- warming by placing effected body part in water heated to 102 degrees F PREVENTION –Dry, non-restrictive clothing –Acclimatize –Layers –Avoid outdoors in extreme cold –Cover head, mouth and extremeties –Try to stay dry –Wind-resistant clothing

FOR YOUR QUIZ 3 things you are looking for in a Primary Assessment Universal Precautions Sign vs Symptom Explain HIPS 5 organs necessary to sustain life Types of shock Explain PRICE Prevention of Heat-related Illness