1. Sports Injuries
T. Bray
B. Bray

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

3. 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)

4. Assessment
ABCs
SAMPLE OPQRST

5. 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

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

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

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

9. 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

10. 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)

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

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

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

14. 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

15. 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

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

17. 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)

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

19. 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.

20. 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

21. 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

22. 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).

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