1. EMERGENCY PROCEDURES Chapter 12

2. Prompt Care is Essential Knowledge of what to do Knowledge of how to do it Being prepared to follow through There is no room for uncertainty There is no room for error

3. The Emergency Plan The key to emergency aid in the sports setting is the initial evaluation of the injured athlete. The prime concern is to maintain cardiovascular function (ABC’s) and central nervous system function.

4. The Emergency Plan EMS communication Telephones must be available Telephones must be available Designate someone to call 911 Designate someone to call 911 The right information must be communicated The right information must be communicated Type of emergency situation Type of suspected injury Present condition of the athlete Current assistance being given Location of telephone being used and location Exact location of the emergency

5. The Emergency Plan Emergency Action Plan Transportation policies Transportation policies Treatment policies Treatment policies Keys to the appropriate gates Separate emergency plans should be developed for each sport’s field, court etc. Cooperation with emergency care providers Parent notification

6. Principles of On-The-Field Injury Assessment Primary Survey: determines the existence of potentially life-threatening situations. Airway Airway Breathing Breathing Circulation Circulation Severe bleeding Severe bleeding Shock Shock

7. Principles of On-The-Field Injury Assessment Secondary Survey: systematically assesses vital signs and symptoms for a more detailed evaluation of the injury. Observation Observation History History Inspection Inspection Palpation Palpation Range of motion Range of motion Special tests Special tests

8. Secondary Survey Recognizing the Vital Signs Pulse: should be taken at the carotid artery or the radial artery with two fingers. Adult resting pulse 60-80 Adult resting pulse 60-80 Child resting pulse 80-100 Child resting pulse 80-100 Rapid and weak = shock, bleeding, diabetic coma, or heat exhaustion Rapid and weak = shock, bleeding, diabetic coma, or heat exhaustion Rapid and strong = heat stroke Rapid and strong = heat stroke Slow and strong = skull fracture or stroke Slow and strong = skull fracture or stroke No pulse = cardiac arrest or death No pulse = cardiac arrest or death

9. Secondary Survey Recognizing the Vital Signs Respiration: check airway and breathing Look Look Listen Listen Feel Feel Normal adult respirations = 12 a minute Normal adult respirations = 12 a minute Normal child respirations = 20 a minute Normal child respirations = 20 a minute Shallow respirations = shock Gasping respirations = cardiac involvement Frothy blood in the mouth = lung injury

10. Secondary Survey Recognizing the Vital Signs Blood Pressure: force of the blood against the arterial walls measured by a sphygmomanometer and stethascope. Systolic / Diastolic Systolic / Diastolic Adult males = 120 / 80 Adult males = 120 / 80 Adult females = 110 / 70 Adult females = 110 / 70 High blood pressure = cardiac involvement High blood pressure = cardiac involvement Low blood pressure = hemorrhage, shock, heart attack or internal organ injury Low blood pressure = hemorrhage, shock, heart attack or internal organ injury

11. Secondary Survey Recognizing the Vital Signs Temperature: is measured by a thermometer under the tongue, armpit, or rectum but skin also reflects temperature. Normal core temperature = 98.6 Normal core temperature = 98.6 Hot dry skin = disease, infection, heat stroke Hot dry skin = disease, infection, heat stroke Cool clammy skin = shock, heat exhaustion Cool clammy skin = shock, heat exhaustion Cool dry skin = over exposure to cold Cool dry skin = over exposure to cold

12. Secondary Survey Recognizing the Vital Signs Skin color: can quickly be used to identigy medical emergencies. Red skin = heatstroke, high blood pressure Red skin = heatstroke, high blood pressure Pale skin = insufficient circulation, shock, hemorrage, heat exhaustion, or insulin shock Pale skin = insufficient circulation, shock, hemorrage, heat exhaustion, or insulin shock Blue skin = poorly oxygenated blood (airway obstruction or respiratory failure) Blue skin = poorly oxygenated blood (airway obstruction or respiratory failure) Dark skin = look at lips, mouth or nails Dark skin = look at lips, mouth or nails

13. Secondary Survey Recognizing the Vital Signs Pupils: are very sensitive to injury affecting the nervous system. Constricted = depressant drug Constricted = depressant drug Dilated = head injury, shock, heat stroke, hemorrhage, stimulant drug Dilated = head injury, shock, heat stroke, hemorrhage, stimulant drug Failed response to light = head injury, alcohol or drug poisoning Failed response to light = head injury, alcohol or drug poisoning

14. Secondary Survey Recognizing the Vital Signs State of Consciousness: awareness Normal (quickly responds to stimuli): alert Normal (quickly responds to stimuli): alert Unconscious (does not respond to stimuli): 3 rd degree concussion Unconscious (does not respond to stimuli): 3 rd degree concussion Groggy (responds slowly to stimuli): 2 nd degree concussion Groggy (responds slowly to stimuli): 2 nd degree concussion Conscious (full memory but responds slowly to stimuli): 1 st degree concussion Conscious (full memory but responds slowly to stimuli): 1 st degree concussion

15. Secondary Survey Recognizing the Vital Signs The Unconscious Athlete Check the ABC’s Check the ABC’s Check for milky fluid from the ears or nose Check for milky fluid from the ears or nose Check for bumps, lacerations or deformity Check for bumps, lacerations or deformity NEVER move an unconscious athlete NEVER move an unconscious athlete NEVER remove the helmet NEVER remove the helmet

16. Secondary Survey Recognizing the Vital Signs Nervous System Check movement of extremities Check movement of extremities Lack of movement = head or neck injury Lack of movement = head or neck injury Check sensation of body areas Check sensation of body areas Numbness = nerve injury Numbness = nerve injury Lack of pain = shock or spinal cord injury Lack of pain = shock or spinal cord injury

17. Response to The Primary Survey Obstructed airway management Rescue breathing CPR / AED Stop severe bleeding Treat for shock Stabilize the athlete until EMS arrives

18. Response to The Secondary Survey Determine the seriousness of the injury Determine the type of first aid necessary Determine if referral is warranted Determine where referral is warranted Determine the manner of transportation Determine the immediate treatment

19. Immediate Treatment BandagingSplinting Metal splints Metal splints Vacuum splints Vacuum splints Anatomical splints Anatomical splints Others Others Immediate Transportation Ambulatory aid Ambulatory aid Manual conveyance Manual conveyance Stretcher / spine board Stretcher / spine boardRICES