1. Trauma in Sports and the Healthcare Provider JSMP May 17, 2013 Kate Perlsweig, MS, ATC Heartland Rehabilitation Services

2. Planning Get to know your EMS Personnel: EMT-B? Paramedic? What equipment is standard? Life Flight? What level of training to police/firefighters receive? Is there a standard way to relay information? What about a back-up or stand-by crew? What is the city/county protocol for mass casualties?

3. Emergency Action Plans Life or Limb Threatening injury Crowd Injury Fights Shooting Explosion Evacuation Routes

4. Trauma Response: Supplies Location of & Access to: PPEs Dressings AED Extra battery/pads Splint/Spineboard Phone/radio Tags/markers

5. Trauma Response: Supplies

6. Trauma Response: ABCs BLS: Airway Breathing Circulation TCCC: Massive Hemorrhage Airway Respiration Circulation Head/Hypothermia Shock

7. Trauma Response: Physiology 10080120140160180200 115bpm: Fine motor skills begin to deteriorate 145bpm: Complex motor skills begin to deteriorate 175bpm: Cognitive processing deteriorates Vasoconstriction Loss of peripheral vision, depth perception Auditory exclusion Heart Rate Response to Stress

8. Case Study 24 August 2007 27 year old male Humvee roll-over in western Afghanistan LOC, Left posterior hip dislocation with intra-articular fragmentation and acetabular fracture, left sacroiliac joint diastasis, right superior and inferior rami fractures, left lumbo-sacral plexus disruption, right wrist fracture, multiple facial fractures, left pneumothorax, bladder extravasation into abdomen

9. Case 2 months ICU at Walter Reed and Brooks Army Medical Centers 8 months Tampa Polytrauma Rehabilitation Center 10 months post-injury issued first AFO 1 year post-injury considered elective amputation

11. Special Considerations During Rehabilitation: Patient Patient Ortho PM&R Neuro Vascular PT OT Internist Dental Pain Mgmt

12. Special Considerations During Rehabilitation: Patient Multiple surgeries Prolonged hospitalization MD Appointments Care takers Family support Financial concerns Personality/Role Changes Coping strategies Depression Suicide Risk Substance abuse Domestic violence

13. Special Considerations: Practitioner Role in patient’s support system? Team approach to treatment Coping Strategies: Recovery relaxation time Support system Emotional processing