1. First Aid Chad Peters, MS, ATC

2. Recognizing and Responding to an Emergency • Whats Out of the Ordinary • Sights, appearances, behaviors, odors, noises • Examples? • Ask Questions

3. Overcoming Barriers • Why don’t people act? • Presence of other people • “Some one else can help” • Being unsure of the ill person’s condition • Fear • Catching Disease • Doing Something Wrong • Law Suit • Unsure when to call 911 • How do we over come these?

4. Good Samaritan Laws • Protect citizens who act the same way a “reasonable and prudent person” would if they were in same situation. • Act in good faith • Not be deliberately negligent or reckless • Act within the scope of his or her training • Not abandon the person

5. Obtaining Consent • Prior to giving care, you MUST get consent • To obtain consent: • State your name • Tell the person you are trained in 1st Aid • Ask the person if you can help • Explain what you think is wrong and what you are going to do • DO NOT give care to some one who refuses • DO call 911 anyway • Unconscious = Implied Consent, as well as child or infant with out parent

6. Preventing Disease Transmission • Avoid contact with bodily fluids • Assume everyone is infected with something • This also includes clothing and surfaces • Cover your own open wounds and lesions • Remove jewelry prior to putting on gloves • Avoid touching your own mouth, nose, or eyes • Have gloves, goggles, breathing barriers available

7. Cleaning Up Blood Spills • Use something to absorb such as paper towels or towels • Bleach and Water (1 ½ cup to one gallon of water solution) or other product. • Use biohazard bag or container if saturated • Most Common Blood Borne Pathogens • Hep B, Hep C, HIV

8. Emergency Action Steps • CHECK • Scene • What Happened • # People Involved • Immediate Danger • Any available to help? • Unconscious? • Breathing • Bleeding

9. Emergency Action Steps • Call • 911 • On campus – call campus safety - 3229 • Dial 7 on campus • Land line • If you are not sure whether or not you should call, CALL

11. 911 Calls... • Must give dispatcher following information • Type of emergency situation • Type of suspected injury • Present condition of athlete • Current assistance being given (CPR, ect) • Location • telephone • cross streets • how to enter facility

12. Assessment Procedures • Primary Survey • ABCs • Bleeding/Shock • Secondary Survey • Vitals • Signs & Symptoms

13. Unconscious Person • Note Body Position • Determine level of consciousness • ABCs • Neck & Spine • Do not remove helmet (face mask o.k. • Establish Airway • If prone and no breathing, role over (supine) • If prone and breathing, do not role over • When consciousness gained, log roll to spine board • Maintain Vitals until EMS arrives • Person is stabilized, 2ndary survey

14. External Bleeding • Direct Pressure • Elevation • Pressure points • Brachial/Femoral

15. Shock • Can occur with any injury • Most likely in • severe bleeding • internal injury • fractures • Definition • Not enough blood available to circulatory system

16. Dilation of blood vessels & imbalance of osmotic pressure • Shock if untreated can cause DEATH • Risky Conditions • extreme fatigue • extreme temperature • extreme dehydration • illness

17. Handling Shock • Signs & Symptoms • Skin • Moist, pale, cool, clammy skin • Weak & rapid pulse • Increased & shallow breathing • decreased b.p. • extreme thirst

18. Treating Shock • Maintain body temperature • Elevate Feet • Unless head & neck • If psychogenic, do not allow athlete to see injury • Do not over react, but confident & in control.

19. VITALS • Pulse • 60-80 in adults • Account for activity • 80-100 in children • Respiration • 12 in adults • 20-25 in children • Blood Pressure • Temperature • Skin Color

20. Blood Pressure • Systolic over diastolic • 120/80 • Temperature • 98.6 • Skin Color • Pupils • shock, heatstroke, hemorrhage • stimulants

21. State of Consciousness • Movement • Head Injury • Stroke (cerebrovascular accident) • Abnormal Nerve Response • Nerve damage • blocked artery • spinal cord injury • head injury

22. Moving an Injured Person • When to move an injured person? • You are faced with immediate danger • Need to move to another person who may have more serious injuries • When you need to provide proper care and cannot do so where you are located. • See pages 8 and 9 for methods of how to move some one.

23. Skill Card – Checking Injured Person • Show Injury Cycle Hand Out

24. The Physics of Injury • Muscle/tendon injuries • injured by excessive tension • muscle/fascia injuries occur during eccentric contraction • tendons are strong -- 8700 to 18,000 lb./sq. inch. • strains occur most often at the musculotendinous junction (MTJ) • MTJ strains -- most common soft tissue sports injuries

25. Mechanical Forces of Injury • Three types of force • Tensile • tendons resist tensile force • Compressive • bones resist compressive force • Shear • ligaments resists tensile force Compressive Tension Shear

26. Critical Force • Critical Force: • Defined: How much force can tissue withstand • Varies for each type of tissue • May vary within the same tissue, depending upon: • age • temperature • skeletal maturity • gender • body weight

27. The Physiology of Injury • The inflammatory process • Whenever damaged, the body reacts with a predictable sequence of physiologic actions, commonly called “swelling.” • begins during the first few minutes following an injury

28. The Physiology of Sports Injury • Normal signs/symptoms include • swelling • pain • reddening of skin • increased local temperature • loss of function • several specific stages: • Acute inflammatory phase • Resolution (Healing) phase • Regeneration & Repair

29. Intervention Procedures • Controlling the inflammatory process • cryotherapy (crushed ice bags, aerosol coolants, ice cups, ice water baths, commercial cold packs) • After the acute phase, application of heat is appropriate (hydrocolator packs, warm towels, and ultrasound).

31. Pain and Acute Injury • Everyone copes with pain differently. • Pain is as much psychological as physiological. • Pain results from sensory input received through the nervous system and indicates location of tissue damage. • Messages concerning sensory information that travel quickly through nervous system are given higher priority than pain messages that travel more slowly. • Pain is not a useful indicator of injury severity.

32. Injuries at Work • Leading causes of injury related death at work • Motor Vehicle accidents • Homicides • Falls • Accidents with machinery • Injuries from falling objects • Electrocutions

33. Types of Open Wounds

34. Care for Open Wound • 1. Stop Bleeding • Direct Pressure with gauze (if available) • Stack gauze, do not remove it. • Pressure points in severe cases (arteries) • Clean with soap and water, irrigate with water, 5 min if possible • Ointment (neosporin, triple antibiotic, etc.) • Cover with band aide or other non stick product. • Stitches? • ½ inch long or skin does not naturally come together.

35. Pressure Points

36. Burn Care • Types • Superficial, or 1st degree • Involves top layer, red, dry skin, painful • Partial thickness, or 2nd degree • Involves top layers of skin, swelling, blisters, heals in 3 to 4 weeks, scarring possible • Full thickness, or 3rd degree • May destroy all layers of skin and underlying structures, such as muscle, fat, bones, and nerves • Skin brown and charred, healing may need assistance

37. Critical Burns • Cause trouble breathing • Covering more than one body part or large surface area • Head, neck, hands, feed, or genitals • Burns to the airway • Children and elderly • Resulting from chemicals, explosions, or electricity • All the above are life threatening,

38. Burn Care • Thermal • Must act quickly to cool skin with cool water • After checking scene, of course! • Chemical • If Powder, brush off prior to rinsing • If liquid, rinse with water until EMS arrives or symptoms cease. • Electrical • Do not touch until sure power source is removed • 911

39. Infection

40. Examples of Staph Infections www.spapex.org/spapex/ impetigobulloso.jpg

41. Staph Infection

42. MRSA

43. Special Situations • Embedded object in eye • Do not attempt to remove embedded object • Use cup or something similar to protect the eye • Cover both eyes to avoid movement • Severed Body Part • Wrap in gauze, place over ice, 911! • Nosebleed • Pressure, lean forward to allow clotting • Find out why bleeding, dry air or injury • Teethe • If misplaced, try to correct • If knocked out, place in milk or water and get to dentist quickly.

44. Acute and Chronic Injuries • Acute injury - “injury characterized by rapid onset, resulting from a traumatic event” • Acute injuries typically involve trauma followed by pain, swelling and loss of function. • Critical force -- “magnitude of a single force for which the anatomical structure of interest is damaged”

45. Acute and Chronic Injuries • Chronic injury - “injury characterized by a slow, insidious onset, implying a gradual development of structural damage” • Chronic injuries develop over time and are often associated with repetitive, cyclic activities, such as running. • These injuries are commonly called “overuse injuries.” Common sites include the Achilles tendon, patellar tendon and the rotator cuff.

46. Soft Tissue and Skeletal Injury • Soft tissue includes: • muscle, • fascia, • tendon, • joint capsule, • ligament, • blood vessels • nerves

47. Majority of injuries involve: Bruises (contusions) Sprains Strains Skeletal injuries involve bony structures Soft Tissue and Skeletal Injury

48. Standard Nomenclature of Athletic Injuries (AMA) 1968. Sprains - injuries to ligaments (three levels) 1st degree: Slightly torn ligament 2nd degree: Significantly torn ligament 3rd degree: Completely torn ligament Strains - injuries to tendon, muscle or musculotendinous junction (Same 3 levels as above) Contusions - commonly called a bruise Connective Tissue Injury

49. Fractures - break or crack in bone -- two types: closed and open Stress fracture - break or crack in a bone which develops over a relatively long time period Dislocations - the displacement of contiguous surfaces of bones comprising a joint -- two types: subluxation - partial Luxation or dislocation - total displacement Connective Tissue Injury

50. Care of musculoskeletal injuries • Severe injuries must be splinted until extent of injury is determined • Splinting always consists of the joint above and below the injury • RICE • Rest, Ice, Compression, Elevation • Or the ARC Version • Rest, Immobilize, Cold, Elevate