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Providing Emergency Care For Potentially Life-Threatening Injuries in Sport. . Ron Straight MEd, ALS Paramedic. State the methods used to help prepare first-responders for sports related injuries. Demonstrate the approach to managing unresponsive, injured athletes.

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Presentation Transcript
slide1
Providing Emergency Care

For Potentially

Life-Threatening Injuries

in Sport.

Ron Straight MEd, ALS Paramedic

objectives
State the methods used to help prepare first-responders for sports related injuries.

Demonstrate the approach to managing unresponsive, injured athletes.

Describe the on-field assessment of a head-injured athlete and potential cervical-spine-injured athlete.

Demonstrate techniques for equipment removal and describe when necessary.

OBJECTIVES

Demonstrate the techniques for stabilizing injured athletes in various locations or environments such as on a field of play, in a swimming pool, on a trampoline, on ice, on a steep slope or in the snow.

Critically assess and determine more effective techniques to manage a potentially life-threatening injured athlete.

repositioning techniques
REPOSITIONING TECHNIQUES

Vise grip

Long and short grip

Modified jaw maneuver

Transfer grip

Head repositioning

Assisting intubation

One and two person supine airway roll

One and two person prone airway roll

Prone, head up against an abutment roll

Helmet removal

Equipment removal

injuries in context
INJURIES IN CONTEXT

Patients in unusual locations

injuries in context8
INJURIES IN CONTEXT

Patients in unusual locations

-standing

-sitting

-prone in the mud

-head up against the goal post/wall etc.

-confined space

-unruly/combative

-steep slope

-ski slope

-ice rink (hair)

-on a trampoline

-swimming pool

the approach
Recognition- An appreciation of an injury is always better if the actual mechanism of injury was visualized. Witnesses, replay?

Reaction/Signaling- A procedure should have been set up to

ensure an efficient response with no interference from other bystanders.

The Approach

Rescue Scene-Mechanism of injury/gather information en route/ Cervical spinal/Hazards

Initial Approach-On approach think of the medical history of the patient, the injuries specific to that facet of the sport and the mechanism of the presenting injury.

slide11
Traumatic Injuries

Limb fractures/injuries

slide15
Traumatic Injuries

Limb fractures/injuries

Chest injuries

Abdominal injuries

Head injuries

concussions in sport
Concussions in Sport

In a study by the Glasgow group,

32% of those who DIED from brain injury

talked after the trauma.

"In various combinations and various severities, the resultant cellular dysfunction (of brain injury) defines the nature and extent of the primary injury, the outcome of which may not become apparent for several days or even weeks after injury." (Graham, Gennarelli, Greenfield's Neuropathology, 1996, page 197.)

okay so how many people actually suffer concussions like this
“ Okay, so how many people actually suffer concussions like this?”

"When you think that 300,000 people in the United States sustain this kind of brain injury [each year], it really is a silent epidemic," said George A. Zitnay, Ph.D., president of the Brain Injury Association in Washington, D.C.

20% of high school football players experience a concussion each year.

Athletes most at risk for a sport-related concussion participate in football, boxing, hockey, lacrosse, rugby, equestrian events, and snow skiing.

slide19
Other Facts About Concussions Having sustained one concussion increases the risk four to six times of sustaining another concussion.
  • The effects of concussion are cumulative over

the span of an athlete's career.

  • Multiple concussions may increase the risk

of degenerative brain diseases such as

Alzheimer's, cerebral atrophy, and

Parkinsonian-like symptomatology.

slide20
“So what happens if we send them back in after a concussion?”

If concussion is overlooked and an athlete is allowed to return to play, he or she runs the risk of suffering a second concussion before recovering from the first, which causes rapid brain swelling resulting in coma and death, said David Thurman, M.D., of the National Center for Injury Prevention and Control in Atlanta.

slide21
Post-Concussion Syndrome (PCS), and Second Impact Syndrome

In the case where an athlete does not fully recover from a concussion and then experiences a second concussion, usually within a week's time, second impact syndrome may occur.

This rare condition often is fatal due to rapid cerebral swelling. It most often occurs in young athletes and in children under the age of 21 years.

Careful concussion assessment and identification are imperative to help prevent brain damage, post-concussion syndrome (PCS), and second impact syndrome.

slide22
Post-Concussion Syndrome (PCS)

One severe concussion or successive mild or moderate concussions can cause permanent damage to the brain or can cause postconcussive syndrome.

The symptoms of postconcussive syndrome include headaches, dizziness, insomnia, poor concentration, memory difficulties, irritability, personality changes, anxiety, or depression.

As many as 30% of professional football players have symptoms of this disorder.

slide25
Traumatic Injuries

Limb fractures/injuries

Chest injuries

Abdominal injuries

Head injuries

Cervical spine injuries

slide28
Medical Conditions

Marfan’s Syndrome is a defect in connective tissue that has widespread effects involving skeletal, eye, and cardiovascular structures that may lead to mitral valve disease and a dissecting aortic aneurysm -thoracic aneurysm pain due to aortic dissection

Mitral Valve Prolapse (MVP) results in complications like

dysrhythmias, sudden death, infective endocarditis, cerebral ischemia and mitral regurgitation

Pneoumothorax has been associated with Marfan’s

syndrome and mitral valve prolapse

slide29
Medical Conditions (cont’d)

Diabetes

Seizures

Mentally handicapped

Physically handicapped

slide30
Environmental Injuries

Hypothermia

Frost bite

Heat disorders

Sun burn/blister

Drowning

event pressure
Event Pressure

Peer pressure

Coaching pressure

Event significance

Significance of Role

Parental pressure

Monetary factor

how to rule out a spinal step by step
Next SessionHow to Rule-Out a spinal step-by-step

Managing The Unruly,

Possible Spine Injured Patient

slide34
Thanks for your participation

and attention.

For more information

or the CD please contact

www.safetraining.info

scenarios
Scenarios

1) A hockey player is checked head long into the boards and is face down not breathing. In three minutes the patient begins to breathe shallowly (diaphramatically only), stertorously and erratically. The patient remains unconscious and when turned has blood and emesis in his/her mouth. The patient seizures at one point.

scenarios36
Scenarios

2) An athlete collides with other athletes or an object and appears to be knocked out or dazed.

On your approach the athlete gets up and tries to say they are okay and want to keep playing.

On palpation you can feel a bump on the back of their head.

The athlete does not really remember what happened and is a bit slow to answer.

When tested they cannot perform the finger to nose test or tandem walk very well.

When the player is asked to move their head they experience pain when flexing.

scenarios37
SCENARIOS

3) An athlete is on their side and unresponsive. They had a collision and were found on the ground. As you begin to assess the athlete, they awaken and are confused and combative.

scenarios38
SCENARIOS

4) You respond to a ski hill to transport an injured snow boarder. The patient was apparently knocked out after hitting a branch while “glade” boarding. The patroller says the patient has no neck injury and was brought down in a toboggan.

slide39
“I did a call last Sunday to a rugby game where a player was seizing.

I rode in with the EMT Intermediate or PCP crew, the patient and the trainer.

Would you like to hear and watch the postictal concussed patient converse with us?”

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