KIN 202 exam 2

most effective way to prevent fatalities and manage nonfatal events is through ________.

most effective way to prevent fatalities and manage nonfatal events is through ________.

a sound and well-rehearsed EAP

what are the EAP components?

1. identify personnel directly involved in carrying out a plan

2. specifies necessary equipment and their location

3. establishes mechanisms for communication or arrangements need to be made to have EMS already present at event

4. Specific to venue/involves all scenarios (games, practices, summer camps, etc)

5. should have specific checklists

6. incorporate local first responders and care facilities

7. specifies necessary documentation

8. reviewed and rehearsed annually (1 time a year)

9. reviewed by admin and legal counsel of the sponsoring organization

what are the 4 functions regarding EAP?

1. immediate care of athlete

2. emergency equipment retrieval

3. activation of EMS (if necessary)

4. signaling EMS to the field if already present

when should you renew CPR/AED/first aid training?

every 2 years

T/F: CRP/AED/FA training should be done only by nationally recognized organizations.

true

what are the best practices for emergency planning in exercise/sport locations?

1. completed comprehensive EAP

2. no activities should occur until all personnel are fully familiar with EAP

3. all staff should be current in CPR, AED, and first aid training and be educated in recognizing dangerous situations

4. establish effective internal and external communication to activate on and off site emergency team members

5. post the specific location of all emergency equipment and assign team members certain jobs for equipment retrieval

6. train team members for equipment usage, including battery replacement and documentation of maintenance records

7. provide guidelines on who will advocate for a minor in an event of an emergency incident when the parent or guardian is absent

what are 4 potentially catastrophic events?

• head and neck injuries

• exertional heat stroke

• exertional sickling

• sudden cardiac arrest

What are the steps to initial checks?

1. scan for signs of uncontrolled bleeding

   assess responsiveness or level of consciousness

2. assess ABC’s

   1. airway

   2. breathing

   3. circulation

3. identify life threats

4. determine priority of patient care and transport

how do you do an external hemorrhage assessment?

control w/ direct pressure, elevation, etc. and take precautions against blood borne pathogens (wear PPE)

how do you do an internal hemorrhage assessment?

rapid weak pulse, rapid shallow breathing, moist and clammy skin, blue skin inside lips and under nail beds, dizziness, confusion

(these are harder to detect)

what is hypovolemic shock?

the earliest sign of severe internal bleeding (inability of cardiovascular system to maintain adequate circulation to all parts of the body)

how do you assess responsiveness?

the APVU scale

what does the APVU scale stand for?

• Alert and Aware

• responds to Verbal stimulus

• responds to Painful stimulus

• Unresponsive to any stimulus

what are the steps to airway assessment?

1. ask person a simple question

2. look for response that indicates that when the airway is open if circulation is adequate

3. if the person is not breathing and spinal or head injury is suspected…

   1. use jaw thrust technique to open airway

   2. use finger sweep if object is lodged in mouth

4. reassess airway after opening it

what should you do for a breathing/respiratory assessment?

• breathing assessment (5-15 sec)

• conscious individual is breathing but must be monitored for difficulty or abnormal sounds

• unconscious person may not be breathing, but circulation must be prioritized, starting compressions if necessary

• look for the chest to rise and fall and feel for chest movement

what should you do for a circulation assessment?

• if there are no signs of circulation begin CPR

• if unresponsive check for signs of circulation after opening airway and checking for breathing (check skin color and a pulse point)

what are the next steps of action after determining that someone is no longer in life-threatening circumstances?

1. take medical history

2. observation

3. palpation

what is a sign (in comparison to a symptom)?

an objective finding (ex: you can see bone sticking out)

what is a symptom (in comparison to a sign)?

something subjective in nature (ex: I have muscle cramps)

what is bilateral comparison?

comparing one side to the other

what is shock?

an acute life-threatening condition involving the failure to maintain adequate circulation to vital organs

what are the 3 causes of shock?

• cardiogenic (heart failure)

• neurogenic (dilated blood vessels)

• psychogenic (fainting)

how is shock treated?

1. do NOT move them (stabilize in position found)

2. rest

3. keep them calm

4. cover w/ blanket (as appropriate)

5. monitor vital signs

what is the normal core body temp at rest?

98.0°F - 98.6°F (36.7°C - 37.0°C)

what is still considered normal core body temp when exercising?

98.0°F - 102°F (36.7°C - 38.9°C)

what core body temp is considered unsafe?

104°F (40°C)

T/F: the body is constantly trying to remain cool and disperse the heat that it produces.

true

T/F: exercise decreases metabolic rate.

false

what are the 2 pathways of heat exchange?

dry and wet

what are the 3 examples of dry pathways?

• radiative

• conductive

• convective

what is the example of a wet pathway?

evaporative

dry pathways are dependent on _____ within organism and occur between said organism and ______.

temp gradient; environment

in wet pathways the potential for heat loss is determined by the _____ and is the most effective pathway on _____.

water vapor pressure gradient; dry land

what happens in a radiative dry pathway?

transfer of heat via electromagnetic waves

what happens in a conductive dry pathway?

direct transfer by contact (ex: you touch a cold surface and heat transfers form you to said surface)

what happens in a convective dry pathway?

transfer of heat from the body to moving liquid or air (ex: blowing a fan on ourselves or falling off a boat into cold water)

T/F: you get cold slower in moving water.

false

what happens in an evaporative wet pathway?

a loss of heat by evaporation of water (ex: sweating b/c sweat is vaporized at the skins surface)

this works best in low humidity

what is relative humidity?

the amount of water suspended in the air

what is the #1 way we lose heat as humans?

sweat

what does WBGT stand for?

Wet Bulb Globe Thermometer (or Temp device)

what does a WBGT do?

it is used to determine the relative humidity, air temp, and other factors in order to determine if exercise activity can happen safely

T/F: we use the WBGT more than heat index today.

true

what is heat index?

the relative humidity to the temperature

what is hypERthermia?

elevated core temp

what are 4 environmental emergencies related to heat?

• heat syncope

• heat cramps

• heat exhaustion

• heat stroke

what is heat sycope?

a fainting episode or dizziness that usually occurs w/ prolonged standing or sudden rising from a sitting or lying position (factors that contribute: dehydration, lack of acclimation to heat, lack of muscle contractions)

how can you prevent a heat syncope?

flex/extend toes or ankles OR contract/relax gastrocnemius

how can you treat a heat syncope?

sit or lie down in a cool place and/or slowly drink water

what are heat cramps?

painful muscle spasms that occur suddenly during or after vigorous exercise or activity

what is one sign/symptom of heat cramps?

painful muscle contractions that happen suddenly

how can you care for heat cramps?

1. have victim rest is a cool place

2. have victim drink beverage with added sodium

3. stretch/roll the cramped muscle(s)

4. place an ice bag on the painful muscles

5. pinch the upper lip just below the nose

what some signs/symptoms of heat exhaustion?

• profuse sweating

• thirst

• fatigue

• flu like symptoms

• dyspnea (labored breathing)

• tachycardia (HR over 100 bpm at rest)

it is characterized by heavy sweating with normal or slightly above normal body temp (less than 104 F though)

how can you care for heat exhaustion?

1. move victim to cool place immediately

2. give victim cool fluids

3. remove excess clothing/equipment

4. place ice bags strategically

5. increase air movement around them

6. seek medical care if there is no improvement within 30 mins

what are the 2 types of heat stroke?

classic and exertional

how long does classic heat stroke take to develop?

a few days

how long does it take for exertional heat stroke to develop?

it develops immediately

how can you care for heat stroke?

1. move victim to cool place fast!

2. call 911 immediately

3. remove excess clothing/equipment

4. keep victims head and shoulders slightly elevated

how can you cool someone quickly when they have heat stroke?

• ice bath while supporting upper body

• spray with water and fan them

• apply cool wet towel and fan them (may need to rotate towels)

• apply ice bags and fan them

water temp greater than _____ can lead to hyperthermia.

32°C (90°F)

T/F: fresh water feels cooler than salt water.

true

water makes up about ____ percent of adults body weight.

55-60

how many fluids do adults need per day?

2 liters

T/F: warm water is easier to absorb than cold water?

false

what are the 2 essential electrolytes?

potassium and sodium

what is hyponatremia?

a condition where sodium levels in the blood are abnormally low (less than 130 mmol/L)

what can cause hyponatremia?

• long duration, low intensity events lasting over 4 hours

• repeated/prolonged exercise in hot environments

• considerable sweating

• low sodium diet

• excessive water consumption

what is thermogenesis?

heat generated from metabolic processes within the body

maintaining normal body temp while exposed to the cold depends on ________ and ________ to the environment.

thermogenesis; heat loss

what is the main life-threatening cold injury?

loss of body heat and whole body hypothermia

what is thermal gradient?

temp difference between the core & extremities and the skin & environment

what is the purpose of shivering?

to create heat within the body when needed

heat loss via radiation example…

head, face, neck, and hands are exposed

heat loss via convection example…

boundary layer of thin warm air around skin is lost due to air flow

heat loss via conduction example…

contact with cold surfaces like rain soaked clothing

heat transfer via water is how many times greater than heat transfer via air?

70x

what parts of the body are poorly designed for retaining heat?

fingers, toes, and face

what are 3 cold-dry environmental emergencies?

• hypothermia

• frostnip

• frostbite

what are 3 cold-wet environmental emergencies?

• hypothermia

• chill-blains

• trench-foot

what is hypOthermia

a decrease in core body temp to a level in which normal muscular and cerebral functions are impaired

any temp less than ____ can be linked to hypothermia.

98.6°F

the core temp falls due to decreased ____ and body functions start to slow down during hypothermia.

basal metabolic rate (BMR)

what characterizes mild hypothermia?

(98.6-96 F) shivering, fine motor control losses, vasoconstriction in extremities

what characterizes moderate hypothermia?

(95-93 F) irrational behaviors, loss of fine motor function, violent shivering, flat affect

what characterizes severe hypothermia?

(92-86 F) violent shivers in waves until it stops completely, muslce rigidity, bradycardia

how can you treat hypothermia?

1. conserve heat, provide carbs (helps with glycolysis/ATP production)

2. avoid rewarming extremities, focus on the core

what is frostnip?

initial freezing of the epidermis, superficial skin tissue is painful but typically does not produce long term damage

what is frostbite?

a more sever freezing of all the layer of the skin (this has 4 stages)

what does the 1st stage of frostbite look like?

hyperthermia, mild itching, edema (swelling)

what does the 2nd stage of frostbite look like?

blistering and desquamation (scaly skin)

what does the 3rd stage of frostbite look like?

necrosis of skin and subcutaneous tissue with ulceration

what does the 4th stage of frostbite look like?

destruction of connective tissues and bone with gangrene

what is chill-blain?

damage to superficial blood vessels, resulting in local edema and inflammation (similar symptoms to 1st degree frsotbite)

what is trench-foot?

severe damage to the local vasculature and nerves characterized by severe ulceration, pain, and risk of infection

what is sickle cell anemia?

a hereditary blood disorder that means the shape of your red blood cells are sickled (crescent shaped)

what is sickle cell trait?

when a person is heterozygous for the sickle cell mutation but are hematologically normal

what can cause a sickle cell crisis?

• change in altitude

• change in temp

• hypohydration/dehydration

• stress

• high intensity workouts or intense sustained activity

what are some signs/symptoms of a sickle cell crisis?

• pain in muscles but no cramps

• breathing issues

• headache and/or syncope

• convulsions

• extreme fatigue

• jaundice

how can a sickle cell crisis be treated?

1. check vital signs

2. cool individual (if needed)

3. call 911 and attach AED (if needed)

what is rhabdomyolysis (rhabdo)?

• a breakdown of skeletal muscle due to direct or indirect muscle injury (disruption of skeletal muscle integrity)

• causes release intracellular muscle components into blood stream and extracellular space

• ranges from asymptomatic illness with elevation in creatine kinase (CK) levels, electrolyte imbalances, acute renal failure, and disseminated coagulation