ATH 263 Emergency Response - Final Exam

Sports Emergency Team

- AT

- PT

- Physician

- EMT

Primary assessment

- SSS

- Vitals (ABC)

- Consciousness

- Emergent conditions

Secondary Assessment

- Special tests

- History (SAMPLE)

- MOI

Mechanism of injury

- How injury occurred

- Ex. Contact/non-contact, torsion forces, eversion/inversion

AVPU

- Alert

- Verbal

- Pain

- Unresponsive

ABC

- Airway

- Breathing

- Circulation

SSS

- Shock

- Severe bleeding

- Spinal Injury

Pain Characteristics

- OPQRST

- Radiating: nerve

- Achy/Dull/Throb: Chronic

- Sharp/pinpoint: acute

- Referred: organ trauma

Vitals: Pulse

- 60-100 BPM

- Carotid, Brachial, Radial, Femoral, Dorsal pedal, Post. Tibial

Vitals: Respiration

12 breath/min

Vitals: Blood Pressure

- 120/80 mmHg

- Let arm @ heart height

Pulse oximeter ideal reading:

96-98%

Capillary refill time

2-3 sec

Body temp:

- 98.6F

- Heat stroke: >104.5F

Cardiac arrest

bad

Myocardial infarction

heart attack

Angina Pectoris

- Chest pain resulting from inadequate blood supply to heart

Commito Cordis

- Direct hit to chest right before peak of T wave

- Death imminent

Stroke FAST:

- Face drooping

- Arm weakness

- Speech difficulty

- Time to call

Syncope

- Loss of consciousness (fainting)

Glasgow Coma Scale

- Eye opening

- Verbal response

- Motor response

- 13-15 Mild

- 9-12 Moderate

- 3-8 Severe

Amnesia memory loss

- Retrograde: before injury

- Anterograde: after injury

Amnesia memory needs to get better:

within few hours

Fencing

elbow extension + shoulder flexion

Decorticate

flexion neck, wrist, elbow

Decerebrate

extension wrist, elbow, neck

Seizures: Tonic

Stiffening of muscles then collapse

Seizures: Clonic

muscle spasm and convulsion of limbs after tonic phase

Grand-Mal

- long term

- full-body spams/contraction

Seizure basic first aid/care

- Remove surrounding dangers

- Loosen restrictive clothing

- Record length of seizure

- Monitor vitals/maintain airway is applicable

When do activate EMS for seizures

- Longer than 5 minutes

- Pregnancy

- Unconscious after

- If 1st seizure or unknown person

- Subsequent seizure

- Injury occurs (airway, tongue...)

Establish airway go to

- Head-Tilt Chin-Lift

- Hand forehead + cup chin - tilt/lift

Establish airway with C-Spine injury suspected

- Jaw thrust

- Thumbs cheeks + fingers behind jaw - slide jaw fwd

Oropharyngeal airway

- Ear to mouth

- Use when unconscious

- Insert tip upward, turn 180 as resistance met

Nasopharyngeal airway

- ear to nostril

- Pinkie/nasal passage width

- Use when conscious

- lubricate distal end

- Arc pointed down

Airway breathing assessment

- Slow/rapid

- Quality

- Effort

Shock/Internal hemorrhaing:

Pulse quickens, BP drops, breathing increases

Axial loading

- Direct force goes down the spine

Worst spinal forces

- Extension with rotation

Type of spine board lifts

- Log roll

- 6-person lift

- Lift-slide

Equipment removal

- Remove helmet, pads, etc.

- Trainers angels, drills, screwdriver, etc.

Types of boards

- Spine board

- Scoop stretcher

Brain injury: Coup

Moving object hits stationary head

Brain jury: Contra-coup

moving head hits stationary object

Epidural hematoma

- Between skull and dura mater

Subdural hematoma (silent killer)

- Between surface of brain and dura mater

Second impact syndrome

- Subsequent head injury too close to initial head injury

Thoracic Injuries

- high pulse

- high breathing rate

- Low BP

Pneumothorax

- air enters pleural cavity

Pneumothorax S&S

Chest pain, distended veins

Pneumothorax care

Refer, lie on affected side

Hemothorax

blood enters pleural cavits

Hemothorax S&S

Chest pain, flat veins, hypotension

Hemothorax care

refer, lie on affected side

Flail chest

- Multiple non-stable rib fractures (+3 fractures in +2 places)

- Stabilize + refer

Abdominal Quadrants

- RL

- RU

- LU

- LL

RLQ

Appendix

RUQ

Liver

LUQ

Stomach + spleen

LLQ

Descending colon

McBurneys Point

- Tests for appendicitis

- Right side halfway between belly-button and ASIS

- Apply pressure and release

- If pain upon release appendicitis positive

Kerr's Sign

- Sharp unexplained left shoulder pain

- Spleen trauma

Rebound test

- Distention, soft, swelling in 1 quadrant

- Other 3 quadrants guarded and hard

Types of fracturs:

- Incomplete

- Complete

- Closed

- Open

Incomplete fractures

- hairline/stress

Complete fractures

- Spiral

- Transverse

- Oblique

- Linear

- Comminuted

Closed fractures

Does not break skin

Open fractures

break skin

Dislocations

- Joint forced out and stays out of position

Sublucation

- Partial or fully dislocation but goes back in by itself

Splinting

Above and below injured site (wood, vacuum, SAM, etc)

Open wound care

- Direct pressure

- Irrigation (water/saline)

- Coverage (bandage, steri-strip, etc)

Heat illnesses

- Heat cramps

- Heat exhaustion

- Heat stroke

Cold illnesses

- Hypothermia

- Frostbite

Hypothermia

- Temp <95

Hypothermia S&S

- Shivering (no shivering = severe)

- Slow breathing

- Lack of mental clarity

- Decrease fine/gross motor skill

Hypothermia Treatment

- Rewarming

- Remove wet clothing

- Monitor/Vitas

- EMS for severe

Frostbite

- Dry tissue @ 28F

- Wet tissues @ 30F

- Remove wet clothing, local rewarming

- Refer

Altitude Illnesses

- Acute mountain sickness

- High Altitude Pulmonary Edema (HAPE)

High Altitude Cerebral Edema (HACE)

Acute mountain sickness

- >9840 feet

- S&S Fatigue, weakness, nausea, dizziness, difficulty sleeping

- Quick onset

- Management: Supplemental O2

HAPE (High Altitude Pulmonary Edema)

- Occurs have 2-4 days

- Fluid enters lungs

- S&S: Fatigue, dyspnea, dry cough

- Management: Decrease elevation, supplement O2, refer

- Mortality up to 50%

HACE (High Altitude Cerebral Edema)

- Occurs after 2-4 days

- >10k feet

- Caused by brain swelling

- S&S: ataxia (without coordination), fatigue, altered mental status

- Management: Decrease elevation, supplement O2, Refer

Diabetes

- Type 1: no insulin production

- Type 2: insulin resistance

Allergies

- Epipen administration

- EMS activation