Transcript Injury Management Ppt

Injury
Management
Recognizing Different Sport
Injuries
• Participation in sports dictates
that sooner or later injury will
occur
• Some of the more common
injuries involve tissues:
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Cuts & abrasions
Contusions
Muscle strains
Ligament sprains
Joint dislocations
fractures
Recognizing Different Sport
Injuries
• Because sports often involve repetitive
body motions, athletes are prone to
overuse injuries
• Need to be able to recognize different
types of injuries, distinguish between
levels of injury severity, and apply
appropriate first aid and ongoing
treatment.
Mechanical Injury
• Trauma is defined as physical injury or wound,
produced by internal or external force
• Mechanical injury results from force or mechanical
energy that changes state of rest or uniform motion of
matter
• Tissue Properties
• Load
• An external force acting on the
body causing internal reactions
within the tissues
• Stiffness
• Ability of a tissue to resist a load
• Greater stiffness = greater
magnitude load can resist
• Stress
• Internal resistance to a load
• Strain
• Internal change in tissue (i.e.
length) resulting in deformation
Figure 9-1
• Body tissues are viscoelastic and
contain both viscous and elastic
properties
• Yield point
• Point at which elasticity is almost
exceeded is the yield point
• If deformation persists, following
release of load permanent or
plastic changes result
• When yield point is far exceeded
mechanical failure occurs
resulting in damage
How do injuries happen?
• Tissue Loading
Figure 9-2
• Tension
• Force that pulls and
stretches tissue
• soft tissue that is
suddenly
stretched
beyond its yield
point will tear or
rupture
• when tissue is
placed in
constant tension,
connective
tissue will
weaken and is
subject to injury
• Tissue Loading
Figure 9-2
• Compression
• Force that results in
tissue crush – two
forces applied
towards one another
• when the force is
excessive and
can no longer be
absorbed a
contusion, or
bruise occurs
• Tissue Loading
• Shearing
• Force that moves
across the parallel
organization of tissue
Figure 9-2
• Bending
• Two force pairs act at
opposite ends of a
structure (4 points)
• Three forces cause
bending (3 points)
• Already bowed structures
encounter axial loading
• Torsion
• Loads caused by twisting
in opposite directions
from opposite ends
• Shear stress
encountered
Figure will
9-2 be
perpendicular and
parallel to the loads
INJURIES
Soft Tissue Injuries
• Abrasion
• Scraping away of outer layer of skin
• Avulsion
• Tearing or pulling away a part of a
structure
• Laceration
• Jagged, irregular cut
• Contusion
• A bruise
• Sprain/Strain
• Tearing of ligament/muscle
Soft Tissue Injury Treatment
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Clean area with soap and water
Apply antibiotic cream
Apply sterile bandage
Watch for infection
Soft Tissue Injuries (cont.)
• Contusion
• Immediate Treatment:
• PRICE (protection, rest, ice,
compression, and elevation)
• Ice with muscles flexed
• Follow-up:
• Continue with ice until swelling
subsided
• Mild stretching through pain-free
range of motion
• Padding when return to play
Soft Tissue Injuries (cont.)
• Puncture
• occurs when a
pointed object
enters the body
• Stepping on a nail
• tend not to bleed
too much, so more
likely to become
infected than freely
bleeding wounds
• Puncture:
• Immediate Treatment:
• Stabilize the object in place
• usually tape into place
• Check for shock
• Minor: clean, cover, and send
to physician for evaluation &
tetanus
• Follow-up: watch for signs of
infection
Treatment:
Severed or Amputated
• Wrap severed part in sterile
gauze
• Put in plastic bag
• Put plastic bag on ice
• Send severed part with victim to
hospital
Soft Tissue Injuries
• Incision:
• open wound made
by a knife-like
object
Deep Lacerations
• Apply steri-strips or butterfly dressing
• Cover with sterile dressing
• Stitches?
• Longer 1 inch
• Deep cut into dermis
• Edges that do not close with steri-strip
or butterfly dressing
• Uneven edges
• Best to get stitches within 6-8 hours to
decrease scarring and infection
• Facial best to get stitches within 4
hours
BITES
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Wash with soap and water
Cover with sterile dressing
Apply antibiotic ointment
Apply Ice
• Never apply ice with snakebites
• Stimulates the spread of the venom
• Complications
• Poisonous
• Minimize movement
• Seek medical attention
• Infection
• Seek medical attention
BLISTERS
• Caused by the skin rubbing against a
hard or rough surface resulting in the
layers of the skin to separate
• Feel a “hot spot”
• Treatment:
• Leave in tact
• Popping blister leaves open skin
susceptible for infection
• If blister is torn, keep clean and
cover with moleskin or second skin.
Muscle Cramps
• Def: involuntary muscle contraction
• Common in calf, abdomen, and
hamstrings
• Related to excessive loss of water and
electrolytes (sodium, chloride, potassium,
magnesium, and calcium)
• Essential for muscle contraction
• Treatment:
• Stretching
• Fluids…mustard / pickle juice
Muscle Soreness
• Def: pain caused by overexertion in exercise
• Typically doing some activity to which they
are unaccustomed
• Two types of soreness:
• Acute-onset muscle soreness
• Accompanies fatigue
• Occurs during and immediately after
exercise
• Delayed-onset muscle soreness (DOMS)
• Becomes intense 24-48 hrs after exercise
• Gradually subsides – symptom free in 3-4
days
• Bursitis
• Def: inflammation of the bursa
• Occur around joints where there
is friction between tendon and
bone, skin and bone, or muscle
and other muscles
• a bursa is a fluid filled sac found
in places where friction might
occur within body tissues
https://www.youtube.com/watch?v=MMXY
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https://www.youtube.com/watch?v=F6jz3Gi
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https://www.youtube.com/watch?v=S0zd39
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Joint Injuries
•Dislocation
•A bone is forced out
of alignment and
stays out until
surgically or
manually replaced or
reduced.
•most common with
shoulder, elbow, and
fingers
Joint Injuries (cont)
• Dislocation
• A first time
dislocation should
always be
considered and
treated as a
possible fracture
• Never reduce!
Joint Injuries
•Subluxation
•A bone is forced out of
alignment but goes back
into place
•most common with
shoulder & patella
Joint Injuries
• Immediate Treatment:
• Check for pulse below the
injury
• Splint/Sling in most
comfortable position
SKIN CONDITIONS
• Caused by a fungus, virus, bacteria or
parasite
• Common in sports such as wrestling, but
can occur in any individual
FUNGUS
• Tinea= superficial fungal infection
• Thrive in Moist, warm, dark
environments.
• Treatment
• Anti fungal creams or sprays.
Sometimes needs an anti-fungal
oral medication
• Common types in athletics
• Tinea corporis, Tinea cruris and
Tinea Pedis
Tinea Corporis- Ringworm
• Common in wrestling
• AKA- Tinea Gladiatorum
• Lesions have a ring-like eruption with red
or brown plaques with raised border
• Appear on scalp, trunk and upper and
lower extremities
• Spread by skin to skin contact
Tinea infections…
Tinea cruris
• Jock Itch
• Rash, scaling small
papules in groin and medial
thigh area
Tinea Pedis
• Athletes foot
• Redness, scaling, cracking
and itching
• Soles of feet and inbetween toe
Bacterial Infections in Sports
• Impetigo
• Pustules that
become
crusted and
rupture
• Highly
contagious with
skin to skin
contact
• Treated with
oral anti-biotic
Bacteria Infections
• MRSA
• Caused by Staphylococcus aureus bacteria
or “staph”
• Start as red bumps and quickly turn into
deep painful abscesses
• Can penetrate into blood stream,
potentially causing life-threatening
infections to body systems
• Treatment
• Antibiotics & Draining abscesses
Common Viral Infection in Sports
• Warts
• Verruca
vulgaris
• Small tumors
with dark
centers
• May appear
anywhere on
body
• Treatment
• Cryosurgery
• Salicylic acid
Verruca Plantaris
Plantar warts
• Develop on sole of foot
• Pinpoint black spots
• Can be protected with donutshaped pad to relieve
pressure
Eczema
• Itchy red rash
• Caused by
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Allergies
Stress
Temperature
Drug reaction
Scratching
Sun exposure
• Treatment
• Corticosteroid
Lotions and
ointments
• Antihistamines
• Lotions to
hydrate skin
Fractures
• Def: a break or crack in a
bone
• Occur as a result of extreme
stresses and strains placed
on bones
Fractures
• Signs and Symptoms of a Fracture:
– Pain at the site of the injury
– Deformity
– Edema (swelling) at the injury site
– Ecchymosis (bruising)
– Grating or crepitation
– Immobility
– Numbness or tingling
– Pale or cold skin due to impaired
circulation
• https://www.youtube.com/watch?v=CUAM
GrWiV6w&index=16&list=PLncR5fBdGIwvBV0Zl7wDZYMt5TCK2MK1
• Greenstick Fracture
• incomplete breaks in bones
• occurs on one side of the bone,
similar to the splintering of a
green twig
• Longitudinal or
Linear Fracture
• bone splits along
its length
• parallel to the
length of the bone
• Spiral Fracture
• S-shaped
fracture
• common in
football & skiing
• where the foot is
planted and the
body is rotated
• looks like a
candy cane
•Oblique Fracture
•occurs when one
end received
sudden torsion or
twisting and the
other end is fixed
•similar to a spiral
fracture
•Transverse Fracture
•occur in a straight
line perpendicular
to the length of the
bone
•direct blow
•right angle
•Comminuted
Fracture
•3 or more fragments
at the fracture site;
shattering
•Caused by direct
trauma
• Epiphyseal fracture
• occurs at the
epiphyseal growth
plate
• also known as a
Salter-Harris fracture
Fractures (cont.)
• Stress Fractures
• Repeated stress over a period of time
• Avulsion fx
• separation of a bone fragment at the
attachment of a ligament or tendon
• Common with ankle sprains
SPLINTING
• Only if the person must be moved
• In the position you find it
• Joints above and below must be immobile
- SNUG
• Check circulation before and after
(warmth, color)
• Only if you can do without causing more
pain
Healing of a Fracture
• In general:
• Long bones = 6 weeks
• Small bones = 3-4 weeks
• For a fracture to heal
• Osteoblasts lay down extra bone
formation, called a callus, over the
fracture site during immobilization
• After immobilization, bone must be
subjected to normal stresses and
strains
• Osteoclasts reshape the bone in
response to normally applied stresses
and strains
Head, Neck and Back Injuries
• Biggest Concern?
• Paralysis if moved
• Signal of One?
• Change in conscious
• Numbness or tingling or loss of
movement
• Complain pain or point tenderness on
cervical spine
• Care for?
• MINIMIZE MOVEMENT
• Provide in-line stabilization
What if athlete is wearing a helmet?
• Do not remove
• IF need to gain access to airway use
appropriate equipment to minimize
movement of spine