Transcript FA/CPR Ppt - South Kitsap School District

Beginning Athletic Medicine
First Aid
• Initial care provided for an acute illness or
injury, when advanced care procedures
are not readily available.
• Intended to preserve life, alleviate
suffering, prevent further illness or injury,
and promote recovery
First Aid Provider
Responsibilities
• Recognizing a medical emergency
• Making the decision to help
• Identifying hazards and ensuring personal
safety
• Activating the EMS system
• Providing supportive, basic first aid care
Recognizing an Emergency
• Quick impression of what is going on or
what has happened
• Injuries occur due to a physical force
• Mechanism of injury = manner in which a
force creates an injury
Personal Safety
• Highest priority is YOUR SAFETY
• Use SETUP to help to see if a scene is
unsafe
SETUP
• S = stop
– Pause to identify hazards – what happened?
• E = environment
– Consider your surroundings – it is safe?
• T = traffic
– Be conscious of vehicles, bikes, people, etc…
• U = unknown hazards
– Consider things that are not apparent
• P = personal safety
– Use protective barriers
Protecting Yourself
• Standard Precautions
– A set of protective practices used whether or
not an infection is suspected
• PPE
– Personal protective equipment
– Examples?
• Disinfecting Surfaces: 1 part bleach to 10
parts water
Legal Terms
• Consent
– Have to ask a responsive person if they want
help
• An unresponsive person, the legal concept
of “implied consent” allows a provider to
help without asking
Good Samaritan Laws
What are they?
How are you protected?
When aren’t you protected?
Good Samaritan Laws
What are they?
• Laws or acts protecting those who choose
to serve and tend to others who are
injured or ill.
• They are intended to reduce bystanders'
hesitation to assist, for fear of being sued
or prosecuted for unintentional injury or
wrongful death
Good Samaritan Laws
• Laws help protect anyone who:
– Voluntarily provides assistance, without
expecting or accepting compensation
– Is reasonable and prudent (having or showing careful
good judgment)
– Does not provide care beyond the training
received
– Is not “grossly negligent” or completely
careless, in delivering emergency care
Washington Good Samaritan Act
The Good Samaritan Act
4.24.3000
Persons rendering emergency care or transportation - Immunity from liability - Exclusion.
•
Any person, including but not limited to a volunteer provider of emergency or medical services, who without
compensation or the expectation of compensation renders emergency care at the scene of an emergency or who
participates in transporting, not for compensation, therefrom an injured person or persons for emergency medical
treatment shall not be liable for civil damages resulting from any act or omission in the rendering of such
emergency care or in transporting such persons, other than acts or omissions constituting gross negligence or
wilful or wanton misconduct. Any person rendering emergency care during the course of regular employment and
receiving compensation or expecting to receive compensation for rendering such care is excluded from the
protection of this subsection. [1985 c 443.19; 1975 c 58.1.]
(Severability - Effective date - 1985 c 443: See notes following RCS 7.69.010.)
4.24.310
Persons rendering emergency care or transportation - Definitions.
•
For the purposes of RCW 4.24.300 the following words and phrases shall have the following meanings unless the
context clearly requires otherwise: (1) "Compensation" has its ordinary meaning but does not include nominal
payments, reimbursement for expenses, or pension benefits.
•
(2) "Emergency Care" means care, first aid, treatment, or assistance rendered to the injured person in need of
immediate medical attention and includes providing or arranging for further medical treatment or care for the
injured person. Except with respect to the injured person or persons being transported for further medical
treatment or care, the immunity granted by RCW 4.24.300 does not apply to the negligent operation of any motor
vehicle.
•
(3) "Scene of an emergency" means the scene of an accident or other sudden or unexpected event or combination
of circumstances which calls for immediate action other than in a hospital, doctor's office, or other place where
qualified medical personnel practice or are employed.
[1985 c 443.20; 1975 c 58.2.; Severability - Effective date - 1985 c 443: See notes following RCW 7.69.010.]
Good Samaritan Law
• Use common sense
– Activate EMS or emergency action plan (EAP)
immediately
– If scene is unsafe, don’t enter
– Ask a responsive person for permission
before giving care
– Never attempt skills that exceed your training
– Once you’ve started, don’t stop until someone
of equal or greater training relieves you
Legal Terms
• Duty to Act
– A predetermined requirement to provide care,
typically by job description or by relationship.
• Negligence
– Occurs when someone is caused further harm due to
care that did not meet the expected standards of
someone with a duty to act
• Assault and Battery
– Placing a person in fear of bodily harm
– Forcing care on a person against her/his wishes
EMS Activation
• Immediately activate EMS for:
– A person is unresponsive
– A significant mechanism of injury has
occurred
– A warning sign of serious illness exists
– The severity of a person’s condition is unclear
Emergency Moves
• Only move if clearly endangered or
requires life-supporting care
• Most effective method is dragging
– Keep in line of long axis of body
• Types
– Extremity
– Clothing
– Blanket
Sudden Cardiac Arrest (SCA)
• Cardiac Arrest is the loss of the heart’s ability to
pump blood to the body
• SCA occurs when the normal electrical impulses
in the heart unexpectedly become disorganized
SCA
• Causes
– Heart disease
– Electrical shock
– Severe blood loss
– Drug overdose
– Severe allergic reaction
– Drowning
Heart Problems
Angina
• Chest pain caused by
reduced blood flow to
heart muscle
Heart attack
• When the heart does not
function properly, denying the
heart muscle of oxygen &
causing chest pain (tissue
death)
Cardiopulmonary Resuscitation
(CPR)
• The immediate treatment for a
suspected cardiac arrest
• Restore limited oxygen to the brain
Early Defibrillation
• Most effective way to end fibrillation is
defibrillation using an automated external
defibrillator (AED)
• A controlled electrical shock is sent
through the heart to stop venricular
fibrillation (V-fib)
• For each minute a person is in cardiac
arrest, his chance of surviving decrease by
about 10%
Chain of Survival
• Most effective approach for treating
sudden cardiac arrest
– Immediate Recognition & Activation of EMS
– Immediate CPR with high-quality chest
compressions
– Rapid Defibrillation
– Effective basic and advanced EMS care and
transport
– Effective Post-cardiac arrest care at a hospital
Chest Compressions
• Increases the pressure inside the chest
and directly compresses the heart
• Compress deeply, more than 2 inches
• Compress fast: 100 to 120 times per
minute
• Allow chest to fully recoil
Chest Compressions
•
•
•
•
Patient face up on flat, firm surface
Kneel close to the chest
Heel of one hand on center of chest
Heel of second hand on top of the
first
• Position shoulders directly above
your hands
• Lock your elbows
Rescue Breaths
• Artificial breaths
• Air you breathe contains 21% oxygen
• Exhaled air contains between 16% and
17% oxygen
Establishing an Airway
• Most common cause of a blocked airway
is the tongue
• Use the head tilt-chin lift to move tongue
out of the way
• Each breath is about 1 second in length
and create a visible rise of the chest
• In CPR, give 2 breaths in less than 10
seconds
JAW
THRUST
VS.
HEAD TILT
AED: Automated External
Defibrillator
• 85% of adults go into an abnormal heart
rhythm before their heart totally stops.
• The most common is Ventricular
Fibrillation (V-Fib)
– Instead of normal squeezing action that the
heart used to circulate blood, the heart
quivers or shakes when in V-Fib
AED Specifics
• Ventricular fibrillation does not circulate any
blood, so CPR should be done prior to the
arrival of the AED.
• CPR should continue while the AED is being
connected to the patient.
• During the “analyze” mode and the “shock
advised” period you should not touch the
period.
– Warn bystanders before shocking a patient and
LOOK when you press the button
AED Specifics
• Chances of successfully defibrillating a
patient diminish rapidly over time: roughly
7-10% per minute.
• De-fib patches are placed: on the
– right upper portion of chest: below the
collarbone and above the nipple
– left side of chest outside the left nipple and
several inches below the armpit.
Automated External
Defibrillation
• Turn on AED
• Bare chest
• Open package & place pads on
– Patients upper right and lower left
• Clear area to let AED analyze rhythm
• Clear area to deliver a shock
• Continue CPR
AED Considerations
• Make sure the patches stick to the chest
– Chest needs to be dry
– Hairy chests need to shaved with razor
• Special Circumstances
– Can be used on a wet surface, put not in a
puddle
– Can be used on a metal surface
– Must remove any medication patches
– Must remove woman’s bra
Other Considerations for AED
•
•
•
•
•
•
Movement
Battery
Medication patches
Implanted medical devises
Children
Emergency Oxygen
PRIMARY ASSESSMENT:
Unresponsive
• Simple way to quickly identify if a lifethreatening condition is present
• Helps to assess for immediate lifethreating problems
PRIMARY ASSESSMENT:
Unresponsive
• SETUP
• Medical Statement – introduce yourself
• Check for responsiveness
– Tap & Shout
– Unresponsive = call EMS
•
•
•
•
Have someone call 911 & get the AED
Check (look) for normal breathing
Check for pulse
Provide indicated care
PRIMARY ASSESSMENT:
Unresponsive
• Checking for normal breathing
– Look at face and chest
– Take no longer than 10 seconds
– Normal breathing is effortless, quiet, and
regular
– Not normal: weak, irregular gasping, snorting,
or gurgling sounds
PRIMARY ASSESSMENT:
Unresponsive
• Checking for pulse
– Check on Carotid artery near you
– Check for no more than 10 seconds
– Using two fingers, but not your thumb
Unresponsive and Breathing
• Even if breathing, lack of responsiveness
is considered life threating
• Need to worry about keeping the airway
open
– #1 cause of a blocked airway?
• Recovery Position
– Helps maintain airway and lets fluids drain
– Also known as the HAINES position
Recovery Position
• Helps protect the airway by using gravity
to drain fluids & keep tongue forward
• Prepare…Roll…Stabilize
• Other rolls:
– Log roll
– Stomach to back?
1.
2.
3.
4.
5.
6.
S.E.T.U.P.
MEDICAL STATE &TAP & SHOUT
LISTEN FOR RESPONSE (check for responsiveness)
CALL 9-1-1, AED, and RETURN
HEAD TILT/CHIN LIFT TO OPEN AIRWAY
LOOK & LISTEN FOR SIGNS OF NORMAL
BREATHING
7. Check for Pulse
8. BEGIN CPR
•
30 compressions & 2 Breaths
9. CONTINUE UNTIL EMS ARRIVES, PATIENT
STARTS BREATHING, YOU ARE TOO
EXHAUSTED TO CONTINUE, SCENE
BECOMES UNSAFE
AED
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Setup
Assess Responsiveness (Tap and shout)
Activate EMS and get AED
No breathing or signs of circulation perform CPR
AED arrives
Bare, prepare, and place pads
Begin analysis of heart rhythm
Clear patient
Deliver shock
Continue CPR
Continue for 5 cycles
Multiple Provider Approach to
CPR
• You can switch every 2 minutes
• Prior to AED
– Person moving out gives 2 rescue breaths
– New person starts CPR
• When an AED arrives
– One person continues CPR
– Other person puts pads on
S.E.T.U.P
Tap & Shout
Listen for Response
Stabilize Head
Medical Statement
Activate 911 & ‘return’
Head Tilt/Chin Lift
Look, Listen & Feel
Breathing
Not Breathing
Check Pulse (present)
Give 2 rescue breaths
Maintain Airway
Check for Deformities & Bleeding Check for Pulse
Wait for EMS
Recheck in 1 min
Begin CPR
30 compressions x 2 breaths
Recheck after 5 Cycles
RESCUE BREATHING
• What happens if the person has a pulse,
but not breathing?
– Rescue breathing
• 1 breath every 5 seconds
• Perform 20 times then recheck
CHOKING
Mild Obstruction
• When a person can speak, cough, or gag
• Cleared naturally through forceful
coughing
ABDOMINAL THRUSTS
Heimlich Maneuver
How do you know
someone is
choking?
Steps involved:
FOREIGN BODY AIRWAY
OBSTRUCTION: CHOKING CONSCIOUS
•
•
•
•
State: “I am certified in First Aid”
Ask: “Are you choking?” “Can I help you?”
If yes, direct someone to call 911
Find correct hand position
– Midline, fist just above the navel
• Give abdominal thrusts, inward & upward
with a clenched fist until obstruction is
removed or patient becomes unconscious
ABDOMINAL THRUSTS
Heimlich Maneuver
• Pregnant or Obese
– Use chest thrusts
• Person becomes unresponsive
–
–
–
–
Carefully lower to ground
If not, activate EMS
Begin CPR
Look in mouth for an object before giving rescue
breaths
– Continue CPR until person shows obvious signs of
life, or another provider or EMS personnel takes over
CHOKING
• If you are alone:
– Try to keep coughing if able
– Find any nearby help
– Use a chair to force air into your throat
– Try to push in above your stomach with
back on a wall
Beginning Athletic Medicine
First Aid
Primary Assessment:
Responsive Person
• Assess for and treat life-threating
problems, including bleeding and shock
– SETUP
– Introduce yourself w/statement
– Check for confusion or disorientation
– Check for difficulty breathing
– Scan for serious bleeding
– Check for tissue color, skin temp
• Normal skin feels warm and dry
• Cool, wet skin can be an indication of shock
ILLNESS ASSESSMENT
PHYSICAL
ASSESSMENT
• DOTS
–
–
–
–
Deformities
Open wounds
Tenderness
Swelling
PATIENT HISTORY
• SAMPLE
–
–
–
–
–
–
Symptoms
Allergies
Medications
Past medical history
Last oral intake
Events leading to the
problem
ILLNESS ASSESSMENT
Sign
see, hear, feel
ex – vomiting
Symptom
they tell you
ex – nausea
Tissue color
nail beds, lips, tips of ears
Colors -- White, Red, Blue
Temperature
Normal is 98.6
(can vary from 98.2-98.9)
drops to 85- dead
ILLNESS ASSESSMENT
Pulse
Take for 30 seconds to be
accurate, first beat is 0
Respiration
count with hand on the stomach
Norms-
Norms-- 60-100 adult
30-35 may be normal
Types–
rapid/weak- shock, bleeding
and diabetic coma
rapid/strong- exercise,
scared, heatstroke
strong/slow- physically fit,
skull fracture, stroke
12-20 adult
Types–
shallow- shock
gasping- exercise, heart
attack, choking
bloody/frothy- chest injury
BLEEDING
Pints of blood in the body - 10-12
shock -2-3 pints lost
death -4-5 pints lost
What is a blood vessel?
Something that carries blood
What are the vessel types?
Artery
Vein
Capillary
BLEEDING
ARTERY
from heart to the
body
under pressure
thick walls
spurts
oxygenated
bright red
BLEEDING
VEIN
from body to heart
no pressure
thin walls
trickles
without oxygen
dark red
BLEEDING
CAPILLARY
network within muscle
exchange between oxygenated or deoxygenated
cell thick walls
oozes
STOP THE BLEEDING
• Control the bleeding first.
– Use direct pressure to stop the
bleeding
• Cover with gauze. Re-cover if
necessary.
– Don’t take off dressing to look.
– Use pressure bandage if direct
pressure is not working
– Use elevation
• Spurting blood = Artery
• Oozing blood = Vein
– Dispose of waste in biohazard
bag or container.
BLEEDING
To stop bleeding
1.
2.
3.
4.
use barriers (gloves, gauze, etc)
apply direct pressure (most effective method)
Elevate
use pressure points (femoral, brachial, radial)
Do not
use tourniquets
remove the dressings
WOUNDS & BANDAGING
• do not remove debris from major wounds
• clean if possible
• Bandage once the bleeding is under
control
• impaled objects need to be left in &
secured
• check circulation – distal to the injury
• gun shot/stab wounds-- cover chest to
maintain pressure
SHOCK
What is shock?
Poor blood flow creating a shortage of oxygen to
body tissue
Signs/Symptoms
uneasy, restless, or worried
cool, pale, and sweaty tissue
rapid weak pulse
TYPES OF SHOCK
• Hypovolemic (most common)
– Stems from trauma which there is blood
loss
– ↓blood volume = ↓blood pressure
• Respiratory
– Lungs unable to supply enough oxygen to
circulating blood
– Trauma (pneumothorax) or injury to
breathing control mechanism
TYPES OF SHOCK
• Neurogenic
– General dilation of blood vessels
– 6 L of blood can no longer fill the system
– Cardiovascular system can no longer supply
oxygen to the body
– can be caused by general or spinal anesthesia,
spinal cord injury, pain, and anxiety.
• Psychogenic
– Commonly known as fainting (syncope)
– Caused by temporary dilation of blood vessels
reducing the normal amount of blood to the brain
Types of Shock
• Septic
– Caused by severe, usually bacterial, infection
– Causes small blood vessels to dilate
• Anaphylactic
– Shock due to the severe allergic reaction
• Cardiogenic
– Inability of the heart to pump enough blood to the
body
• Metabolic
– Occurs when a severe illness (diabetes) goes
untreated
– Extreme loss of body fluid (e.g. through urination,
vomiting, or diarrhea)
SHOCK
• What to do:
– Check ABCs
– Maintain body temperature, keep patient
warm
– Keep patient lying down or treat in position
found
– Do not give food or drink even if patient asks
– Continue primary care and seek medical aid
as indicated
WARNING SIGNS OF SUDDEN
ILLNESS
• ALTERED MENTAL STATUS
• BREATHING DIFFICULTY OR
SHORTNESS OF BREATH
• PAIN, SEVERE PRESSURE, OR
DISCOMFORT IN THE CHEST
• SEVERE ABDOMINAL PAIN
ALTERED MENTAL STATUS
• Is a warning sign of a serious
problem
• Activate EMS
• Comfort, Calm & Reassure
FAINTING
• Drop of blood flow to the brain
• Treatment
– Lay the person flat
– Raise feet 6-12 inches
– Or keep person seated forward and place
head between knees
STROKE
What is a stroke?
Interrupted blood supply to a portion of the brain
• Most common is a blot clot
Aneurysm?
ruptured blood vessel in the brain
warnings
these can start small and act like pounding
headaches
STROKE
• Signs & Symptoms
– Numbness or weakness of face, arm, or
leg; especially on one side of the body
– May appear confused
– Change in ability to speak or understand
– Sight and balance can be affected
– Severe, sudden headache
STROKE
• Quick test
– Have the person:
• Smile
• Hold up both arms
• Speak a simple sentence
– Problem with any = suspect a stroke
STROKE
• Care
– Medical emergency
– Activate EMS
– Calm, Comfort, and Reassure
– Do not give food or drink
– CPR & AED?
– If patient is unconscious, place on affected
side to allow fluids to drain from mouth
– Minimize movement and continue primary
care until help arrives
SEIZURES
• Brief episodes of disorderly
electrical activity in the brain which
affects its normal functions and
produces changes in a person’s
movements, behavior, or
consciousness.
DID YOU KNOW?
¤ 2,000,000 people in the U.S. have
some form of Epilepsy.
¤ 300,000 of those are under age 18.
¤ 100,000 new cases are reported each
year.
¤ In 70% of cases, the cause is
unknown.
ABSENCE SEIZURES
• Very brief, last only a few seconds, and
look like a blank stare, or daydreaming.
The person is completely unaware of his
surroundings. They begin and end
suddenly.
TONIC-CLONIC SEIZURES
• Person blanks out, falls, stiffens, then
jerks uncontrollably for a minute or two.
FIRST AID
FOR SEIZURES
•
•
•
•
Move large objects away from person
Place nothing in the mouth
Don’t hold person down
As seizure ends, offer help and
assurance
• Turn person on their side if possible; do
not force.
SEIZURES
• Activate EMS if the person:
– First time or unknown
– Has no prior history of seizure
– Continues to seize for more than 5 minutes
– Has more than one seizure (one right after the
next)
What Is Diabetes?
A disorder of the pancreas
The pancreas stops making
insulin, an essential hormone
in the body.
Insulin is the key that
allows glucose to enter the
cells.
Glucose is used by every
cell in the body for energy
INSULIN
Without insulin, glucose cannot
enter the cell. Glucose stays in
the bloodstream, creating high
levels of blood sugar.
Diabetes
• Type I
– body no longer produces insulin
– most commonly effects children & young adults
• Type II
– body no longer utilizes insulin
– commonly occurs as we age & become inactive
(genetic involvement)
• Gestational
– women who are pregnant & have high blood
pressure
DIABETES
• General Signs /Symptoms
– Change in mental status
– Pale, moist skin
– Disoriented appearance
– Aggressive, irritable, or unusual behavior
– Fruity or sweet smell on breath
– Medical Alert tag or necklace
DIABETIC EMERGENCIES
Care
Responsive
• both cases sweet stuff
– Orange juice, milk, candy bar
Unresponsive
• EMS
• maintain ABC’s (they need iv from here)
NEVER GIVE INSULIN AS A TREATMENT
SYMPTOMS OF LOW BLOOD
SUGAR
• Weakness or
tiredness
LOW
• Shaking
• Headache
• Anxious, Pale
LOW
PERSON’S WITH
HYPOGLYCEMIA WILL:
 Have a blood sugar level below
80mg
 Need treatment depending on
type of reaction.
Three levels of reactions:
1.
2.
3.
Conscious and able to swallow
Conscious but uncooperative or
disoriented
Unconscious or having a seizure
LOW
TREATMENT OF
HYPOGLYCEMIA
Treatment
– Glucose tablets--start with 2
– Juice
– Regular soda pop (not diet)
»
»
Symptoms should improve within 15-20
minutes. If not, repeat.
If longer than 1 hour until next meal or
snack, give small snack containing protein
(cheese crackers or milk)
Remember !!
•
Low blood sugar can develop within
minutes and requires immediate attention.
• Never send a person with suspected low
blood sugar anywhere alone.
HIGH
Symptoms of
Hyperglycemia
• Extreme • Drowsiness
thirst
• Nausea
• Frequent • Blurred vision
urination
• Dry skin
• Hunger
HIGH
Treatment of
Hyperglycemia
• Test blood sugar
• Drink water
• Insulin
WHAT IS ASTHMA?
• A reversible, obstructive lung disease
caused by an excessive reaction of the
airways to certain stimuli or “triggers”
• One of the Reactive Airway Diseases
(RAD) that is treatable
• A life-threatening disease if not
properly managed
100
0
1st
Qtr
3rd
Qtr
Eas
We
No
3 Components of an
Asthma Attack
1. Bronchospasm
The smooth muscles that wrap around
the windpipe (bronchi) tighten, reducing
the size of the airway.
normal
Asthma attack
COMPONENTS OF AN
ASTHMA ATTACK
2. Inflammation
The mucosal lining of the windpipe
becomes inflamed and swells, thereby
reducing the size of the airway even
further.
3. Mucus
Increased mucus production takes up
more space; now the airway is very
constricted.
ASTHMA
What causes an asthma attack?
cold/change in temp
exercise
allergies
POSSIBLE EARLY
WARNING SIGNS
• The person may cough, especially after activity.
• The person may complain of not being able to
take a deep breath
• The person may have a high pitched wheeze
• The person may feel fatigued
• He or she may complain of a heavy feeling in the
chest, may press on their in chest compensating
for the pressure.
HOW CAN YOU HELP?
• Recognize the early signs and
symptoms of an asthma attack
• Medication if they have an
inhaler
• Reassure the person and
try to calm them; comfortable
position
• Refer to the person if not
getting better
HOW TO ASSIST THE
PERSON
• Call or have someone call for help
• Ask person if they have an inhaler
WHEN DO YOU CALL 911
• Wheezing or coughing increases
after taking medications
• Difficulty breathing
-retractions seen
-hunched over position
• Child has trouble walking or
talking, or stops playing and
cannot start again
• Lips or fingernails appear “blue”
ALLERGIC REACTIONS
What is an allergy?
Extreme response of the
body’s immune system
to something it is very
sensitive to
Causes
ingestion
inhalation
injection
insects
interaction
S/S• Itching or swelling of
the lips, tongue,
mouth or throat
• Hoarseness, hacking
cough, shortness of
breath, wheezing
• Hives, itchy rash
and/or swelling about
the face or extremities
• Nausea, abdominal
cramps, vomiting,
and/or diarrhea
ANAPHYLAXIS
Life-Threatening Allergies
ALLERGIC REACTIONS
Types of life-threatening allergies
usually seen in persons:
– Insects, Bees
– Latex or Rubber
•Peanuts and Tree Nuts
•
Foods
ANAPHYLAXIS
SYMPTOMS
•
•
•
•
•
•
Itching
 Wheezing
 Shallow respirations
 Loss of consciousness

Throat “closing off”
Rapid onset
Sweating
Weakness
Feelings of apprehension
Tingling in mouth, face, or
throat
ALLERGIC REACTION
• What to do:
– Call 9-1-1 if onset is rapid (within 1 hour)
– Epi-pen or other medication
– Continue with primary care until help arrives
WHAT IS AN
“EPI-PEN”?
• Many people with Anaphylaxis carry an “epipen” with them at all times.
• An “Epi-pen” contains a single dose of
epinephrine (adrenalin) that when given, will
open the airways for approximately 15
minutes and allow them to breathe.
• This is only temporary relief. You must also
call 911 when a person has an Anaphylaxis
reaction.
POISONING
What is a poison?
Any substance that can enter the body and create a
harmful disturbance or reaction in the body
POISONING
• Signs / Symptoms
– Pain, cramps, vomiting, diarrhea, and/or
unconsciousness
– Burns on hands or around mouth, odor of
breath
– Information with witnesses
– Suspicious circumstances, such as empty
containers
POISONING – cont.
• What to Do:
– Ingested
• Activate EMS if showing any life-threatening signs
• Call Poison Control Center:
– 800-222-1222 (NATIONWIDE)
• Never induce vomiting unless Poison Control
Center tells you – save vomit for EMS
• Save bottles/containers for EMS
POISONING – cont.
• TREATMENT:
– Inhaled
• Perform SETUP
• Move patient to fresh air – when safe
• Contact Poison Control Center
– Absorbed
• Call Poison Control Center
• Dry Powder - brush off dry powder and flush with gallons of
water for at least 20 mins.
• Liquid - flush with gallons of water for at least 20 mins
INJURY ASSESSMENT
AKA - secondary assessment
after primary has been established
DO NOT DO ON AN
UNCONCIOUS PATIENT
• DOTS
Palpation: examine by touch
how done:
give statement
maintain communication
done in position found in
begin at neck
look for fluid, deformity, pain
• SAMPLE
–
–
–
–
–
–
–
–
Deformities
Open injuries
Tenderness
Swelling
Symptoms
Allergies
Medications
Past medical
history
– Last oral intake
– Events
S.O.A.P.
H.O.P.S.
Subjective
History
Objective
Observation
Assessment
Palpation
Plan
Stress
HEAD , NECK & BACK
INJURIES
• occurs when body suffers a significant
force from a high fall, shooting, or motor
vehicle
HEAD , NECK & BACK
INJURIES
• Signs and Symptoms
– Mechanism of injury
– Numbness, tingling, burning or loss of sensation
in arms or legs
– wound on head/scalp
– blood/clear fluid from nose & ears
– Deformity
– bruising around eyes/ears
– Vomiting
– blurred vision
– Lack of obvious injury…could be a spine injury!
NECK & SPINE INJURY
• What to do:
– Immobilize head, neck, and back manually
– Do not move the patient
– Maintain airway with jaw-thrust
– Monitor vitals
– Treat for shock
HEAD , NECK & BACK
INJURIES
• Stabilize head
• Ask about any numbness, tingling,
burning, or loss of sensation in arm(s) or
leg(s)
• Lack of obvious injury does not mean that
the spine is not injured
• Significant mechanism of injury = assume
spinal injury
• If unconscious = assume spinal injury
BRAIN INJURY
• A blow or force to the head or body
• Look for:
– Confusion
– Disorientation
– Problems with concentration, memory,
judgment, balance, and coordination
HEAD INJURY
aka “Concussion” or TBI
• Signs / Symptoms
–
–
–
–
–
–
–
–
Headache
Nausea
Dizzy
Blurred vision
Not all there
Emotional state changed
Unequal pupils
Bright lights or loud noises bother
HEAD INJURY
• What to do:
– Activate EMS system for serious head injury,
or if in doubt
– Monitor signs and symptoms.
– Call parents.
– Notify EMS if signs/symptoms get worse
SWOLLEN, PAINFUL,
DEFORMED LIMB
• Strains
– Stretching or tearing injuries of muscles or tendons
• Sprains
– Tearing injuries to ligaments (hold bones together)
• Dislocation
– Separation of bone ends at a joint
• Fracture
– Break in a bone
SWOLLEN, PAINFUL,
DEFORMED LIMB
• Signs and Symptoms
– Swelling
– Pain
– Discoloration
– Deformity
– Person may be guarding by holding the limb
against her body
SWOLLEN, PAINFUL,
DEFORMED LIMB
• Treatment
– Do not allow the person to move the injured limb --prevent further damage
– Immobilize fracture
– Check for circulation, sensation, and movement
• 3 RULES OF SPLINTING:
1. Splint as is
2. Fingers and toes showing for circulation
3. Splint one joint above and one joint below to
stabilize the injured area
EYE INJURIES
• don’t touch the eye, touch the bones that
surround the eye
• eye injuries are referrals
• bandage both eyes together, they track
together
• leave impaled objects in & secure object
INJURED TOOTH
• Control bleeding
• Use ice to reduce bleeding, swelling, and
pain
• Whole tooth out:
– Put back into socket if possible
• Can keep tooth in: milk, saliva, contact
solutions; avoid water
• Get to dentist quickly: 24 hrs
COLD RELATED PROBLEMS
• Hypothermia
– Generalized cooling of
the body
– Core temp <95°F
– Life threating
– Signs and Symptoms
• Pale, cold skin
• Uncontrollable
shivering
• Loss of coordination
• Difficulty speaking
• An altered mental
status
– Treatment
• Activate EMS if
available
• Move to a warmer place
• Remove wet clothes
• Cover with something
dry and warm
• Cover the head & neck
to retain heat
• Active rewarming: near
a heat source
– Recognize and treat
early…the chance for
survival decreases as
the condition
progresses
COLD RELATED PROBLEMS
• Frost Bite
– Develops when skin freezes
– Fingers, toes, ears, cheeks, and nose
– Signs and Symptoms
• Pins-and-needles sensation and throbbing
• Firm, pale, cold, numb skin
– Treatment
• Minor
– Rewarm using skin-to-skin contact
– Do not rub the skin together!
• More Serious
– Warmer place
– Remove wet clothes
– Activate EMS
• Remove jewelry
• Place clean pads between fingers and toes
• Calm, Comfort, Reassure
HEAT RELATED PROBLEMS
• Occur when body’s normal temperature-reducing mechanisms get
overwhelmed
Heat Exhaustion
not a medical emergency
S/S: sweating, rapid/weak pulse, pale skin, nausea, headache
cool immediately, fluids
may lead to kidney failure
Heat Stroke
medical emergency
S/S: no sweating, red/dry skin
cool as quickly as possible, fluids only if conscious
Prevention is the key
BURNS
Epidermis- top layer of skin
Dermis- second layer of skin
• Caused by close exposure to:
– High temperatures
– Chemical reactions
– Electrical current
• Larger the surface area burned, greater the
disruption of the skin’s ability to properly
maintain body temperature
• Deeper the burn, the greater the chance of
infection
BURNS
• Signs / Symptoms
– First degree: redness of
skin, no blistering
(sunburn)
– Second degree: redness
of skin with blistering
(scald burns: hot liquid)
– Third degree: deep burn,
black & charred, white or
tan skin (flame or hot
metal)
– Pain
– Difficulty breathing
– Shock
BURNS: Treatment
Minor Burns
• Cool burn with cold water
ASAP
• Continue cooling until pain
is relieved
• Do not apply ice directly to
the burn
• Leave any blisters intact
• Cover with loose sterile pad
Critical Burns
• Blisters
• Deep
• Over a large area
• Activate EMS immediately
• Apply sterile dressing
• Separate fingers or toes with
sterile, non-adhesive dressing
Don’t
apply ointment, lotion, gels, or
anti-septic
remove stuck on clothing
ABDOMINAL INJURY
• Signs/symptoms
–
–
–
–
–
Swelling
Discoloration
Board like feeling
Shock
Mechanism of injury
• Treatment
– Treat for shock
– Call EMS
– Monitor vitals
INTERNAL BLEEDING
• A significant blow can injury and cause
bleeding inside the body
• Difficult to detect
• Look at the mechanism of injury (MOI)
• Activate EMS
Emergency Plans
• Used to help ensure safe and healthy
conditions at work, school, sports, and
home
• Provides step-by-step procedures on how
to report and respond to emergencies
• Takes into account specific layout, size,
and features of a particular area
COMPONENTS OF THE
EMERGENCY PLAN
• These are the basic components of every
emergency action plan for athletics:
– Emergency Personnel
– Emergency Communication
– Emergency Equipment
– Roles Of Certified Athletic Trainer(s), Ath Med
Student(s), Coaches, And Administrators
– Venue Directions With map
Emergency Plan – cont.
• Must have a pre-arranged emergency plan with
the following:
– Phones should be readily accessible
• Cellular phones are helpful but don’t rely on them
• Make sure coaches, officials, and students know
where they are
– Assign someone to wait at nearest street entrance
and direct emergency personnel
– Make sure keys to gates and padlocks are easily
accessible
Emergency Plan – cont.
• Have separate EAP’s for different locations and
venues
• Inform coaches, AD’s, school nurses,
maintenance personnel and campus security
about EAP’s
• Assign someone to accompany the athlete to the
hospital
SKHS Training Room
Emergency Plan – when calling
1.
2.
3.
4.
5.
6.
7.
8.
SETUP – remain calm
Dial 911
State the following:
We have an injury at South Kitsap High School in
Port Orchard, WA
Give the athlete/person’s name, age, injury/condition,
level of consciousness.
Give your name and the phone number you are calling
from.
Tell them where the athlete/person is located and the
easiest way to get there.
Tell them: “An athletic medicine student will meet you
at _____”
Stay on the line until the operator hangs up first
DEVELOP AN
EMERGENCY PLAN
• Need to where the following are:
– Phone (s)
- AED?
– Doors?
- Where are you?
– Gate?
- Meet ambulance?
– What is going to be said?
– Any thing else?
Example Emergency Plan
• McKinney High School Football Practice Fields
• Emergency Personnel: Licensed athletic trainer(s) and student
athletic trainer(s) on site for practices.
• Emergency Communication: The licensed athletic trainer carries a
cellular phone and 2-way radios are also used to facilitate
communication with the training room.
• Emergency Equipment: Supplies (AED, splinting materials, spine
board, crutches, ice and medical supplies) are available in MHS
Indoor Facility Training Room.
Example Emergency Plan – Cont.
• Roles of First Responders:
– Immediate care of the injured or ill student-athlete.
– Emergency equipment retrieval.
– Activation of emergency medical system (EMS)
– Direction of EMS to the scene
– Scene control
• Venue Directions:
– The McKinney High School Football Practice Fields are located on
Graves Street directly North of McKinney High School. Emergency
vehicles may access the fields by entering the grass area North of the
MHS Softball Field. (See Venue Map)
SKHS ATR EAP
• Emergency Personnel: certified athletic
trainer, athletic medicine students, and
physician (limited basis) on site.
•
• Emergency Equipment: emergency
equipment (AED, vacuum splints,
crutches)
• Roles of First Responders:
– Immediate care of the injured or ill studentathlete
– Emergency equipment retrieval
– Activation of emergency medical system
(EMS)
• 911 call (provide name, address, telephone number; number
of individuals injured; condition of injured; first aid treatment;
specific directions; other information as requested
– Direction of EMS to scene
• open appropriate gates and doors
• designated individuals to “flag down” EMS and direct to
scene
• scene control: limit scene to first aid providers and move
bystanders away from area
• Venue Direction:
– Enter off of Wolves Rd. Drive to the upper
roundabout between the school and gym.
Entrance is between the gyms.
• Venue Map
DEVELOP AN
EMERGENCY PLAN
• Your job will be to write an emergency
plan for one (1) setting.
– No more than 2 pages (1” margins)
– Must include a map or drawing
• Due Date:
– 2nd Period: _______________________
– 6th Period : _______________________
• Worth 50 points