Transcript BAM FA Ppt - South Kitsap School District

FIRST AID
Beginning Athletic Medicine
Primary Assessment – Responsive Person
• Look for any immediately life-threatening problems
• Introduce yourself
• See if there are and diminished levels of
• responsiveness,
• Altered mental status
• Difficulty Breathing
• Scan for serious bleeding
Primary Assessment – Responsive Person
• Check tissue color
• Normal is pink
• Paleness = blood loss or shock
• Bluish = lack of oxygen
• Feel forehead for skin temperature
• Normal is warm and dry
• Cool, wet can indicate shock
• ONGOING ASSESSMENT: continue to monitor the person for
responsiveness, breathing, skin color and temp
Secondary Assessment
• When no life-threatening problems, do a secondary
assessment
• An organized approach to gather more information about
an ill or injured person
• Use DOTS and SAMPE
• If a secondary assessment reveals any specific
problems, provide the indicated care.
Secondary Assessment
DOTS
• what to look for in a
physical assessment
• Deformities
• Open injuries
• Tenderness
• Swelling
SAMPLE
• what to ask
• Signs and symptoms
• Allergies
• Medications
• Past medical problems
• Last oral intake
• Events leading to the
problem
Secondary Assessment
Palpation: examine by touch
how done:
• give statement
• maintain communication
• done in position found in
• begin at neck
• look for fluid, deformity, pain
Sign
see, hear, feel
ex – vomiting
Symptom
they tell you
ex – nausea
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
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.
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?
Inadequate supply of oxygen to vital organs/body tissue
Signs/Symptoms
uneasy, restless, or worried
cool, pale, and sweaty tissue
confused
rapid weak pulse
through pain in chest
TYPES OF SHOCK
• Hypovolemic (most common)
• Plasma loss due to burns, dehydration, traumatic shock due
to blood loss and major tissue damage
• Respiratory
• When respiratory system fails due to illness or obstruction
• Body is deprived of oxygen
TYPES OF SHOCK
• Neurogenic
• Dialation of blood vessels
• caused by the loss of sympathetic control (tone) of resistance vessels,
resulting in the massive dilatation of arterioles and venules.
• can be caused by general or spinal anesthesia, spinal cord injury,
pain, and anxiety.
• Psychogenic
• Shock like condition produced by excessive fear, joy, anger or
grief
Types of Shock
• Septic
• Overwhelming infection leads to low-blood pressure
• Anaphylactic
• Shock due to the severe allergic reaction
SHOCK
• What to do:
• Activate EMS
• Maintain normal body temperature
• Keep patient lying down or treat in position found
• Do not give food or drink even if patient asks
• Keep person as comfortable and calm as possible
• Continue ongoing assessment
Internal Bleeding
• A significant blow
• Hard to detect
• Signs of shock and mechanism of injury are the
earliest indications of internal bleeding may have
occurred.
Amputation
• Complete detachment of a body part
• Control severe bleeding
• Call EMS
• Wrap severed part in a sterile or clean cloth
• Place in tightly sealed plastic bag
• Cool the bag indirectly with ice or a chemical cold pack
• Calm, Comfort, Reassure
• Ongoing Assessment
Impaled Objects
• General rule: to not remove an impaled object
• Acts like a plug
• Activate EMS
• Prevent movement of body part and impaled object
• Gloved hand or bandage
• Eye
• Activate EMS
• Stabilize object
• Cover both eyes….why?
• Calm, Comfort, and reassure
Open Chest Injuries
• May allow oxygen to be drawn into the chest
• Activate EMS
• Stop any bleeding but don’t seal the wound
• Calm, Comfort, Reassure
• Ongoing Assessment
Open Abdominal Injury
• Evisceration: abdominal organs protrude through an open
wound
• Activate EMS
• Position of comfort
• Cover any protruding organs with thick, moist dressing
• Do not apply direct pressure
• Calm, comfort, reassure
• Ongoing assessment
Head, Neck, or Back Injury
• Spinal Injury
• Signs and Symptoms
• Mechanism
• wound on head/scalp
• blood/clear fluid from nose & ears
• Deformity
• bruising around eyes/ears
• Numbness, tingling, or paralysis anywhere in the body
Head, Neck, or Back Injury
• Spinal Injury
• What to do:
• Call EMS
• Immobilize head, neck, and back manually
• Do not move the patient
• Maintain airway with jaw-thrust
• Treat for shock
• Ongoing assessment
Head, Neck, or Back Injury
• 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, Neck, or Back Injury
• 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, Neck, or Back Injury
• HEAD INJURY aka “Concussion” or TBI
• 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, or Deformed Limb
• Strains: stretching or tearing of muscles or tendons
• Sprains: tearing injuries of ligaments
• Dislocation: separation of bone ends at a joint
• Fractures: break in the bone
• Commons Signs/Symptoms
• Swelling, pain, discoloration
• Point tenderness, deformity
• Inability to move or doesn’t want it moved
Swollen, Painful, or Deformed Limb
• Care
• Call EMS
• Immobilize Fracture / Dislocation
• Check for circulation, movement, and sensation
• Calm, Comfort, Reassure
• Ongoing assessment
Splinting
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
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
BURNS
Epidermis- top layer of skin
Dermis- second layer of skin
Full thickness burns
• stop burning
• apply sterile dressing
Partial thickness burns
• if skin is unbroken, cool
with water & apply a dry
dressing
Don’t
• apply gels
• remove stuck on clothing
• Apply ice
Burns
Electrical Burns
Chemical Burns
• Call EMS
• Turn off electricity
• May have to do CPR and use
an AED
• Treat burn(s)
• Flush area with large
amounts of water
• If powder: brush off first
Minor Injuries
Nosebleed
• Sit straight up or head tilted
forward
• Pinch the nose
• May use a nose plug
Injured Tooth
• Break, dislocate, or knock
out
• Knocked out: re-implant
ASAP
• Control bleeding
• To save:
• Cup with saliva
• Others:
• Milk, saline solution, Sav-atooth
Cutoff for FA Test #1
Sudden Illness
• Suspect when, without warning, a person suddenly
appears weak, ill, or in severe pain
• The most common warning signs of serious 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 & considered a
medical emergency
• Activate EMS
• Comfort position
• Calm & reassure
• Ongoing assessment
Fainting
• Unexpected drop of blood pressure and blood flow to
the brain
• Causes: anxiety, fear, pain, stress, standing in place
too long, or rapid movements
• Treatment
• Lay the person flat
• Raise feet 6-12 inches
• Or keep person seated forward and place head between
knees
Stroke
• Brain attack
• Occurs when the blood supply to a portion of the
brain is suddenly interrupted
• A blocked or ruptured artery in the brain which stops
the adequate flow of blood to a portion of the brain
• Stroke? blockage of blood and O2 to the brain
• Aneurysm? ruptured blood vessel
Stroke
•Signs / Symptoms
• Numbness or weakness of face, arm, or leg;
especially one sides
• Confusion
• Change in the ability to speak or be understood
• Changes in sight and balance
• A severe, sudden headache
Stroke
• Quick test: FAST
• Face droop: ask the person to smile
• Arm drift: ask the person to hold up both arms
• Speech difficulty: ask the person to speak a simple
sentence
• Time to activate EMS: if a person has trouble with
any of these tasks, call EMS
STROKE
• What to do:
• Calm, Comfort, and Reassure
• Insure that family & bystanders do not make inappropriate
comments. Hearing is the last sense to fail
• Call 9-1-1
• If patient is unconscious, place on affected side to allow
fluids to drain from mouth
• Minimize movement and continue ongoing assessment
until help arrives
What Is Diabetes?
Disease in which the body cannot
effectively use sugar for energy.
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
LOW
SYMPTOMS OF LOW BLOOD SUGAR
• Weakness or tiredness
• Shaking
• Headache
• Anxious, Pale
• Pale, cool, and sweaty skin
LOW
Treatment of
Hypoglycemia
Treatment : responsive person
• Provide
• Glucose tablets--start with 2
• Juice
• Regular soda pop (not diet)
• If longer than 1 hour until next meal or snack, give small
snack containing protein (cheese crackers or milk)
•
•
•
Calm, Comfort, and Reassure
Ongoing assessment
If no response to sugar in 10-15 minutes, call EMS &
provide additional glucose or sugar
Hypoglycemia
•Treatment for Unresponsive
• Quickly activate EMS
• Do not give anything to eat or drink
• Provide any required supportive care
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.
Seizure
• Typically occur without warning
• May have an aura/smell/noise before seizure
• Signs/Symptoms
• Jerking movements
• Breathing may seem absent
• Can lose control of bowel or bladder
• May vomit
FIRST AID FOR SEIZURES
• Protect person from injury
• Move objects away
• Do not restrain
• If possible, roll the person onto his/her side to allow saliva to
drain
• Do not put any thing in her/his mouth
• Calm, comfort, reassure
• Ongoing assessment
SEIZURES
• Activate EMS if the person:
• Is injured or vomits
• Has no history of seizure
• Continues to seize for more than 5 minutes
• Has more than one seizure (one right after the next)
Breathing Difficulty, Shortness of Breath
• A medical emergency
• Caused by an underlying medical illness such as asthma, allergic
reaction, heart failure, or lung disease
• S/S: coughing, wheezing, or other unusual breathing sounds; bluish
lips or fingers
• Treatment:
•
•
•
•
Call EMS
Comfortable position
Calm & Reassure
Ongoing assessment
WHAT IS ASTHMA?
•A reversible, obstructive lung disease
caused by an excessive reaction of the
airways to certain stimuli or “triggers”
• cold/change in temp
• Exercise
• allergies
100
0
1st
Qtr
3rd
Qtr
Eas
We
No
ASTHMA IS NOT
• Contagious- Usually genetic
• Infectious- It is a chronic disease
• A Good Excuse
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.
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.
ASTHMA
• Signs/symptoms
• Treatment
• 1. Labored breathing
• 2. Wheezing sound when exhaling
• 3. High pitched cough
• 4. Weakness
• 5. Chest tightness
• 1. Assist with medication
• 2. Activate EMS if not getting
better or no history of asthma
• 3. Calm them down
• 4. Monitor vitals*
WHEN DO YOU CALL 911
• Wheezing or coughing increases after taking
medications
• Medication doesn’t help within 5 minutes
• 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?
over reaction by the body to a
substance that is normally harmless
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
•Peanuts and Tree Nuts
• Latex or Rubber
•
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
• Calm, comfort, reassure
• Continue with ongoing assessment 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.
Pain, Severe Pressure, or Discomfort in the
Chest
• Acute coronary syndrome (ACS) occurs when there is
reduced blood flow to the tissues of the heart
• Heart Attack
• Signs/Symptoms
• Pain, pressure, or discomfort in the chest
• Women: indigestion, weakness, or fatigue
• Shortness of breath, nausea, lightheadedness
• Pain in the arms or back
• Pale, cool, and sweaty skin
Pain, Severe Pressure, or Discomfort in the
Chest
• Treatment:
• Activate EMS
• Get AED
• Comfortable position
• Calm, comfort, and reassure
• Ongoing assessment
Poisoning
• Any substance that can enter the body and create a
harmful reaction in the body
• Ingested:
• prescribed medications, personal care products,
household cleaning products
• Inhaled:
• Carbon monoxide, natural gas, solvent fumes, and
chemical vapors
Poisoning
• Signs / Symptoms
•
•
•
•
•
•
•
•
•
•
Abdominal pain or cramping
Nausea
Vomiting
Altered mental status
Headache
Dizziness
Difficulty breathing
Burns on hands or around mouth, odor of breath
Information with witnesses
Suspicious circumstances, such as empty containers
Poisoning
• 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
• What to Do:
• 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
Severe Abdominal Pain
• May be a warning sign of a serious illness
• Signs and Symptoms
• Appears suddenly or is a new experience for the person
• Intense pain
• Abdomen may be rigid or tender to the touch
• Nauseated and vomit
• Treatment
• Activate EMS
• Find a comfortable position
• Calm, comfort, and reassure
Heat Emergencies
• Occur when a body’s normal temperature-reducing
mechanisms get overwhelmed and become inefficient or
stop working
• Heat Exhaustion
• Signs/Symptoms
•
•
•
•
•
•
Heavy sweating
Pale, cool, sweaty skin
Nausea and vomiting
Headache
Dizziness
Feeling weak
Heat Emergencies
• Heat Exhaustion
• Treatment:
• Move to a cool place
• Loosen or remove excess clothing
• Cool person off
• Drink fluids
Heat Emergencies
• Heat Stroke
• Body temp rises because the body’s cooling system is
overwhelmed or shut down
• Signs/Symptoms
•
•
•
•
Warm, even hot to the touch
Heavy sweating may be present…may have red and completely dry skin
Confused and trouble communicating
May become unresponsive and could have a seizure
• Treatment:
• EMS…medical emergency
• Cool ASAP
Cold Emergencies
• Hypothermia
• Generalized cooling of the body
• Occurs when body temp is below 95° F
• Signs/Symptoms
• Pale, cold skin
• Uncontrollable shivering
• Loss of coordination
• Treatment
•
•
•
•
•
Remove wet clothing and cover with something warm & dry
Activate EMS
Move to a warm place
Cover head and neck to retain body heat
Rewarm near a heat source
Cold Emergencies
• Frostbite
• Skin and underlying body tissue
freezes
• Most common: fingers, toes,
earlobes, cheeks, and nose
• Prevent freezing by simple skin-toskin rewarming technique
• Signs of freezing
• Loss of feeling in affected part
• Firm, pale, cold, numb skin
• Treatment
•
•
•
•
Warm place
Activate EMS
Remove wet clothes
Do not rub or massage affected
area
• Remove jewelry
• Place clean pads between fingers
& toes
• Wrap with clean towel or pad
Stinging Insects
• If a stinger is present in the skin, remove it as quickly as
possible
• S/S: local pain, redness, swelling, itching
• Treatment
• General: wash site with soap & water
• Cover with band-aid
• Use local cooling to help reduce swelling & pain
• Watch for allergic reaction
Snake Bites
• Venomous snakebite is a medical emergency
• Person sit and stay calm
• Activate EMS
• Remove any constricting items from the affected limb
• Control any bleeding with clean pad & direct pressure
• Do not apply a tourniquet, cold compresses, or try to suck
out the venom
• Keep person warm, reassure, and quiet
Marine Animal Stings
• Sea Anemones or Jellyfish
• Wash wound with vinegar for at least 30 sec to
deactivate the venom
• Take hot shower or bath for 20 mins to ↓ pain
• Monitor ABCs
Animal and Human Bites
• Control bleeding with direct pressure
• Wash area with lots of water
• Seek professional medical attention
• Can cause bacterial infection
Emergency Plans
What are they?
Who is involved?
Materials/ Signals?
• As soon as it is determined that an ambulance is needed:
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 student-athlete
• 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:
• Worth 50 points