Emergency PlansLecture 5

Emergency Action Plans Emergency personnel (team)

Team physician, therapist, coach , student therapists , local EMS

This team will provide 1) immediate care of athlete, 2) equipment retrieval , 3) activation of EMS, 4) directing EMS to scene

Emergency communication Plan must be written out , procedure for home and

away must be outlined , plan must include location of phones directions to contest site, access points for the facility

Emergency equipment Stretches, spine boards, splints etc

Emergency Procedures

serious injuries may be frightening, particularly when breathing or circulation is impaired

as first person on the scene , you must evaluate the situation , assess the extent and seriousness other injury and recognize life threatening conditions , and then provide the immediate emergency care

although there are few sport related injuries of this seriousness but they do occur so one must be prepared

Reasons to activate EMS

Loss of consciousness Suspected cervical injury Unresponsiveness Need to establish an airway Performance of Recue breathing Performance of CPR Major bleeding Any obvious or suspected fracture

Emergency Situations

conditions or injuries that impair or have the potential to impair breathing and circulation

primary / initial survey – determines responsiveness , recognizes and identifies immediate life threatening situations

ABC’S secondary survey – involves a more hands on ,

detailed assessment from head to toe, looking for other non life threatening injuries

Responsiveness

Before making any decisions about rendering care it is essential that their level of responsiveness be determined.

AVPU A –Alert and awareV- responds to verbal stimulusP- responds to Painful stimulusU – Unresponsive to any stimulus

Alert and aware – name , location time etc

Verbal – do they respond to verbal communication

Painful – do they respond to painful stimulus , (pinching the skin , thumbnails etc) response would be facial gestures , movement of limb away from pain

Unresponsive – if athlete fails to show any response to above they are said to be unresponsive.

Airway Assessment

Assess athlete breathing in position found ( look listen and feel)

If not breathing try jaw thrust, if that does not work use the head tilt chin lift

Remember to check for foreign objects , do not sweep , if you can see it then try to get out .

Partial airway obstruction there is still some air exchange and individual

will be able to cough will typically grasp the throat ( universal distress

sign ) do not interfere stand by and encourage them to continue

coughing in attempt to dislodge obstruction an ineffective cough or high pitched noise during

breathing should be treated as a total airway obstruction

Total Airway Obstruction no air passing through, individual unable

to speak , breath or cough must react quickly to clear airway , and

stimulate breathing Abdominal thrusts if standing or chest

thrusts if lying down

Cardiopulmonary Emergencies cardiac arrest, determine if there is a

heartbeat… if not begin CPR.. AED’s S/S pain in the chest , radiating to both arms

(usually left) into neck , jaw or teeth, upper back or superior middle abdomen

shortness of breath , nausea, feeling of impending doom

medical emergency activate EMS

Unconscious Athlete head injuries leading cause of unconsciousness

in sports level of consciousness may very depending on

responses of individual to verbal and sensory stimuli

unconsciousness identifies an individual who lacks conscious awareness and is unable to respond to stimuli

different methods of stimuli – pinching triceps, rubbing knuckles on sternum

if unconscious – check ABC’s and call ambulance

Bleeding severe bleeding will cause a loss in blood

volume and decrease blood pressure this results in increased work load on the

heart (rapid weak pulse) arterial bleeding – bright red , usually

spurting venous bleeding – dark blueish – red –

steady flow

best controlled with direct pressure over the wound

elevate above the heart

Internal bleeding usually the result of a blunt trauma, can

lead to shock if overlooked s/s – abdominal rigidity, Nausea, discomfort emergency situation activate EMS

Fractures is a break in the continuity of the bone and

is classified as open or closed, depending on if the skin is broken or not.

obviously open fractures are worse because the risk of infection

swelling , bruising , deformities, shortening of limb, guarding , point tenderness , grating or crepitus

Ice and Immobilize , minor refer to physician for x-rays , displace or more severe fractures activate EMS

Splinting & Immobilization suspected #’s need to be splinted before a

person is moved most organized sports settings should be

prepared with commercial splints, but outdoor pursuits rarely bring splinting material --> make shift splints have to work

Shock shock can occur with any injury, serious or

non serious shock is an acute life threatening

condition that involves the body’s failure to maintain adequate circulation to the vital organs ( hypovolemic)

rapid weak pulse, breathing rapid and shallow

anxiety, disorientation , cold clammy moist skin, profuse sweating and extreme thirst

Activate EMS

Shock

Treatment of Shock control any major bleeding and splint

fractures if no head or neck injury is suspected –

elevate feet 8 to 12 inches if individual vomits – place on side to avoid

blocking the airway maintain body heat –remove wet clothing if

possible – cover with blanket do not give individual anything by mouth monitor vital signs Activate EAP

Shock

Anaphylactic shock A sever reaction to a stimulus (allergen)

such as a bee sting , medication or food Must activate EMS immediately

Anaphylactic shock

Secondary Survey

Obtain an accurate history SAMPLE S- signs and symptoms A- Allergies M – medications P- pertinent past history L – Last meal ( food & water) E – events leading up to the injury

Secondary survey

Visually inspect Pupils ( PEARL) Mouth , nose , neck Palpate body from Head to Toe ( look for

bruising , swelling deformities)