SPORTS FIRST AID

Course Outline

Role of the SportsAider

Professional liability and legal issues

Injury Prevention

On the Sidelines

First Aid Kits

In the Event of an Injury

Emergency Conditions

Heat/cold related conditions

Non Life-Threatening Conditions

2

Role of the SportsAider

Assess and treat acute injuries

Never allow minor injuries to become major ones

Prevention is better than a cure

When in doubt, -refer!

Walk-in, emerg, family MD

3

LIABILITY AND PROFESSIONAL BEHAVIOR

CONSENT

Explicit Consent

Athlete asks for help

SportsAider offers help, athlete accepts it

Implied Consent

Immediate help needed but athlete is unable to give it.

SportsAider must do ONLY what is necessary Unconscious, unable to make proper

judgment for themselves

Children under 10 years old – use proper judgment. Ask parent is available.

5

6

Good Samaritan Act

The act applies when you are providing emergency

care in a “happen-stance” situation

It DOES NOT apply when a person is employed

(volunteer or paid) specifically for the purpose of

providing first-aid

The Act, applies to a SportsAider who inadvertently

came across an injured person “at the side of the

road”, but would not apply when a SportsAider is

working at an event or team

Avoidance of liability check list

Give help that in similar circumstances, you would hope to receive

Inspect the competition area on a regular basis

Communicate what you are doing to the athlete/parent

Maintain control

Know your limitations

Document injuries

Know your stuff

Preparation!

7

INJURY REPORTING

Complete an injury report following an injury

Be sure to document:

Who was injured

What happened

What treatment was done

Follow up recommended

Allows the tracking of injuries

Promotes proper care of injury

Liability protection

8

9

INJURY REPORT

Available online for FREE on the Sport Safety Network

Sexual Harassment/Assault

Remain professional

Always explain to the athlete what is being done and why

Avoid misunderstanding of intent

Err on the side of caution

Do not put yourself if a questionable situation Ex: be alone in locker room with

athlete of the opposite sex

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11

Confidentiality

SportsAiders interact with coaches, officials, athletes and medical professionals.

Medical information must only be disclosed with expressed written consent of the athlete, or the parent/guardian if the athlete is under 18 years of age.

Injury Prevention

12

Injury Prevention

Medical Examinations

Facilities & Equipment

Hygiene

Warm-up and Cool-down

Hydration

Technique

Importance of Rehabilitation

13

MEDICAL HISTORY

A preseason medical exam identifies specific medical conditions and needs PAR-Q, custom forms

Early detection of warning signs and red flags

Seek medical evaluation if red flags are present. (next slide)

14

Available on the SportMed Safety network

Contraindications For Participation In Contact Sport

Concussions

Absence of an Eye

Lung Infection

Bone Infection

Abnormal or Infected Heart

Epilepsy

15

Absence or Infection of a Kidney

Unhealed Fracture

Hip Disease

Bacterial Infection

Skin Infection

Enlarged Organ (ex: post-mono)

Etc.

Medical History Form and Card

Current and Past Medical History

Vital Information

Condensed version located on the History Card

1 copy placed in Medical Kit in Plastic Envelope

16 Available on the SportMed Safety network

Facility & Equipment Checklist

• Inspection list that promotes regular inspections/checks

• Available on the SportMed Safety Network 17

Equipment

Proper protective equipment

Footwear (cleats)

Helmets

Shin pads, shoulder pads, etc

One size does not fit all

Equipment must meet safety standards (Ex: CSA)

Equipment condition should be inspected regularly

Hygiene

Personal (important in wrestling and combat sports)

Locker/Shower Rooms

Equipment

SportsAider:

SportsAiders should keep personal wounds covered. Should always use gloves when dealing with wounds. Should wash hands after dealing with athletes. Should clean up blood and spills on surfaces

19

Warm-up and Cool down

Getting the body ready for activity reduces the potential for injury

Active (dynamic) warm-up prior to all practices and games. Light jog Dynamic stretching Sport specific stretching Sport Specific drills

Cool down activities after practices and games. Light jog/walk Static stretching Ice/cold therapy

20

Stretching considerations

Larger muscle groups require the targeting of specific muscle fiber

Ex: Pectorals, Hip Adductors (groin) and hamstrings

21

Technique Proper technique should be taught during:

Training

Competition

Strength & Conditioning

Warm up

Cool down

Proper technique will reduce both acute and chronic injuries

22

Hydration

General guidelines: Varies per sport and per individual

Pre-activity: 500-700ml/1-2 hours prior to

During activity: 200-300ml every 15-20 minutes (3-4 large gulps)

Post exercise: 500-1000ml

23

Return to play considerations

Musculoskeletal injuries Should be supervised by a Sports

Medicine Practitioner

Don’t want a minor injury to become a major one

Athlete should be mentally ready to return

Minimal guidelines before RTP Pain free Full range of motion Minimum 90% strength

Medical Preparation

Emergency Action Plan

Available on the SportSmart Online

Network

EAP:

Pre-planned protocol that

ensures a rapid and

effective response to

emergencies

Emergency action planning

Attention to details is important:

Defining the roles: Charge person

The lead person

Call person Activates EMS and communicates with dispatch/security Update with any changes

Control person Controls crowd and equipment needed

Must Consider: Location of telephones Accuracy of emergency numbers Access route planned for ambulance Doors and gates unlocked for ambulance

Emergency Conditions

•Life Threatening Physical Conditions Require Immediate Action - Activate EMS/911

Loss of Ventilation/Circulation

Suspected Spine Injury

Head Injury (Loss of Consciousness)

Shock

Femur or multiple fractures

Diabetic attack

Epilepsy/seizures

Anaphylaxis

Hemorrhaging (Internal or External) 29

Non-Life Threatening Physical Conditions Require Immediate Action

Serious Eye Injury

Fracture of Long Bone

Athlete cannot support own weight or unwilling to support own weight

Dislocation / Subluxation

30

Examining The Injured Athlete

Conscious

Scene survey

Injury History

Check Vitals

Examine the Injured Area

Secondary Survey

Check for Other Injuries

Repeat Vitals Check

31

Examining The Athlete

Unconscious

Check for Hemorrhaging

Check Vitals

“Head to Toe” Scan

Repeat Vitals Check

32

Vital Signs: Evaluation and Resting Values

Evaluation Normal Vital Signs

Respiration Rate Look, listen & feel for

number of breathes/min.

Adults 12-20/min

Adolescents 16-20/min

Children 23-32/min

Pulse Carotid and Radial Adults 60-75 BPM

Adolescents 70-85 BPM

Children 60-120 BPM

Level of Consciousness

(LOC)

Orientation to person,

place, time

Alert and coherent

Response to stimuli

Pupils Size, response Equal, immediate

constriction

Skin color/condition Forehead, finger-nail

beds

Normal skin temp and

color

33

Suspected Spinal Injury

Signs And Symptoms Suspect a spinal injury if there is a MOI and any

of the following:

• Neck Pain and Rigidity

• Muscle Spasms

• Deformity

• Change or Loss of Sensation in Both Limbs

• Weakness or Paralysis of the Arms or Legs

• Referred Pain in Arms or Legs

34

Suspected Spinal Injury

Management

Do not move the athlete

Stabilize the head and neck

Activate EAP

Head to Toe

Treat for Shock

Reassure athlete

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Shock

Definition

Inadequate circulation of oxygenated blood to vital organs which forces the heart to pump faster (weak and rapid pulse).

36

Possible causes Damaged Heart

Blood Loss or Pooling

Spinal & Brain Injuries

Fractures

Internal Organ Injuries

Allergic Reactions

Psychological Responses

Shock

Signs and Symptoms Restlessness & irritability

Skin pale, cool & clammy

Weak and rapid pulse

Shallow and rapid breathing

Dilated pupils

Weakness, dizziness

Feeling of thirst

37

Shock

Management

Activate EAP

Treat Injuries

Maintain Body Temperature

Laying down on back

Moisten Lips (if thirsty)

Monitor Vitals

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Environmental conditions

39

Heat Stress Or Hyperthermia Who’s at Risk?

Dehydrated athletes

Illness, Fever, Infection

Poor Acclimatization

Injury

Fatigue

Excessive or Improper Clothing

Obesity

Low Fitness Level

Alcohol Consumption

Age (<15 Or >40 Years)

People on sidelines or in stands

40

Heat Stress

Signs and Symptoms

Nausea and vomiting

Increased body temperature

Dizziness

Faintness

Fatigue

41

Heat Stress Specific Signs and Symptoms

Heat Exhaustion Pale, Cool, Clammy Skin

Weak, Rapid Heart Rate

Slow, Shallow Respiration

Muscle Cramps

Conscious

Core Temp. up to 40°C

Heat Stroke Dry, Warm, Flushed Skin

Rapid, Bounding Heart Rate

Fast, Deep Respiration

Flaccid Muscles

Mental Status Altered or Unconscious

Core Temp. Past 40°C

42

Heat Stress

Management:

Remove from Heat (Shade or

Indoors)

Water mist – spray bottle

Replace Fluids (Water and

Electrolytes)

Ice Application (Neck Armpit,

Groin Areas)

Loosen Clothing

43

Heat Stress

Prevention

Proper Hydration Before, During and After Activity

Exercise Times – modify if needed

Appropriate Equipment and Clothing

Education

44

Hypothermia

Definition

The body’s core temperature drops below 37°C

45

Hypothermia Signs And Symptoms

Early

Shivering

Poor Coordination

Slow Movements

Stumbling Gait

Euphoria

Poor Judgment

Apparent Intoxication

Later

Hallucinate

Exhibit Erratic, Jerky Movements

Blue Skin

Loss of Consciousness

Weak, Erratic Heart Rate

46

Hypothermia

Management

Insulate

Remove Wet Clothing and

Insulate with Dry Blanket

or Clothing

Warm Fluids

If Athlete is Conscious

Handle With Care

Limited Movements

Prevent Erratic Heartbeats

47

Hypothermia

Prevention

Know the Effects of

Temperature

Appropriate Clothing

Change into Dry Clothes

after Activity

Reduce Inactive Time

During Competition or

Practice

Education

48

Internal Injuries Recognition: GENERAL

History

Vitals

Signs and Symptoms of Shock

Increased Body Temperature

Nausea and/or Vomiting

Rigid, Painful Abdominal Wall

Participant is in Fetal Position

49

Internal Injuries Recognition: Specific Organs

Lungs

Coughing Bright Red, Frothy Blood

Stomach

Vomiting Blood, “Coffee Grounds” Appearance

Spleen

Pain Radiating To Left Arm

Bladder

Feel the need to but unable to Urinate

Kidney

Blood in Urine (Hematuria), Lower Back Pain

Gastrointestinal

Blood in Stool

50

Non Life-Threatening Conditions

Types of Injuries

Acute - result from sudden traumatic incident

Chronic - result from injuries that have not healed properly

Overuse - result of continual “wear & tear” or “too much too soon”

52

Injury Assessment History

Establish how the Injury Occurred from the Athlete, Teammates, Observers, PQRST

Observation

Visual Check of the Injured Area (Bilateral Comparison)

Special Tests

Active, Passive, Resisted Range of Motion

Palpation

Note Any Tenderness, Apprehension, Pain, Warmth, (Bilateral Comparison)

53

Assessment - Severity of the Injury

Pain

P – Pain location

Q – Quality

R – Radiate

S – Severity

T – Timing

Knowing the Athlete - important

54

Soft Tissue Healing and Repair

Inflammatory Phase

Body’s reaction to injury

Lasts 3-5 days

Repair Phase

Healing and restoration

Approx 3 weeks post injury

Remodeling Phase

Strength of the scar is forming

Up to 1 yr

RICE Principle

REST

Reduce or stop activity – crutch use

ICE 15-20 every 2 hours or post exercise

COMPRESSION

Apply pressure, tensor, wrap, tape

ELEVATION

above the level of the heart

56

Joints

Sprains

Dislocation / Subluxations

57

Sprain Over-stretching of the ligament due to excessive joint movement

Signs and Symptoms

Local pain

Swelling

Possible discoloration

Loss of strength (depending on severity)

Laxity

58

Sprain

Management

Rule out a fracture

Ottawa Ankle rule

RICE

Ice (15 mins/2 hours)

Tensor with horseshoe

Crutches

Medical Referral

59

Dislocation / Subluxation Temporary movement of a bone out of its normal position

Signs and Symptoms

Pain (in the affected area)

Swelling

Deformity

Possible numbing and tingling

60

Dislocation / Subluxation

Management RICE

Immobilize the joint

Medical referral

Do NOT reduce the

joint yourself (not of scope of practice)

61

Cartilage

Signs and Symptoms Locking of the joint

‘Pop’ or ‘Crunching’ sound

Pain

Giving away feeling

Swelling

Decreased ROM

Management: RICE and referral

62

ACL Injuries

Provides stability of the knee

Mechanism of injury:

Plant and twist

Hyperextension

Direct blow

More prevalent in females than males

Strengthening programs to help prevent injury

ACL Strengthening

Knee exercises

Glute activation

Ball squats

Lateral walks

Multi directional lunges

Calf raises

Muscle

Muscle cramps

Strain

Contusion

Shin Splints

66

Muscle Cramp A painful, involuntary contraction of a muscle

Signs and Symptoms: Sudden, sharp and severe pain

usually during play

Typically near the end of the game

Hard “knotting” (involuntary contraction) of a muscle

Loss of function

67

Muscle Cramp

Management:

PIER

Gentle stretching

Hydration

Gentle massage

68

Strain Muscle placed under stretch while forcefully contracting

Signs and Symptoms Swelling Discoloration Loss of strength Pain (may increase with

active movement) Spasm & Stiffness Deformity depending on

severity

69

Strain

Management:

Determine accurate history

RICE

Do NOT massage

Medical referral

70

Contusion A blow causing excessive compression of soft tissue against

bone

Signs and symptoms: Swelling

Discoloration

Pain & spasm

Loss of strength

Decreased Range of Motion (ROM)

Stiffness

71

Contusion (Bruise)

Management:

PIER

Continued compression

Do NOT massage or apply heat

Medical referral

72

Shin Splints a wastebasket term for pain at the front of the shins (medial tibial stress syndrome)

Signs and symptoms Pain at the front of the

lower leg

Pain usually occurs during and after exercise

Pain is usually located just lateral to the tibia

73

Shin Splints

Management

Rest

Ice

Switch to pain-free exercises

(Swimming or cycling)

Shock absorptive insoles

Proper footwear

Calf stretching

Taping

Shin Splints

Exercises and prevention Toe raises

Heel walks

Theraband exercises

Dorsiflexion jumps

Shin Splints

Stretching

Tibialis anterior stretch

Calf muscles stretch

Gastrocnemius + Soleus

Plantar Fasciitis A painful irritation of the connective tissue on the sole of the foot

Signs or symptoms: Pain along the arch or near

the bottom of the heel

Feeling of muscle tightness or weakness

Inability to push off with the foot or point the foot down

Pain and inability to walk without limping

77

Stretching

Arch and calf muscles

Plantar Fasciitis

Plantar Fasciitis

Exercises:

Build strength and endurance

in intrinsic foot muscles Towel Curl s

Towel walk

Marble pickup

Bone

Fractures

Stress-overload

80

Fractures The partial or complete break in the bone Signs and symptoms:

Pain

Loss of limb function

Swelling

Possible deformity

81

Fractures

Management:

Support the joint if possible (Splint)

RICE

Do NOT reduce

Medical referral

82

Introduction to Splinting

Avoid splinting if it would cause more pain or discomfort

Splint the area and joints above and below

Check circulation and sensation

83

Stress Fracture Usually in major weight bearing bones

Gradual onset of Pain Point tenderness Increase in training Surface

Rest Referral

84

Signs & Symptoms

Management

Osgood Schlatter’s Disease (Traumatic Tibial Tubercle Apophysitis)

Occurs with growth spurts

Pain during and after activity

Swelling over the tibial tubercle

Visible lump over the Tibial Tubercle

Tenderness over the Tibial Tubercle

85

Signs & Symptoms

Osgood Schlatter’s Disease

PIER

Decrease activity level

Referral to medical professional

86

Management

Tendon

Acute Rupture

Tendonitis

ITB Friction Syndrome (Runners Knee)

87

Tendon Rupture Complete tearing of the tendon

Tendon attaches muscle to bone

Signs and symptoms: Loss of muscle function

Localized pain

Swelling may or may not present

Deformity may or may not present

Sensation (athlete will claim to heard or felt a “pop” or “snap”)

88

Tendon Rupture

Management:

RICE

Crutches (if necessary)

Medical referral

89

Tendonitis

Inflammation of the tendon or tendon sheath

Signs and symptoms: Tenderness to touch

Pain on activity

Swelling (sometimes)

Thickening of the tendon

A crackling sound (Crepitus) is often heard and/or felt on palpation

90

Tendonitis

Management: RICE

Gentle, pain free stretching

(when body is warmed up)

Medical referral

91

Abdominal, Thoracic and Pelvic Conditions

Winding

“Stitch in the side”

Testicular Trauma

92

Winding A temporary paralysis or spasm of the diaphragm causing breathing to stop

ABC’s

Relax the athlete

Have them breathe in slowly, through their nose and out through their mouth

93

Management

“Stitch in the Side” A common abdominal pain usually associated with running sports

Attempt to relax the spasm

Attempt to regulate the breathing

Compression over the area with your

hand

Stop activity if pain continues

94

Management

Testicular Trauma A direct blow to a male athlete’s groin

Place the athlete in a comfortable position

Ice (for 10 minute intervals)

Determine position of the testes (determined

by the athlete)

Medical referral (if pain continues for more than 5 minutes or if the testes are not in the scrotal sac)

95

Management

Testicular Trauma A direct blow to a male athlete’s groin

Management:

Place the athlete in a comfortable position

Ice (for 10 minute intervals)

Determine position of the testes (determined by the athlete)

Medical referral (if pain continues for more than 5 minutes or if the testes are not in the scrotal sac)

96

Facial Injuries

Black Eye

Foreign Body in the Eye

Nose Bleeds

Broken Nose

Dental Injuries

97

Black Eye A bruising of the eye area associated with a direct blow

Management: Determine the extent of the

injury (no fractures, vision is normal)

Check for possible head injury

Ice

Rest

98

Foreign Body in Eye

Signs and symptoms:

Blurred Vision

Red Eye

Complaint of feeling like something is in the eye

99

Foreign Body in the Eye

Management:

Gently remove the object (if possible)

Protect the eye (cover with sterile dressing)

Medical referral (if vision is blurred or blood is evident in the cornea)

100

Nose Bleeds Can occur spontaneously or as a result of a direct blow

Management:

Apply direct pressure (sit and lean slightly forward while pinching the nose)

Apply ice to nose and back of neck

Medical referral (if bleeding does not stop in five minutes)

101

Broken Nose An actual break in the cartilage or bone of the nose caused by a direct blow

Signs and symptoms:

Excessive bleeding

Extreme pain

Deformity

Inability to breathe through the nose

102

Broken Nose

Management:

ABC’s

Secondary scan (rule out head injury)

Ensure the airway is clear

Ice

Medical referral

103

Dental Injuries A tooth that is chipped, loose or knocked out

Management:

Stop the bleeding (direct pressure)

Replace the tooth if possible (be cautious)

Protect the tooth in bag of athlete’s saliva

Medical referral (Dentist)

104

Asthma A condition in which the lungs air passages overreact to stimuli by constricting and making breathing difficult

Tightness in the chest

Inability to breathe

Wheezing noises when breathing

Pulse rate may increase dramatically

Athlete usually has history of asthma

105

Asthma

Management:

Reassure the athlete (coach during administering of their medication)

Monitor vital signs

Medical referral if athlete does not improve following intake of their medication

106

Skin Wounds and Conditions

Precautions

Blisters

Abrasions

Lacerations

Athlete’s foot

Lice

Pink Eye

Warts

107

Blister A localized accumulation of fluid between layers of skin

Signs and symptoms:

Swelling

Redness

Pain

108

Blisters

Management:

Wash the area

Protect the blister

Apply lubricant or protection (2nd skin)

Tape Grips

Medical referral if it is a blood blister

If blister pops, MUST keep clean

109

Abrasions A disruption of the top layers of skin

Management: Cleanse the wound

Apply ice

Protect the wound

Medical referral (if an

infection is suspected)

110

Lacerations A disruption of the deep layers of skin usually causing bleeding

Management:

Cleanse the wound

Stop the bleeding (direct compression)

Close the wound (using steri-strips or butterfly strips

Medical referral (if necessary)

111

Athlete’s Foot An itchy, scaly rash between the toes caused by a fungal

infection

Signs and Symptoms:

Pain

Swelling

Itching

Scaling of skin

Can have burning

112

Athlete’s Foot

Management:

Medical Referral

Apply an anti-fungal cream or powder

113

Plantar Warts Small tumors on the foot caused by a viral infection

Signs and Symptoms:

A hard lump found on the bottom of the foot

Tiny specks may be found in the centre

Skin striations go around wart

114

Plantar Warts

Prevention:

Avoid walking barefoot on moist surfaces

Do not share footwear

Avoid direct contact with warts

115

Conjunctivitis (Pink Eye) An Inflammation of the outermost layer of the eye and inner

surface of the eyelids

Signs and Symptoms:

Redness in the eye

Irritation of the eye

Watering of the eye

116

Pink Eye

Management:

Medical Referral

Usually resolves without treatment in 2-5 days

Avoid touching the eyes

117

Pink Eye

Prevention:

Avoid contact with those effected

Personal Hygiene

118

Thank you for your time and participation in this session!

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