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Trauma in Sports and the Healthcare Provider
JSMP May 17, 2013
Kate Perlsweig, MS, ATC
Heartland Rehabilitation Services
Planning
Get to know your EMS Personnel: EMT-B? Paramedic? What equipment is standard? Life Flight? What level of training to police/firefighters
receive? Is there a standard way to relay information? What about a back-up or stand-by crew? What is the city/county protocol for mass
casualties?
Emergency Action Plans
Life or Limb Threatening injury
Crowd Injury
Fights Shooting Explosion
Evacuation Routes
Trauma Response: Supplies
Location of & Access to:PPEsDressingsAED
Extra battery/padsSplint/SpineboardPhone/radioTags/markers
Trauma Response: Supplies
Trauma Response: ABCs
BLS:AirwayBreathingCirculation
TCCC:Massive HemorrhageAirwayRespirationCirculationHead/HypothermiaShock
Trauma Response: Physiology
10080 120 140 160 180 200
115bpm: Fine motor
skills begin to deteriorate
145bpm: Complex motor skills begin to
deteriorate
175bpm: •Cognitive processing deteriorates•Vasoconstriction•Loss of peripheral vision, depth perception•Auditory exclusion
Heart Rate Response to Stress
Case Study
24 August 2007 27 year old male Humvee roll-over in western Afghanistan LOC, Left posterior hip dislocation with intra-articular
fragmentation and acetabular fracture, left sacroiliac joint diastasis, right superior and inferior rami fractures, left lumbo-sacral plexus disruption, right wrist fracture, multiple facial fractures, left pneumothorax, bladder extravasation into abdomen
Case
2 months ICU at Walter Reed and Brooks Army Medical Centers
8 months Tampa Polytrauma Rehabilitation Center
10 months post-injury issued first AFO 1 year post-injury considered elective
amputation
Special Considerations During Rehabilitation: Patient
Patient
Ortho
PM&R
Neuro Vascular
PT
OT
Internist
Dental
Pain Mgmt
Special Considerations During Rehabilitation: Patient
Multiple surgeries Prolonged
hospitalization MD Appointments
Care takers Family support Financial concerns
Personality/Role Changes
Coping strategies
Depression Suicide Risk Substance abuse Domestic violence
Special Considerations: Practitioner
Role in patient’s support system? Team approach to treatment Coping Strategies:
Recovery relaxation time Support system Emotional processing