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After an incident occurs, what is involved in the Primary survey?
ABC – airway, breathing, circulation
Response (conscious or unconscious, slow or normal)
Call 911 if needed
What is involved in the Secondary survey?
HOPS + F (written in SOAP note form)
Performed on the field and off the field
What situations constitute life threatening emergencies (LTE)?
- Head or neck (spinal)
- Fractures with gross deformity
- LOC (loss of consciousness)
- Heat illness – heat stroke
What are signs and symptoms (S/S) of a LTE?
- Not breathing
- No pulse
How should an AT plan ahead for LTE?
- * Typed directions to hospital and post them
- * Phone locations – cell phones don’t receive signal from absolutely everywhere
- Identify personnel (and what their responsibilities will be)
- * Who is/isn’t CPR/FA certified
- Establish roles
- * Who calls, meets, informs parties involved
- * Who keeps records – if a person has lost conscious or seizing, someone needs to keep account of what’s happened thus far (“He’s been unconscious for 30 seconds”, “His seizure lasted 2 minutes”, etc.)
- Meet with EMS to:
- * Give directions (on how to get to your facility)
- * Establish communication, rapport
- * Review equipment
- * Establish coverage dates (when they will need to be on call)
What vitals should be examined after an incident occurs?
State of Consciousness
- * Changes can be due to medications, age exertion, condition, etc.
- * Normal 60-80 (may be lower in well conditioned athletes)
- Respiratory Rate
- * 10-12 breaths per minute
- * Check for flush tips of ears or cheeks
- * Important to have a baseline temp recorded on file (not everyone has a baseline temp of 98.6, some are lower and higher)
- Blood Pressure
- * Normal 110/70 (new guidelines): HBP>140/80 (hypertension)
- Skin Color
- * Red skin may indicate heat illness
- * Pale skin may indicate shock or hemorrhage
- * Cyanotic skin may indicate airway obstruction
- * Constricted may indicate Central Nervous System depressant
- * Dilation may indicate head trauma or stimulant drug
- * Response is more important than size (Use PEARL – Pupils Equal and Reactive to Light)
Movement (whether its normal or abnormal)
Abnormal Nerve Response (heat/cold, soft/prick, lack of response to Babinsky test)
What is "shock"?
A life threatening condition in which the heart is unable to pump sufficient blood/oxygen to the body
Typically, shock is preceded by a serious injury, but the shock must be attended to before the gross deformity/injury
What are S/S of shock? What factors predispose an individual to shock?
- Pale, clammy skin
- Rapid shallow breathing
- Decreased BP
- Rapid but weak pulse
- Profuse sweating
- Pain tolerance
What are the different types of shock?
Hypovolemic – Due to blood loss
Respiratory – Lungs are unable to supply oxygen to blood
Neurogenic shock – Dilation of blood vessels
Psychogenic shock – Fainting (*Potential Bonus ?*: Syncope – Fainting due to lack of blood flow and therefore oxygen to the brain)
Septic shock – Bacterial infection
Anaphylactic shock – Severe allergic reaction
What steps should an AT take if it appears an athlete has suffered a head/spinal injury?
Check LOC (level of consciousness)
Check neurological response
Transport as necessary - “When in doubt, ship them out”
DO NOT REMOVE HELMETS WITHOUT REMOVING SHOULDER PADS (Usually no reason to removes the shoulder pads anyway)
DO NOT SHAKE THE ATHLETE
DO NOT LET OTHER TEAM MEMBERS TOUCH ATHLETE