Weekly Update #3Patient: Troy Pedroza

Case: Soccer Incident Case: During a championship soccer tournament, 15 year old Troy Pedroza, collided with another player during a soccer game. According to the replay, the collision looked harmless. The coach quickly ran onto the field to check the status of his #1 player. Troy did not lose consciousness but he was slow to get up. After a minute or two, he stood up and was able to walk and talk. He explained to his coach that his head hurt, but he believed he was okay to return to the game. Ten minutes later, however, Troy had a seizure and lost consciousness.

History: Information shared at the hospital● One week earlier, Troy hit his head on the pavement when he fell off his skateboard.

Physical Examination: Patient Height: 5’-8” Patient Weight: 125 lbs

ASSESSMENT RESULTS:

● complained of headaches● had difficulty sleeping● found it difficult to concentrate. ● admitted to being bothered by light and having double and

blurry vision.

Weekly Update #3 Patient: Dana Rettke

Case: Volleyball Incident Case: During a championship volleyball tournament, Dana and her team were performing well. Dana worked hard for this day and everyone on her team knew that her dream was to obtain an NCAA scholarship and play volleyball in college. Dana is a nationally ranked volleyball player in the position of middle blocker. She was performing a high impact block and became tangled with another team mate and fell, landing with full pressure on her hand.

History: Information shared at the hospital She practices competitive volleyball at least 2 to 3 hours daily and competes locally and nationally during the regular season.

Physical Examination: Patient Height: 6’-8” Patient Weight: 195 lbs

ASSESSMENT RESULTS:

● Initial pain over the back of the wrist, dull pain upon movement of wrist

● Stiffness and loss of flexibility in the wrist● Swelling, heat and tenderness in the wrist area● Tingling or numbness in the hand● Mild deformity of the wrist● Redness around the wrist● Pain with activities such as lifting, gripping, or weight bearing.

Weekly Update #3

Patient: Apollos Hester

Case: Football Incident Case:

It was halftime and our team was up by a touchdown. 18-year-old Apollos became unconscious and was rushed to the hospital. He is a nationally ranked football player in the position of quarterback. He performed well during the game, but during half-time, he said that he was not feeling well and then collapsed. Coaches quickly called an ambulance. Doctors ordered a scan of Apollos’ brain. .

History: Information shared at the hospital

● Apollos complained of cramping during football practice on Friday before the game. ● When asked what Apollos ate before the game, the coach responded “it's funny because I

did not see him eating anything, however, Apollos did have a gallon of water with him. ● The teen’s aunt, confirmed these accounts by stating that Apollos drank two gallons of

water and two more gallons of Gatorade before the game.

Physical Examination: Patient Height: 6’-3”

Patient Weight: 230 lbs ASSESSMENT RESULTS:

● Loss of consciousness● Confusion and Disorientation● Headache and Irritability● Initial blurred vision● Cramping

Weekly Update #3

Patient: Jade Degouveia

Case: Gymnastics Incident

Case:

Jadeis a very talented young lady who practices gymnastics at least 5 hours daily, and competes locally, regionally, and nationally during the regular season. During football season, Jade is the captain of the cheerleading squad and during off season, Jade competes as a gymnast. Jade is a nationally ranked all-around competitive gymnast.

During Nationals, Jade was reprimanded by her coaches for not eating properly and taking her insulin in a time fashion. Jade explained that she struggled with knowing how much to eat and how to adjust her insulin during practice and for performances. Thirty minutes into practice, Jade broke out in a sweat , began to feel jittery and then fainted. Jade was rushed to the hospital and was seen immediately by doctors.

History:

● Became more physically active than usual

● Missed a meal

● Does not know when to or how much you normally eat

● Took her insulin at a different time than usual

Physical Examination: Patient Height: 5’-0” Patient Weight: 91lbs Assessment Results

● Urinating often.● Feeling very thirsty.● Feeling very hungry - even though you are eating.● Extreme fatigue.● Blurry vision.

Weekly Update #3Patient: Eric Weng

Case: Swimming Incident Injury Area: Shoulder

Case: Eric Weng is a nationally ranked all-around competitive swimmer and an Olympian. He swims at least 5 miles a day. During a swim meet, a Eric felt an uncharacteristic pain in his shoulder. At first Eric placed an ice pack on his shoulder, but the pain continued to persist. Eric contacted his parents and they drove to the emergency room to X-Ray his shoulder.

History: This is patient’s first severe shoulder incident although the shoulder is used excessively and extensively in practice and competition. He practices at least 4 hours daily and competes locally, regionally, nationally, and internationally.

Physical Examination:

Patient Height: 6’-0” Patient Weight: 155 lbs

ASSESSMENT RESULTS: • Reduced range of motion.• A forward shoulder slouch while seated.• A mild winging on the affected side's left scapula.• Tenderness in the impingement area.• Tenderness in the affected side's bicep tendon.• Moderate posterior and anterior laxity in both shoulders.• Impingement and adduction-compression tests on the affected side were positive.

Weekly Update #3

Patient: Danielle Lugo

Case: Softball

Case:

She is a nationally ranked all-around competitive fast pitch pitcher. Danielle pitches at least 2 hours a day. During a softball tournament, Danielle complained that she felt a recurrent lower forearm/elbow pain. The athletic trainer on-site checked her vitals and rushed Danielle to the hospital.

History: Danielle started pitching at 11 years of age. She started throwing more advanced pitches such as curveballs and changeups at age 13 or 14. Throughout the course of her softball career, she had no significant injuries. For the past 3 to 4 years, the patient participated in spring and summer leagues (approximately 5 to 6 months a year) and practiced pitching with a pitching coach 12 months of the year. She frequently pitched as many as 130 pitches per outing or practice session. She pitched multiple games per weekend, and she often pitched on consecutive days. During her last physical, Danielle’s red blood count was low.

Past Medical History –Surgical History – None Medications – Folic acid, Multivitamin • Allergies – None Family History – Father and mother in good health •

Physical Examination: Patient Height: 5’-3” Weight: 120 lbs ASSESSMENT RESULTS:

Intravenous fluid resuscitation was initiated in the ERhydromorphone was given as needed for pain. • Admitted to the hospital for further work‐up and management.

Weekly Update #3 Patient: D’Jenne Egharevba

Case: Track and Field Incident Case:

During an extensive outdoor track and field practice, D’Jenne Egharevba suffered difficulty breathing and heavy wheezing. She was running the 800m for the fourth time on an outdoor track under sunny conditions. She is a nationally ranked track and field athlete in the specialty area of heptathlon.

History: This is patient’s first medical visit pertaining to a breathing issue. Patient trains for both indoor and outdoor track and field for at least 3 to 4 hours daily and competes locally, nationally, and internationally during the indoor/outdoor season.

Physical Examination: Patient Height: 5’-10”

Patient Weight: 130 lbs ASSESSMENT RESULTS: · Episodic symptoms of airflow obstruction are present· Wheezing and coughing· Rapid heart rate and fatigue· Shortness of breath· Chest tightness/pain· Sweating

Questions:

Weekly update #3

Patient: Kyle Guy

Case: Basketball incident

Kyle Guy 18 years old is preparing for the high school All-Stars games. He is graduating and has been accepted into the University of Virginia. Last Wednesday, while practicing for the All-Star game, Kyle was spotted bending over and complaining of pain in his side. Kyle had been practicing hard because the the All-Star game meant everything to him. This was to be his last high school game before attending college. When the pain became too much for Kyle to bear, Kyle’s coach had one of the assistants to escort him to the nurse's office who eventually called an ambulance.

Assessment Results: ● Severe pain in the side, below the ribs

● Pain that radiates to the lower abdomen and groin

● Pain that comes in waves and fluctuates in intensity

● Pain on urination● Pink, red or brown urine

● Cloudy urine● Nausea and vomiting

● Persistent need to urinate● Urinating more often than usual

● Fever and chills if an infection is present● Urinating small amounts