Chapters 4,5,6

Primary Survey

Secondary Procedures

First Aid

Primary vs. Secondary Assessment

• Primary Assessment– Life-threatening

Conditions– Determine

Responsiveness– Check CAB

• C• A• B

• Secondary Assessment– You have ruled out

Life-Threatening conditions

– Begin HIT/HIPS• H• I /O• P• S/T

Primary Assessment

This is the first thing that needs to be done when approaching a victim. Once a life-threatening condition has been ruled out, your evaluation can continue.

• Airway– Partial Airway Obstruction– Universal Choking Sign– Total Airway Obstruction

• Breathing• Circulation

SO YOUR ATHLETE IS BLEEDING…

• External Bleeding– Ways to control it:

• Hemorrhage– More severe, heavy

flow of bleeding– Emergency!

• If bleeding cannot be controlled, 911 needs to be called!!!

UNIVERSAL PRECAUTIONS

• Used to prevent the spread of blood-borne pathogens.– Barrier Protection– Sharps Disposal– Infectious Control– Hand Washing

HIT/HIPS

• History

• Inspection

• Palpation

• (Special) Testing

HISTORYCommon Questions to Ask…

• What happened?• How did it happen?• When did it happen?• Has this happened

before?• Where was the pain

initially?• Did you hear any sounds/

feel any sensations?• Were you able to

continue participating?• How soon did it swell?• Does it feel unstable?

• What relieves the pain?• How severe is the pain?• What does the pain feel

like?• Are you experiencing any

numbness or tingling?• Have you had any

treatment for this yet? If so, what has been done?

• Have you injured this body part before?

Vital Signs

• These are taken during a secondary procedure. It could be part of the history or the inspection.

• Heart Rate (pulse)• Breathing Rate

(respirations)• Breath Sounds/Odor• Blood Pressure• Body Temperature• Skin Color• Capillary Refill• Pupillary Reaction• Ability to Move• Response to Pain

INSPECTION

• Inspect

• Look for

• Really observe the athlete– Watch how they are holding the body part– Watch them as they approach you– Have them walk/do a motion for you and

watch their reaction

PALPATION

• Examining an injury through touch

• Compare bilaterally

• If something feels different, then you have probably found your point of injury.

SPECIAL TESTING

• Range of Motion (ROM)– Compare Bilaterally– Test all ROM at the

joint

• Manual Muscle Testing (MMT)– Compare Bilaterally– Grade Scale 0-5

• Table 5.1 pg 46 in book

• Neurological Testing– Can be tested through

sensation or movement

– Every body part is linked to a specific nerve

• Special Testing– Specific tests for the

injury• Ex) Lachman’s ACL

test

SIGN vs. SYMPTOM

• Sign– Something that can be

measured/observed– Something that the

Athletic Trainer can see or test

– Examples:

• Symptom– Something that cannot

be measured by the caregiver.

– Information is something that only the athlete will know (what they feel)

– Examples

WHAT IS SHOCK?

• A condition in which inadequate blood and oxygen are supplied to vital organs.

• Inadequate blood supply to these organs will result in shock (5 organs necessary for life):

1.

2.

3.

4.

5.

WHY DO WE GO INTO SHOCK?

1. Axial blood vessels dilate while appendicular blood vessels constrict.

2. Heart Stops

3. Significant loss of blood

RECOGNIZING SHOCK

• SIGNS– Agitation– Rapid, weak pulse– Decreased BP

(100mm HG or lower systolic)

– Cold, clammy skin– Sweating– Cyanosis– Increasing

unconsciousness– Pale skin tone

• SYMPTOMS– Nausea– Dizziness– Thirst– Anxiety

TYPES OF SHOCKTable 5.2 pg 47 in book

• Psychogenic• Septic• Neurological• Cardiogenic• Hemorrhagic/Hypovolemic• Metabolic• Respiratory• Anaphylactic

TREATING SHOCK

• Treat the original injury• Keep the athlete warm• Elevate arms and legs 10-12in above heart (as

long as there is no fracture)• Measure respirations and pulse every 5min• Don’t give them anything to eat or drink• If vomiting occurs, put them in recovery position• Get them to hospital ASAP!!

ASSESSING FRACTURES

• Check:

1.

2.

3.

• Do not ask the athlete to use the body part as it could cause further damage!

MANAGING FRACTURES

• Requires immediate attention from a Physician

• Splint the area whether the fracture is obvious or not (if you suspect a fracture, splint it)

• Once the athlete is splinted, they can be moved and should be monitored for signs/symptoms of shock

TYPES OF SPLINTS

• Types of splints:– Traction Splint

– Rigid Splint

– Semi-rigid Splint

– Soft Splint

PRICE

• P

• R

• I

• C

• E

• Method used to treat most sprains, strains, contusions and splinted fractures.

HEAT-RELATED PROBLEMS

• Hyperthermia =

• Heat Cramps

• Heat Exhaustion: body temp 98.6-104.9

• Heat Stroke: body temp ≥ 105 degrees F– Medical emergency, 911 needs to be called

HOW TO PREVENT HEAT-RELATED ILLNESS

• Acclimatize• Wear lightweight

uniforms• Frequent water

breaks• Weigh in before and

after practice• Check humidity and

temperature

• Avoid saunas and hot-tubs for extended time

• Eat properly• Get plenty of rest• Replace fluids lost

after practice• STAY HYDRATED

ALWAYS!!!!

COLD-RELATED PROBLEMS

• Hypothermia =

• Frostbite– Treat with gradual re-

warming by placing effected body part in water heated to 102 degrees F

• PREVENTION– Dry, non-restrictive

clothing– Acclimatize– Layers– Avoid outdoors in

extreme cold– Cover head, mouth

and extremeties– Try to stay dry– Wind-resistant clothing

FOR YOUR QUIZ

• 3 things you are looking for in a Primary Assessment

• Universal Precautions• Sign vs Symptom• Explain HIPS• 5 organs necessary to sustain life• Types of shock• Explain PRICE• Prevention of Heat-related Illness