Emergency Procedures - PowerPoint PPT Presentation

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Emergency Procedures

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Chapter 2 Emergency Procedures – PowerPoint PPT presentation

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Title: Emergency Procedures


1
Chapter 2
  • Emergency Procedures

2
The Emergency Action Plan
  • A process for activating EMS
  • Should be written for each activity site
  • Plan should answer questions in Box 2-1
  • Individual responsibilities and protocols should
    be reviewed
  • Should meet annually with EMS to review
    procedures
  • Should be practiced regularly

3
The Emergency Action PlanContinued
  • EAP members should be certified in first aid and
    CPR
  • Emergency medical supplies and equipment should
    be easily accessible ATCs responsibility
  • The most medically qualified on-site individual
    should assume responsibility

4
Emergency Situations
  • Primary survey
  • Assess life threatening conditions Box 2-4
  • A,B,Cs
  • Triage-assessing all injuries quickly and then
    returning to the more serious injuries
    immediately - MASH
  • Secondary survey
  • Detailed head to toe assessment
  • Signs measurable objective findings-bleeding,
    fluid
  • Symptoms subjective info provided by person

5
Secondary SurveyHOPS
  • If the athlete is talking and moving, start your
    2nd survey if they are unconscious call 911 if
    they are unconscious and ABCs are adequate begin
    2nd survey
  • History
  • Observation
  • Palpation
  • Special Test

6
History
  • History-gather subjective information via a
    series of questions see Field Strategy 2.2
  • Type of pain, Location of Pain, Mechanism of
    injury, Nauseous or sick to stomach, any ringing
    in the ears, sensations in body
  • Questions should be open ended
  • A person who is not fully responsive may have a
    head or neck injury
  • Diplopia double vision

7
Observation
  • Survey the scene as you come on to it
  • Look dont touch What to look for
  • Bleeding, discoloration, swelling, obvious
    deformity, fluid from ears/nose, state of athlete
    (alert, lethargic, restless), pupil size,
    tracking, and reaction to light
  • Observe bilaterally

8
Palpation
  • Using your hands to feel for abnormalities in
    bone or soft tissue
  • Palpate bilaterally- good (uninjured) then bad
    (injured) palpate for
  • Local heat, swelling, deformity, crepitus, point
    tenderness, muscle spasm, pain, sensations at
    site of injury and below
  • Start away from the injury and move toward start
    with light touches and increase pressure

9
Special Test
  • Limited in an emergency situation main job is to
    determine if possible spinal cord injury
  • Avoid any unnecessary movement
  • Motor test muscle test-ask to wiggle fingers
    and toes, then compare bilateral grip and foot
    strength
  • If athlete is unconscious, try painful
    stimulation- pinching the soft tissue in the
    armpit may make their eyelid flutter or
    involuntary movement away from the stimulus
  • If no response, do not move, wait for EMS, and
    monitor ABC

10
Unconscious Athlete
  • Call 911 for all unconscious athletes
  • Head injuries are 1 cause for loss of
    consciousness
  • Use Glasgow coma scale to quantify
  • http//www.neuroskills.com/tbi/glasgow.shtml
  • Always assume serious neck injury
  • See guidelines to help an unconscious
    athlete-p.17 1-10.

11
Hemorrhage
  • Three types of bleeding
  • Arterial bright red, spurting
  • Venous dark bluish-red, steady flow
  • Capillary red, oozing
  • Treatment
  • Direct pressure
  • Elevation (if no fracture)
  • Pressure points (femoral/brachial arteries)

12
Wound Cleansing
  • Wear gloves
  • Clean wound with saline, mild soap
  • Dont use alcohol or concentrated peroxide (water
    it down)
  • Soak wounds (if appropriate) in betadine solution
  • Apply ointments (neosporine etc)

13
Wound Dressing
  • Apply Occlusive dressings
  • Second skin
  • Duoderm
  • Covering wound
  • Use telfa pad/ ointment/ tape
  • Allow the wound to breath at night in a
    controlled environment-cover before sleeping in
    the beginning

14
Fractures
  • C/S-direct contact, fall, dynamic overload
  • Signs swelling, bruising, deformity, shortening
    of the limb, crepitus, disability
  • Types-open (c),closed (s), transverse,
    epiphyseal, avulsion
  • Five ways of recognizing fracture Figure 4-12
  • Palpation
  • Percussion
  • Vibration
  • Compression (be careful)
  • Distraction (be careful)

15
Treating Fractures
  • Splint before moving-Follow 1st Aid/Safety Rules
  • Types of splints
  • Anatomic
  • Stiff/rigid
  • Soft
  • Vacuum
  • Check skin color, temp, and capillary refill
    before and after splinting

16
Shock
  • Shock can occur with any injury involving pain,
    bleeding, internal trauma, fracture, or spinal
    injury
  • Occurs when the heart is unable to exert
    adequate pressure to circulate enough oxygenated
    blood to the vital organs.
  • S/S- Box 2-6 p.18
  • Treatment-Elevate legs, keep warm, monitor ABCs
    See P. 18

17
Heat injuries
  • Ways of cooling body Box 2-8
  • Evaporation (sweat)
  • Conduction (coming in contact with cool object)
  • Convection (air/water flow)
  • Dehydration increases chances for heat illness

18
Preventing Heat Illness
  • Identify at risk individuals-children pre-season
    athletes
  • Acclimatize athletes 7-10 days 2-4 hrs/day
  • Wear appropriate clothing-light weight,
    light-colored, porous
  • Fluid hydration-should be often and unlimited
    8-12 cups 24 hrs before 5-10oz during every 15
    mins 24 oz after for every lb lost
  • Weight Charts

19
Preventing Heat Illness-Cont
  • Temperature/ humidity guide workouts-Fig
    2-2http//www.srh.noaa.gov/elp/wxcalc/heatindex.h
    tml
  • Allow humidity and temperature to guide workouts
  • Practice schedules

20
Types of heat illness
  • Heat cramps
  • Muscle spasms caused by electrolyte loss-early in
    season
  • Heat exhaustion
  • More common early in season
  • S/Sx (signs and symptoms) dizziness, headache,
    profuse sweating, rapid breathing, gray skin,
    rapid weak pulse, uncoordinated gait, elevated
    temp, nausea

21
Types of Heat Illness (2)
  • Heat stroke
  • Bodys temp control mechanisms have shut down
  • MEDICAL EMERGENCY-CALL 911
  • S/Sx unconscious, sweating has stopped, shallow
    breathing, hot dry red skin, rapid strong pulse
    (bounding), high body temp, convulsions,
    seizures, comma

22
Treating Heat Illness
  • Move person to cool place
  • Remove equipment/unnecessary clothes
  • Lie person on back, with feet elevated
  • Give cool fluids (unless unconscious)
  • Specifics See table 2.1
  • Heat cramps stretch, ice, drink cool fluids
  • Heat exhaustion call EMS (if necessary), rest
    in cool room utilize cool/wet towels
  • Heat Stroke call EMS, RAPID COOLING

23
Hypothermia
  • Reduced core body temperature
  • S/Sx intense shivering, inability to perform
    tasks, speaking difficult, incoordination, in
    severe cases unconscious (see table 2.2)
  • Treatment Maintain ABCs, Activate EMS, remove
    wet clothing, jewelry, give warm fluids, re-warm
    person

24
Frostbite
  • Most common in fingertips, toes, earlobes, tip of
    nose
  • Occurs when soft tissue freezes
  • Superficial Involves skin and superficial tissue
  • Deep Involves subcutaneous layers, tissue
    destruction
  • S/Sx red swollen skin diffuse numbness, skin
    turns yellow-white/ blue with waxy look
  • Treatment remove wet clothing re-warm area
    immediately cover with sterile dressing
    transport to hospital

25
Vital Sign Assessment
  • Respirations (Normal (N) 12(A)-20(C)
  • Skin Color
  • Rubor red skin
  • Pallor pale skin
  • Pupils (light reflex) and vision
  • Pulse (N60-80)
  • Blood pressure
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