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RSAT 215 Final

RSAT 215 Sports Emergency Care Final OU

QuestionAnswer
parts of an EAP implementation, personnel, equipment, communication, transportation, venue, emergency care facilities, documentation, NATA positions
normal pulse 60-100 bpm
tachycardia >150bpm. indications shock
bradycardia <60bpm. indications head injury; respiratory/cardiac arrest
pulse deficit radial pulse<pulse @ heart
palpable pulses carotid=60 mm hg femoral=70 mm hg radial=90 mm hg
normal respiration 12-20 (1 in & 1 out = one)
normal pulse pressure 120-80=40
avpu alert, pain, verbal, unconsciousness
contradictions to neutral neck position increased pain, neurological s/sx, spasm, airway compromise, physically difficult, resistance, patient apprehension
when to remove helmet if cannot remove face mask, airway is not maintained, doesn't fit, prevents immobilization
when to remove pads when helmet comes off, full shoulder access is required, improper fit
reasons for oxygen use cardiac/respiratory distress, hypoxia, unresponsive patient, injury to torso/CNS, severe bleeding
epidural hematoma s/sx initial: headache, nausea, unequal pupils, disorientation later: drowsiness, neck rigidity, altered consciousness, increased BP, decreased pulse, cranial nerve dysfunction, sleepiness.
subdural hematoma s/sx initially lucid, possible LOC, headache, dizziness, nausea, sleepiness, cranial nerve dysfunction, impaired cognitive/behavioral/motor skills
inter cranial hematomas management CT or MRI. possibly surgery required to relieve pressure
types of skull fractures depressed(indentation toward brain), non depressed(minimal indentation), linear(runs circumference), comminuted(multiple fragments), and basal(base of skull)
zurich concussion statement abandon the "simple vs complex" terminology when referring to concussion
RTP protocol no activity, light aerobic activity, sport specific exercise, non contact training drills, full contact practice, RTP
concussion s/sx vacant stare, delayed verbal/motor response, inability to focus, disorientation, slurred speech, gross incoordinations, heightened emotions, and memory deficits
reason to refer a concussion LOC, amnesia>15min, decreased respiration, increased BP, negative pupillary assessment, cranial nerve deficits, seizure activity,vomiting, bony injuries
type of heat illness *order of severity heat rash heat cramps heat syncope heat exhaustion heat stroke
heat stroke s/sx slight to profuse sweating, red/hot skin, tachycardia/strong pulse, rapid respiration, high BP
predisposing risk factors large BMI, age, conditioning level, poor hydration, prev hx, medications, motivation level, pre-existing illness, environmental conditions, alcohol and drug use.
prevention of heat illness proper nutrition, proper rehydration, avoidance or environmental extremes, appropriate clothing, rest periods, acclimation
golden 1/2 hour get below 104 degrees in 30 min
TTP rule Temporary physiologic impairment, Predisposition still exist, Peers have improved acclimatization.
top 5 predisposing factors to heat illness (doug casa) 1) intensity of exercise 2) environmental factors 3) fitness level/acclimatization 4) equipment 5) hydration status
%carbohydrates for proper rehydration 6% (14g per 8oz)
sample s/sx, allergies, medications, past medical hx, last intake, events leading/examine
dcapbtls deformities, contusions, abrasions, punctures, burns, tender, lacerations, swelling
opqrst onset, provocation/palliation, quality of pain, region/radiation, severity, time
7 types of shock anaphylactic, septic, neurogenic, psychogenic, metabolic, cardiogenic, hypovolemic
number of sickle cell trait deaths in past 7 years 9
benign cause of syncope dehydration
rule of 100 pulse below BP above temp below
measuring hydration urinanalysis (usg, reagent strips), urine volume, urine color chart, refractometer, weight chart
prevention of cold illness clothing, shelter, hydration/diet, education, EAP, PPE for past med hx.
predisposing factors for cold illness body size/comp, medical conditions, previous hx, black, female, clothing choice, drug use
treatment for cold illness remove wet clothing, warm the trunk first. water immersion for frostbite.
cold illness factors wind and cold. affects CNS, cardiac, respiratory, and renal
mild hypothermia s/sx 98.6-95 degrees, shivering, polyuria, decrease in fine motor skills, lethargy, normal BP, conscious.
moderate hypothermia s/sx 94-90 degrees, fainting, decreased pulse/respiration/BP, shivering stops, disorientation/LOC, slurred speech, gross motor skill loss
severe hypothermis s/sx below 90 degrees, unconscious, decreased HR/respiration, rigidity
progression of shock 1-8(16 steps from midterm) 1.injury 2.rapid pulse 3. athlete is anxious, restless, and in severe pain 4.bleeding continues 5.pulse rapid/weak 6.decreased BP 7.athelete becomes thirsty 8.BR increases
progression of shock 9-16 9.blood pulled from periphery 10.pale/cold 11.blood pulled from vital organs 12.vital organs w/o oxygen 13.athlete will be lightheaded, dull/vacent pupils, drowsy 14.athlete may LOC 15.pulse is undetectable 16.severe state of shock
sudden cardiac arrest sudden, abrupt loss of heart function in a person who may or may not have diagnosed heart disease
hypertrophic cardiomyopathy s/sx chest pain, dyspenea, exercise intolerance, syncope, palpitations, 1st symptom usually SCA
commotio cordis unresponsive w/ no pulse. 90% occur under 16 yoa
myocardial infarction s/sx chest pain/pressure/ache, profuse sweating, breathing difficulty, nausea, dizziness, radiating pain.
cerebrovascular accident (stroke) s/sx numbness, decreased function, sudden severe headache, vision problems, uneven pupils, LOC, balance problems, confusion, loss of bowel/bladder control, difficulty speaking.
cardiac tamponade (compression of heart's ventricle) s/sx jugular vein distension, hypotension, tachypnea, muffled heart sounds, paradoxical pulse(lose on inspiration), s/sx of shock.
myocarditis exercise intolerance, syncope, cough, palpitations, chest pain, persistent tachycardia
orthostatic blood pressure sudden low BP when someone stands up after a period of rest. last < 3min.
asthma attack s/sx wheezing, coughing, chest tightness/pain, shortness of breath, difficulty w/ expiration, increased respiration w/ intercostals/abdominals
asthma water loss theory loss of water in the epithelium of the airway changes the ph, temp and osmolarity causing bronchoconstriction.
asthma heat exchange theory higher minute ventilation=more air that needs warming=cooler airway. rapid rewarming causes EIA and bronchospasm
rescue medications for asthma beta 2 agonist (albuterol) last 4-6 hrs
non-rescue medications for asthma mast cell stabilizers: prevents release of histamine and anti-inflammatory. corticosteroids: stronger anti-inflammatory. both prophylactic
asthma referral after first asthma attack and if relying on inhaler for 3 to 4 puffs a day
asthma triad syndrome asthma, nasal polyps, aspirin allergy
flash to bang theory # of sec (b/w lightning and thunder)/5. _< 6miles=inherent danger. _<3miles=seek immediate shelter
lightning procedure if stuck outside crouch down, balls of feet, head down, cover ears. do not lay flat.
mechanisms of lightning injury direct, contact, side flash, ground current, blunt injury
Lightning RTP 30 past last thunder/lightning. 30-30 rule. 30 sec flash to bang=off field. 30 min wait after storm=RTP
lightning fun facts storms avg 25mph. #2 cause of death by weather. most common may to sept from 10 am to 7pm. approx 400 injuries.
sickling occurs if oxygen in blood drops. sickled cells clump and block blood flow to vital organs and muscles.
rhabdomyolysis break down of muscle fibers. can be acute or exertional
risk factors for sickling heat/dehydration, drugs, altitude, timed running, sprints>500 meters, asthma, prolonged intense exercise w/o rest.
sickling vs heat illness heat cramping is more painful and produces muscle twinges. cramps lock the muscle up while sickling muscle just go weak. response is more violent to cramps, sicklers often just lay limp
types of ankle dislocation posterior, anterior, lateral, superior
anterior compartment syndrome s/sx numbness in dorsum of foot, achy/sharp or dull pain on anterolateral lower leg, muscle tightness, cramping, swelling, dorsiflexion weakness, inability to exercise, glossy/waxy skin.
syncope unconsciousness followed by quick recovery. s/sx: unresponsive, pale/cool skin, rapid/weak pulse, increased RR, low BP
stupor decreased state of mental activity/awareness. causes: head injury, shock, drug abuse, heat illness, hypoglycemia, hyperglycemia
coma deep state of unconsciousness w/ no response to stimuli. causes: serious loss of brain function/head injury, drug abuse, diabetic reaction, hemorrhage.
seizures recurrent paroxysmal disorder or cerebral function characterized by sudden brief attacks of altered consciousness, motor activity, sensory phenom, or inappropriate behavior. caused by: epilepsy, head injury, fever, hypoglycemia, poisoning.
seizure s/sx aura signs: dizzy, feeling of warmth, metallic taste. "pot-ictal" is the transition back to normal state.
epilepsy petit mal=5 to 15 sec. grand mal=a few minutes. s/sx: tense up(tonic) and collapse, muscle contractions(clonic), unconscious.
reasons to call EMS for seizures no previous hx, last longer than r min(30+ =status epilepticus), recurrent seizures, injured during, no return to normal consciousness, or resulted from another injury.
EEG electroencephalogram. records brain waves.
herpes zoster (shingles) follows a nerve root pattern. s/sx: unilateral pain/tingling, reddening of skin w/ blisters, grouped/dense blisters that ooze and crust. antiviral medication
abscess enclosed collection of pus. can be septic (common) or sterile. s/sx: throbbing pain at site, malaise, fever, pus-filled, bright red/tender upon palpation.
formation of abscess 1.germs invade 2.blood flow/temp increases 3.swelling 4.turns red 5.irritation from swelling an chemical activity hurts 6.heat, swelling, redness, pain 7. tissue turns to liquid and abscess forms.
furunculosis(boil) external abscess. infection of hair follicle. antibiotics
carbuncle external abscess. bigger,deeper,more. surgical drainage and antibiotics.
cellulitis bacterial. diffuse inflammatory response within solid tissues, s/sx: red streaks extending from patch, pain, edema, redness.
pediculosis head louse. survive 55 hours on scalp. NIX shampoo for tx.
MRSA(methicillin-resistant staphylococcus aureus) s/sx pain, redness, swelling, drainage, fever, shortness or breath, malaise, chest pain, change in mental status.
MRSA risk factors colonizes in nostrils. CA:young age, contact sports, weakened immune system, crowded unsanitary conditions. HA: current/recent hospitalization, living on long term care facilities, invasive devices.
MRSA treatment drain. culture. keep clean. cover wounds(pack if big).
heart auscultations 1.intercostal right of sternum 2.intercostal left of sternum 3.4th/5th intercostal left of sternum 4.cuspal region
thorax auscultations listen from back(upper and lower lobes). absence=collapsed lung. rales=build up of fluid. wheezing=asthma. rhonchi=pneumonia
abdomen auscultations done before palpation. absent=injury. high pitched=intestinal obstruction. gurgling=normal
palpation of heart under 5th rib in 5th intercostal space along the midclavicular line. patient comfort position
palpation of thorax symmetry of chest(flail chest). TTP around intercostal spaces. AP compression(rib fx). transverse compression(costochondral injuries)
palpation of abdomen light to deep. start away from pain and work clockwise. percussion. RUQ, LUQ, RLQ, LLQ. hook method may be used.
mediastinum heart, aorta, trachea, esophagus, superior/inferior vena cava.
decerebrate vs decorticate brainstem(more severe)/extension vs abnormal flexion
Created by: fd249407