2nd Quarter Notes

What is an athletic injury?

A damage to the musculoskeletal structures brought about by forces (i.e. acute or repetitive) during athletic performance.

Compression

Forces that act along the long axis of a structure which produces a crushing effect.

Tension

A pulling force that acts along the long axis of the structure which stretches the tissue.

Shear

Forces that act at opposite directions at different points causing one part of the structure to move away from another part of the structure.

1. Acute Injury

Injury with a sudden onset brought about by large forces

2. Overuse Injury

Injury that developed over time as a result of repetitive microtrauma

Neurological EmergenciesConcussion

• Temporary disturbance in brain function brought about by a blow or jolt to the head

• Symptoms include headache, balance problem, confusion, and dizzy

• Signs include unconsciousness, amnesia, and clumsy

Neurological Emergencies

Skull Fracture

• Trauma to the bony structure that protects the brain

• Could be linear, comminuted, depressed, or basilar

• Watch out for complications!!

• Signs and symptoms include cushing’s triad, nausea, and CSF leak

Neurological Emergencies

Intercranial Hematoma

• Symptoms include headache, dizziness, and vomiting

• Signs include HR decrease, BP increase, raccoon eyes, battle’s sign, and CSF leak

Neurological EmergenciesSpinal Cord Injury

• Trauma to the spinal cord leading to temporary or permanent paralysis

• C1-C4 paralysis from neck

• C5-C7 paralysis from chest

• T1-T9 paralysis of lower extremities

ManagementSteps to Spinal Injury Management

1.Check consciousness (AVPU)

2.Manage airway

3.Perform neurological tests

4.Apply cervical collar

5.Log roll into spine board

FracturesDisruption in the continuity of a bone

Type of fracture depends on mechanical load and bone maturity

Several types of fractures include . . .

1.Simple

2.Compound

3.Greenstick

4.Comminuted

5.Spiral

Signs and Symptoms

Signs

1.Deformity

2.Weakness

3.Bruise

4.Swelling

5. Positive X-ray

Symptoms

1.Pain

2.Grating sensation

Evaluation

Palpation – deformity, tenderness, indentation

Percussion – pain during tapping

Compression – distal to proximal

Distraction – apply traction

Treatment

Cast? Internal Fixation? External Fixation?

DislocationsBone is pushed out of the joint capsule

Signs and symptoms are similar to fracture

Treat like fracture!!!

Immobilization

Anatomical – fingers

Rigid - wood

Soft - bandage

Guidelines for Splinting

• Support the injured area above and below the site of the injury, including the joints.

• If possible, splint the injury in the position that you find it.

• Don’t try to realign bones or joints unless . . .

• Before and after splinting, check for proper circulation (warmth, feeling, and color).

• Immobilize above and below the injury.

Triangle and Cravat Bandages

• Cotton cloth that can be substituted if roller bandages not available

• First aid device, due to ease and speed of application

• Primarily used for arm slings – Cervical arm sling– Shoulder arm sling– Sling and swathe

SPRAINS vs. STRAINS

NOT INTERCHANGEABLE!!

Both injuries are caused by abnormally high tensile forces which tears the tissue but damaged tissues are different . . .

Which is Which?!?

SPRAINS vs. STRAINS

• Shoulders

• Elbow

• Wrist

• Knee

• Ankle

• Lower Back

• Hamstrings

• Gastrocnemius

SPRAINS vs. STRAINS

1st Degree (Mild) No loss of function

2nd Degree (Moderate) Unstable / Weak

3rd Degree (Severe) Loss of function

Dependent on the number of torn fibers . . .

Control Inflammation

What is inflammation? Is it bad?

P – protect

R – rest

I – ice

C – compression

E – elevation

Elastic Bandage Application

• Hold bandage in preferred hand with loose end extending from bottom of roll

• Back surface of loose end should lay on skin surface

• Pressure and tension should be standardized

• Anchor at the distal end

• Body part should be wrapped in position of maximum circumference

• More turns with moderate tension

• Each turn should overlap by half to prevent separation

• Circulation should be monitored when limbs are wrapped

Elastic Bandage Application

The Skin

• Epidermis

• Dermis

• Hypodermis

Function?!?

Common EmergenciesWounds

Break in the skin and underlying tissues

• Open

• Closed

Burns

Injury caused by heat, cold, chemical, electricity, etc.

Common Emergencies

Bites

Wound caused by teeth or mouth

Stings

Small puncture wounds with chemical injected

Wounds and Bleeding

Types of Wounds

• Incision Clean, sharp edge

• Laceration Irregular, tearing

• Abrasion Friction, scrape

• Puncture Pointed object

• Avulsion Partially ripped

!DANGER!

• Hemorrhage – 1 glass (250cc) – normal– 2 to 3 glasses – casualty becomes anemic and

predisposes to infection– 4 to 6 glasses – fatal

• Infection – gangrene may develop, amputation may be necessary

• Shock – circulation is compromised and may lead to death

Kinds of Bleeding

• Capillary bleeding – oozing flow of blood

• Venous bleeding – even flow of blood, dull color

• Arterial bleeding – irregular spurting of blood, bright red color

Wounds and Bleeding

Proper Care

•Protect self

•Control bleeding

a. direct pressure**

b. elevation

c. pressure points

•Use sterile dressing

•Prevent shock

a. raise legs

b. prevent heat loss

•Irrigate wound

•Change dressing regularly

SUTURES are needed for deep cuts as well as cuts more than an inch long.

Interrupted or Subcuticular?