Basic First Aid for Coachesby

Denise Moniz EMT-I

INTRODUCTION

The Good Samaritan Law is out there to protect you, but anyone has the right to sue you. Never, ever attempt to practice medicine outside the scope of your training.When in doubt, call 911. The EMT’s can assess a patient and if the parents do not want the transport they can sign a refusal with the EMT’s. Ice is the best “medication” you can administer!When in doubt, sit them out.

HEAD INJURIES

Concussions in Youth Sports

Signs and Symptoms

Signs Observed by Coaching Staff

•Appears dazed or stunned•Is confused about assignments or position•Forgets plays•Is unsure of game, score or opponent•Moves clumsily•Answers questions slowly•Loses consciousness (even briefly)•Shows behavior or personality changes•Can’t recall events prior to hit or fall•Can’t recall events after hit or fall

Symptoms Reported by Athlete

•Headache or “pressure” in head•Nausea or vomiting•Balance problems or dizziness•Double or blurry vision•Sensitivity to light•Sensitivity to noise•Feeling sluggish , hazy, foggy or groggy•Concentration or memory problems•Confusion•Does not “feel right”

ACTION PLAN

•Remove athlete from play•Ensure athlete is evaluated by an appropriate health care professional. Do not try to judge the seriousness of the injury yourself.•Inform the athlete’s parents or guardians about the known or possible concussion and give them the fact sheet on concussion.•Allow athlete to return to play ONLY with permission from an appropriate health care professional.

REMEMBER

NO game is worth risking the irreversible damage

that can occur with recurrent head injury!

INJURIES TO THROAT / AIRWAYSigns and Symptoms

•Bleeding in the mouth or throat•Loss of landmarks due to swelling•Loss of breath, labored breathing•Increased breath sounds•Spitting up blood•Hoarseness**MOST COMMON SIGN•Difficulty swallowing **2nd MOST COMMON•Loss of movement in the laryngeal structures during speech or swallowing

WHAT TO DO

•Remain calm.•Have the player either sit or lie down and apply ice to the sides of the neck to help stop swelling.•DO NOT give anything to drink. The action of swallowing will bring blood to the area and likely cause more swelling.•Monitor the breaths per minute.•CALL 911 – You only have one airway. Airway injury is a true medical emergency! •Be prepared to begin CPR if necessary.

ANAPHYLAXIS

A severe, potentially life-threatening allergic reaction caused by contact with certain foods, medications, insect venom or latex. Anaphylaxis can also be caused by physical exercise.

EXERCISE INDUCED ANAPHYLAXIS

Exercise-induced anaphylaxis is a form of physical allergy. Although the mechanism by which exercise can cause anaphylaxis is unknown, some medications (such as aspirin or ibuprofen) or foods ingested before exercise have been associated with exercise-induced anaphylaxis.

INITIAL SIGNS & SYMPTOMS

•Fatigue•Diffuse warmth•Skin itching•Skin redness•Hives

ADVANCED SIGNS & SYMPTOMS

•Gastrointestinal symptoms (nausea/vomiting)•Swelling of the throat•Loss of consciousness

SIGNS AND SYMPTOMS OF ALLERGIC REACTIONS

•Hives•Swelling of the lips, throat, tongue or around eyes•Difficulty breathing or swallowing•Metallic taste or itching in the mouth•Generalized flushing, itching or redness of skin•Abdominal cramps, nausea, vomiting or diarrhea•Increased heart rate•Rapidly decreasing blood pressure (and accompanying paleness)•Sudden feeling of weakness•Anxiety or overwhelming feeling of doom•Collapse•Loss of consciousness

TREATMENT OF ANAPHYLAXIS

•Once an anaphylactic reaction has begun the most recommended treatment is epinephrine.•Available in epi-pen auto-injectors for both pediatric strength and adult strengths.•Medication effect lasts approximately 10-15 minutes.•Emergency medical care/treatment is necessary.•Anaphylaxis can occur quickly and progress to become life threatening rapidly. It is important that those with known allergies carry and epi-pen and adults supervising be able to administer the medication.

HOW TO ADMINISTER AN EPI-PEN

•Confirm ownership of epi-pen•Check expiration date•Check dose•Grip pen with a closed fist. •Remove cap from end of pen and gently jab the opposite end to the lateral thigh. •Hold in place to the count of 10.•Remove the pen, be sure to withdraw straight out.•Gently massage area of injection.•Call 911 if not already done.

CUTS AND SCRAPES

Minor cuts and scrapes require nothing more than cleaning, drying and covering. You should never apply bacitracin/neosporin ointment on a dirty cut. Let the parents take care of that after the player goes home and cleans the injury well. If the wound can be covered with a simple bandaid be sure to cover the bandaid with tape to be sure it stays on. If the wound needs a larger cover a dry, sterile 4x4 gauze covered with cling then taped is most effective.

LACERATIONS/UNCONTROLLED BLEEDING

If a laceration involves an artery and results in an arterial bleed:

•First, the blood will be spurting with each beat of the heart.• Immediately apply continuous direct pressure to the wound.•Direct someone to call 911; be sure to inform dispatch of the severity of the wound!•Lay the injured player down. •Elevate the injury above the heart.•Keep the player warm and still.•DO NOT RELEASE PRESSURE ON THE WOUND AT ANY POINT!•If bandages soak though with blood add to the top of what you are already holding. Do not remove the soaked bandages to replace with clean, dry bandages.

FRACTURES/MUSCLE INJURIES

What is a fracture?A bone fracture is a medical condition in which there is a break in the continuity of the bone.

What causes a fracture? When outside forces are applied to bone it has the potential to fail. Fractures occur when bone cannot withstand those outside forces.

Remember – a fracture and a broken bone are the same thing.

SIGNS AND SYMPTOMS OF FRACTURES

•Pain and swelling at the fracture site.•Tenderness close to the fracture.•Paleness and deformity (sometimes).•Loss of pulse below the fracture, usually in an extremity (this is an emergency).•Numbness, tingling or paralysis below the fracture (rare; this is an emergency).•Bleeding or bruising at the site.•Weakness and inability to bear weight.

Fractures occur for the following reasons

•Direct blows •Twisting injuries •Falls

The type of forces on the bone determine the type of injury that will occur.

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MUSCLE INJURIESStrain: A strain is an injury to a muscle or tendon, and is often caused by overuse, force, or stretching.

Sprain: A sprain is a wrenching or twisting injury to a ligament. Sprains often affect the ankles, knees, or wrists.

SIGNS AND SYMPTOMS OF A SPRAIN/STRAIN

•Pain in the injured area (The child typically may guard or protect this area from being touched or looked at.) •Swelling in the injured area•Difficulty using or moving the injured area in a normal manner•Warmth, bruising, or redness in the injured area

Symptoms of a strain/sprain can resemble those of a fracture and may require a physician’s evaluation and diagnosis.

TREATMENT FOR A SPRAIN/STRAIN

•Initial treatment for a sprain or strain includes R.I.C.E. (rest, ice, compression, and elevation).•Activity restrictions•Splint/cast•Crutches/wheelchair•Physical therapy (to stretch and strengthen the injured muscles, ligaments, and tendons).•Surgery (especially if the injury is reoccurring or if a muscle, tendon, or ligament is badly torn).

ASSESSING THE INJURY ON THE FIELD

•Whenever possible try and get the player to the sideline.•When evaluating an injury do not try and move the injured body part for the player, allow the player to move it themselves.•Assess the area above and below the injury.•Be sure the player has good sensation over the area of the injury, above and below it.•If the injury involves arms or legs squeeze the fingernail/toenail and be sure it blanches and comes pink again quickly.

TREATING FRACTURES/SPRAINS/STRAINS ONTHE PLAYING FIELD

•Stabilize the injured body part.•ICE, ICE, ICE•If there is no obvious serious injury rest the player and assess again after 5 minutes.•Involve the player’s parents.•If necessary call 911 and transport player to the hospital.

HOW TO TELL THE DIFFERENCE BETWEEN A FRACTURE, STRAIN AND SPRAIN

Unless there is a gross deformity to a limb or joint it is almost impossible to determine if an injury is a fracture, strain or sprain.

When trying to determine if a player can resume play after an injury let the player be the judge. Observe range of motion and the ability of the player to run, handle their stick, move without pain.

INJURY TO RIBS/CHEST

Signs and Symptoms of Broken Ribs

•Mild to severe pain in the injured area. •Pain when you breathe. •Pain around the fracture when someone pushes on your breastbone.

Due to a change in breathing pattern you may also notice•Feel short of breath. •Feel anxious, restless, or scared. •Have a headache. •Feel dizzy, tired, or sleepy.

ASSESSING INJURY TO RIBS/CHEST

•Look at the area of the chest/ribs that has been injured. Check for obvious deformity, bruising, size of injury.•Gently palpate that area: assess for pain, note any crepitus, unequivocal movement of ribs.•Have player take a deep breath while still palpating the injured area. Again note any abnormality. •Have patient cough and report any pain from coughing.

•NOTE: If a player has broken ribs you need to be diligent in observing for other internal injuries such as:•Punctured lung(s) or heart•Lacerated spleen, liver, kidney

TREATING A RIB/CHEST INJURY

Ice to the affected area. Observe player for signs of more serious injury.

PaleDiaphoreticNausea, vomitingWeaknessLoss of consciousnessLarge area of bruising over damaged organRapid pulseChill/shivering

In the event of the above symptoms, call 911. Lay the player down, elevate feet and keep patient warm till ambulance gets there. A lacerated organ is a medical emergency and needs immediate medical care.

HYDRATIONHydration does not start on the playing field. It starts the night before a game. If a player starts the game without having anything to eat or drink before the game they have an empty fuel tank an will not be able to perform at their best. Encourage all players to start hydrating the night before a game with water and gatorade. In the morning before a game be certain the players eat a healthy breakfast and get plenty to drink – this can include water and gatorade. During a game the only liquid a player should be drinking is water or watered down gatorade. Full strength gatorade is too concentrated to provide any benefit.

SIGNS AND SYMPTOMS

•Cramps!!•Nausea/vomiting•Headache•Confusion•Weakness•Dizziness•Tenting of skin•Loss of consciousness

ASTHMA

•Asthma occurs when the airways in your lungs (bronchial tubes) become inflamed and constricted. The muscles of the bronchial walls tighten, and your airways produce extra mucus that blocks your airways.

•Signs and symptoms of asthma range from minor wheezing to life-threatening asthma attacks.

ASTHMA SIGNS AND SYMPTOMS

•Shortness of breath.•Chest tightness or pain. •Trouble sleeping caused by shortness of breath, coughing or wheezing. •An audible whistling or wheezing sound when exhaling. •Bouts of coughing or wheezing that are worsened by a respiratory virus such as a cold or the flu.

TREATMENT ON THE FIELD

•Know your players health history.•If you have an asthmatic player be sure the parents provide a rescue inhaler with the players name and dosing on the package.•Beware of extreme temperatures as an asthma trigger.•If player has a severe attack on the field, call 911 immediately.

DIABETIC REACTIONSigns and Symptoms

•Shaking•Sweating•Blurred vision•Dizziness and confusion•Numbness of the lips •Fast heart rate•Seizures•Pale appearance•Confusion or poor concentration•Loss of consciousness

TREATMENT FOR LOW BLOOD SUGARS

•The emergent treatment for a low blood sugar is to provide the person with 15-20 grams of quick carbohydrates.

•The quick carbs listed next should rapidly raise the blood sugar between 45 and 80 mg/dl depending upon your weight.

QUICK CARBS = 15 mg of carbs

•1 tablespoon of honey•3 BD Glucose Tablets•3 Smartie® Rolls (in cellophane)•4 CanAm Dex4® Glucose Tablets•5 Dextrosols Glucose Tablets •5 Wacky Wafers®•6 SweetTart® (3 tabs/packet)•7 Pixy Stix•8 SweetTarts® (3/4" Lifesaver size)•14 Smarties® (3/4" diameter roll

CONCLUSION

The Good Samaritan Law is out there to protect you, but anyone has the right to sue you. Never, ever attempt to practice medicine outside the scope of your training.When in doubt, call 911. The EMT’s can assess a patient and if the parents do not want the transport they can sign a refusal with the EMT’s. Ice is the best “medication” you can administer!When in doubt, sit them out.