Sports Medicine Essentials, 3e - xix

xix

Contents

CHAPTER 4

|

73

Emergency Preparedness and Assessment

Patients who are unconscious must always be treated as if they have a head or
spine injury. Stabilize the patient's head and neck immediately with blankets or pillows and take all precautions. Monitor the patient's vital signs until EMS arrives.
Note the amount of time the patient was unconscious, and give the information to
the EMS personnel. If the patient regains consciousness, keep the patient calm while
maintaining the head and body position until EMS arrives.

THINKING IT THROUGH
It was the first game of
the season and the team
was playing at St. O'Leary
High School. In the third
quarter, Germane, the
starting defensive back, hit the running
back head on, went down in a lump, and
didn't move. Terry, one of the athletic training students, accompanied the head athletic trainer, Mr. Hill, out to the injured player,
who was face-up. Mr. Hill checked his vital
signs. The vitals were good, but Mr. Hill
was concerned about Germane's neck.
Mr. Hill stabilized Germane's neck while
Terry used a Trainer's Angel to remove the
face mask. If things took a turn for the
worse, they would at least have unobstructed access to Germane's airway.
This was all very scary, but Terry knew
what she had to do because they had
practiced this very scenario many times
and she was ready for cases like this. They
went to work without even thinking twice.

THINKING IT THROUGH
By reading the scenarios and answering the questions, you
will apply your knowledge of chapter concepts to actual
situations while enhancing your critical thinking skills.

As soon as Mr. Hill put his hands to the athlete's head, the athletic training students
went about the jobs they were trained
to do in situations like this: Terry stayed to
assist Mr. Hill; Emily went to activate EMS
and show them in; and Justin went to get
Germane's insurance information.
The next day Germane was fine. He
had been taken to the hospital for x-rays
and further evaluation. All the athletic
training students met with Mr. Hill and
walked through what had happened
the previous day. It was a great feeling
to know that all the practicing they had
done, which had seemed kind of boring
at the time, was well worth it.

Why was it a good thing that the injured football player was face-up? Why is
it important to have a plan for activating
EMS? What are the benefits of reviewing
the plan of action before and after an
emergency situation has taken place?
■

THE SECONDARY SURVEY

CHAPTER 4

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Emergency Preparedness and Assessment

The secondary survey is a head-to-toe physical assessment that is done on patients
to determine the extent of illness or injury. Some injuries and illnesses are obvious,
but some are not so obvious. A head-to-toe assessment, or secondary survey, will help
in locating all major injuries. Ideally, this shouldn't take much time, but do not feel
rushed. This survey will determine if the injured player will be allowed to leave the
field independently, with assistance, or if EMS is required. If it is determined the athlete will be lying on the field for any amount of time, a blanket or shade should be
placed over or around the patient depending on the weather condition and the patient's

79

Asking about the injury provides information about the nature and location of
the injury. Visually observing the injured area before feeling (palpating) it can avoid
causing the athlete unnecessary pain and help determine the need for protective
gloves before continuing with the assessment. Finally, performing palpation prior
to stress testing can supply information to help prevent further injury. For example,
in a compound fracture bone ends sometimes slip back beneath the skin, hiding the
severity of the injury. By first asking questions, then looking at the injury, and then
feeling for breaks in the skin, one can determine the possibility of such a fracture and
avoid unnecessary movement of the injured body part that might lead to additional
complications.

secondary survey
A head-to-toe
physical assessment;
an additional
assessment of a
patient to determine
the existence of any
injuries other than
those found in the
primary survey.

MOVEMENT OF THE ATHLETE
Provide any necessary emergency first aid before moving the athlete. If the athlete
shows any symptoms that indicate a head or spinal cord problem, such as paralysis,
leave the athlete in the position produced by the incident (if breathing) and protect
the head and neck until EMS arrives. The one exception to this rule is if the spineinjured patient is not breathing. In this case, stabilize the spine, turn the patient carefully using the log-roll procedure, and begin CPR while waiting for EMS to arrive.
(See Chapter 7.)
If the athlete has no symptoms that indicate a head or neck injury, the person may
be assisted to a sitting position. Reevaluate the situation while the athlete is seated,
checking for dizziness and evaluating the athlete's coherence. Bring the patient to a
standing position, and recheck to make sure there is no change in signs or symptoms.
This will give the athlete a chance to relax and confirm that dizziness or faintness is
not a problem. If everything appears to be all right while the athlete is standing, assist
the athlete back to the bench for a better assessment of the injury. If at any time the
signs and symptoms change, help the patient lie down and call EMS.

CHAPTER SUMMARY

E

verything addressed in this chapter, as well as in other chapters in this book,
will help in the preparation to provide quality care to athletes and patients.
Practice these newly learned skills frequently. These skills must become second
nature. When an emergency arises, there will not be time to refer to a book
to look up what is supposed to be done. Do not ever guess at the correct way to
approach an injury! Remember, people will be relying on your help. Take the time
not only to learn this information, but also to understand why it is necessary to perform these tasks in a particular way. This will increase self-confidence and ability to
competently take care of injuries when they happen-and they do happen!
Make sure that the entire sports medicine team is aware of the emergency action
plan and its importance. Practice this plan frequently, involving as many athletes
and members of the sports medicine team as possible. Anticipate how conditions
of the emergency action plan might be affected during night or weekend use of the
facilities.

paralysis
Loss of sensation
and movement over
an area of the body
because of nerve
damage.

CHAPTER SUMMARY
The chapter summaries provide an overview and summation
of the main learning outcomes within the chapter.

80

CHAPTER 4

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Emergency Preparedness and Assessment

STUDENT ENRICHMENT ACTIVITIES
Complete the following sentences.
1. The primary survey is an initial assessment of _________, _________, and

_________.
2. The _________ _________ is a head-to-toe injury assessment.
3. HOPS is an acronym for _________, _________, _________, and _________

tests.
4. In an unconscious patient with a closed airway, the _________ maneuver

STUDENT ENRICHMENT ACTIVITIES
As a method of reviewing a chapter, answer this series of questions. These activities will stimulate your learning and allow you
to synthesize and evaluate the knowledge gained when you study
each section.

should be used to open the airway.
5. After approaching a downed athlete and finding that he is unresponsive, you

should begin the _________ _________ immediately.
6. The face mask of a potentially neck-injured football player can be removed

safely using the _________ _________ or _________ _________.
7. When you place an emergency phone call, the EMS will need all of the

following information, except
A. the first aid being provided.
B. the exact location of the injured athlete.
C. your address.
D. where you will meet the EMS team.
8. If a patient is not breathing, the correct procedure is to

A.
B.
C.
D.

call for help, begin rescue breathing, and clear the airway.
call for help, clear the airway, and begin rescue breathing.
begin rescue breathing, clear the airway, and call for help.
notify your supervisor.

9. If an athlete is face-down, is not breathing, and has no pulse, you must do

which of the following before beginning CPR?
A. Perform a log roll.
B. Attempt to revive the athlete with an inhalant.
C. Remove the athlete from the field.
D. None of the above
10. If you see an injury occur and the athlete is responsive, you will most likely

A.
B.
C.
D.

perform a primary survey and secondary survey.
perform only a secondary survey.
perform only an isolated injury assessment.
perform an isolated injury assessment, followed up with a secondary
survey if the athlete shows symptoms of additional injury during your
assessment.

xix



Table of Contents for the Digital Edition of Sports Medicine Essentials, 3e

Contents
Sports Medicine Essentials, 3e - Cover1
Sports Medicine Essentials, 3e - Cover2
Sports Medicine Essentials, 3e - A
Sports Medicine Essentials, 3e - B
Sports Medicine Essentials, 3e - i
Sports Medicine Essentials, 3e - ii
Sports Medicine Essentials, 3e - iii
Sports Medicine Essentials, 3e - iv
Sports Medicine Essentials, 3e - Contents
Sports Medicine Essentials, 3e - vi
Sports Medicine Essentials, 3e - vii
Sports Medicine Essentials, 3e - viii
Sports Medicine Essentials, 3e - ix
Sports Medicine Essentials, 3e - x
Sports Medicine Essentials, 3e - xi
Sports Medicine Essentials, 3e - xii
Sports Medicine Essentials, 3e - xiii
Sports Medicine Essentials, 3e - xiv
Sports Medicine Essentials, 3e - xv
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Sports Medicine Essentials, 3e - xvii
Sports Medicine Essentials, 3e - xviii
Sports Medicine Essentials, 3e - xix
Sports Medicine Essentials, 3e - xx
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