LIFE THREATENING SITUATIONS
•ENSURE SAFETY:
• MAKE SURE THE SCENE IS SAFE
• ASK THE ATHLETE IF YOU CAN HELP
• CALM THE ATHLETE AND ADVISE THEM NOT TO MOVE
• DO NOT MOVE THE ATHLETE UNLESS THEY ARE AT RISK OF FURTHER INJURY
•DO NOT REMOVE ANY OF THE ATHLETE’S EQUIPMENT – ESPECIALLY
DO NOT MOVE THE HEAD OR NECK
•PROTECT YOURSELF WITH BARRIERS SUCH AS RUBBER GLOVES
OR VENTILATING MASK
•ESTABLISH A CONTROL PERSON
•ASSESS CONSCIOUSNESS
• IS THE ATHLETE:
• ALERT AND ORIENTED?
• CONFUSED AND DISORIENTED?
• RESPONDING APPROPRIATELY TO VERBAL COMMANDS?
• RESPONDING TO TOUCH?
• OBTUNDED – UNRESPONSIVE TO VERBAL COMMANDS, MUMBLING OR
MOVING LIMBS WITHOUT PURPOSE?
• UNCONSCIOUS AND UNRESPONSIVE
•ASSUME A NECK INJURY
• IF UNCONSCIOUS – ASSUME A NECK INJURY
• IF THERE IS SIGNIFICANT COMPLAINT OF NECK PAIN
• DO NOT MOVE THE ATHLETE’S HEAD OR NECK
• STABILIZE THE NECK IN THE POSITION FOUND
STABILIZING NECK
•ACTIVATE EMERGENCY ACTION PLAN
• SEND A CALL PERSON TO CONTACT EMERGENCY MEDICAL SERVICES AND
HAVE THEM REPORT BACK TO YOU!
PRIMARY SURVEY
•ABC’S
•ASSESS AIRWAY (A)
• LOOK FOR OBSTRUCTIONS IN THE MOUTH (MOUTH GUARDS, GUM OR ATHLETE’S OWN
TONGUE
• DO FINGER SWEEP
• IF OBSTRUCTION CAN NOT BE CLEARED WITH SWEEP – ABDOMINAL THRUSTS MAY BE
USED
• CAUTION IF NECK INJURY IS SUSPECTED
•ASSESS BREATHING (B)
• LOOK, LISTEN, FEEL
• LOOK TO SEE IF THE CHEST IS RISING AND FALLING
• LISTEN FOR BREATH SOUNDS
• FEEL FOR BREATH FROM MOUTH OR NOSE AGAINST YOUR CHEEK
•ASSESS CIRCULATION (C)
•DOES THE ATHLETE HAVE A PULSE?
•CONTROL ANY BLEEDING WITH DIRECT PRESSURE
•LOOK FOR LACK OF CIRCULATION – COLD OR BLUE/GREY COLOR
OF LIMBS
SECONDARY ASSESSMENT
•ONLY TO BE DONE WHEN THE ATHLETE :
• HAS AN OPEN AIRWAY
• IS BREATHING SATISFACTORILY
• HAS A GOOD PULSE AND BLEEDING IS UNDER CONTROL
• IF THE PATIENT BECOMES UNRESPONSIVE, REVERT TO THE PRIMARY
SURVEY
• COMPLETE THE SECONDARY SURVEY IN THE POSITION THE ATHLETE WAS
FOUND AND AVOID MOVEMENT THAT COULD AGGRAVATE AN INJURY
• A FULL HEAD TO TOE EXAMINATION MAY BE NEEDED IF THE INJURY WAS NOT
SEEN OR THE ATHLETE’S CONSCIOUSNESS WAS IMPAIRED
SECONDARY ASSESSMENT
SECONDARY ASSESSMENT (H.I.T.)
• H – HISTORY – LOCATION OF INJURY, MECHANISM OF INJURY, SYMPTOMS OF INJURY
• I – INSPECTION – LOOK AT INJURY SITE FOR SIGNS OF INJURY, CHECK FOR FUNCTION OF LIMB OR JOINT
• T – TOUCH – FEEL (PALPATE) THE INJURED AREA TO CHECK FOR:
- POINT OF MAXIMAL TENDERNESS
- DEFORMITY
- INSTABILITY
- SWELLING
- TEMPERATURE DIFFERENCES
HISTORY – WHAT TO ASK
• WHAT HURTS? WHERE EXACTLY DOES IT HURT?
• DOES PAIN RADIATE TO OTHER AREAS?
• DESCRIBE THE PAIN (SHARP, DULL, BURNING, THROBBING, ACHING)
• HOW INTENSE IS THE PAIN (SCALE OF 1-10)
• ANY PREVIOUS INJURIES OR SURGERIES TO THIS AREA?
• HOW EXACTLY DID IT HAPPEN?
• TINGLING, NUMBNESS, HEARING A POP OR SNAP, HEADACHE, BLURRY VISION, LIGHTHEADED
INSPECTION – VISUAL CHECK
• BLEEDING – SLOW OR PROFUSE? COLOR – BRIGHT RED (ARTERIAL – LIFE
THREATENING)
DARK (VENOUS) SERIOUS BUT NOT LIFE THREATENING
• SKIN CHANGES – BRUISING, CUTS, ABRASIONS, REDNESS
• DEFORMITY – COMPARE TO THE UNINJURED SIDE, ABNORMAL BULGING
INSPECTION – HEAD/NECK/CHEST
• EYE INJURY – BLOOD IN EYE, FOREIGN OBJECT, ROLLED CONTACT LENS
• TOOTH INJURY – MISSING, CHIPPED, BROKEN
• PUPIL RESPONSE TO DIRECT LIGHT – ABNORMAL IN HEAD/EYE INJURY
• RAPID BREATHING – HIGHER THAN 20 BREATHS PER MINUTE IN ADULTS OR WHEEZING,
GASPING OR CHOKING
• CHEST BRUISING OR SIGNS OF BROKEN RIBS
TOUCH
• DO NOT CAUSE EXCESSIVE PAIN TO THE ATHLETE
• START PALPATION (GENTLE PRESSING) AWAY FROM THE INJURY SITE AND MOVE
TOWARDS IT TO ESTABLISH EXACTLY WHAT IS INJURED
• SKIN IS DOUGHY – INFLAMMATION. WARMTH INDICATES INFLAMMATION, COOL
INDICATES POOR CIRCULATION
• RANGE OF MOTION – ONLY IF THE ATHLETE IS NOT EXPERIENCING TOO MUCH PAIN
DO NOT MOVE THE LIMB IF YOU SUSPECT A BROKEN BONE
TOUCH
• CREPITUS – FEELING OF CRUNCHING OR GRINDING THAT CAN SOMETIMES BE FELT IF
THERE IS A BROKEN BONE
• PULSE – NORMAL RANGE IS 60-100 BEATS PER MINUTE. SERIOUS INJURY CAN CAUSE
SIGNIFICANT CHANGES TO PULSE RATE