• Injury and Illness Prevention
• Injury and Illness Recognition and First
Aid
• Assessment/Diagnosis and Treatment
• Rehabilitation

• Many make up a successful Sports Medicine
Team, each must know and stay within their role.
– Athlete
– Coach
– EMT/Paramedic
– Physicians
– Athletic Trainer
– Physical Therapist
– Dentist/Oral Surgeon
– Optometrist
– Strength and Conditioning Coach
– Equipment Manager
– And more….

• Proper planning and instruction
• Warn of inherent risks
• Provide a safe physical environment
• Proper equipment
• Match up appropriately
• Recognize injuries or incapacity
• Supervise activity closely
• Provide appropriate medical care

– Varies greatly depending on level of play.
– PPE and Liability Forms
• See COC Athletics for example
– Weather
– Facilities
– Conditioning
– Equipment/Bracing
– Correct Skill Instruction
– Nutrition

• Trained Personnel
– Credentials
• 1st Aide
• CPR
• ATC
• EMT
• MD
– Emergency Care Equipment
• Field Kits
• Splint Bags
• Stretcher
• Biohazard

• Emergency Transportation
– Transportation Vehicles
– Ambulance & Paramedics
– School personnel
• Communication System
– Equipment
• radios
• telephones
• on-the-scene transfer of information
– Notification
• ER & Urgent Care
• Parents
• Administrators

• Emergency Care Facility
– Hospitals
• Services Offered
• Locations
– Legal Considerations
• Group Health Care Plan Facilities
• Emergency Care Protocol
– Chain of Command
• Assignments and responsibilities
• on the scene care
• telephone emergency
• Map (directions)

– Mock Drills
• Be Prepared
• Record Keeping
– Accident Report
– Emergency Cards
– Documentation

• Must give dispatcher following information
– Type of emergency situation
– Type of suspected injury
– Present condition of athlete
– Current assistance being given (CPR, ect)
– Location
• telephone
• cross streets
• how to enter facility

• On The Field
– Primary Survey
• ABCs
• Bleeding/Shock
– Secondary Survey
• Vitals
• Signs & Symptoms

– Note Body Position
– Determine level of consciousness
– ABCs
– Neck & Spine
– Do not remove helmet (face mask o.k.
– Establish Airway
– If prone and no breathing, role over
(supine)
– If prone and breathing, do not role over
– When consciousness gained, log roll to spine board
– Maintain Vitals until EMS arrives
– Athlete is stabilized, 2ndary survey

• External Bleeding
– Direct Pressure
– Elevation
– Pressure points
• Brachial/Femoral

• Can occur with any injury
• Most likely in
– severe bleeding
– internal injury
– fractures
• Definition
– Not enough blood available to circulatory system

– Dilation of blood vessels & imbalance of osmotic pressure
• Shock if untreated can cause DEATH
• Risky Conditions
– extreme fatigue
– extreme temperature
– extreme dehydration
– illness

• Signs & Symptoms
– Skin
• Moist, pale, cool, clammy skin
• Weak & rapid pulse
• Increased & shallow breathing
• decreased b.p.
• extreme thirst

• Treating Shock
– Maintain body temperature
– Elevate Feet
• Unless head & neck
– If psychogenic, do not allow athlete to see injury
– Do not over react, but confident & in control.

• Pulse
– 60-80 in adults
– Account for activity
– 80-100 in children
• Respiration
– 12 in adults
– 20-25 in children
• Blood Pressure
• Temperature
• Skin Color

• Blood Pressure
– Systolic over diastolic
– 120/80
• Temperature
– 98.6
• Skin Color
• Pupils
– shock, heatstroke, hemorrhage
– stimulants

• State of Consciousness
• Movement
– Head Injury
– Stroke (cerebrovascular accident)
– Abnormal Nerve Response
• Nerve damage
• blocked artery
• spinal cord injury
• head injury

• Bones
– Shape, support, protect
• Joints
– When 2 bones meet
• Ligaments
– Bone to bone
• Tendon
– Muscle to bone
• Cartilage
– Absorb force and reduce friction in a joint
• Muscles
– Shorten to cause movement
• Bursa
– Small, fluid filled sacs for reduce friction

• Neurological
– Body’s control center
• Digestive
– Energy Supply
• Respiratory and Circulatory Systems
– Oxygenated blood
• Urinary System
– Remove waste from blood.

23
• Muscle/tendon injuries
– injured by excessive tension
– muscle/fascia injuries occur during eccentric contraction
– tendons are strong -- 8700 to 18,000 lb./sq. inch.
– strains occur most often at the musculotendinous junction (MTJ)
– MTJ strains -- most common soft tissue sports injuries

24
• Critical Force:
– Defined: How much force can tissue withstand
– Varies for each type of tissue
– May vary within the same tissue, depending upon:
• age
• temperature
• skeletal maturity
• gender
• body weight

25
• The inflammatory process
– Whenever damaged, the body reacts with a predictable sequence of physiologic actions, commonly called “swelling.”
– begins during the first few minutes following an injury

• Acute injury - “injury characterized by rapid onset, resulting from a traumatic event”
• Acute injuries typically involve trauma followed by pain, swelling and loss of function.
• Critical force -- “magnitude of a single force for which the anatomical structure of interest is damaged”

• Chronic injury - “injury characterized by a slow, insidious onset, implying a gradual development of structural damage”
• Chronic injuries develop over time and are often associated with repetitive, cyclic activities, such as running.
• These injuries are commonly called
“overuse injuries.” Common sites include the Achilles tendon, patellar tendon and the rotator cuff.

• 1. Stop Bleeding
– Direct Pressure with gauze (if available)
– Stack gauze, do not remove it.
– Pressure points in severe cases (arteries)
• Clean with soap and water, irrigate with water, 5 min if possible
• Ointment (neosporin, triple antibiotic, etc.)
• Cover with band aide or other non stick product.
• Stitches?
– ½ inch long or skin does not naturally come

• Sprains - injuries to ligaments (three levels)
– 1 st degree: Slightly torn ligament
– 2 nd degree: Significantly torn ligament
– 3 rd degree: Completely torn ligament
• Strains - injuries to tendon, muscle or musculotendinous junction (Same 3 levels as above)
• Contusions - commonly called a bruise

• Fractures - break or crack in bone -- two types: closed and open
• Stress fracture - break or crack in a bone which develops over a relatively long time period
• Dislocations - the displacement of contiguous surfaces of bones comprising a joint -- two types:
– subluxation - partial
– Luxation or dislocation - total displacement

– Chronic Muscle Strain
• Repetitive straining
– Tendonitis
• Irritated tendon, inflamed
– Bursitis
• Inflamed Bursa
• With all chronic injuries, its important to discover what changed.