3 Quarter Notes

3rd 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

Fractures Disruption 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

Symptoms

1. Deformity

1. Pain

2. Weakness

2. Grating sensation

3. Bruise 4. Swelling 5. Positive X-ray

Evaluation Palpation – deformity, tenderness, indentation Percussion – pain during tapping Compression – distal to proximal Distraction – apply traction

Treatment

Cast? Internal Fixation? External Fixation?

Dislocations Bone 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

• Lower Back

• Elbow

• Hamstrings

• Wrist

• Gastrocnemius

• Knee • Ankle

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

Elastic Bandage Application • 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

The Skin • Epidermis • Dermis • Hypodermis Function?!?

Common Emergencies Wounds 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**

• Prevent shock a. raise legs b. prevent heat loss

b. elevation

• Irrigate wound

c. pressure points

• Change dressing regularly

• Use sterile dressing

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

Interrupted or Subcuticular?

Burns Classifications According to DEPTH • 1st degree

redness, epidermis

• 2nd degree

blisters, dermis

• 3rd degree

charred, subcutaneous

Determine the depth!! What are the causes?

Burn Severity Determine extent of burned area!! Remember the Rule of Nines Adult

Child

Anatomic structure

Surface area

Anatomic structure

Surface area

Head

9%

Head

18%

Anterior Torso

18%

Anterior Torso

18%

Posterior Torso

18%

Posterior Torso

18%

Each Leg

18%

Each Leg

14%

Each Arm

9%

Each Arm

9%

Perineum

1%

Perineum

1%

Burn Severity Determine location of burned area!! • Face • Hands and Feet • Genital Area • Joint Area

Burn Severity Look for complicating factors!! • Below 5 years old (fluid loss) • Above 55 years old (delayed healing) • Diabetes (delayed healing) • CVD (hypoperfusion)

BURN SEVERITY CLASSIFICATION CRITICAL • 3rd degree burn involving hands, feet, face, or genitals • 3rd degree burns covering more than 10% • 2nd degree burns covering more than 20% • burns encompassing a body part MODERATE • 3rd degree burns covering 2%-10% • 2nd degree burns covering 20%-30% • 1st degree burns greater than 50%

FIRST AID • Stop the burning process (HOW?) • Remove clothing / jewelry • Transport if critical / moderate • Do not drain the blisters • Take analgesic • Cover with “burn sheet”