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RSAT 215 Final
RSAT 215 Sports Emergency Care Final OU
| Question | Answer |
|---|---|
| parts of an EAP | implementation, personnel, equipment, communication, transportation, venue, emergency care facilities, documentation, NATA positions |
| normal pulse | 60-100 bpm |
| tachycardia | >150bpm. indications shock |
| bradycardia | <60bpm. indications head injury; respiratory/cardiac arrest |
| pulse deficit | radial pulse<pulse @ heart |
| palpable pulses | carotid=60 mm hg femoral=70 mm hg radial=90 mm hg |
| normal respiration | 12-20 (1 in & 1 out = one) |
| normal pulse pressure | 120-80=40 |
| avpu | alert, pain, verbal, unconsciousness |
| contradictions to neutral neck position | increased pain, neurological s/sx, spasm, airway compromise, physically difficult, resistance, patient apprehension |
| when to remove helmet | if cannot remove face mask, airway is not maintained, doesn't fit, prevents immobilization |
| when to remove pads | when helmet comes off, full shoulder access is required, improper fit |
| reasons for oxygen use | cardiac/respiratory distress, hypoxia, unresponsive patient, injury to torso/CNS, severe bleeding |
| epidural hematoma s/sx | initial: headache, nausea, unequal pupils, disorientation later: drowsiness, neck rigidity, altered consciousness, increased BP, decreased pulse, cranial nerve dysfunction, sleepiness. |
| subdural hematoma s/sx | initially lucid, possible LOC, headache, dizziness, nausea, sleepiness, cranial nerve dysfunction, impaired cognitive/behavioral/motor skills |
| inter cranial hematomas management | CT or MRI. possibly surgery required to relieve pressure |
| types of skull fractures | depressed(indentation toward brain), non depressed(minimal indentation), linear(runs circumference), comminuted(multiple fragments), and basal(base of skull) |
| zurich concussion statement | abandon the "simple vs complex" terminology when referring to concussion |
| RTP protocol | no activity, light aerobic activity, sport specific exercise, non contact training drills, full contact practice, RTP |
| concussion s/sx | vacant stare, delayed verbal/motor response, inability to focus, disorientation, slurred speech, gross incoordinations, heightened emotions, and memory deficits |
| reason to refer a concussion | LOC, amnesia>15min, decreased respiration, increased BP, negative pupillary assessment, cranial nerve deficits, seizure activity,vomiting, bony injuries |
| type of heat illness | *order of severity heat rash heat cramps heat syncope heat exhaustion heat stroke |
| heat stroke s/sx | slight to profuse sweating, red/hot skin, tachycardia/strong pulse, rapid respiration, high BP |
| predisposing risk factors | large BMI, age, conditioning level, poor hydration, prev hx, medications, motivation level, pre-existing illness, environmental conditions, alcohol and drug use. |
| prevention of heat illness | proper nutrition, proper rehydration, avoidance or environmental extremes, appropriate clothing, rest periods, acclimation |
| golden 1/2 hour | get below 104 degrees in 30 min |
| TTP rule | Temporary physiologic impairment, Predisposition still exist, Peers have improved acclimatization. |
| top 5 predisposing factors to heat illness (doug casa) | 1) intensity of exercise 2) environmental factors 3) fitness level/acclimatization 4) equipment 5) hydration status |
| %carbohydrates for proper rehydration | 6% (14g per 8oz) |
| sample | s/sx, allergies, medications, past medical hx, last intake, events leading/examine |
| dcapbtls | deformities, contusions, abrasions, punctures, burns, tender, lacerations, swelling |
| opqrst | onset, provocation/palliation, quality of pain, region/radiation, severity, time |
| 7 types of shock | anaphylactic, septic, neurogenic, psychogenic, metabolic, cardiogenic, hypovolemic |
| number of sickle cell trait deaths in past 7 years | 9 |
| benign cause of syncope | dehydration |
| rule of 100 | pulse below BP above temp below |
| measuring hydration | urinanalysis (usg, reagent strips), urine volume, urine color chart, refractometer, weight chart |
| prevention of cold illness | clothing, shelter, hydration/diet, education, EAP, PPE for past med hx. |
| predisposing factors for cold illness | body size/comp, medical conditions, previous hx, black, female, clothing choice, drug use |
| treatment for cold illness | remove wet clothing, warm the trunk first. water immersion for frostbite. |
| cold illness factors | wind and cold. affects CNS, cardiac, respiratory, and renal |
| mild hypothermia s/sx | 98.6-95 degrees, shivering, polyuria, decrease in fine motor skills, lethargy, normal BP, conscious. |
| moderate hypothermia s/sx | 94-90 degrees, fainting, decreased pulse/respiration/BP, shivering stops, disorientation/LOC, slurred speech, gross motor skill loss |
| severe hypothermis s/sx | below 90 degrees, unconscious, decreased HR/respiration, rigidity |
| progression of shock 1-8(16 steps from midterm) | 1.injury 2.rapid pulse 3. athlete is anxious, restless, and in severe pain 4.bleeding continues 5.pulse rapid/weak 6.decreased BP 7.athelete becomes thirsty 8.BR increases |
| progression of shock 9-16 | 9.blood pulled from periphery 10.pale/cold 11.blood pulled from vital organs 12.vital organs w/o oxygen 13.athlete will be lightheaded, dull/vacent pupils, drowsy 14.athlete may LOC 15.pulse is undetectable 16.severe state of shock |
| sudden cardiac arrest | sudden, abrupt loss of heart function in a person who may or may not have diagnosed heart disease |
| hypertrophic cardiomyopathy s/sx | chest pain, dyspenea, exercise intolerance, syncope, palpitations, 1st symptom usually SCA |
| commotio cordis | unresponsive w/ no pulse. 90% occur under 16 yoa |
| myocardial infarction s/sx | chest pain/pressure/ache, profuse sweating, breathing difficulty, nausea, dizziness, radiating pain. |
| cerebrovascular accident (stroke) s/sx | numbness, decreased function, sudden severe headache, vision problems, uneven pupils, LOC, balance problems, confusion, loss of bowel/bladder control, difficulty speaking. |
| cardiac tamponade (compression of heart's ventricle) s/sx | jugular vein distension, hypotension, tachypnea, muffled heart sounds, paradoxical pulse(lose on inspiration), s/sx of shock. |
| myocarditis | exercise intolerance, syncope, cough, palpitations, chest pain, persistent tachycardia |
| orthostatic blood pressure | sudden low BP when someone stands up after a period of rest. last < 3min. |
| asthma attack s/sx | wheezing, coughing, chest tightness/pain, shortness of breath, difficulty w/ expiration, increased respiration w/ intercostals/abdominals |
| asthma water loss theory | loss of water in the epithelium of the airway changes the ph, temp and osmolarity causing bronchoconstriction. |
| asthma heat exchange theory | higher minute ventilation=more air that needs warming=cooler airway. rapid rewarming causes EIA and bronchospasm |
| rescue medications for asthma | beta 2 agonist (albuterol) last 4-6 hrs |
| non-rescue medications for asthma | mast cell stabilizers: prevents release of histamine and anti-inflammatory. corticosteroids: stronger anti-inflammatory. both prophylactic |
| asthma referral | after first asthma attack and if relying on inhaler for 3 to 4 puffs a day |
| asthma triad syndrome | asthma, nasal polyps, aspirin allergy |
| flash to bang theory | # of sec (b/w lightning and thunder)/5. _< 6miles=inherent danger. _<3miles=seek immediate shelter |
| lightning procedure if stuck outside | crouch down, balls of feet, head down, cover ears. do not lay flat. |
| mechanisms of lightning injury | direct, contact, side flash, ground current, blunt injury |
| Lightning RTP | 30 past last thunder/lightning. 30-30 rule. 30 sec flash to bang=off field. 30 min wait after storm=RTP |
| lightning fun facts | storms avg 25mph. #2 cause of death by weather. most common may to sept from 10 am to 7pm. approx 400 injuries. |
| sickling | occurs if oxygen in blood drops. sickled cells clump and block blood flow to vital organs and muscles. |
| rhabdomyolysis | break down of muscle fibers. can be acute or exertional |
| risk factors for sickling | heat/dehydration, drugs, altitude, timed running, sprints>500 meters, asthma, prolonged intense exercise w/o rest. |
| sickling vs heat illness | heat cramping is more painful and produces muscle twinges. cramps lock the muscle up while sickling muscle just go weak. response is more violent to cramps, sicklers often just lay limp |
| types of ankle dislocation | posterior, anterior, lateral, superior |
| anterior compartment syndrome s/sx | numbness in dorsum of foot, achy/sharp or dull pain on anterolateral lower leg, muscle tightness, cramping, swelling, dorsiflexion weakness, inability to exercise, glossy/waxy skin. |
| syncope | unconsciousness followed by quick recovery. s/sx: unresponsive, pale/cool skin, rapid/weak pulse, increased RR, low BP |
| stupor | decreased state of mental activity/awareness. causes: head injury, shock, drug abuse, heat illness, hypoglycemia, hyperglycemia |
| coma | deep state of unconsciousness w/ no response to stimuli. causes: serious loss of brain function/head injury, drug abuse, diabetic reaction, hemorrhage. |
| seizures | recurrent paroxysmal disorder or cerebral function characterized by sudden brief attacks of altered consciousness, motor activity, sensory phenom, or inappropriate behavior. caused by: epilepsy, head injury, fever, hypoglycemia, poisoning. |
| seizure s/sx | aura signs: dizzy, feeling of warmth, metallic taste. "pot-ictal" is the transition back to normal state. |
| epilepsy | petit mal=5 to 15 sec. grand mal=a few minutes. s/sx: tense up(tonic) and collapse, muscle contractions(clonic), unconscious. |
| reasons to call EMS for seizures | no previous hx, last longer than r min(30+ =status epilepticus), recurrent seizures, injured during, no return to normal consciousness, or resulted from another injury. |
| EEG | electroencephalogram. records brain waves. |
| herpes zoster (shingles) | follows a nerve root pattern. s/sx: unilateral pain/tingling, reddening of skin w/ blisters, grouped/dense blisters that ooze and crust. antiviral medication |
| abscess | enclosed collection of pus. can be septic (common) or sterile. s/sx: throbbing pain at site, malaise, fever, pus-filled, bright red/tender upon palpation. |
| formation of abscess | 1.germs invade 2.blood flow/temp increases 3.swelling 4.turns red 5.irritation from swelling an chemical activity hurts 6.heat, swelling, redness, pain 7. tissue turns to liquid and abscess forms. |
| furunculosis(boil) | external abscess. infection of hair follicle. antibiotics |
| carbuncle | external abscess. bigger,deeper,more. surgical drainage and antibiotics. |
| cellulitis | bacterial. diffuse inflammatory response within solid tissues, s/sx: red streaks extending from patch, pain, edema, redness. |
| pediculosis | head louse. survive 55 hours on scalp. NIX shampoo for tx. |
| MRSA(methicillin-resistant staphylococcus aureus) s/sx | pain, redness, swelling, drainage, fever, shortness or breath, malaise, chest pain, change in mental status. |
| MRSA risk factors | colonizes in nostrils. CA:young age, contact sports, weakened immune system, crowded unsanitary conditions. HA: current/recent hospitalization, living on long term care facilities, invasive devices. |
| MRSA treatment | drain. culture. keep clean. cover wounds(pack if big). |
| heart auscultations | 1.intercostal right of sternum 2.intercostal left of sternum 3.4th/5th intercostal left of sternum 4.cuspal region |
| thorax auscultations | listen from back(upper and lower lobes). absence=collapsed lung. rales=build up of fluid. wheezing=asthma. rhonchi=pneumonia |
| abdomen auscultations | done before palpation. absent=injury. high pitched=intestinal obstruction. gurgling=normal |
| palpation of heart | under 5th rib in 5th intercostal space along the midclavicular line. patient comfort position |
| palpation of thorax | symmetry of chest(flail chest). TTP around intercostal spaces. AP compression(rib fx). transverse compression(costochondral injuries) |
| palpation of abdomen | light to deep. start away from pain and work clockwise. percussion. RUQ, LUQ, RLQ, LLQ. hook method may be used. |
| mediastinum | heart, aorta, trachea, esophagus, superior/inferior vena cava. |
| decerebrate vs decorticate | brainstem(more severe)/extension vs abnormal flexion |
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