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

FracturesDisruption 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

1.Deformity

2.Weakness

3.Bruise

4.Swelling

5. Positive X-ray

Symptoms

1.Pain

2.Grating sensation

Evaluation

Palpation – deformity, tenderness, indentation

Percussion – pain during tapping

Compression – distal to proximal

Distraction – apply traction

Treatment

Cast? Internal Fixation? External Fixation?

DislocationsBone 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

• Elbow

• Wrist

• Knee

• Ankle

• Lower Back

• Hamstrings

• Gastrocnemius

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

• 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

Elastic Bandage Application

The Skin

• Epidermis

• Dermis

• Hypodermis

Function?!?

Common EmergenciesWounds

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**

b. elevation

c. pressure points

•Use sterile dressing

•Prevent shock

a. raise legs

b. prevent heat loss

•Irrigate wound

•Change dressing regularly

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

Interrupted or Subcuticular?

BurnsClassifications According to DEPTH

• 1st degree redness, epidermis

• 2nd degree blisters, dermis

• 3rd degree charred, subcutaneous

Determine the depth!!

What are the causes?

Burn Severity

Remember the Rule of NinesAdult

Anatomic structure Surface area

Head 9%

Anterior Torso 18%

Posterior Torso 18%

Each Leg 18%

Each Arm 9%

Perineum 1%

Anatomic structure Surface area

Head 18%

Anterior Torso 18%

Posterior Torso 18%

Each Leg 14%

Each Arm 9%

Perineum 1%

Child

Determine extent of burned area!!

Burn SeverityDetermine location of burned area!!

• Face

• Hands and Feet

• Genital Area

• Joint Area

Burn SeverityLook 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”