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Splinting and Sports Injuries CME 2007


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Splinting and Sports Injuries CME 2007

  1. 1. Sports Injury and Splinting Clem Marshall Stephen Rosenberg
  2. 2. What is the most dangerous sport? Cheerleading
  3. 3. What will we see in EMS? <ul><li>Soft Tissue Injuries </li></ul><ul><li>Bony Injuries / Dislocations </li></ul><ul><li>3) Sprains and Strains </li></ul><ul><li>4) Head and Spinal Trauma </li></ul>Also, non traumatic problems including cardiac problems, dehydration, asthma exacerbations
  4. 4. Mechanisms of Injuries An object: Baseball, ice skate, etc. Collision: With another player, with a goalpost, wall, etc. “ Self Inflicted” Fall, sprains/strains, etc.
  5. 5. Soft Tissue Injury <ul><li>What are the types of Soft Tissue Injuries? </li></ul><ul><li>Open </li></ul><ul><ul><li>a) Penetrating </li></ul></ul><ul><ul><li>b) Blunt </li></ul></ul><ul><ul><li>c) Abrasion </li></ul></ul><ul><li>Closed </li></ul><ul><ul><li>Hematoma </li></ul></ul><ul><ul><li>Contusion </li></ul></ul>
  6. 6. Treatment? *Wound may look bad but if not life threatening do not get distracted from life threatening injuries Open 1) Control Bleeding 2) Irrigate wound / Apply Dressing 3) Penetrating objects- not removed, but stabilized Closed 1) Apply cold pack or ice 2)Elevate above the heart Can they still play? When do you transport?
  7. 7. Bony Injuries <ul><li>Fractures/Breaks </li></ul><ul><ul><li>Open </li></ul></ul><ul><ul><li>Closed </li></ul></ul><ul><li>Dislocations </li></ul>
  8. 8. Fractures Treatment? Open and Closed Fractures 1) Cover an open wound with dressing, control bleeding and do not try to push the bone back in 2) Elevation for if appropriate for wound control 3) Immobilize the injury, checking for distal pulses, motor function, and sensation before and after splinting (DNVS) 4) Fractures should not be reduced in the field, but we can apply traction to one type of fracture.
  9. 10. Dislocation Treatment? <ul><li>Assess DNVS </li></ul><ul><li>Immobilize affected in position of comfort </li></ul><ul><li>Reassess DNVS </li></ul><ul><li>Apply Ice </li></ul><ul><li>Do not try to reduce the dislocation </li></ul>
  10. 11. Sprains and Strains What is the difference between sprains and strains? Strains (pulled muscle): tearing of the muscle fiber from excessive stretch Sprains: a stretch of tear of a ligament Signs and Symptoms? Pain Swelling Redness Limited mobility
  11. 12. How bad can they be?
  12. 13. Treatment Sprains and Strains <ul><li>Splinting affected area if necessary </li></ul><ul><li>Assess DNVS before and after splinting </li></ul><ul><li>Ice/elevation </li></ul><ul><li>Discontinue activity </li></ul>Is it broken or a sprain/strain?
  13. 14. Head Trauma/Concussions What is important for this patient? What should we be assessing very carefully?
  14. 15. Signs and Symptoms of Head Injury/Concussions? <ul><li>Changes in personality </li></ul><ul><li>Aggressiveness </li></ul><ul><li>Memory Loss </li></ul><ul><li>Nausea/Vomiting </li></ul><ul><li>“ Sick” Feeling </li></ul><ul><li>Dizziness </li></ul><ul><li>Faintness </li></ul><ul><li>Changes in Vision </li></ul>So, what’s the moral of the story? Concussions are easy miss!
  15. 16. Head/Neck Trauma Treatment? <ul><li>Careful attention to ABCs </li></ul><ul><li>Full Trauma Assessment </li></ul><ul><li>Careful attention to LOC, GCS </li></ul><ul><li>Maintain C-Spine </li></ul><ul><li>Complete Spine board immobilization </li></ul><ul><li>Watch for changes in mental status and vital signs </li></ul><ul><li>Look for Cushing’s Triad: </li></ul><ul><li>Bradycardia </li></ul><ul><li>Hypertension </li></ul><ul><li>Irregular Respirations </li></ul><ul><li>PERRL </li></ul>
  16. 17. C-Spine Immobilization
  17. 18. <ul><li>Be Creative (not overly creative) </li></ul><ul><li>Immobilization in a position that is comfortable for the patient, yet maintains stabilization and is safe for transport </li></ul><ul><li>Loss of any aspect of DNVS is a bad splint </li></ul><ul><li>Immobilize proximal and distal joints if possible </li></ul><ul><li>There is never just one “right” splint </li></ul>General Splinting Tips
  18. 19. Splints Today <ul><li>Fingers </li></ul><ul><li>Wrist </li></ul><ul><li>Forearm </li></ul><ul><li>Sling and Swathe </li></ul><ul><li>Ankle </li></ul><ul><li>Legs </li></ul>
  19. 20. Any Questions?