Sports Injury and Splinting

Clem MarshallStephen Rosenberg

What is the most dangerous sport?

Cheerleading

What will we see in EMS?

1) Soft Tissue Injuries2) Bony Injuries / Dislocations3) Sprains and Strains4) Head and Spinal Trauma

Also, non traumatic problems including cardiacproblems, dehydration, asthma exacerbations

Mechanisms of Injuries

An object:Baseball, ice skate, etc.

Collision:With another player, with a goalpost, wall, etc.

“Self Inflicted”Fall, sprains/strains, etc.

Soft Tissue Injury

What are the types of Soft Tissue Injuries?

Opena) Penetratingb) Bluntc) Abrasion

Closed a) Hematomab) Contusion

Treatment?*Wound may look bad but if not life threatening do not get distracted from life threatening injuries

Open1) Control Bleeding2) Irrigate wound / Apply Dressing3) Penetrating objects- not removed, but stabilized

Closed1) Apply cold pack or ice2)Elevate above the heart

Can they still play? When do you transport?

Bony Injuries

1) Fractures/BreaksA) OpenB) Closed

2) Dislocations

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.

Dislocation Treatment?1) Assess DNVS2) Immobilize affected in position of comfort3) Reassess DNVS4) Apply Ice5) Do not try to reduce the dislocation

Sprains and StrainsWhat 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

SwellingRedness

Limited mobility

How bad can they be?

Treatment Sprains and Strains1) Splinting affected area if necessary2) Assess DNVS before and after

splinting3) Ice/elevation4) Discontinue activity

Is it broken or a sprain/strain?

Head Trauma/Concussions

What is important for this patient? What should we be assessing very carefully?

Signs and Symptoms of Head Injury/Concussions?

1) Changes in personality2) Aggressiveness3) Memory Loss4) Nausea/Vomiting5) “Sick” Feeling6) Dizziness7) Faintness8) Changes in Vision

So, what’s the moral of the story?Concussions are easy miss!

Head/Neck Trauma Treatment?1) Careful attention to ABCs2) Full Trauma Assessment3) Careful attention to LOC, GCS4) Maintain C-Spine5) Complete Spine board immobilization 6) Watch for changes in mental status and vital signs

Look for Cushing’s Triad:1) Bradycardia2) Hypertension3) Irregular Respirations

PERRL

C-Spine Immobilization

1) Be Creative (not overly creative)

1) Immobilization in a position that is comfortable for the patient, yet maintains stabilization and is safe for transport

1) Loss of any aspect of DNVS is a bad splint

1) Immobilize proximal and distal joints if possible

1) There is never just one “right” splint

General Splinting Tips

Splints Today

1) Fingers2) Wrist3) Forearm4) Sling and Swathe5) Ankle6) Legs

Any Questions?