Trauma in Sports and the Healthcare Provider

JSMP May 17, 2013

Kate Perlsweig, MS, ATC

Heartland Rehabilitation Services

Planning

Get to know your EMS Personnel: EMT-B? Paramedic? What equipment is standard? Life Flight? What level of training to police/firefighters

receive? Is there a standard way to relay information? What about a back-up or stand-by crew? What is the city/county protocol for mass

casualties?

Emergency Action Plans

Life or Limb Threatening injury

Crowd Injury

Fights Shooting Explosion

Evacuation Routes

Trauma Response: Supplies

Location of & Access to:PPEsDressingsAED

Extra battery/padsSplint/SpineboardPhone/radioTags/markers

Trauma Response: Supplies

Trauma Response: ABCs

BLS:AirwayBreathingCirculation

TCCC:Massive HemorrhageAirwayRespirationCirculationHead/HypothermiaShock

Trauma Response: Physiology

10080 120 140 160 180 200

115bpm: Fine motor

skills begin to deteriorate

145bpm: Complex motor skills begin to

deteriorate

175bpm: •Cognitive processing deteriorates•Vasoconstriction•Loss of peripheral vision, depth perception•Auditory exclusion

Heart Rate Response to Stress

Case Study

24 August 2007 27 year old male Humvee roll-over in western Afghanistan LOC, Left posterior hip dislocation with intra-articular

fragmentation and acetabular fracture, left sacroiliac joint diastasis, right superior and inferior rami fractures, left lumbo-sacral plexus disruption, right wrist fracture, multiple facial fractures, left pneumothorax, bladder extravasation into abdomen

Case

2 months ICU at Walter Reed and Brooks Army Medical Centers

8 months Tampa Polytrauma Rehabilitation Center

10 months post-injury issued first AFO 1 year post-injury considered elective

amputation

Special Considerations During Rehabilitation: Patient

Patient

Ortho

PM&R

Neuro Vascular

PT

OT

Internist

Dental

Pain Mgmt

Special Considerations During Rehabilitation: Patient

Multiple surgeries Prolonged

hospitalization MD Appointments

Care takers Family support Financial concerns

Personality/Role Changes

Coping strategies

Depression Suicide Risk Substance abuse Domestic violence

Special Considerations: Practitioner

Role in patient’s support system? Team approach to treatment Coping Strategies:

Recovery relaxation time Support system Emotional processing