Chapter 6: Injury management

Management of bloodborne pathogens

Treatment setting Clean work surfaces immediately following treatment with a biohazard product or a bleach and water solution (mixed at a ratio of 1:10) Clean floor spills Dispose of biohazard materials appropriately Maintain recordkeeping and documentation

mobilization

Muscle regeneration Stiffer, stronger ligament Joint lubrication & nourishment Promotes healthy joint mechanics

the emergency action plan

Well-developed, written process that defines the policies and procedures to be used in the management of an acute injury Should not be limited to emergency conditions Comprehensive, yet flexible No single plan can satisfy the needs of every organization

Determination of findings

-Determine whether the situation can be handled on-site or if referral to a physician is warranted -Acute care options available to the coach: Standard acute care (i.e., cold, compression, elevation, protected rest, as appropriate) with no physician referral Standard acute care with physician referral Standard acute care with immediate physician referral (i.e., emergency care facility) Summon EMS

developing the EAP

-Input from: Personnel at the facility Higher authorities to which the institution reports Medical personnel Legal personnel -Areas to address: Population being served Potential injuries/conditions Personnel Availability of medical/first aid equipment Facility access Communication Documentation

protected rest

Continued unrestricted activity could result in increased bleeding, increased pain, and delayed healing Technique: Lower extremity - use of crutches Upper extremity - splint or brace (e.g., sling) Length of time - varies (does not mean cessation of activity ... means relative rest) Immobilization can prolong the repair and regeneration of damaged tissues Early controlled mobilization can optimize the healing process following Wolff's law

Advantages of movement in the inflammatory phase

Encourages venous return Encourages fluid resorption Encourages phagocytosis Prevents contracture and loss of range of motion

coach is expected to

Evaluate the situation Assess the severity of injury Recognize life-threatening conditions Provide immediate care Initiate procedures to ensure proper referral for on-going management

soft tissue wound management: open wounds

Follow universal precautions & infection control standards Steps: Control the bleeding Direct pressure & elevation If not effective, use indirect pressure Clean the wound Determine whether emergency care is required (conditions - refer to Box 6.3) Dress the wound

closed wounds

Goal: reduce inflammation, pain, and secondary hypoxia Treatment: PRICE principles Protected rest, ice, compression, and elevation

immobilization

Loss of strength Weakness Joint adhesions

bloodborne pathogens

Microorganisms present in blood and other body fluids of infected individuals Best practice - treat the blood of any individual as if infected

The Role of Movement in the Healing Process of Soft Tissue

Movement can be initiated when bleeding has stopped Movement type - gentle and controlled motions that progress to routine activities of daily living (ADLs)

application of compression

Physiological effects Decreases hemorrhage Reduces the space available for fluid seepage Encourages fluid absorption Technique: elastic wrap Apply distal to proximal Sufficient tension to compress but not constrict Length of application time: constant Option: cold wet compression wrap to secure cold pack Do not use compression if additional pressure compounds trauma

elevation of injured site

Physiological effects Reduces bleeding in the area Encourages venous return Prevents pooling of blood in the extremities Technique: 6-10 inches above heart

application of cold

Physiological effects Vasoconstriction at the cellular level Analgesic Decreased Tissue metabolism (i.e., decreases the need for oxygen), which reduces secondary hypoxia Capillary permeability Pain Muscle spasm Length of application time ASAP following injury 15 - 30 minutes on; 1-2 hours off Stages of cold sensation: cold, burning, aching, and analgesia

implementing the EAP

Rehearse plan Personnel other than just those involved in implementing the plan should evaluate the plan

for suspected fracture

Splint joint above and below fracture site, in the position found Utilize cold application and elevation Refer to physician

Bone Injury Management

Suspected fracture associated with a major trauma or injury - treat as a medical emergency Waiting for EMS Control any bleeding (e.g., application of gentle pressure) Immobilize the injured area in the position in which it was found Apply cold to the area If shock is suspected, provide treatment for shock

Stages of cold sensation

cold burning/tingling aching/pain analgesia (numb) after 5 mins

Wolff's Law

principle that changes in the form and function of a bone are followed by the changes in its internal structure