National health standards and elements


First Aid procedures: heatstroke affecting children



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First Aid procedures: heatstroke affecting children


What is it?

Heatstroke is when the body is unable to cope with prolonged exposure to heat. This can be as a result of vigorous exercise in hot weather, or because of a fever.

Children can develop heatstroke when they become too hot and dehydrated.

Symptoms


  • Sudden headache

  • Dizziness and confusion

  • Hot, flushed and dry skin

  • Rapid deterioration in level of response

  • High temperature (40˚C/104˚F or above)

Actions

  • Reassure child

  • Lie them down in a cool place and remove their outer clothing

  • Put a folded towel under head

  • Sponge repeatedly with cool water and allow damp skin to dry in air

  • Fan to bring down temperature

Further actions

If the child loses consciousness:



  • Check for a response, check for breathing and prepare for CPR

  • Call 911


First Aid procedures: heatstroke affecting adults


What is it?

Heatstroke is when the body is unable to cope with prolonged exposure to heat. This can be as a result of overexertion in hot weather, or because of a fever.

Older people are more at risk of heatstroke because their bodies can't cope as well with changes in temperature.

Symptoms


  • Restlessness

  • Headache and dizziness

  • Flushed, hot skin

  • Raised body temperature

First aid aims


Actions

  • Lie casualty down

  • Wrap in a cold, wet sheet and fan until their temperature falls, then replace wet sheet with a dry one

  • Monitor casualty carefully

Further action

If the casualty's temperature rises again, repeat cooling actions.



BONE INJURIES



Recognizing Fractures:

An open fracture will typically be self evident due to the exposed bone. The following clues suggest you are dealing with a probable closed fracture:



  • The athlete felt a bone break or heard a "snap";

  • The athlete feels a grating sensation when he/she moves a limb;

  • One limb appears to be a different length, shape or size than the other, or is improperly angulated;

  • Reddening of the skin around a fracture may appear shortly after the injury is sustained;

  • The athlete may not be able to move a limb or part of a limb (e.g., the arm, but not the fingers), or to do so produces intense pain;

  • Loss of a pulse at the end of the extremity;

  • Loss of sensation at the end of the extremity;

  • Numbness or tingling sensations;

  • Involuntary muscle spasms;

  • Other unusual pain, such as intense pain in the rib cage when a patient takes a deep breath or coughs.

Ice On A Fracture Usually Makes It Throb Worse…

Splinting

Any suspected fracture should always be splinted before the athlete is allowed to move.

Splint the joint above and below the affected area.

How to Splint:

1. Check pulse. Then remove clothing from the injured part. Don't force a limb out of the clothing, though. You may need to cut clothing off with scissors to prevent causing the athlete any additional pain.

2.  Apply a cold compress or an ice pack wrapped in cloth.

3.  Place a splint (or boards) on the injured part by keeping the injured limb in the position you find it. Add soft padding around the injured part placing something firm (like a board or rolled-up newspapers) next to the injured part, making sure it's long enough to go past the joints above and below the injury keeping the splint in place with first-aid tape. Re-check pulse.



4.  Seek medical care, and don't allow the athlete to eat or drink anything, in case medication or surgery is needed.

  • Check CSM’s before and after splinting

    • Splint should include joint or bone above or below

    • Use blankets, boards, and bandages, or an uninjured body part

    • Triangular bandage for sling

  • Types of splints

    • Soft

    • Anatomical

    • Rigid

    • Sling

    • CSM’s

    • Circulation

    • Sensation

    • Movement

    • Skin Signs





Wrist, Arm & Shoulder

Sling and Swath



Ankle and Lower Leg


CONCUSSIONS


Recognizing Concussion

Concussions do not always involve a loss of consciousness. ANY traumatic blow to the head or to another part of the body (which causes a whiplash effect to the head) should be considered as a mechanism of concussion injury. While headache is the most common symptom of concussion, all people will experience concussion differently. Therefore, all of the potential signs and symptoms of concussion should be considered. A symptom checklist can assist the evaluator in making a more objective return to play decision.



If a player sustains any signs or symptoms of concussion, he/she must be pulled from play. Only an athletic trainer or a physician may clear the athlete to return to play.

Concussion Signs and Symptoms

Amnesia

Loss of orientation

Balance problems

Memory problems

“Bell rung”

Nausea


Dazed or Confused

Nervousness

Depression

Numbness or tingling

Double vision

Drowsiness



Poor concentration

Easily distracted

Personality changes

“Glassy Eyed”

Excessive sleep

Ringing in the ears

Fatigue

Sadness


Feeling “in a fog”

Seeing “stars”

Feeling “slowed down”


Sensitivity to light

Headache


Sluggishness

Inappropriate emotions

change in personality

Sensitivity to noise

Irritability

sleep disturbance

Loss of consciousness

Vacant stare

Vomiting


ALL ATHLETES WHO GET “ROCKED” AND EXHIBIT ANY OF THESE SIGNS OR SYMPTOMS SHOULD BE REFERRED IMMEDIATELY TO THE ATHLETIC TRAINER AND/OR A PHYSICIAN!!!

Recovery

Coaches need to know that research indicates high school aged athletes take from 7-15 days to fully recover from a Grade 1, or mild, concussion (a “bell ringer”). Returning the athlete to play too soon following even a mild concussion can lead to death.

Athletes that are not fully recovered from an initial concussion are significantly vulnerable for recurrent, cumulative, and even catastrophic consequences of a second concussive injury. Such difficulties are prevented if the athlete is allowed time to recover from concussion and return to play decisions are carefully made. No athlete should return to sport or other at-risk participation when symptoms of concussion are present and recovery is ongoing. In summary, the best way to prevent difficulties with concussion is to manage the injury properly when it does occur.
First Aid for Dehydration

When your body is dehydrated, it doesn't have as much water and fluids as it should. Dehydration may be caused by not drinking enough fluids, losing too much fluid, or both. Depending on how much of the body's fluid is not replenished or is lost; dehydration can be mild, moderate, or severe. Severe dehydration is a life-threatening emergency. Vomiting, diarrhea, excessive urine output, excessive sweating, and fever all cause fluid loss in the body. Nausea, loss of appetite during illness, and sore throat or mouth sores may cause you to not drink enough fluids.

Symptoms of dehydration include:


  • Dry or sticky mouth

  • Decreased or no urine output

  • Urine that appears dark yellow

  • Lack of tearing

  • Sunken eyes

  • Lethargy and coma (in severe dehydration)

  • In infants, the soft spot on the top of the head (fontanelle) will be markedly sunken

Children and the elderly have a higher risk of developing dehydration.

You can correct mild dehydration by the following methods:




  • Frequent small amounts of fluid, rather than drinking a large amount of fluid all at once, which may cause vomiting. Electrolyte solutions are especially effective, but avoid sport drinks that contain sugar that may cause or worsen diarrhea. Also avoid plain water for rehydrating infants and children; instead, use commercial electrolyte solutions such as Pedialyte.

  • Hospitalization and intravenous fluids are sometimes necessary for moderate to severe dehydration, as well as to treat the cause of the dehydration. Call 911 for symptoms including:

    • Dizziness

    • Lightheadedness

    • Lethargy

    • Confusion

    • Lack of tears

In an infant less than two months old, diarrhea or vomiting, little or no urine output in an eight-hour period, sunken eyes, dry skin that stays up like a tent when pinched into a fold (called skin tenting), dry mouth or eyes, sunken soft spot (fontanelle), rapid heartbeat, blood in the stool or vomit, or listlessness and inactiveness.

A test for dehydration is to pull on the skin and see if it stays up like a tent

Everyone should drink plenty of fluid every day and more during hot weather and while exercising. While ill, don't wait for signs of dehydration; attempt to push fluids or get medical attention.

R.I.C.E


  • Rest victim

  • Ice injured part

  • Compress injury

  • Elevate injury



SPECIAL CONCERNS

Allergic Reactions

    • If an athlete has an allergic reaction, it is important that he/she gets medical treatment immediately.

    • If the athlete experiences breathing difficulty and and/or if he/she has an Epi-Pen, get it for them and have him/her give themselves an injection. Do not do it for them. If they cannot do it themselves, call 9-1-1.

    • If the athlete’s reaction is minor (hives, itching, irritation, etc.), contact parent. In most cases, a Benadryl will fix the problem but as a coach, you cannot give that medicine to the athlete.


Asthma

  • Only athletes who have been diagnosed with asthma should use inhalers;

  • Athletes with asthma should only be allowed to use their own inhaler;

  • If trouble persists, call 9-1-1.


Dental - Broken Tooth

If an athlete gets a tooth knocked out (or broken off)



  • Keep the tooth;

  • Put the tooth in a cup of milk (only enough to cover tooth). If milk is unavailable, use water;

  • Have athlete chew gum and put over the exposed tooth in mouth (to prevent nerve irritation);

  • Send to dentist – don’t forget to send the tooth.


Diabetics

Symptoms: rapid onset of altered mental status, intoxicated appearance, elevated heart rate, cold and clammy skin, hunger, seizures, anxiousness

What to Do: Ask the athlete. The athlete will direct you (is he/she hypoglycemic or hyperglycemic?). Does he/she want juice? Sugar? Get him/her what they need.

Muscle Cramping

  • Poor hydration and low electrolyte count is the cause;

  • Administer Powerade or other sports drink;

  • Have the athlete chug some mustard (seriously!) and “chase” it with lots of water or Powerade.


Seizures

  • Have athlete lie down. Remove any objects in hand or nearby;

  • Loosen restrictive clothing;

  • Allow the seizure to finish;

  • After the convulsions have ended, protect the airway. If athlete is blue, lift chin and tilt head back.

Call 9-1-1


WOUND CARE

Abrasions & Turf Burns

•        Clean affected area thoroughly. 

•        Clean/Scrub with a 4 in 1 saline solution to make sure any dirt/grass is removed; If using peroxide, dilute to

50% peroxide / 50% saline solution.

•        Apply antibiotic ointment (Neosporin);

•        Cover with gauze bandage, pre-wrap and soft tape;

•        After 2 days, uncover and air dry.  The open air will help the wound to scab over;

•        Wrap with pre-wrap and soft tape for all participation.



Covering the wound is not enough. It is imperative that the wound is first cleaned thoroughly in order to prevent potentially harmful bacteria

 Lacerations

•        Apply direct pressure with gauze to stop bleeding;

•        Clean the wound thoroughly and irrigate with saline and Betadine;

•        Steri-strip, if the bleeding stops;

•        If bleeding does not stop and wound is deep (greater than 1/8” deep, cover with pressure bandage and send to physician for evaluation/stitches;

•        If wound is caused by object, refer for tetanus.

  

Blisters

•        Clean thoroughly. Irrigate with saline and Betadine;

•        Place petroleum jelly pad over blister to avoid continuous rubbing;

•        Wrap with pre-wrap and soft tape;

•        Watch for inflammation (redness) and warmth, and possibly streaking (long term). These are signs of

infection;

•        If infection develops, refer to physician immediately for antibiotics.



Never cut away the top skin off a blister if it’s soft.

The skin helps to provide a protective barrier.
 Watch for Shock

  • Excessive bleeding can lead to shock. Don’t waste time trying to find a dressing;

  • Use gloved hand and apply direct pressure over the wound;

  • Elevate the extremity;

  • Keep applying steady, firm pressure until the bleeding is controlled;

  • Once bleeding is controlled, apply a dressing firmly in place (pressure bandage);

  • Refer to Emergency Room for further treatment.


NEVER apply white athletic tape around muscle. This eventually kills muscle cells and places unnecessary stress on bones – potentially causing stress fractures. Only use stretch elastic tape (adhesive) around muscle bellies.

Activity:

  1. Introduce different types of tape

  2. Demonstrate and Practice different types of taping

    1. Buddy Tape

    2. Wrist

    3. Thumb

    4. Thigh

    5. Ankle

    6. Shoulder




  1. Demonstrate and practice splinting various body parts

    1. Anatomical

    2. Pillow splints

    3. Wrist and cardboard splints


Athletic Training Taping Techniques

Taping is used for sports injuries and offers numerous benefits. Taping assists in the retention of wound dressings. It stabilizes compression to prevent internal and external hemorrhaging. And it supports recent injuries to prevent additional damage that may result from further athletic activity. Modern adhesive linen tape is best to use for taping sports injuries due to its adhesion qualities. When taping injuries, it's best to have the assistance of a qualified professional but in the event that you can't get to one in time, follow a few simple procedures to tape injuries properly.



Tips and Warnings

  • When taping an injury, get the assistance of a qualified athletic trainer or personal trainer. If in doubt of taping procedures, splint the injury with a piece of wood or cardbord and go to the nearest emergency medical facility.

  • When wrapping the foot, avoid wrapping the tape so tightly as to hamper the action of the ankle. Check for capillary refill after taping by squeezing the external portion of the wrapped limb. If wrapped loosely, the area should be pink instead of white or blue. If an athlete has a history of tape blisters avoid application of tape adherent when taping an ankle.




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