Jennifer Ellison Brown: Indentifying and treatment principles for sport injuries
The following injuries are considered as dangerous conditions:
- Concussions: Injury to the brain after a knock on the head. Sometimes there is a delay between the injury and losing consciousness. The casualty may be unconscious, sick or drowsy, get confused, stare and suffer memory loss. These signs may not appear until hours after the injury.
- Shock: When enough blood is not circulating around the body due to fluid loss from severe bleeding or burns, vomiting, diarrhoea, or heavy sweating. The signs and symptoms are cold clammy skin, blue lips, rapid weak pulse, rapid shallow breathing, thirst, dizziness, nausea. The casualty may become restless, anxious and aggressive, may yawn and gasp for air and may even become unconscious and dies.
- Hypothermia (freezing): The internal body temperature becomes dangerously low (below 350C). This happens when the body is being exposed to cold and wind or in very cold water for too long. The signs and symptoms are shivering, cold, pale dry skin, slow shallow breathing, slow weakening pulse, feeling confused and lacking energy. The casualty may collapse, become unconscious and die if not treated.
- Hyperthermia (overheating): The body temperature has risen above 390C and can lead to several different conditions such as:
• Heat exhaustion: the body temperature rises and water and salt is lost through excessive sweating. Signs of heat exhaustion includes headaches, lightheadedness, pale grey skin, weak rapid pulse, dizziness, muscle cramps. Shock may develop if water loss is severe.
• Dehydration: this is like heat exhaustion, but less severe. The individual feels weak and dizzy through the loss of water and salts from the body.
- Heat stroke: this is when the body suddenly stops sweating and the temperature rises out of control. This usually happens during long, vigorous physical activity in a hot and humid environment. The signs and symptoms are sudden lapses into confusion or delirium, rapid strong pulse and hot dry skin. He or she may become unconscious and die if not treated quickly.
Treatment principles for common sport-related injuries
The immediate action to be taken when an individual suffers an injury during physical activity is to get the person from the pitch or playing area and seek appropriate help. We can reduce the time before we return to sport by acting quickly when we are first injured.
The following procedures are used:
The R.I.C.E Principle
This routine is used in the case of most soft tissue injuries. Such injuries must be treated as soon as possible after they occur to prevent them from getting worse. The purpose of RICE is to reduce pain, swelling and bruising around an injured area and speed up the healing process.
Rest: Stop activity and support the injury in a comfortable position to prevent further injury.
Ice: Put an ice pack on the injury for 10-15 minutes every hour. Remove the ice pack after every 15 minutes. This reduces blood flow and swelling.
Compression: Wrap a bandage firmly around the injured area. This reduces internal bleeding.
Elevation: Raise the injury above the level of the heart. This reduces internal bleeding, swelling and throbbing.
We also need to continue to treat the injury properly throughout the recovery.
First 48 hours: Ice 10-15 minutes every hour. Avoid using heat because it increases blood flow, avoid drinking alcohol, it increase swelling, avoid activity and do not massage.
48-72 hours: Apply ice and heat alternate for 5 minutes periods to increase blood flow to and from injured area. This encourage healing.
72 hours and after: Heat baths, hot water bottles etc, start rehabilitation activities. (Active movement, passive stretching and active strengthening).
Rice should not be used for fractures and dislocations. These should be moved as little as possible and professional medical assistance sought.
This routine is used when a person has collapsed and may be unconscious. The aim is to keep the casualty breathing until an ambulance arrives. Lack of oxygen very quickly leads to brain damage.
D: Danger - check for danger, this could mean stopping the game.
R: Response - shake the casualty gentle to get a response. If the casualty is conscious and can speak find out where the pain is. Stop any bleeding and support broken bones. Send for an ambulance.
If the casualty is unconscious move on to resuscitation (A, B, C)
A: Airways make sure the tongue is not blocking the airways. Loosen tight clothing, raise the chin and tilt the head backwards, remove obvious obstructions such as gum, or vomit.
B: Breathing - look for signs of breathing. If the casualty is breathing, stop any bleeding and support broken bones. Place in the recovery position while you get help. If no sign of breathing move to C.
C: Circulation - feel for the carotid pulse in the neck. A pulse will show that the heart is beating. If there is a pulse, give mouth-to-mouth ventilation to restore breathing. If there is no breathing, phone for an ambulance as quickly as possible. Give cardiac massage and mouth-to-mouth ventilation to restore circulation and breathing.
Next week: Emergency Procedures