Trauma in Sports and the Healthcare Provider JSMP May 17, 2013 Kate Perlsweig, MS, ATC Heartland Rehabilitation Services.

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