Welcome Manager & Coaches Folsom American Little League February 24, 2013.

Welcome Manager & CoachesFolsom American Little League

February 24, 2013

First Aid and Safety For Youth Sports

Ernest J. Hook DPM

Updated and Condensed from “Prevention and Emergencies of

Management of Little League Baseball and Softball Injuries, LLB

Inc. 1989

Introduction

• Objectives Be Familiar with basic sports injuries and

terminology. Be aware of up-to-date techniques of

preventing sports Be able to differentiate among mild, moderate

and severe Know appropriate first aid techniques for the

injuries you will encounter Be able to design an emergency plan for your

league to use when severe injuries occur Know specific techniques to determine whether

an injured player is ready to practice and play again

Evaluating Injuries

• Injuries are classified as: mild, moderate, or severe

• Symptom- what a player reports• Sign- what you observe• You’ll discover the injured player’s

symptoms and signs as you evaluate the injury by looking and listening, then by carefully feeling and moving the injured part.

• Do Not Force the player to move the body part if it is extremely painful.

Severe Injuries

• Pain• Swelling• Deformity• Unconsciousness• Eye Injury• Nausea/ Vomiting• Head, Neck, Chest (Heart)

Treatment

• P protect• R rest• I ice (20- 30 min)• C compression• E elevation• S support

• “It is important that coaches and parents be responsive to complaints of injuries from athletes in all age groups. They should be aware that any athlete who is not playing up to skill level may be suffering from a significant injury.”

• “Minor sprains, muscle pulls, blisters and overuse are the prevalent injuries in non-contact sports”

First Aid Kit

• Ice• Zip Lock Bags• Player Emergency Info.

~Phone Numbers

Contusions

• Commonly called bruises• Bleeding into soft tissue

• Treatment~PRICES

Special ConsiderationsA. Calcium deposit- occurs from deep muscular bruiseB. Testicular / Groin (cup and Jill pad)C. Cardiac (Heart)

~ May be no symptoms~ May be life-threatening ~ Refer to a physician or local emergency room

D. Spleen- Occurs from blow to upper abdomen under left rib cage

E. Kidney-Occurs from blow to flankF. A severe blow to the head, the mouth or the eyes is a

serious situationG. For suspected severe head, neck, spinal injuries avoid

movement, and immobilize until EMT arrives for transportation and stabilization

Muscle Pulls and Strains

• A strain is a tear or “pull” of muscle or a tendon• Treatment: PRICES• Locations:

~Achilles Tendon~ Patella Tibia~Hamstring~Thigh~Shoulder~Elbow

• Prevention: Stretching & Warming up• Rehabilitation: Gradual

Over-use Injuries

• Results when a part of the body is subjected often enough to repeat stress

• Can lead to growth plate (soft immature bone areas) injury and pain~shoulder~elbow~upper anterior tibia- “Osgood- Schlatter’s condition”~heel bone- “Sever’s Calcaneus Apophysitis”

Bone Growth Plate Injuries

• To learn more about growth plates. The National Institute of Arthritis and Musculoskeltal and Skin Diseases.

• 1 AMS Circle• Bethesda, MD 20892-3675 has an

informative presentation at www.niams.nih.gov/hi/topics/growth_plate/growth.htm.

Evaluation

• Consider the pitch count rules to protect players arms

• Look for:~change in throwing form~limping~other outward signs that the player has pain, such as continually rubbing a sore area

Treatment: rest, ice, heat, & gradual rehabilitation

Evaluation

• Twisting injury to a joint, most commonly ankle or knee

• Report of a “pop” when the joint was twisted

• Severe sprains (complete tear or be stiff) may not hurt much, or be very swollen

• Treatment: PRICES- see doctor

Sprains

• A sprain is an injury to a ligament. A ligament is the strong connective tissue that runs from bone to bone across a joint. Ligaments make our joints stable.

• A severe sprain (or tear) of a ligament can render one of our joints unstable.

Fractures

• Look for: • Obvious deformity• Immediate swelling• Bone ends protruding through the skin• Feel For: • Marked tenderness• A grating sensation of one bone end

rubbing against the other

Treatment

• Physician Evaluation• Splinting and Transporting • For an open fracture, apply a sterile

dressing and summon emergency help immediately.

• Keep athlete calm

Injuries to the Small Joints

• May not be a small injury• Often fingers or toes• May be a strain, sprain,or fracture

(commonly called a jammed finger)• Treatment: PRICES or buddy tape

Facial Injury

• Treatment: ~PRICES~Nosebleed- compression to nostrils. If bleeding continues,gently pack nostril with sterile gauze or cotton, and continue compression

• Notify parents• Physician referral• Possibility of a concussion should be

considered

Injuries to Teeth• Evaluation:

~Complaints of pain~A chip, a crack,looseness of a tooth~Complaints of numb feeling in a tooth

• Look For: ~ Missing teeth or fragments of teeth~An uneven tooth that appears to be driven in the gum

Treatment

• Sterile gauze, pressure and ice as needed for bleeding and swelling

• Notify parents• Send a tooth or fragment with the player• Special Considerations: gently rinse off

the tooth with water. Transport the tooth in sterile, moist gauze sponge or in a cup of water. The best solution is to put the tooth in fresh milk.

Eye Injuries Listen for: ~Complaints of pain in the eye~Complaints of blurred vision~Complaints of double vision~Complaints of loss of part or all the visual field

• Treatment: ~Ice is the only acceptable pain killer for the eye~Notify parents~Immediate physician referral~Make an eye shield: this helps protect the eye from pressure as well as to keep it clean until a doctor can examine

• Consider: Facial fractures and concussions

Insect Bites and Stings

• Possible allergic reaction– Pain/Swelling/Rash– Weakness, Headache– Difficulty breathing– Stomach cramps

• Treatment:– Apply ice– Epinephrine– Family should provide info.if the player has

any allergies

The Unconscious Athlete: Heat Illness

• Head and neck injury• Cardiac arrest• Heat Illness• Other illness

– Asthma– Diabetes– Epilepsy

Type of Heat

Illness

Symptoms and

Complaints

PhysicalFindings

HeatCramps

• Muscle tightening & Spasm with intense pain•Usually lower leg but may be abdominal or rib cage

•Muscle spasms, either seen or felt, that usually do not respond to kneading to massage

Heat Exhaustion

•Severe fatigue, profound weakness, light-headed•“Flu-like” symptoms: headache, muscle aches, nausea, vomiting, diarrhea

•Elevated temperature, ranging from 98.6 F to 103 F.

Heat Stroke

•Confusion, disorientation, agitation in milder cases•Hysterical behavior, delirious behavior, coma in more severe cases

• Temperature at least 105F.•Hot, flushed, dry

Treatment

• Move player immediately out of the sun & into the shade

• For heat cramps:– Rest, cooling– Gentle stretching– Diluted salt solution (1 salt to 1 quart

water) by mouth

Treatment• For heat exhaustion

– Rest, rapid cooling– Diluted salt solution– Activate emergency care plan– Notify parents– Watch for progression to heat stroke

• For heat stroke– Extreme medical emergency– Rapid cooling, remove clothing, pack in ice, wet & fan– Activate emergency care plan– Notify parents– Caution do not: try and force a player to drink water

unless you are certain he or she is conscious

Special Considerations

• All children are more susceptible to heat illness than adults

• Heat exhaustion may lead on to heat stroke, so it is important to treat heat exhaustion as vigorously as possible

• Prevention: – Drink water– Periods of cooling– Avoid practice when temp. is above 90 or

humidity is above 95%

• Check the field conditions for hazards prior to practice or game

• Watch for snakes, players should avoid brush areas.

• The End

A concussion is a brain injury that results from a bump, blow or jolt to the head or body which causes the brain to move rapidly in the skull and which disrupts normal brain function.

Concussions

• All concussions are serious.

• Concussions can happen in any sport or recreational activity.

• Recognizing and responding properly to concussions when they first occur can help prevent further injury or even death.

Concussions

Concussions

Causes of Concussion

• A knock to the head from a fall…

• A jolt to the torso from a collision…

• A hit to the head from a stick or ball…

ConcussionsSIGNS OBSERVED BY COACHING STAFF

Appears dazed or stunned Is confused about assignment or position Forgets an instruction Is unsure of game, score, or opponent Moves clumsily Answers questions slowly Loses consciousness (even briefly) Shows mood, behavior, or personality changes Can’t recall events prior to hit or fall Can’t recall events after hit or fall

ConcussionsSYMPTOMS REPORTED BY ATHLETES

Headache or “pressure” in head Nausea or vomiting Balance problems or dizziness Double or blurry vision Sensitivity to light Sensitivity to noise Feeling sluggish, hazy, foggy, or groggy Concentration or memory problems Confusion Just not “feeling right” or “feeling down”

ConcussionsWhen You Suspect a Concussion

1. Remove the athlete from play2. Ensure that the athlete is evaluated by a health care

professional experienced in evaluating for concussion. 3. Inform the athlete’s parents or guardians about the

possible concussion 4. Keep the athlete out of play the day of the injury and

until a health care professional, experienced in evaluating for concussion, says it’s OK for the athlete to return.

Positive Coaching Alliance

THANK YOU!!