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HOSA STUDY GUIDE:CAREERS: THE SPORTS MEDICINE TEAM: 8%NATA: national athletic training associationBOC: Board of Certification (national exam) (certifying organization of athletic trainers)CAATE: commission on accreditation of athletic training education (accredited programs)The sports medicine team consists of…Team physician: This is the captain of the sports medicine teamMakes decision on whether an athlete can play or notNobody can over rule the physicianIf there is no team physician, then the athlete’s family physician is in chargeCertified athletic trainer: aka ATC (4 years of college- bachelor’s degree)Specialize in preventing, recognizing, managing, and rehabilitating injuries that result from physical activityWork under the care of the team physicianTo become an ATC you must get a bachelor’s degree from an accredited school and then pass a board of certification examAthletic training student: aka ATSTapingOverseeing rehabAssisting with daily record keeping on injuriesPrepping playing field and equipmentFirst aid under ATC supervisionActivating EMSCertified Strength and conditioning specialist: aka CSCSWorking out, lifting weights, build programs, etcPhysical therapist: aka PT Physical therapy after an injury or surgeryCoach:Should be knowledgeable about the injuries that might occur in their sport and know how to properly prevent them Maintain equipment and proper equipment fittingAthlete:Carry out instructions given out by the team physician, ATC, or coachIf they get injured, make appropriate person awareAthletes parents/guardians:Must be informed of any injury or treatment that the athlete getsSchool administration:Make sure that each school event is attended by someone who can provide proper first aid and CPRETHICAL AND LEGAL CONSIDERATIONS: 8%Negligence: Failure to give reasonable care or to do what another prudent person with similar experience, knowledge, and background would have done under the same or similar circumstancesStandard of care:The degree of care, skill, and diligence an equally qualified caregiver in the profession would provide in similar circumstances Malfeasance:When someone performs an act that is not the care provider’s responsibility or standard of care. (Ex: ATC relocated and dislocated ankle)Misfeasance:When someone commits an act that is the care givers responsibility to perform, but uses the wrong procedures. (Ex: ATC improperly stabilizes a dislocated ankle while waiting for 911)Nonfeasance:When someone fails to perform the care provider’s legal duty of care. (Ex: all signs point to ankle fracture and ATC sends athlete away without doing anything)Gross negligence:When someone has total disregard for the safety of othersMalpractice:When someone commits a negligent act while delivering care.Ethics:MoralsStandard of care:The degree of care an equally qualified care giver in a similar circumstance would provideAssumption of risk:Individual taking responsibility for the danger involved while participating in a sport or activityLiability:The legal responsibility for any loss or damage that occursTort:A wrongful act resulting in injury to another person’s property or reputationBattery:Hitting a player or inappropriately touching an athleteHIPAA: health insurance portability and accountability actPatient privacy act-protects patient’s right to keep medical records confidentialA patient’s injury and treatment in accordance with HIPAA must never be discussed in circles outside of the sports medicine teamFERPA: family educational rights and privacy actProtects the privacy of student education recordsINFECTION CONTROL/VITAL SIGNS: 8%OSHA: occupational health and safety administrationChain of infection…Pathogen: Disease causing micro-organismReservoir host:Person who has the diseasePortal of exit:Disease’s route of escape (ex: cough, sneeze, etc)Route of transmission:How disease gets from person to person (ex: shaking hands, etc)Portal of entry:How disease enters new host (ex: eats food, rubs eyes, etc)Susceptible host:Person needs to be accepting of the diseaseHepatitis B- is caused by a direct contact with infected blood, such as from receiving a tattoo, acupunctureHepatitis C (HCV) - was originally known as the non-A hepatitis and non-B hepatitis. It is a viral disease that leads to swelling (inflammation) of the liver. currently there is no vaccine for HCVHepatitis A- is caused by a virus. It is the most common form of the disease occurring in children and young adults.Human immunodeficiency virus (HIV)- is the virus that can lead to acquired immune deficiency syndrome (AIDS). HIV destroys specific blood cells, calledCD4+ T cells, which are very important in fighting disease. HIV is spread by having unprotected sex, sharing needles, or being born to an infected mother.-Proper techniques to carry/dispose of needles:-all needles, scalpel blades, and other sharp objects should be disposed of in the proper puncture resistant container (sharps container)- never carry needles or sharps from one location to another with the tips pointing toward other people or yourself. Point them toward the floor!VITAL SIGNS are the assessment of pulse, respiration, blood pressure, and temperature; body functions essential to life.Pulse:The pulse reflects the condition of the patient’s circulatory system and cardiac function. Therefore, changes in the pulse indicate a change in the patient’s status.If a pulse is not detected, emergency medical services (EMS) should be activated and cardiopulmonary resuscitation (CPR) must be started immediatelyVeins carry blood from body to heartArteries carry blood from heart to bodyReflects the condition of a patient’s circulatory system and cardiac functionNormal adult pulse is 60-100 beats per minute –tachycardia=pulse over 100, and Bradycardia = pulse below 60Average pulse is 70-80 beats per minuteAthletic pulse is typically 50-60 beats per minute (bpm) Radial pulse is taken on the thumb side of the wrist (radial artery)Carotid pulse is taken at the front of the neck (carotid artery)Pulse must be taken with the index and middle finger because your thumb has its own pulseYou count the beats of the pulse for one minuteTHINGS THAT CAN RAISE YOUR PULSE… rapid/weak pulse may indicate:Shock, bleeding, diabetic coma, heat exhaustion rapid/strong pulse may indicate:Heat stroke, severe freight, pain strong/slow pulse may indicate:skull fracture, stroke no pulse may indicate:cardiac arrest, deathPulse locations/main arteries:RespirationsBreathing, or respiration, is the process of bringing oxygen into the body where it can be utilized by the cells, and expelling carbon dioxide, which is eliminated as a waste product from the cells.Age 15+: Average respirations are 16-18 breaths per minuteA well trained athlete can be lower because of the increase of lung volume and vital capacity.Abdominal breathingBreathing using primarily the abdominal muscles while the chest is mostly stillApneacessation (end) of breathingbradypneaabnormally slow breathingcheyne-strokes respirationsperiods of apnea lasting 10-60 seconds followed by periods of fast and slow breathingdecreasedvery little air movement in the lungsdyspneadifficult or painful breathing/shortness of breathhyperpnea or tachypneabreathing that is fast and deep; hyperventilatingkussmauls breathingdeep, gasping breathinglabored breathingdifficult breathing that uses shoulder muscles, neck muscles, and abdominal musclesblood pressure:pressure of the blood exerted against the walls of the arteriessystolic pressure (top #)pressure when heart contracts (normal is 120)diastolic pressure (bottom #)pressure when heart is at rest (normal is 80)normal blood pressure is 120/80positive test results:a systolic pressure value below 100 mm Hg or above 139 mm Hga diastolic pressure value below 65 mm Hg or above 89 mm Hgimplications:low blood pressure (hypotension) may indicate shock, dehydration, or internal injurypossible causes for low blood pressure: heart failure, heat exhaustion, heat stroke, pregnancy, hypoglycemia, hypothyroidism, or severe infectionhigh blood pressure (hypertension) may be a dangerous precursor for cardiac problems/strokes. High blood pressure can exhert extreme pressure on blood vessels including the vascular regions of the brain.Possible causes of high blood pressure: obesity, lack of physical activity, too must salt in the diet, stress, medications (birth control, decongestants, pain relievers), and drugs (cocaine and amphetamines).Tools needed to assess blood pressure:Stethoscope-tool you put in your earsSphygmomanometer- blood pressure cuff (should cover ? of the patients upper arm diameter)temperature:normal body’s core temperature is 98.6PHYSICAL FITNESS ASSESSMENT: 8%muscular endurance evaluations:muscular endurance can be measured by how many reps are performed continually over a period of time or by how long a muscle contraction can be heldbent leg sit ups:measure muscular endurance of the abdominal muscleshow many can they do in 1 minutepush ups:measures upper body enduranceperform as many as possiblemodified push up:on kneesbench jump:measures muscular endurance of the lower extremitiesperform as many in 1 minuteflexibility evaluations:flexibility is the ability to stretch a muscle through its full ROMsit and reach:measure forward trunk flexion and flexibility of the hamstringstape measure on floor with 15 inch mark at the patients heelsmeasure distance of flexibilityback bend:measures ability of abdominal muscles and spine to bend backwardlay flat on stomach, hand behind head, bend backmeasure distance between floor and patients chincardiovascular endurance:measures cardiovascular endurance by measuring the resting heart rate and recovery heart ratemeasuring the heart rate: (same as pulse)measure the number of beats per minutedetermining resting heart rate:taken while patient is sitting and never after activityuse this as a baseline60-100 bpm average personathlete should be 40-60 bpmover 100 bpm is considered in poor conditionpulse recovery step test:record resting heart rate12” step- step up/down for 3 minwait 60sec after completion and take pulsebody composition:amount of body fat a person hasfat weight= body weight x % body fatlean body weight= body weight – fat weightrecommended ranges of body fat:age 30 or less/ male 9-15%/ female 14-21%age 30-50/ male 11-17%/ female 15-23%age 50 or more/ male 12-19%/ female 16-25%NUTRITION AND WEIGHT MANAGEMENT: 16%1. food supplies energy, supports new tissue growth and repair, and regulates metabolism6 classes of nutrients:carbsfatsproteins vitaminsmineralswatercarbs:starches and sugarsmost readily available sources of food energyathletes and carbs:the glycogen contained in carbs helps athletes maintain stamina and high energyathletes should eat at least 800 milligrams of carbs daily for 3 days before activitybest source of quick energy comes from carbsprotein:required for tissue growth and repairnot a significant source of energycomposed of amino acidsmeat, fish, poultry, beans, grains, nutsathletes and protein:athletes should consider the fat to nutrient (protein) ratio when choosing high protein foods.Proteins take longer to digest and turn into energy than carbsfats:lipidsmost concentrated source of food energy1 gram of fat is 9 caloriescalories are the unit in which energy is measuredinsulates and protects body organs2 types: saturated and unsaturatedgood cholesterol carried by high density lipoproteins (HDL’s)bad cholesterol carried by low density proteins (LDL’s)athletes and fats: some fat is stored in lean muscle tissue, tissue used in athletic activityfat should contribute to no more than 30% of the total energy to the dietvitamins:organic compounds that the body requires in small amounts but cannot manufacturevitamins are divided into 2 groups: water soluble and fat solublewater soluble include: vitamin C and B complex and must be replaced on a regular basisfat soluble include: A, D, E, and K which are stored in fatty tissueathletes and vitamins:athletes will not need vitamin and mineral supplements if they consume a variety of foodsmay be needed if they are trying to lose weight or eliminate one or more food groupsfiber:dietary fiber is the portion of plant foods that cannot be digestedwomen should consume 25g of fiber dailymen should intake 17g of fiber dailyathletes and fiber:fiber should not be a part of the pre exercise mealathletes should avoid fiber 6 hours prior to an eventminerals:inorganic compounds that serve a variety of functions in the bodybuilding bone/teethcomponents of hormonesformation of hemoglobinelectrolytes are mineralsathletes and minerals:calcium intake should be 800-1200 mg daily to help maintain bone strength and prevent osteoporosisiron depletion may result in reduced hemoglobin levels leaving the athlets to feel tiredwater:essential to lifedehydration impairs athletic performance and can cause heat illnesseswhen at rest people need 2 quarts or 64oz a daycontrols body temp, energy production, and waste productsaccounts for 60% of body’s weightathletes and water:athletes should consume 2 cups (8-16oz) of water 2 hours before physical activity15 min before activity athletes should consume another 2 cups-the target body fat % for adult males is around 15% and females ranges from 20-25%-calories:Vegetarians: DO NOT EAT MEATVegan: DO NOT EAT ANY ANIMAL PRODUCTS (meats, eggs, dairy products, etc)-The body can make complete proteins from a variety of plants foods such as beans, grains, vegetables, nuts, and seeds. -Vegetarians don’t need to combine specific foods within a meal to achieve complete proteins.PHYSICAL CONDITIONING: 10% 1. overload principle:a. overloading body’s muscular/cardiovascular system by working them harder than normalb. muscle strength, endurance, and size will all increase without injury bc muscles will be overloaded in a controlled exercisec. overload methods:increase weightincrease the repsincrease setsdecrease speeddecrease rest2. variation principle:a. modification/alteration of the type of exercise performedb. combats boredom and works total musclec. same methods as overload principled. change equipment/order of exercisese. change body position3. specificity principle:a.relationship between exercise and activity b.choosing exercises/workouts that relate to your sport/activityc.used when improvement in a specific activity is desired4. isometric:a.no change in length of muscleb.neither lengthens or shortens5. isotonic:a.same weight throughout entire range of motionb.shortening and lengthening6. isokinetic:a.speed of the exercise stays constant throughout exercise while the resistance variesCOMMON ATHLETIC INJURIES 34%:INJURIES TO SOFT TISSUE:1. abrasion- scrape of the skin-wash wound, antibiotic ointment2. laceration- tearing or cut in the skin-clean with soap and water, stitches if deeper then ?”3. puncture- poked/pierced by a pointy object-major: stabilize object, tape securely in place, go see physician-minor: clean with soap and water and cover, tetanus shot if needed4. incision- cut by a sharp object (like a laceration but like surgery cut)-clean with soap and water, steri-strip/stitches5. avulsion- flap of skin-clean with soap and water, cover with sterile dressing6. callus- thickening of the skin due to high friction-stop the problem causing friction/file down the callus7. blister- build up of fluid that collects under the skin caused by friction-donut pad, tape/wrap8. bites/stings- insects, reptiles, animals. Etc-clean thoroughly, control bleeding, bites (other than mosquito) should be evaluated by physician9. hematoma- closed wound, usually considerable damage to the soft tissue surrounding the area-RICE10. contusion- bruise causing bleeding in the tissue-RICEINJURIES TO THE MUSCLE:1. strain- overstretching or tearing of the muscle-RICE2. myositis ossificans- condition which calcium is produced in the muscle after a blow-physician, protect with donut pad3. tendonitis- repeated stress on tendon causing inflammation of the tendon-RICEJOINTS:Joints or articulations allow movement according to their range of motion1. fibrous- (immoveable) includes the bones of the cranium or skull2. cartilaginous- (slightly moveable) includes the vertebrae in the spine3. synovial- (freely moveable) includes the elbow, knee, fingers, etcINJURIES TO THE JOINTS:1. sprain- overstretching or tearing of a ligament or other connective tissue-PRICE (protect, rest, ice, compression, elevation)2. dislocation- injury resulting from a force that causes a joint to go beyond its normal anatomical limits-check for pulse and sensation, call EMS, splint the injury3. subluxation- dislocation that immediately goes back in-same treatment as dislocation4. synovitis-inflammation of a synovial membrane-RICE5. bursitis- inflammation of a bursa-RICEINJURIES TO THE SKELETAL SYSTEM:1. fracture-break in the boneINJURIES TO THE HEAD AND SPINE:1. hemorrhage- bleeding in the brain or its surrounding tissue2. TBI- traumatic brain injury3. concussion- type of TBI, injury to the brain that results in a temporary disturbance in the brain’s neural functioningINJURIES TO THE EAR:1. cauliflower ear- aka hematoma auris is the most common injury of the ear in sports activity. It is caused by extreme friction, or repeated trauma to the ear-ice, compression, bandagethe ear. Send to physician2. otitis externa (swimmer’s ear)- infection of the ear canal. Occurs when moisture is trapped in the external ear canal by an accumulation of ear wax, foreign object, swelling, or some other blockage-dry ear thouroughly, use drops, and send to physician3. rupture of the tympanic membrane- most likely in a contact sport-send to physician4. foreign bodies in ear- foreign bodies can ebter and become trapped in the ear-send to physicianINJURIES TO THE EYE: 1. contusions-bruise of the eye caused by a blow-ice2. corneal abrasions or lacerations-scratch to the corneal surface of the eye-patch the eye and do not let athlete rub eye3. retinal detachment- separation of the retina from the underlying epithelium-patch eye4. foreign bodies and embedded objects- debris in the eye-do not rub eye. Use eye cup to flush eye with water5. fractures: orbital roof, and blowout-orbital roof: fracture of the orbital roof of the eye caused by a direct blowblowout: fracture in the floor of the orbital socket caused by a direct blow-control bleeding, patch eye, go to see physician6. conjunctivitis- inflammation of the conjunctiva-acute conjunctivitis (pink eye) can be highly contagious…see physician7. sty- result of an infection of the eyelid follicle or the subcutaneous gland. Often near the eyelash-flush the eye if it is believed that the particle is still there. Apply moist heat pack and send to physician8. hyphema- bleeding within the anterior chamber of the eye-cover eye with sterile gauze and send to physician9. ruptured globe- small object (golf ball, tennis ball, etc) hits eye and ruptures the globe (eyeball)-transport to emergency to see ophthalmologist INJURIES TO THE NOSE:1. nose bleed (epistaxis)- nosebleed caused by direct blow-control bleeding, ice2. nasal septal deviation- blow to nose causes septum to shift (deviate)-control bleeding, ice, send to physician3. nasal septal hematoma- septum is the area between the nostrils. -control bleeding with direct pressure, ice, maintain open airway4. nasal fracture- fracture of the nose-control bleeding, ice, maintain open airway, see physicianINJURIES TO THE MOUTH AND JAW:1. temporomandibular joint (TMJ) dislocation- dislocation of the jaw-ice and send to physician. Do not attempt to relocate2. jaw fracture: fracture of the jaw-ice, see physician3. dislocation/fractures of teeth- teeth are displaced, fractured or knocked out-if tooth is knocked out replace back into socket and keep pressure on tooth to keep in place4. exposed nerve- nerve can become exposed after tooth is knocked out- apply sterile gauze , see dentistINJURIES TO THE SPINE:1. contusions- bruise because of a direct hit-ice2. brachial plexus injuries- cervical nerve stretch (aka “burner” or “stinger”)-ice, see physician3. abnormal curvatures of the spine--kyphosis: exaggerated curve of the thoracic spine (hunchback)-lordosis: exaggerated curve of the lumbar spine-scoliosis: lateral curve of the spine4.muscle spasms- uncontrolled painful muscle contraction-ice massage5. back sprain- injury to the ligaments of the facet joints caused by improper lifting or sudden twisting motions-rest and ice6. back strain- injury to the back muscles because of sudden twisting motions or an overload of muscle or muscle groups-rest, ice7. fractures/dislocations- caused by direct blow, lifting, compression, or a fall-follow emergency action plan (EAP), activate EMS8. intervertebral disc herniation- a disc that has distorted to the point where is pushes against a nerve-put athlete in most comfortable position, ice9. spondylolysis (scottie dog fracture)- a defect in the vertebrae caused by repeated stress from hyperextension that may result in a stress fracture of the pars interarticularis-rest, ice, see physician10. sponylolysthesis- vertebrae slips forward-rest, ice, see physicianINJURIES TO THE UPPER EXTREMITIES:INJURIES TO THE SHOULDER:1. fracture- -splint, send to physician2. dislocations/subluxation- - do not relocate, PRICE, see physician3. contusion--PRICE4. sprain--PRICE5. strain--PRICE6. impingement- pinching of soft tissue such as bursa, tendon, or nerve-PRICE7. tendonitis--PRICE8. synovitis/bursitis--PRICE, moist heat packs if no swellingELBOW AND FOREARM INJURIES:1. biceps tendon rupture- rupturing of the biceps muscle tendon-immobilize the upper arm and see physician2. epicondylitis- inflammation of the epicondyles of the humerus and surrounding tissues-PRICE3. volkmann’s contracture- injury that occurs when the brachial artery is obstructed preventing bloodflow distally-activate EMSWRIST AND HAND INJURIES:1. ganglion cyst of the wrist- fluid filled sac in the synovial membrane that’s locate dnext to the joint capsule or tendon sheath. It appears as a bump on the posterior aspect of the wrist-see physician if not healed within a week2. mallot finger (baseball finger)- blow to the tip of the finger, tearing the extensor tendon-PRICE, see physician3. buttonhole (boutonniere) deformity- rupture of the tendon sheath causing DIP joint to extend and PIP joint to flex-PRICE, see physician4. jersey finger- athlete grabs a jersey and tears tendon causing DIP joint into permanent extension-PRICE, see physicianINJURIES TO THE CHEST AND ABDOMEN:1. myocardial contusions and aortic ruptures- severe blow to chest or bruising of the heart muscle-possibly begin CPR, activate EMS2. fracture-- ask athlete to take deep breath, if sharp pains fx may have occurred. See physician3. pneumothorax- condition in which air has entered the space between the pleura and the chest wall and change in pressure can cause lungs to collapse-have athlete sit down and stay calm and control breathing, call EMS4. hemothorax- condition in which blood collects between the lungs and the chest wall in the pleural cavity-activate EMS5. hyperventilation- breathing at a faster rate than is necessary-control and slow breathing by inhaling through nose and exhaling through mouth6. flail chest- ribs sustain multiple fractures resulting in one or more rib segments that are not attached at either end-activate EMS7. pulmonary contusions- bruise to the lungs-compression, ice, activate EMS8. blows to the solar plexus- sever to the “pit” of the stomach (solar plexus) which knocks the wind out of the athlete-slow deep breaths9. side stitches- spasms of the intercostal muscles brought on by a lack of oxygen during physical activity (side cramps)-stretch the affected side by having athlete raise the arm on involved side over the head10. shock- condition that occurs when an inadequate amount of blood flows through the body causing extremely low blood pressure-lay athlete down, elevate feet, and activate EMS11. hernias- lump of tissue that protrudes through the abdominal wall-surgery is generally required (not emergency)INJURIES TO THE PELVIS AND LOWER EXTREMITIES:INJURIES TO THE PELVIC REGION:1. osteitis pubis- repeated stress to the pubic symphysis from sports activity can cause inflammation of this area resulting in pain in groin region INJURIES TO THE KNEE AND LOWER LEG:1. meniscus tears- result from a rotation or twisting of the knee which causes damage to the cartilage-PRICE, refer to physician2. inflammation of the patellar fat pad- occurs when the infrapatella fat pad that lies beneath the patella becomes impinged, causing knee pain-RICE3. Osgood schlatter’s disease- condition of the tibial tubericle which is where the patellar tendon attaches to the front of the tibia-PRICE4. chondromalacia patella (CMP)- gradual degenerative change that occurs to the cartilage beneath the patella and on the surface of the femur-PRICE5. shin splints (medial tibial stress syndrome [MTSS])- pain, irritation, or inflkammation in the lower leg-PRICE6. anterior compartment syndrome-swelling of the compartment or muscular area between the tibia and the fibula. Usually from a direct blow or trauma.-PRICE (if drop foot occurs, see physician immediately)INJURIES TO THE ANKLE AND FOOT:1. Achilles tendon rupture- Achilles is ruptured or torn-PRICE, see physician2. ingrown toenail- when the skin extends over the edge of the nail while the nail grows into the nail bed causing pain and possible infection-soak toe in warm salt water a few times a day, cut a “V” shape centered in the top edge of the nail encouraging the nail to grow inward away from tender skin on edges of toe3. turf toe- sprain of the metatarsalphalangeal (MTP) joint of the great (big) toe-RICE4. athletes foot- fungal condition of the foot -keep feet dry and powdered, anti fungal medication5. plantar fasciitis- inflammation of the fibrous membrane supporting, covering, and separating the muscles of the sole of the foot-PRICEENVIRONMENTAL CONDITIONS:1. heat cramps- 2. heat exhaustion-3. heat stroke-4. hypothermia- occurs when the bodies core temperature drops below 95 degrees-remove wet clothing, move to warner environment, apply heat to axillary regions (armpits, necks, groin), blanket, activate EMS5. frostbite- freezing of skin or other tissues that result in reduced bloodflow-activate EMS, remove jewelry or restrictive clothing. Slowly attempt to warm affected areasTAPING, WRAPPING AND BRACING 8%:1. athletic taping/strapping: STRAPPING MEANS TAPING! -prophylactic strapping: taping that helps to prevent or decrease the severity of injuries-Backcloth: the cloth layer of athletic-Tensile strength: the ability of fabric or tape to resist tearing, based on thread count-3 ways to increase tensile strength: 1. fold over the leading edge of the tape2. twist the tape into a cord3. Layering/overlap-Tension: the degree to which tape is stretched2. Common taping degrees: what degree to put joint in for taping-Basic ankle taping: Dorsiflexion to 90 degrees-Basic knee strapping: flex to 20 degrees-Elbow tapping: angle should be slightly more acute then the angle where discomfortOTHER:1. types of massage: 2. burns:-first degree:-second degree:-third degree: ................
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