During the emergency trauma session, we recapped the different acronyms associated with this topic, went through a scenario which included the primary survey (ABCDE) and used the different emergency equipment such as the spinal board.

The acronyms included ATMIST which is what you will be asked by the emergency services, SAMPLE that is considered the secondary survey and SALTAPs which is used to identify when a player goes down injured on the field of play.

During the scenario ABCDE (airways with cervical spine protection, breathing with adequate ventilation, circulation with haemorrhage control, disability and everything else) was used. When going over to an injured athlete, on the field of play, it is important to approach from the feet and put the player into anterior hold. Another therapist can place the athlete into manual in line stabilisation (MILs), ensuring the player is unable to move their head. Next, we check the airways by listening, looking and feeling; we want to listen for any gurgling or snoring and if debris needs removing we place a torch in the mouth, so we can look and it stops the patient biting down on our fingers. We would then check breathing accessing 3 things; pain, depth/expansion and rate. To do this place your hand horizontally over the lungs equally, then one hand under each armpit and finally over the lower ribs. With circulation, it is important to check strength, rate and rhythm. Disability is assessed using AVPU (alert, voice, pain, unresponsive) and under everything else includes the secondary survey as well as long bones, abdominal area, pelvis (by compressing it), thoracic and kidney.

The last activity we did in the session was practicing using neck collars, spinal boards and other emergency equipment.

Once the session was over, I met with the hockey girls and did some pre-game taping for them. This included putting rigid tape on one of the girl’s ankles for stability.

During the hockey game, most of the mechanisms of injury were contact, mainly from the ball. One of the girls got hit on the radial side of the hand and caused numbness in the fingers, mostly the 5^th finger. They also had pain going up the lateral side of the arm indicating it could be something related to the ulnar nerve. When testing range of motion (ROM) the player was able to perform flexion and extension, but they were unable to get to end of range. With ulnar and radial deviation, the player struggled with this movement, feeling pain even with slight movement. We checked the player could grip; firstly, we asked them to do it actively by flexing fingers which appeared limited, although when we asked them to grip the hockey stick they did it with no struggle. After half time, another girl got hit with the ball in the ankle and experienced a lot of pain. Ice was used for swelling and acute localised pain, which the client had (Lubkowska, 2012). The final injury was a player who had radiating pain down their leg.  Initially we thought it could have been a dead leg as it was a dull ache in the upper quad, but the player had no recollection of any trauma to the leg. Instead, it could have bene femoroacetabular impingement (FAI) due to the movement of pain. To help with the pain I got them to foam roll over the area as it does the exact same thing as massage.

Areas for further improvement 

My first area for further improvement would be to ensure that when I am applying rigid tape, it is not creased, else it could cause blisters. I also need remember to check contraindications with any of the players I am applying treatment to. I could have also give aftercare advise so they know how to remove the tape effectively in order to prevent skin damage. Another improve that I could make is to consider adapting equipment to make it as effective as possible for the clients need. One of the players was experiencing a dull ache which was too painful to foam roll herself. Therefore, I could have done it for them to ensure that there was not too much pressure.

Things to Remember:

1. If you get a pulse at the carotid artery but not at the wrist, this can indicate respiratory arrest
2. If a cervical spine injury is suspected, try a jaw thrust first as we want to try and place an oropharyngeal airway (OPA) in the mouth, rather than using a nasopharyngeal airway (NPA).
3. Heartrate is expected to be high when taken straight after the player has gone done, but re check ten minutes later as we would have expected it to decrease
4. Only start talking to the patient when you are either in anterior hold or MILs, to prevent head movement
5. People are generally more likely to do something if you apply it to their sport
6. Always consider differential diagnosis with any possible injury

References 

Lubkowska, A. (2012). Cryotherapy: physiological considerations and applications to physical therapy. In Physical Therapy Perspectives in the 21st Century-Challenges and Possibilities. IntechOpen.