Non-Orthopedic Emergency Care in Athletics

145 Pages·2019·17.844 MB·English

by  Francis Feld, Keith M. Gorse

Francis Feld, DNP, CRNA, LAT, ATC, NRP
UPMC Passavant Hospital Staff CRNA
Prehospital RN Ross West View EMSA
Medical Group Supervisor, Allegheny County Hazmat Medical Team
Pittsburgh, Pennsylvania
Keith M. Gorse, EdD, LAT, ATC
Assistant Professor and Clinical Coordinator
Department of Athletic Training
Duquesne University
Pittsburgh, Pennsylvania
Robert O. Blanc, MS, LAT, ATC, EMT-P
Head Athletic Trainer—Football
Adjunct Clinical Instructor
University of Pittsburgh, ATEP
Pittsburgh, Pennsylvania
Senior Vice President: Stephanie Arasim Portnoy
Vice President, Editorial: Jennifer Kilpatrick
Vice President, Marketing: Mary Sasso
SLACK Incorporated Acquisitions Editor: Brien Cummings
6900 Grove Road Managing Editor: Allegra Tiver
Thorofare, NJ 08086 USA Creative Director: Thomas Cavallaro
856-848-1000 Fax: [phone]
Cover Artist: Katherine Christie
www.Healio.com/books
Project Editor: Joseph Magaletta
© 2020 by SLACK Incorporated
All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording or otherwise, without written permission from the publisher, except for
brief quotations embodied in critical articles and reviews.
The procedures and practices described in this publication should be implemented in a manner consistent with the professional
standards set for the circumstances that apply in each specific situation. Every effort has been made to confirm the accuracy of
the information presented and to correctly relate generally accepted practices. The authors, editors, and publisher cannot accept
responsibility for errors or exclusions or for the outcome of the material presented herein. There is no expressed or implied
warranty of this book or information imparted by it. Care has been taken to ensure that drug selection and dosages are in accor-
dance with currently accepted/recommended practice. Off-label uses of drugs may be discussed. Due to continuing research,
changes in government policy and regulations, and various effects of drug reactions and interactions, it is recommended that
the reader carefully review all materials and literature provided for each drug, especially those that are new or not frequently
used. Some drugs or devices in this publication have clearance for use in a restricted research setting by the Food and Drug and
Administration or FDA. Each professional should determine the FDA status of any drug or device prior to use in their practice.
Any review or mention of specific companies or products is not intended as an endorsement by the author or publisher.
SLACK Incorporated uses a review process to evaluate submitted material. Prior to publication, educators or clinicians provide
important feedback on the content that we publish. We welcome feedback on this work.
Library of Congress Cataloging-in-Publication Data
Names: Feld, Francis, 1954- editor. | Gorse, Keith M., editor. | Blanc,
Robert O., 1960- editor.
Title: Nonorthopedic emergency care in athletics / [edited by] Francis
Feld, Keith M. Gorse, Robert O. Blanc.
Description: First edition. | Thorofare, NJ : SLACK Incorporated, [2020] |
Includes bibliographical references and index.
Identifiers: LCCN 2019038353 | ISBN 9781630916176 (paperback) | ISBN
9781630916183 (epub) | ISBN 9781630916190 (adobe pdf)
Subjects: MESH: Emergency Treatment | Sports | First Aid | Emergency
Medical Services | Athletic Injuries | Emergencies
Classification: LCC RA645.5 | NLM WA 292 | DDC 362.18--dc23
LC record available at https://lccn.loc.gov/2019038353
For permission to reprint material in another publication, contact SLACK Incorporated. Authorization to photocopy items
for internal, personal, or academic use is granted by SLACK Incorporated provided that the appropriate fee is paid directly to
Copyright Clearance Center. Prior to photocopying items, please contact the Copyright Clearance Center at 222 Rosewood
Drive, Danvers, MA 01923 USA; phone: [phone]; website: www.copyright.com; email: [email protected]
Printed in the United States of America.
Last digit is print number: 10 9 8 7 6 5 4 3 2 1
D
EDICATION
To all the health care providers who are devoted to the development and implementation of proper emergency care for
people who are involved at the recreational, high school, college, and professional levels of athletics.

C
ONTENTS
Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
Acknowl edgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix
Contributing Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii
Chapter 1 Design and Implementation of Emergency Action Plans and Standard Operating Procedures . . . . .1
Keith M. Gorse, EdD, LAT, ATC
Chapter 2 Mass Casualty Incidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Francis Feld, DNP, CRNA, LAT, ATC, NRP
Chapter 3 Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Joseph Andrie, MD; John Panos, MEd, LAT, ATC, EMT; and Matthew Schaff er, MD
Chapter 4 Cardiovascular Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Jason Ferderber, MD and Vincent Mosesso Jr, MD
Chapter 5 Endocrine Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
John Murphy, DO; Robert O. Blanc, MS, LAT, ATC, EMT- P; and James Medure
Chapter 6 Respiratory Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Francis Feld, DNP, CRNA, LAT, ATC, NRP
Chapter 7 Environmental Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Aaron V. Mares, MD and Shane Hennessy, DO
Chapter 8 Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Timothy Rausch, MSN, CRNP
Chapter 9 Wound Management and Bleeding Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Alan Shapiro, DO
Chapter 10 Epileptic Seizures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Ryan P. McGovern, PhD, LAT, ATC
Chapter 11 Psychiatric Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Christian Conte, PhD and Donald J. Conte, MS, MA
Chapter 12 Abdominal Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Harsh K. Desai, MD; Christine M. Leeper, MD; and Kevin Garrett, MD
Chapter 13 Emergencies Related to Conditioning and Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Sarah Manspeaker, PhD, LAT, ATC and Kelley Henderson, EdD, LAT, ATC
Appendix 1. Diabetic Athlete Treatment Algorithm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
Appendix 2. Intravenous and Interosseus Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
Appendix 3. Bleed Bags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
Appendix 4. Individualized Seizure Response Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125

A
CKNOWLEDGMENTS
Many people have assisted us during the year that Non-Orthopedic Emergency Care in Athletics has been in production.
The staff at SLACK Incorporated was both supportive and patient during the entire pro cess of developing this textbook. In
par tic u lar, we thank Mr. Brien Cummings, who provided the continuing support that gave us the initial okay to proceed
and help make the book happen. We also thank all our contributors for their efforts in helping put together this textbook.
Francis Feld thanks the contributors for providing the material that makes this a unique textbook for athletic medi-
cine professionals. Management of serious conditions requires education and experience, plus the wisdom to calmly apply
them in a critical situation when others may be in a panic. This text supplies the education, but readers must develop the
experience and wisdom necessary to perform well in a crisis. Francis also thanks his wife, Christine, for her love and sup-
port. Keith and Rob deserve special consideration for occasionally throwing out the sea anchor and keeping this ship from
running aground during development.
Keith Gorse thanks both Fran and Rob for their mentorship, guidance, and friendship over the last 30-p lus years.
Keith also thanks his wonderful family (Betsy, Erin, and Tyler) for their never- ending support through all his years as an
athletic trainer, a husband, and a father. Without them, his professional career and personal life would not have a w hole
lot of meaning.
Robert Blanc thanks every one involved in the writing of this material, especially Keith and Fran, who have taken the
lead in providing our profession, as well as others, with the most comprehensive information necessary for the excellent
care of active individuals. Keith and Fran have led the way with their professionalism and dedication to making athletic
training better for all. Rob also thanks his wife, Peggy, for unmatched patience and support throughout the years.