Case Study
A 15-year-old boy was playing field hockey. He was not wearing a mouthguard, and was hit in the mouth and jaw by the ball. There was a large amount of blood. Describe your assessment plan for this patient.
Magee, David J. Orthopedic Physical Assessment. St. Louis, Mo.: Saunders Elsevier, 2008. Print.
Magee, David J. Orthopedic Physical Assessment. St. Louis, Mo.: Saunders Elsevier, 2008. Print.
Questions
1. An ice skater falls and hits the back of her head on the ice, incurring a possible cerebral concussion. Initially, what observational signs may indicate a cerebral injury?3. An ice hockey player is checked hard into the boards head first and receives a grade 2 concussion. This is his second concussion of the season. What guidelines should be followed regarding his return to play?5. A field hockey player sustains a severe blow to the cheek by a stick. The blow fractures her maxilla but does not knock her unconscious. How should the patient be transported to the hospital and why?7. A racquetball player who is not wearing eye protection is hit in his eye with a ball and develops a collection of blood in the anterior chamber. What type of eye injury is this, and what complications may follow?9. While carrying the ball, a football player is clothes-lined and seriously injures his throat. What should the concern be with such an injury? |
2. A football player sustains a cerebral concussion while making a tackle during a game. How should the athletic trainer determine the athlete's level of orientation and memory?4. A professional firefighter falls from a ladder, striking his head on the pavement, and develops a subdural hematoma. How can an athletic trainer distinguish the symptoms of a subdural hematoma from the symptoms of an epidural hematoma?6. A wrestler is hit in the nose, which injures the lateral nasal wall and causes epistaxis. How should this nosebleed be managed?8. A patient develops an eye-lash follicle infection. What is the cause of this condition, and how should it be treated?10. A football linebacker is making a tackle and makes initial contact with his head down, forcing the neck into hyper-flexion. The athlete immediately has transient quadriplegia with burning and tingling associated with motor weakness in arms and legs. Within 15 minutes that athlete recovers completely. What type of injury should be suspected and how should it be managed? |
Arnheim, Daniel D, and William E Prentice. Principles Of Athletic Training. Boston, Mass.: McGraw-Hill, 2000. Print. pg763-819
Answers
1. Patient's face would look pale, moist skin, rapid pulse with shallow breathing, and her pupils may become dilated.
2.The athletic trainer should ask the patient questions that are related to recently acquired information, such as the current date, name of current/previous opponent, who won that game, etc.
3. The patient should be out of play for at least one month. After this period, he may return to play for one week if asymptomatic. The physician may consider terminating the patient from participation for the rest of the season based on symptoms.
4. A subdural hematoma is due to venous bleeding and the symptoms appear gradually over hours or even days. However, an epidural hematoma results from arterial bleeding and therefore the onset of symptoms will appear much more rapidly.
5. The conscious patient with a fractured maxilla is transported to the hospital in a forward-leaning position. This allows for external drainage of saliva and blood.
6. Patient should sit up with a cold compress placed over the nose and ipsilateral carotid artery. Digital pressure should also be applied to the affected nostril for five minutes.
7. Blood in the anterior chamber of the eye is known as a hyphema, which could lead to major lens, choroid, or retinal problems.
8. Otherwise known as a stye, this is caused by a staphylococcal organism that is commonly spread by rubbing or by dust particle contamination. The condition should be managed with hot, moist compress and a 1 percent yellow oxide or mercury ointment.
9. The compressive force could produce a blood clot in the carotid artery. A large enough force could damage the larynx and cause a breathing emergency.
10. The patient shows signs indicative of cervical stenosis, which involves a narrowing of the spinal canal in the cervical region that can impinge on the spinal cord. The presence of cervical stenosis is determined by an x-ray that measures the canal diameter. Patient should be advised of potential risks with continued play.