Emergency

Question 1

Which situation related to epistaxis presents NO obvious need for urgent referral to an otolaryngologist? Facial paresthesias; Laceration over the nasal dorsum; persistent brisk epistaxis after pressure, elevation and nasal decongestants; trauma from a high-velocity impact.

Answer 1

Laceration over the nasal dorsum

Question 2

What is the correct initial treatment for epistaxis?

Answer 2

Apply ice and have the seated athlete tilt their head forward.

Question 3

T/F: No emergency in sports medicine, short of a complete cardiopulmonary arrest, is more immediately life-threatening than loss of an adequate airway.

Answer 3

TRUE

Question 4

What are the main concerns in evaluating acute extremity injuries? (4)

Answer 4

1: Determine the type and severity of injury; 2: Assess the distal neurologic and vascular status; 3: Determine the need for rediographic imaging and specialty treatment; 4: select appropriate splinting for immediate protection.

Question 5

T/F: The decision to order diagnostic imaging can be particularly problematic. Except for newer professional and a few college stadiums, radiographic equipment will not be available on site. The team physician must either send the athlete to a local facility for x-rays or splint the injury and allow the athlete to see his or her regular provider or hospital for further evaluation.

Answer 5

TRUE

Question 6

T/F: Any defect in the overlying skin may signal an open fracture, which may require urgent orthopedic referral.

Answer 6

TRUE

Question 7

Vascular stats of an injured limb is assessed by palpating pulses distal to the injury. Which of the following is INCORRECT regarding this process? Capillary refill time greater than 2 seconds may indicate vascular injury; capillary refill is measured by elevating the limb above the level of the heart; refill time can also idicate neurological status; In patients who have substantial swelling, this may require a Doppler device.

Answer 7

Refill time can also indicate neurological status

Question 8

T/F: An ice bag can be incorporated into a splint by wrapping it in the elastic bandage.

Answer 8

TRUE

Question 9

T/F: Symptoms such as neck pain, numbness, loss of range of motion of the nexk, paralysis, or loss of consciousness require immediate action to prevent further, and possibly permanent, cervical spinal cord damage.

Answer 9

TRUE

Question 10

T/F: In any athlete suspected of having a cervical spine injury, the prevention of further injury is the single most important objective.

Answer 10

TRUE

Question 11

T/F: In any athlete suspected of having a cervical spine injury, the shoulder pads, helmet, and chin strap should be removed.

Answer 11

FALSE

Question 12

T/F: Prior to transportation, the face mask should be removed from all athletes who may have cervical spine injuries.

Answer 12

TRUE

Question 13

T/F: Feldick and Albright (18) reported that cervical spine x-rays done as a part of the University of Iowa’s preparticipation examination for freshman football players revealed eveidence of previous injury in 35 of 108 men. This implies that forces sufficient to create structural injury are encountered with significant frequency in football.

Answer 13

TRUE

Question 14

T/F: The examiner first determines the patient’s level of consciousness, mental status, and symproms and assesses for neck injury.

Answer 14

False (ensure adequate airway, breathing and circulation first)

Question 15

Which airway is usually better tolerated in the semiconscious or conscious patient?

Answer 15

Nasopharyngeal

Question 16

T/F: The most commonc cause of airway restricion in the unconscious athlete is loss of tongue muscle tone that allows it to fall back and obstruct the upper airway.

Answer 16

TRUE

Question 17

What is the second most tocmmonly dislocated (major, not finger and toes) joint?

Answer 17

Elbow

Question 18

What is the preferred method of reducing a dislocated shoulder for the inexperienced doctor?

Answer 18

Stimson

Question 19

The most important historical question to ask the concussed athlete is if they have ever had a previous concussion. Why is this so important?

Answer 19

To avoid second impact syndrome

Question 20

Which of the following are(is) used to evaluate and grade concussions? LOC; PTA; confusion; All the above

Answer 20

All the above

Question 21

T/F: The most protective solution outside the athlete’s tooth socket is a bottle of Hank’s Balanced Salt Solution. The best storage for a tooth is a commercially prepared product. Other options in order of preference are cold milk (skin, 2%, whole), cold normal saline solution, saline-soaked gause on ice or in the athlete’s cheek, under the athlete’s tongue (if he or she is alert, and cold water.

Answer 21

TRUE