first aid…first

Sunday, October 23, 2016

Injuries in the NFL are a way of life but every time a player goes down, at least there is some comfort in knowing that they are getting the best medical care possible. Certified athletic trainers, physical therapists and physicians are on the sideline, at the ready if needed. Sometimes, though, there are lessons to be learned when first steps are forgotten. Case in point: Brian Hoyer, Chicago Bears quarterback injures his arm and an entourage walks him off the field, as he gingerly holds his injured forearm.

hoyer injury

Shortly thereafter, Mr. Hoyer is seen on a cart being driven back from the x-ray area (every NFL stadium is well equipped) and the video streams from CBS suggest that there might be something missing in the care provided.

hoyer on cart

Most boy scouts, first responders and EMTs know that fractures and sprains need to be splinted. Letting the patient hold their own injured arm is not necessarily ideal. Look at the photo again.

Medicine has become high tech and even the pros in the ER need to step back, take a deep breath and remember the basics. First aid is called that because it comes first, but in the goal of providing care, those first steps can get missed. The purpose of splinting an injury is to prevent any worsening of the injury and to help relieve pain.

Consider a couple of other basic firsts that happen before high tech can kick in:

  • Putting a victim in the recovery position on their side so that they can’t hurt themselves or aspirate vomit into their lungs takes priority.
  • An unconscious patient should always have a blood sugar checked to make certain that they aren’t diabetic and in hypoglycemic (low blood sugar) coma. It’s bad form to emergently send a patient to the CT scan looking for brain damage when the treatment is an intravenous injection of sugar. Many a medical student and resident can remember a hypoglycemic patient where the diagnosis was made an hour later, when blood tests came back from the lab.
  • In trauma patients, the ABCs are always most important. (A=airway, B=breathing, C=circulation). Looking after visible injuries like lacerations or broken bones does little for a patient who can’t breathe or does not have blood pressure or a pulse. That’s why there are hard stops in trauma care to make certain that the patient can maintain their own airway and are not choking, that their breathing effort is adequate and that they do not  have low blood pressure because of lung or heart problems like tension pneumothorax (collapsed lung that increases pressure in the chest and prevents from returning to the heart) or pericardial tamponade (fluid around that heart that prevents it from squeezing adequately).

Basic first aid isn’t always so basic; it requires some knowledge and training and literally everybody should have some of that knowledge.

  • CPR is a given. It’s the right thing to know to help our family, friends, neighbors and even strangers in the street. And there is an opportunity to learn CPR every time a newborn baby or grandchild comes into a family.
  • The ability to look after minor injuries seems routine. We all know how to look after cuts and scrapes and that knowledge should extend to be able to initially care for wounds, lacerations, burns and chemical exposures (we live in a chemical world after all). Eye injuries and nosebleeds are tougher but a little knowledge goes a long way.
  • Sudden illnesses like heart attack, diabetes and seizures all start with placing the victim in a safe position and calling 911.

rescue position

While it takes a little time and effort to learn basic first aid, it’s not hard to find a place. First aid information and available courses can be found on line or through American Heart Association and Red Cross offices. And don’t forget your doctor’s office or local hospital as a resource. Opportunity is there to learn the basics. Then you too, can watch a football game and wonder why a broken arm isn’t splinted.

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