Tuesday, February 11, 2014

Sport's Team First Aid Kit (for Jake's baseball team) OR Why you don't ask a nurse to do your first aid kit

So the coach of Jake's baseball team off handedly said to me, "hey you're a nurse, why don't you put together a first aid kit for us".

HA

Well since I vacillate from saying things like, "you call that a wound, suck it up buttercup and get back on the field and PLAY", to over-thinking all possible scenarios and planning for them, this may have been a bad idea (middle ground? balance? these are concepts I do not understand).

I went with the second option and will now share with you what I did. And yes, I'm sure there are support groups out there for people like me.
 I put everything into a a Thirty One Utility Tote that I had around the house.
Here's where the insanity gene in my family manifests itself with me -- what's included:
coke (migraines, low blood sugar, asthma), water, eye wash, wipes, vaseline, q-tips, finger braces, two ace bandages, 10 instant ice packs, chapstick, sun block, cortizone cream, antibacterial cream, Benadryl cream, aspirin (for adults experiencing chest pain), Advil,Tylenol, Benadryl , bandaids, 4x4 gauze and tape, saline wash, Icy-Hot, hydrogen peroxide (not for wounds, but for cleaning blood out of uniforms) and water.


I also put together a little manual to help people triage and treat (I'll post these later if any of you want to also go off the deep end in over-prepardness)
 I lumped like things together in baggies to help in grabbing what is needed, rather than digging through the bag -- I also labeled the aspirin as "Adult Only" - in this bag, Ibuprofin, Tylenol, Aspirin, and Benadryl. 
 In this bag, Icy-Hot, cortizone cream, bacitracin (stay away from neo-sporin and other triple antibiotic creams), and Benadryl lotion.
In this bag, 4x4's, bandaids, finger splints, bandaids, ace bandages, and tape.

 In the side pockets I put some quick grab items -- this pocket, q-tips (for application of chapstick, or if you need to put vaseline in someone's nose for a blood nose etc), chapstick and vaseline.
 wipes
 Eye wash and sun block -- we play is some dusty fields and there's always a kid who forgets his sun block
Water -- emergency hydration, taking pills, or washing wounds
 Putting it together

Now for the binder (each heading has it's own page, that I put in plastic page protectors)

General

Best ways to avoid illness and injury

Stay hydrated
·     Water is the best choice
·     Electrolyte waters are a good choice when working out for long periods in the heat
·     Stay away from sugary sodas
·     Chocolate milk makes a great recovery drink, has some protein that the electrolyte drinks do not have

Make healthy food choices during game days, especially tournaments
·     Fruits, veggies and lean proteins
·     Light breakfasts of complex carbohydrates and lean protein, great way to start

Stretch before each game and after

Do strengthening exercises on days you are not practicing to help stabilize joints


Breaks/strains/sprains

Contrary to popular belief, unless the bone is sticking out of the skin or there is an obvious deformity there is no way to know if something is broken. Pain is not an indicator of a break. Soft tissue injuries can actually “hurt” more and pain is relative and what the person says it is (as much as we want to roll our eyes at our children :D )

What to do:

RICE
Rest
Ice
Compression (wrap snugly with an ace bandage)
Elevation

If tingling and numbness may be nerve damage, do the above without the ice.

Go to hospital if:

There are bones sticking out (911 – this needs to taken care of right away because there is a bleeding risk and there is an infection risk).

If there is an obvious deformity, take the child to the closest ER after stabilizing it.

If the child can’t bear weight, have him sit it out and elevate the injured area and put ice on it.  Reevaluate, if still can’t bear weight, or pain not subsiding or going away then take to ER to evaluate

If it’s a kneecap displaced, straighten out leg and see if kneecap pops back into place. If not, gently push knee cap back into place and take to ER.

Follow Up:
If pain doesn’t go away, check with pediatrician.
Because your kid is an athlete, it’s always a good idea to have a PT evaluation too if it’s a bad sprain/strain.
Cuts and Scrapes

Irrigate with water
Wash with soap and water
Bandaid if needed

If quite a bit of bleeding or oozing, use gauze to put pressure on wound until bleeding stops

Can use antibiotic cream (not Neosporin, use Bacitracin)

Once game is over wash again with soap and water and leave it open to air, can reapply antibiotic cream if needed

Don’t use Neosporin
Don’t use hydrogen peroxide

 Fainting


If player feels faint:
·    Have him sit down or lie down, hydrate
·    Have him sit down and put his head between his legs

If has fainted
·    Check airway, make sure it’s clear
·    Check for pulse and breathing, call 911 if can’t find pulse or player is not breathing – start CPR
·    Position player on his back and raise legs above the heart – when player is awake, do not let him get up too quickly
 Stroke

(adult)

Symptoms:
Speech difficulty
Drooping on one side of face
Headache
Vision changes
Numbness tingling loss of movement

Use FACE to help determine if possible stroke:

FACE – Does one side of the face droop? 
(have the person smile)
ARMS – Is one arm weak or numb? 
 (have the person lift both hands to the side and see if one drifts down)
SPEECH – Is the speech slurred? 
(have the person talk to you, are the words garbled, are they using the wrong words in the sentence?)
TIME – Time is critical.

Call 911 and let them know when symptoms started (time is critical) If it’s a stroke caused by an obstruction they need to give the person tPA within 3 hours of symptoms starting.

Do NOT give aspirin; you don’t know if it is a bleed (Hemorrhagic) or an obstruction (ischemic) type of stroke. They will need to do a CT and/or MRI at the hospital to determine treatment and what type of stroke it is.

Possible Heart Attack

(adult)



Symptoms



Left Arm, Shoulder pain, back pain, neck, jaw pain can travel to right side

Pressure, tightness, pain in chest

Shortness of Breath

Nausea/vomiting

Feeling of impending doom

Breaking into cold sweat

Heart palpitations


Women are more likely to have uncommon symptoms, although men can also present with less common symptoms

Give the person aspirin and call 911
Nose Bleed

1.pressure with two fingers bridge of nose
2.do NOT have player lie flat on back
3.either have patient suck on ice, or put ice pack on back of neck
4.can use antibiotic cream, or Vaseline in nares, if bloody nose caused by dryness
5.hydrogen peroxide is good for getting blood out of uniform (don’t use on skin)
6.hydrate
Hit to the Head

The force of the hit to the head isn’t always an indicator of whether or not there’s going to be a concussion, so it’s always a good idea to be concerned.

Take player to emergency room If player experiences (1&2 – depending on severity may need a 911 call):
1.     Loss of consciousness
2.     Seizure
3.     Severe head ache
4.     Nausea and vomiting
5.     Direct hit to the eye with immediate bruising surround the eye

Assessment:
1.     Physical
a.     Check pupils, see if equal and reactive to light (if not, 911)
b.     Have player stand on one foot, then the other to check for balance
c.      Have patient put both arms out and then bring hands together
2.     Questions
a.     have player rate pain
b.     have player remember 3-5 words and have him repeat it to you
c.      have player rate irritability
d.     does player feel ‘right’
e.     is player getting drowsy
f.      vision problems
g.     hearing problems
h.     feeling in a fog
i.       neck pain
j.       pressure in head
Treatment:
1.     If player has any of the above symptoms, have him stop playing and go to the doctor  (ER if any symptoms severe or getting considerably worse)
2.     If player does not have symptoms, have him sit out an inning with an ice pack and reevaluate
3.     If there is ever a SECOND hit, have child sit out game and get evaluated by MD.
4.     If there is a concussion, player has to be cleared by MD before being able to play again
Follow up:
1.     If parent sees any changes in player, parent should seek advice of medical professional right away
2.     Have player rest at home without stimulus, no tv, no video games

Bee Stings



1. remove stinger (black spot in middle of wound) by scraping a credit card or hard flat object over it.
2. Wash with soap and water
3. Ice pack
4. If needed can take some Benadryl, Tylenol or ibuprofen for pain and localized allergic reaction

Anaphylaxis

If allergic to bee stings and no epi-pen call 911 immediately, give Benadryl (if can still swallow).

Symptoms to be concerned about (call 911 if these are evident):

1. wheezing
2. swelling, especially around the face, throat, eyes
3. dizziness
Asthma Attack w/out an inhaler

Symptoms

1.wheezing (doesn’t always happen)
2.tightness feeling in chest
3.pressure in chest
4.dry persistent cough
5.difficulty breathing


Treatment

1.Over the Counter inhaler
2.Caffeine (2 cups, 2 cokes)
3.Calming deep breathing
4.Benadryl
5.If player passes out, call 911


There you have it -- it'll be a good thing if we didn't have to use any of these items -- but glad to have them on hand just in case - better to be over-prepared than not prepared at all (this may surprise you but I was in fact a girl scout for a couple of years -- some of it stuck).

Most likely, I'll take a look at a kid and say, "really? you're fine, get back out there and play and win and there's no crying in baseball"

Because I'm one of those moms.

Not really - okay sometimes.
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4 comments:

KathE said...

Great kit! You should market them using a name like Neuroti-Kit. ;-) I would love something like that. Curious, why no peroxide or neosporin?

tz said...

Neroti-kit - brilliant! no Peroxide and neosporin because simply they also destroy skin cells along with the bacteria (particularly with Caucasian skin)- best thing is always soap and water and if you're going to keep getting dirty (boys playing baseball) you can add some bacitracin

Colleen Dobson said...

Neuroti- Kit ! Perfect!

Linda said...

You thought of everything! Thanks for visiting Night Owl Corner....just stopping by to check out your blog too!
Linda
www.nightowlcorner.com