1. Can lead to major brain swelling and death 2. Can occur with minor head trauma iv. Post-concussion Syndrome 1. Months to years of headache,

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1 Baseball First Aid 1. The Top ten injuries in little league baseball are: a. Elbow pain b. Leg sprains and strains and breaks c. Shoulder pain d. Head injury e. Tooth injury f. Jaw injury g. Eye injury h. Heat related problem i. Foot injury j. Back injury 2. Pitchers and catchers are most likely to get injured 3. Elbow and Shoulder injuries a. Due to overuse b. Rest ice and ibuprophen c. Return to full activity when no pain 4. Strains/Sprains/ Breaks i. Sprain - Ligaments ii. Strain - Muscle iii. Break Bones 1. Initial treatment is the same a. Ice Elevation Stabilization b. Ice pack and Ace wrap usually work very well c. Axial loading - if lots of pain a fracture is possible d. Obvious deformity besides swelling most likely fracture e. If a player can bear weight on an ankle or knee less likely a significant fracture f. Persistent pain for more than a few days may indicate a fracture 2. Return to play when pain free - Pain is a good guide 5. Head injury a. Concussion i. Brain injury that results in a functional disturbance ii. Concussions can have immediate bearing on school & work performance iii. Second Impact Syndrome is second injury before first injury heals

2 1. Can lead to major brain swelling and death 2. Can occur with minor head trauma iv. Post-concussion Syndrome 1. Months to years of headache, concentration difficulties, depression v. Potential long term consequences 1. Increased risk of Alzheimer s later in life vi. Recognition is very important vii. Signs of a Concussion are 1. Headache 2. Dizziness 3. Ringing in the ears 4. Balance problems 5. Nausea vomiting 6. Confusion 7. Amnesia (important indicator of severity) 8. Loss of consciousness 9. Convulsions 10. Concentration issues 11. Irritability 12. Blurred vision 13. Light sensitivity 14. Depression 15. Sleep disturbance 16. Fatigue viii. If unconscious on the field call medic. Do not move patient unless they wake up and say they are ok and their neck does not hurt ix. If dazed for seconds after being hit in the head and no loss of consciousness, amnesia or confusion the player can return to play x. All concussions = out for rest of practice or game!! xi. If any loss of consciousness, amnesia or confusion that persists more than 5 minutes have parents take them to the hospital xii. No return to play until a player is symptom free for at least a week including no confusion no dizziness no headaches no trouble concentrating no nausea xiii. Impact testing by a concussion specialist is recommended if a player has any of these symptoms that last for more than a few minutes

3 xiv. If two head injuries in one season the player needs to be out for a longer period of time. Make sure parents have a concussion specialist check a patient and cleared them for play. xv. Athletes (and parents) frequently downplay history and minimize symptoms xvi. Recommend relatively constant monitoring by someone xvii. Periodic medical rechecks (every 5-10 minutes) xviii. Don t let the athlete drive themselves home xix. Recommend that athlete be closely monitored for next hours (particularly first 24 hours) xx. Do not need to wake every 2 hours while sleeping (leads to prolonged symptoms and delayed recovery) rec: wake only 1 or 2x at night the first night xxi. Rest (both physical and mental) while symptomatic xxii. Includes ALL physical exercise and labor xxiii. Also includes school work, video games, texting, and other activities that require concentration and attention xxiv. Rec: Tylenol for pain (avoid motrin or aspirin due to increased bleeding risk) xxv. Counsel that red flag symptoms (worsening HA, focal neuro sx s, cognitive decline, etc.) = immediate eval xxvi. Office follow-up in 1-3 days Pediatrician or Concussion specialist xxvii. Final word When in doubt keep them out! 6. Tooth/Jaw a. If a primary tooth is knocked out nothing to do b. Permanent tooth - They have a root i. The faster it is put back in the socket the better ii. If partially out push it back in iii. If all the way out and not dirty put it back in if possible iv. If dirty - clean it and put it back in - try not to touch the root v. If unable to put back in they should go to the hospital or their dentist 1. Transport the tooth under the tongue if possible 2. If they cannot hold it in their mouth then transport the tooth in Milk 3. If no milk or cannot do in the mouth then transport clean water vi. If tooth fractured not much to do - have player see their dentist 7. Eye a. Look at eyeball before it becomes too swollen

4 b. Remove contacts c. Make sure the player has vision if no vision refer to hospital d. Make sure the eyeball moves around in the socket if not refer to hospital e. Look for blood behind the cornea if present refer to hospital f. Ice to area to prevent a large amount of swelling g. Finger in the eye with lots of pain is a corneal abrasion and should be referred to the hospital 8. Nose a. Direct pressure b. Pinch the nose just below the boney part i. Hold for 10 minutes ii. If still bleeding have them blow and repeat pressure for 10 minute iii. If still bleeding after two attempts go to the hospital iv. Ice to face after bleeding stops v. Not much to do for a nasal fracture 9. Neck/Back a. If a neck injury and player on the ground do not move the player b. If a player voluntarily moves the neck without significant pain it is usually Ok to have the player get up if they have pain with movement keep then down and call medic c. Do not move the player until medic arrives d. Back injuries similar guidelines but not as critical to keep them still 10. Chest a. Commotio Cordis Sudden cardiac death after direct blow to the chest i. If player hit is chest with a ball and is unconscious immediately get the AED and apply ii. The sooner you can defibrillate the better chance you have to save the players life 11. Groin a. Have all players where a cup b. It can really swell c. Ice to the groin d. If swelling or bruising they need to go to the hospital or their MD 12. Laceration a. If gapping it probably needs sutures b. Direct pressure to stop the bleeding 13. Environmental a. Heat i. Have them drink when on the bench ii. Kids dehydrate faster than adults

5 iii. If dizzy or fatigued have them sit and drink water b. Bee stings i. Benadryl good for local swelling ii. Some stings will get very red and swollen iii. Remove stinger Credit card helps with this iv. If full body rash, or trouble breathing call medic 14. Medical problems a. Diabetic and hot day sometimes a tough mix i. Make sure they stay hydrated b. Asthma i. Grass and exercise can set off an asthma attack ii. Take is seriously if an asthmatic tells you he is SOB

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