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Care and Prevention Chapter 27
Head, Face, Ears, Nose, Throat
Head and Neck

If a person is unconscious and you didn't see what happened consider it a C-spine injury

C-Spine Injury:
MOI: axial loading, loose curve in neck ( neck flexed) and direct blow on axis- forces transferred down spine and unable to dissipate force, vertebra fractured or displaced compromising the cord
S&S: cervical pain- very specific, pt tender, numbness in trunk or limbs, weakness, paralysis, loss of bladder control, cervical muscle spasm
Treatment:
1. Check ABCs
2. Stabilize C-spine
3. Don't remove helmet
4. Check for pain in neck and back
5. Check neurological function:  Can you move your arms and legs?
6. Check for numbness or tingling in extremities 
7. Call 911
If at any time the individual stops breathing:  log roll, remove face mask , perform CPR (The fact that he/she has stopped breathing is a life-threathening injury and takes precedence of the neck injury which may lead to paralysis or death in it's worth case.

Head Injury (concussion): contusion of brain
MOI: direct blow
Treatment: assess and monitor
do not give aspirin, use Tylenol or Advil

Brachia Plexus (stinger):
MOI: overstretching and contusion
S&S: neurological symptoms down arm
Treatment: evaluate, monitor, if feeling doesn't come back within 5 minutes refer to doctor

Nose Bleeds:
MOI: in sports usually result from a direct blow
S&S: usually bleeding is present 
Treatment: an athlete with an acute nosebleed should sit upright with a cold compress placed over both the nose and the ipsilateral carotid artery while finger pressure is applied to the affected nostril for five minutes.  It has ben suggested that a piece of rolled-up gauze be placed between the upper lip and gum, which places direct pressure on the arteries that supply the nasal mucosa.  If this procedure fails to stop the bleeding, a nasal plug may be used.  If this pledget is used, the ends should protrude from he nostrils at least 1/2 inch to facilitate removal.  After bleeding has ceased, the athlete may resume activity but should be reminded not to blow the nose under any circumstances for at least two hours after the initial insult.

Dislocated Tooth:
MOI: direct blow
Treatment: if whole, rinse off and stick back in or refer to dentist

Orbital Blowout Fracture:  pressure on eye socket blows out bottom of eye socket, after pressure is released, it comes back up and impinges tissue
MOI: blow to eye socket
S&S: pain in eye, blurry or double vision, difficulty with tracking especially up, downward displacement of the eye, pain accompanied  soft tissue swelling and hemorrhage.
Treatment: ice and refer to doctor, xray, anti-biotics prophylactically may be indicated to minimize risk of infection 

Acute conjunctivits:  Pink eye

MOI: usually caused by various bacteria or allergens.  It may begin with conjunctival irritation from wind, dust, smoke, or air pollution.  It may also be associated with the common cold or other upper respiratory conditions.

S&S: eyelid swelling, sometimes with a purulent discharge.  Itching is associated with allergy.  Eyes may burn or itch.

Treatment: Acute conjuctivits can be highly infectious.  A 10 percent solution of sodium sulfacetamide is often the treatment of choice.

Hordeolum (Sty)

MOI:  A sty is an infection of the eyelash follicle or the sebaceous gland at the edge of the eyelid.  The infection is usually caused by a staphylococcal organism that has been spread by rubbing or by dust particles.

S&S: The condition starts as erythema of the eye.  It localizes into a painful pustule witihin a few days

Treatment: consists of the application of hot, moist compreses and an ointment of 1 percent yellow oxide or mercury.  Recurrent sites require the attention of an ophthalmologist.


Spear Tackler's Spine: spine straight even when in neutral position
 
The proper technique employed when making a tackle is to tackle with the head up.  Looking at the person being tackled.  The cervical spine has a normal lordotic curve which compensates from axial forces.  If the tackler lowers his head and in affect straighthens his neck, then he places the vertebral bodies in an axial alignment which allows tranmission of force from one vertebrate to the next.  This increases the likely of fracturing the neck.  A fractured neck can in-turn lead to a severed spinal cord or spinal nerve.  Nerve damage may lead to paralysis or death.

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