Question

An opposing player charging the net runs into the goalie for your ice hockey team, and the goalie lays motionless on the ice. When you get to him, he is conscious and alert but complaining of not being able to move. He denies having any pain and is becoming very anxious and scared. He has no difficulty breathing. You complete your initial evaluation and find all vitals to be within normal limits, but the athlete does not respond to painful stimuli in his extremities and has no motor activity. You instruct the coach to contact the local EMS and decide to wait for the assistance of EMS personnel to stabilize the athlete on a spine board. While you are waiting, the athlete sates he is beginning to feel some stinging in his feet and can now move his fingers slightly.

Questions:
1.What condition do you think this athlete is suffering from?
2.What do you expect to see happen over the next several minutes?
3.What concerns do you have with the patient and scenario?
4.Describe your referral strategy.
5.What care would you render if the symptoms persist?
6.What would you do if, by the time the ambulance arrives, the athlete has fully recovered his sensation and motor function?

Answer 1

1. He is suffering from neurological disorders or cord compressions due to which his motor and sensory organs are not working properly.

2. We can see in the patient following problems :

• Irritability
• Confusion
• Giddiness
• Dizziness
• Headache
• Nausea and vomiting
• Fainting
• Inability to recognize things
• Sensitive to light
• Post traumatic seizure

3. If the patient lies in the same condition for a long time it is very difficult to diagnose and treat without any help. The patient may even go in the hemorrhagic shock causing internal bleeding.

4. Referal strategies : while referring a detail data must be provided to physicians or EMS

• History ( when did it happen ? How did it happen ?)

- symptoms

- time

- mechanism

• Consciousness
• Any primary care provided
• Any allergies to medication etc

5. If the condition persist

- Continue to check the vitals

- Pinch the patient for any painful stimulation

- assess the joint movements

- if there is any sign of fainting raise the legs of patient above heart level to increase the blood flow to heart and brain

- check for ABC

• AIRWAY
• BREATHING
• CIRCULATION

- gently massage the patient hand and foot to make it warm

- observe for any bleeding

- Apply splint if there is any fracture

6. It is better to shift the patient to hospital rather than keeping him there . Because post traumatic have worse effect .

It is better to hospitalize and have all diagnostic evaluations like CT , XRAYS , BLOOD INVESTIGATION, MRI etc and has per the policy