CCSP - Certified Chiropractic Sports Physician On-Field Emergency Procedures Questions and Answers — Questions and Answers
Question 1: During an on-field assessment of a football player who sustained a blow to the head, which of the following signs MOST urgently necessitates activation of the Emergency Action Plan and immediate transport to a hospital?
- Athlete reports a headache and sensitivity to light.
- Athlete exhibits a brief period of confusion but is now lucid.
- Athlete has one episode of vomiting but is otherwise stable.
- Athlete experiences a seizure and has a Glasgow Coma Scale (GCS) score of 13. (Correct answer)
Correct answer: Athlete experiences a seizure and has a Glasgow Coma Scale (GCS) score of 13.
A seizure following head trauma is a significant red flag indicating a potentially severe brain injury. A Glasgow Coma Scale (GCS) score of less than 15, in this case 13, also signifies a moderate to severe injury and requires immediate emergency medical attention. While headache, confusion, and a single episode of vomiting are all signs of concussion, a seizure and a lowered GCS score represent the most immediate threat to life and require urgent hospital evaluation.
Question 2: A soccer player collapses on the field without contact from another player. They are unresponsive and not breathing normally. According to best practices for managing suspected Sudden Cardiac Arrest (SCA), what is the most critical immediate action for the on-site medical team?
- Perform a detailed neurological examination.
- Administer oxygen and wait for EMS to arrive.
- Begin high-quality chest compressions and call for an AED. (Correct answer)
- Move the player to the sideline for a more thorough assessment.
Correct answer: Begin high-quality chest compressions and call for an AED.
For any athlete who collapses and is unresponsive, Sudden Cardiac Arrest (SCA) should be assumed. The immediate priority is to start high-quality cardiopulmonary resuscitation (CPR) with chest compressions and to retrieve and apply an Automated External Defibrillator (AED) as quickly as possible. Early CPR and defibrillation are the most critical factors in improving survival rates from SCA.
Question 3: When managing a suspected cervical spine injury in an American football player who is wearing a helmet and shoulder pads, what is the primary principle guiding the on-field provider's actions?
- Remove the helmet immediately to assess the airway.
- Log-roll the athlete onto their side to prevent aspiration.
- Maintain manual in-line stabilization of the head and neck. (Correct answer)
- Apply a cervical collar before moving the athlete.
Correct answer: Maintain manual in-line stabilization of the head and neck.
The absolute first priority in a suspected cervical spine injury is to manually stabilize the head and neck in a neutral, in-line position to prevent any movement that could cause further neurological damage. All other actions, such as equipment removal or transfer to a spine board, are secondary and must be performed while this stabilization is maintained. The rescuer holding stabilization is in charge of all subsequent coordinated movements.
Question 4: A long-distance runner finishes a race on a hot, humid day and presents with a core body temperature of 102°F (38.9°C), heavy sweating, dizziness, and nausea. Their mental status is intact. Which condition is most likely, and what is the appropriate initial on-field treatment?
- Heat Stroke; immediate cold water immersion and activation of EMS.
- Heat Exhaustion; move to a cool environment, provide fluids, and apply cool cloths. (Correct answer)
- Exercise-Associated Hyponatremia; administer a salt tablet and restrict fluids.
- Heat Cramps; gently stretch the affected muscles and provide electrolytes.
Correct answer: Heat Exhaustion; move to a cool environment, provide fluids, and apply cool cloths.
This athlete's presentation, including a core body temperature below 104°F (40°C), heavy sweating, and intact central nervous system function (no confusion or delirium), is characteristic of heat exhaustion. The appropriate initial treatment is to move the athlete to a cool, shaded area, begin fluid replacement, loosen clothing, and apply cool, wet cloths. Heat stroke would involve a higher core temperature (>104°F/40°C) and significant CNS dysfunction, requiring more aggressive cooling and immediate EMS activation.
Question 5: An athlete suffers an obvious, displaced fracture of the tibia during a game. Which of the following is the MOST appropriate on-field management strategy by the attending chiropractor?
- Attempt a single, gentle reduction of the fracture on the field.
- Have the athlete try to bear weight to assess the severity.
- Immobilize the joints above and below the fracture site and arrange for transport. (Correct answer)
- Apply heat to the area to relax the surrounding muscles.
Correct answer: Immobilize the joints above and below the fracture site and arrange for transport.
The primary goal for on-field management of an acute, displaced fracture is to prevent further injury by immobilizing the limb. This is accomplished by splinting the joints directly above and below the fracture site (in this case, the knee and the ankle). After immobilization, the athlete should be safely transported for definitive medical care. Attempting reduction on the field is generally not recommended unless there is neurovascular compromise, and applying heat or encouraging weight-bearing would be contraindicated.
Question 6: Which of the following is a critical component of a comprehensive Emergency Action Plan (EAP) for an athletic venue?
- A list of preferred chiropractic clinics for follow-up care.
- The head coach's personal cell phone number.
- Designation of personnel with specific roles and a clear chain of command. (Correct answer)
- A detailed schedule of all planned athletic events for the season.
Correct answer: Designation of personnel with specific roles and a clear chain of command.
A well-developed Emergency Action Plan (EAP) must clearly define the roles and responsibilities of each member of the emergency team and establish a clear chain of command. This ensures a coordinated, efficient response in a high-stress situation. The EAP should be specific to each venue, include emergency contacts for EMS, and detail the location of emergency equipment like AEDs. While other information might be useful, the designation of roles is a foundational and critical component.
CCSP - Certified Chiropractic Sports Physician On-Field Emergency Procedures Questions and Answers
During an on-field assessment of a football player who sustained a blow to the head, which of the following signs MOST urgently necessitates activation of the Emergency Action Plan and immediate transport to a hospital?