Immediate and Emergency Care
Seconds Matter: The Primary Survey
Emergency questions test sequence and decision-making under pressure. Begin with scene safety and the emergency action plan (EAP): who calls EMS, who retrieves the AED, who controls the crowd, and where the ambulance will enter. The primary survey addresses life threats - responsiveness, airway, breathing, circulation, and severe bleeding - before any musculoskeletal assessment. The secondary survey (head-to-toe, history, vital signs) comes only after the athlete is stable.
Know BLS: high-quality compressions around 100-120 per minute at roughly 2 inches deep, a compression-to-ventilation ratio of 30:2 for a single rescuer, and early defibrillation. Place AED pads per the device diagram, avoid placement over an implanted device, and resume compressions immediately after a shock. Suspected spine injury means spinal motion restriction, not routine backboarding; a football helmet and shoulder pads are removed together, and the facemask is cut off to gain airway access.
Differentiate the can't-miss conditions: exertional heat stroke (CNS dysfunction - cool first, transport second with cold-water immersion), anaphylaxis (epinephrine auto-injector, then EMS), asthma, hypoglycemia, seizure, exertional sickling, commotio cordis, and sudden cardiac arrest.
Trap: check for a pulse and give two rescue breaths reflects an older or healthcare-provider algorithm. Read the stem to see who the rescuer is and follow the current sequence for that role.
Rule of thumb: if the athlete is unresponsive or not breathing normally, compressions and an AED outrank everything else.