Communication Counts
This communication rule emphasizes treating the athlete as the expert on their own body.
What is speaking directly to the athlete and respecting their expertise?
This acronym is used to assess level of responsiveness.
What is AVPU?
This life-threatening condition is common in athletes with SCI at T6 or above.
What is Autonomic Dysreflexia (AD)?
This crisis is common in SCI, MS, and TBI due to autonomic dysfunction.
What is a thermoregulatory crisis?
This device drains excess fluid from the brain.
What is a shunt?
This strategy helps confirm understanding without relying on yes/no questions.
What is asking them to show, point to where it hurts, or repeat information?
This concept is critical because many disabled athletes have “normal” readings that differ from the general population.
What is understanding the athlete’s baseline vital signs?
A sudden pounding headache and sweating above the injury level suggests this condition.
What is Autonomic Dysreflexia?
This MS-specific phenomenon causes temporary vision or motor loss when overheated.
What is Uhthoff’s Phenomenon?
Projectile vomiting and downward-looking eyes suggest failure of this device.
What is shunt malfunction?
This adjustment is critical to reduce distress during first aid for athletes with sensory sensitivities.
What is minimizing sensory overload (noise, lights, multiple speakers)?
This tool is especially useful when limb movement is limited.
What is a pulse oximeter?
This visual clue is known as the “split-skin sign.”
What is flushing/sweating above the injury and pale skin below?
This skin presentation is dangerous despite the athlete appearing dry.
What is hot, dry skin without sweating?
This abdominal device controls severe spasticity.
What is a baclofen pump?
This is the correct way to assist someone using a wheelchair or mobility device.
What is asking permission and how they prefer to be assisted—never grabbing equipment?
These skin changes may indicate a medical emergency even without pain.
What are changes in skin color, temperature, moisture, or integrity?
This common trigger should be checked immediately during assessment.
What is a full bladder or kinked catheter?
Confusion with hot, dry skin during exertion most likely indicates this emergency.
What is heat illness due to impaired thermoregulation?
This complication causes sudden, violent whole-body rigidity.
What is baclofen withdrawal (pump failure)?
During a tournament, a visually impaired athlete collides at high speed and goes down on the court.
Multiple staff rush in. Someone reaches to grab the athlete’s shoulder without speaking.
The athlete becomes tense and panicked, shouting that they “don’t know where anyone is.”
They report new flashes and shadows in their vision.
Question :
What is the correct communication response, and what specific communication techniques must be used before providing further care?
What is a visually‑impaired emergency requiring controlled, descriptive communication?
The responder must verbally identify themselves before touching the athlete, clearly state where they are positioned, describe actions and surroundings, and use the “clock method” for directions (e.g., “I am the medic, I’m at your 2 o’clock”).
This communication is critical because sudden, silent touch increases panic and disorientation in visually impaired athletes, especially after a collision with potential ocular trauma.
A wheelchair athlete with SCI finishes a high‑intensity drill and appears uncomfortable.
Their blood pressure reads 120/80, oxygen saturation is normal, and they deny pain.
Their caregiver urgently says, “That BP is high for them.” The athlete now reports a headache and looks flushed above the chest.
Question:
What is the most important assessment principle being violated, and what should guide your response?
What is failure to assess deviation from baseline?
The responder must compare current vital signs to the athlete’s individual baseline, recognizing that “normal” values can represent a medical crisis in disabled athletes, especially those with SCI.
The caregiver’s input is critical in identifying dangerous baseline deviation.
Scenario
An athlete with a known T4 SCI suddenly complains of a pounding headache, blurred vision, and a “sense of doom.”
You observe heavy sweating above the injury level and cold, pale skin below.
Their BP is “within normal limits.”
Question:
What is the condition, and what is the single most important first action?
What is Autonomic Dysreflexia?
The first and most critical action is to sit the athlete upright at 90° to immediately lower blood pressure, followed by searching for the noxious trigger and calling EMS if unresolved.
The “split‑skin” presentation and misleadingly normal BP confirm the diagnosis.
During a summer competition, an athlete with SCI becomes confused and reports “mental fog.”
Their skin is hot and dry, and they are not sweating, even during intense exertion.
A coach says, “They don’t look flushed — they must be fine.”
Question:
What emergency is occurring, and what cooling strategy is emphasized as especially effective?
What is a thermoregulatory crisis due to autonomic dysfunction?
The responder must initiate active cooling, including misting with water, fans, ice packs to major heat‑loss areas, and hand immersion in cool water, which is particularly effective for SCI athletes.
Lack of sweating does not indicate safety in this population.
The most important rule when dealing with either of these devices.
What is never attempting to manipulate or “fix” the device and calling emergency care immediately?