Show:
CONDITION, CLUES, ACTION
SCENARIOS
SCENARIOS
PREPARE, PREVENT, PROTECT
SCENARIOS
300

On a hot day, a wheelchair tennis player becomes confused and stops responding correctly. Their skin is hot, but their jersey is completely dry.

  • Condition: Thermoregulatory crisis (heat)
  • Clues / Symptoms: Confusion, hot dry skin, no sweating
  • Action: Begin active cooling (water spray, fans, ice packs)
300

Scenario

A wheelchair athlete says they feel “fine” after a collision and wants to keep playing. You notice blood on their sock and a red smear on the floor.

  • Condition: Sensory‑deprived skin trauma
  • Clues / Symptoms: No pain reported, visible bleeding, autonomic signs
  • Action: Stop play and perform a full visual skin check
300

Scenario

A visually impaired athlete is sitting on the floor after a collision and asks repeatedly, “Who’s here?”

  • Condition: Visual impairment communication need
  • Clues / Symptoms: Disorientation, repeated questioning
  • Action: Verbally identify yourself and describe surroundings before touching
300

AUTONOMIC DYSREFLEXIA (PREVENTION FOCUS)

Scenario

Before a wheelchair rugby game, an athlete with a T5 SCI mentions they feel “off” and slightly flushed. Their leg straps were tightened just before warm‑up.

  • Condition: Risk of Autonomic Dysreflexia
  • Clues / Symptoms: Flushing, recent tightening of equipment below injury level
  • Action: Loosen straps, reassess, and monitor before allowing play
300

DEAF ATHLETE – FIRST CONTACT

Scenario

You approach an injured athlete from behind and speak loudly. They jump and pull away.

  • Condition: Deaf / hard‑of‑hearing communication barrier
  • Clues / Symptoms: Startle response, pulling away
  • Action: Move into their line of sight and use visual communication
300

Scenario

A sledge hockey athlete with a T4 spinal cord injury suddenly stops playing. They complain of a pounding headache and nausea. You notice their face is red and sweaty, but their legs are pale and cold.

  • Condition: Autonomic Dysreflexia
  • Clues / Symptoms: Headache, sweating/flushing above injury, pale skin below
  • Action: Sit the athlete upright and look for the trigger (e.g., catheter, tight straps).
300

Scenario

An athlete with normally controlled muscle tone suddenly becomes extremely rigid, arches their back, has a high fever, and appears confused or hallucinating.

  • Condition: Baclofen pump failure
  • Clues / Symptoms: Sudden whole‑body rigidity, fever, hallucinations
  • Action: Call EMS immediately—this is life‑threatening
300

Scenario

A powerchair athlete with both SCI and TBI suddenly stares blankly, then becomes flushed with a pounding headache. Their blood pressure is high.

  • Condition: Complex emergency (AD + neurological event)
  • Clues / Symptoms: Mixed seizure‑like signs and autonomic symptoms
  • Action: Prioritize airway and Autonomic Dysreflexia management; consult carer
300

THERMOREGULATORY CRISIS (EARLY RECOGNITION)

Scenario

An athlete with SCI says they feel “foggy” and slow during practice but insists they’re fine. Their skin feels warm and dry.

  • Condition: Early thermoregulatory crisis
  • Clues / Symptoms: Mental fog, warm dry skin, no sweating
  • Action: Stop activity and begin active cooling immediately
300

Scenario:
An SCI athlete suddenly looks flushed and sweaty above the chest during warm‑up. They say their head feels “weird.” Their leg straps were just adjusted.

  • Condition: Autonomic Dysreflexia
  • Clues: Flushing/sweating above injury, headache, tight equipment
  • Action: Sit upright and loosen straps
300

Scenario

A basketball player with cerebral palsy falls. Their arm is pulled tightly to their chest. They are awake, talking, and say their arm “won’t move.”

  • Condition: Muscle spasticity
  • Clues / Symptoms: Fully conscious, rigid muscle tension, no jerking
  • Action: Use slow, gentle stretching and warmth—do not force the limb
300

Scenario

A runner with a prosthetic leg suddenly limps and says it feels like their leg is “shrinking.” The limb moves inside the socket.

  • Condition: Residual limb trauma due to volume change
  • Clues / Symptoms: Pistoning, stump pain, loose prosthetic fit
  • Action: Remove the prosthesis and inspect the residual limb
300

Scenario

A prosthetic user reports mild discomfort but no visible injury. Their gait has subtly changed.

  • Condition: Early residual limb issue
  • Clues / Symptoms: Gait change, localized discomfort
  • Action: Remove prosthesis and inspect the limb
300

SHUNT MALFUNCTION VS CONCUSSION

Scenario

A visually impaired athlete with Spina Bifida hits their head and vomits once. A coach assumes it’s “just a concussion.”

  • Condition: Possible shunt malfunction
  • Clues / Symptoms: Vomiting after head impact, history of VP shunt
  • Action: Treat as a neurosurgical emergency and call EMS
300

Scenario:
An athlete with SCI appears anxious and nauseous. BP is higher than usual for them, but still “normal” by standard charts.

Answer

  • Condition: Autonomic Dysreflexia
  • Clues: Nausea, anxiety, baseline BP change
  • Action: Treat as AD and search for trigger
400

Scenario

An athlete suddenly stares blankly and begins rhythmic jerking while seated in their sports chair.

  • Condition: Seizure
  • Clues / Symptoms: Loss of awareness, rhythmic movements
  • Action: Lock chair brakes, support the head, protect the airway
400

Scenario

After a head impact, a partially sighted athlete stops playing and says it feels like a dark curtain is falling over their vision. They report flashes of light.

  • Condition: Retinal detachment
  • Clues / Symptoms: New shadows, flashes, curtain‑like vision loss
  • Action: Keep the athlete still and arrange immediate emergency transport
400

Scenario

A Deaf athlete falls and injures their ankle. When you speak to them, they push you away and appear agitated. They point to their ear and shake their head.

  • Condition: Communication / information gap
  • Clues / Symptoms: No response to speech, agitation, pointing to ear
  • Action: Move into their line of sight and use visual or written communication
400

SENSORY‑DEPRIVED SKIN CHECK (PREVENTION)

Scenario

After every game, a paraplegic athlete says they feel fine and wants to leave immediately.

  • Condition: Risk of sensory‑deprived skin injury
  • Clues / Symptoms: No pain sensation below injury level
  • Action: Perform a routine visual skin check before leaving
400

Scenario:
A quadriplegic athlete insists they are fine but appears confused and flushed on a hot day.

Answer

  • Condition: Heat‑related thermoregulatory crisis
  • Clues: Confusion, environmental heat
  • Action: Remove from heat and cool immediately
500

An athlete with a T4 spinal cord injury stops during play complaining of a severe headache and nausea. Their face is flushed and sweating, while their legs appear pale and cold. Their blood pressure reads “normal” for the general population.

Condition

  • Autonomic Dysreflexia

Causes

  • Noxious stimulus below injury level
  • Common triggers: bladder distension, kinked catheter, bowel impaction, tight straps

Prevention

  • Regular bladder/bowel management
  • Proper equipment fit
  • Skin checks and avoiding pressure points

First Aid Actions

  • Sit athlete upright immediately
  • Loosen tight clothing/equipment
  • Identify and remove trigger
  • Call EMS if unresolved

Communication

  • Speak calmly and directly to the athlete
  • Explain each action before performing it
  • Ask where triggers may be (athlete is expert)

Vital Signs / Baseline

  • SCI athletes may have low baseline BP
  • “Normal” BP can represent a medical emergency
  • Monitor BP and symptoms continuously
500

During a hot competition, a quadriplegic athlete becomes confused and stops responding appropriately. Their skin is hot but dry, and they are not sweating.

Condition

  • Thermoregulatory crisis (heat illness)

Causes

  • Autonomic nervous system dysfunction
  • Inability to sweat below injury level
  • High environmental temperature and exertion

Prevention

  • Scheduled cooling breaks
  • Pre‑cooling strategies
  • Hydration and environmental monitoring

First Aid Actions

  • Immediate active cooling
  • Water spray and fans
  • Ice packs to neck, armpits, groin
  • Hand immersion in cool water

Communication

  • Use simple, calm instructions
  • Reduce sensory overload
  • Reassure athlete during confusion

Vital Signs / Baseline

  • Monitor temperature and heart rate
  • Athletes may overheat without visible sweating
  • Mental status change is a key warning sign
500

An athlete with cerebral palsy falls during play. Their arm is rigidly flexed against their chest, but they remain fully conscious and responsive.

Condition

  • Muscle spasticity (not a seizure)

Causes

  • Cold exposure
  • Sudden movement or trauma
  • Baseline hypertonia in CP

Prevention

  • Warm environment
  • Proper warm‑up
  • Gradual movements

First Aid Actions

  • Gentle, slow stretching
  • Apply warmth
  • Do NOT force limb movement

Communication

  • Reassure athlete
  • Ask about baseline muscle tone
  • Calm bystanders who may think it’s a seizure

Vital Signs / Baseline

  • Consciousness intact
  • Normal breathing
  • Awareness differentiates from seizure
500

An athlete suddenly stares blankly, loses awareness, and begins rhythmic jerking while seated in a sports chair.

Condition

  • Seizure

Causes

  • Abnormal electrical brain activity
  • May be related to TBI or neurological conditions

Prevention

  • Medication compliance
  • Stress and trigger management

First Aid Actions

  • Lock chair brakes
  • Support the head
  • Protect airway
  • Do not restrain or remove unless airway compromised

Communication

  • Speak calmly
  • Give space
  • Explain actions once consciousness returns

Vital Signs / Baseline

  • Loss of awareness
  • Monitor breathing and responsiveness
  • Compare to known seizure history if available
500

A goalball athlete with Spina Bifida hits their head. They develop projectile vomiting, severe headache, and downward‑fixed eyes.

Condition

  • Shunt malfunction

Causes

  • Blocked or disconnected VP shunt
  • Trauma or sudden jarring

Prevention

  • Protective equipment
  • Early reporting of symptoms after head impacts

First Aid Actions

  • Keep athlete upright
  • Call EMS immediately
  • Do NOT manipulate the shunt

Communication

  • Speak calmly
  • Explain seriousness without panic
  • Reassure athlete while awaiting EMS

Vital Signs / Baseline

  • Signs of increased intracranial pressure
  • Vomiting, altered consciousness
  • Rapid deterioration possible