CCSP Emergency Procedures & Sideline Management 4 — Questions and Answers
Question 1: During a football game, a player sustains a facial laceration with active arterial bleeding. The most appropriate immediate sideline action is:
- Apply direct firm pressure with a sterile gauze for at least 5–10 minutes (Correct answer)
- Apply a tourniquet proximal to the wound
- Pack the wound with hemostatic gauze and close with adhesive strips immediately
- Elevate the head and apply ice to reduce bleeding
Correct answer: Apply direct firm pressure with a sterile gauze for at least 5–10 minutes
Direct continuous pressure for 5–10 minutes is the first-line treatment for facial lacerations, which have excellent vascularity and typically respond well.
Question 2: The primary reason a sports medicine provider should NOT remove a football helmet in a suspected cervical spine injury (except in specific indications) is:
- Helmet removal without shoulder pad removal can extend the cervical spine and worsen injury (Correct answer)
- Helmets provide adequate airway access through the face mask
- Helmet removal is too time-consuming in an emergency
- The helmet stabilizes cervical vertebrae directly
Correct answer: Helmet removal without shoulder pad removal can extend the cervical spine and worsen injury
Removing the helmet without simultaneously removing shoulder pads creates cervical extension because shoulder pads elevate the torso relative to the head.
Question 3: An athlete on the sideline reports a sudden severe headache described as 'the worst headache of my life' after heading a soccer ball. The most concerning diagnosis is:
- Subarachnoid hemorrhage (Correct answer)
- Tension headache
- Cervicogenic headache
- Migraine with aura
Correct answer: Subarachnoid hemorrhage
A thunderclap headache — sudden severe 'worst headache of my life' — is the classic presentation of subarachnoid hemorrhage and requires immediate emergency transport.
Question 4: Which of the following is the most accurate field test for assessing exertional heat stroke severity?
- Rectal temperature measurement (Correct answer)
- Axillary temperature measurement
- Tympanic membrane temperature
- Oral temperature measurement
Correct answer: Rectal temperature measurement
Rectal temperature is the gold standard for core temperature measurement in heat stroke; oral, axillary, and tympanic methods are unreliable during exercise.
Question 5: During sideline assessment of a potential pneumothorax after a chest wall blow, which finding most strongly supports this diagnosis?
- Absent breath sounds on the affected side with respiratory distress (Correct answer)
- Paradoxical chest wall movement during breathing
- Crepitus over the sternum with midline tenderness
- Bilateral wheezing with prolonged expiration
Correct answer: Absent breath sounds on the affected side with respiratory distress
Absent unilateral breath sounds combined with respiratory distress after chest trauma strongly indicates pneumothorax requiring immediate EMS activation.
Question 6: A basketball player with a known peanut allergy develops urticaria, throat tightness, and hypotension after eating a snack bar. After administering epinephrine, the next step is:
- Activate EMS and prepare for a second dose of epinephrine if no improvement in 5–15 minutes (Correct answer)
- Monitor for 30 minutes on the sideline and allow return to play if stable
- Administer diphenhydramine and discharge the athlete
- Apply oxygen and reassess without further medications
Correct answer: Activate EMS and prepare for a second dose of epinephrine if no improvement in 5–15 minutes
Biphasic anaphylaxis can occur hours after initial reaction; all anaphylaxis cases require EMS transport and observation, with a second epinephrine dose available if needed.
Question 7: The Modified SITS test (shoulder instability assessment) is LEAST appropriate in which sideline scenario?
- Suspected posterior glenohumeral dislocation with neurovascular compromise (Correct answer)
- Evaluating subclinical shoulder instability for return-to-play decision
- Screening for multidirectional instability in a swimmer
- Assessing anterior instability in a throwing athlete between plays
Correct answer: Suspected posterior glenohumeral dislocation with neurovascular compromise
Neurovascular compromise with a suspected dislocation is a surgical emergency — sideline instability testing is contraindicated and delays necessary care.
CCSP Emergency Procedures & Sideline Management 4
During a football game, a player sustains a facial laceration with active arterial bleeding.
The most appropriate immediate sideline action is: