CCSP Emergency Procedures & Sideline Management 5 — Questions and Answers
Question 1: A wrestler collapses on the mat and bystanders report a witnessed tonic-clonic seizure lasting 2 minutes that has just stopped. On your arrival the athlete is post-ictal. The most important initial sideline action is:
- Ensure airway patency, place in recovery position, and monitor vital signs (Correct answer)
- Restrain the athlete to prevent injury during postictal agitation
- Insert an oral airway adjunct immediately
- Administer oral glucose assuming hypoglycemia caused the seizure
Correct answer: Ensure airway patency, place in recovery position, and monitor vital signs
After a seizure ends, maintaining airway patency and placing the athlete in the recovery (lateral) position prevents aspiration and manages the post-ictal state.
Question 2: An EAP (Emergency Action Plan) for an athletic venue should include all of the following EXCEPT:
- Detailed treatment protocols for each possible injury (Correct answer)
- Location of nearest AED and emergency equipment
- Chain of communication and personnel responsibilities
- Directions and access routes for emergency vehicles
Correct answer: Detailed treatment protocols for each possible injury
EAPs define who does what and how to access resources; detailed treatment protocols belong in clinical guidelines, not the venue emergency action plan.
Question 3: A lacrosse player is struck in the chest by a ball during the vulnerable window of cardiac repolarization and collapses immediately. This phenomenon is called:
- Commotio cordis (Correct answer)
- Cardiac contusion
- Costochondral fracture with vasovagal syncope
- Hypertrophic cardiomyopathy exacerbation
Correct answer: Commotio cordis
Commotio cordis is ventricular fibrillation triggered by a low-energy chest blow during the T-wave peak and requires immediate CPR and defibrillation.
Question 4: Which of the following is the MOST reliable early indicator of impending exertional sickling collapse in a sickle cell trait athlete?
- Sudden severe muscle pain and weakness disproportionate to effort (Correct answer)
- Core temperature above 39°C
- SpO2 below 92% on pulse oximetry
- Resting heart rate above 100 bpm
Correct answer: Sudden severe muscle pain and weakness disproportionate to effort
Exertional sickling presents with sudden cramping, ischemic pain, and weakness during intense exertion — distinct from heat cramps — and requires immediate rest and oxygen.
Question 5: During a sideline evaluation, an athlete with a known history of exercise-induced bronchospasm reports worsening dyspnea not relieved after two doses of albuterol. The CCSP should:
- Activate EMS immediately and continue bronchodilator therapy while monitoring (Correct answer)
- Administer a third dose of albuterol and observe for 10 minutes
- Apply supplemental oxygen and have the athlete breathe into a paper bag
- Advise the athlete to remain calm and breathe slowly through pursed lips only
Correct answer: Activate EMS immediately and continue bronchodilator therapy while monitoring
Bronchospasm unresponsive to two doses of albuterol constitutes a severe asthma exacerbation requiring emergency services and advanced airway management.
Question 6: A football player sustains a 'burner' (stinger) during a tackle and has unilateral arm burning and weakness. What is the correct return-to-play criterion?
- Full, painless range of motion and symmetric upper extremity strength before return (Correct answer)
- Resolution of burning sensation alone regardless of strength
- Return immediately if the athlete feels ready and bilateral grip strength is equal
- Wait 48 hours from injury regardless of clinical findings
Correct answer: Full, painless range of motion and symmetric upper extremity strength before return
Return to play after a burner requires complete resolution of symptoms AND full symmetric strength to prevent recurrent injury in a vulnerable neural tissue.
Question 7: During mass participation event medical coverage, an athlete presents with hyponatremia (Na+ 118 mEq/L) and is confused with seizure activity. The correct immediate intervention is:
- Activate EMS for IV hypertonic saline (3% NaCl) administration (Correct answer)
- Administer 1 L of isotonic normal saline IV bolus rapidly
- Give 500 mL of oral sports drink and monitor closely
- Place in Trendelenburg position and restrict all fluids
Correct answer: Activate EMS for IV hypertonic saline (3% NaCl) administration
Symptomatic severe hyponatremia with seizures is a medical emergency requiring hypertonic saline — isotonic fluids can worsen cerebral edema.
CCSP Emergency Procedures & Sideline Management 5
A wrestler collapses on the mat and bystanders report a witnessed tonic-clonic seizure lasting 2 minutes that has just stopped.
On your arrival the athlete is post-ictal.
The most important initial sideline action is: