EVALUATING INJURIES

OBJECTIVES Student will be able to describe the step

by step process of evaluating injuries

REGOGNITION OF INJURIES The primary functions of an athletic

trainer are to: recognize when injury occurred to determine its severity and to apply proper evaluation procedures and

treatment protocols

EMERGENCY CONSIDERATIONS There are 2 major considerations in

emergency evaluation:Control of life-threatening conditions and

activation of emergency medical servicesManagement of non-life-threatening injuries

. IF ANY OF THE FOLLOWING SITUATIONS EXIST, IMMEDIATE REFERRAL IS CRITICAL loss of breathing severe bleeding suspicion of intracranial bleeding and bleeding

from ears, mouth, +/or nose unconsciousness shock obvious deformity suspected fracture/dislocation pain, tenderness, or deformity along vertebral

column loss of motor sensory sensation loss of motion doubt about severity of the injury

EMERGENCY TRANSPORTATION PROCEDURES 2 points to consider when deciding

about transportation: availability of emergency ambulance service severity of injury

Athletic training staff or coaches should NEVER transport an athlete in a private vehicle.

EMT’s are skilled, practiced pros. who routinely provide advanced medical care and transport injured patients.They have the proper equipment and

training to prepare injured athletes for transportation.

EVALUATING INJURIESPrimary Survey

airway breathing circulation

SECONDARY SURVEY after primary survey has

determined there is no life-threatening condition.

It consists of 2 elements:History Physical Examination

INJURY HISTORY ask questions of the athlete to determine:

mechanism of injury how did the injury occur?

onset of symptoms when did symptoms begin

location of injury quantity and quality of pain type and location of any abnormal sensationsprogression of signs and symptomsactivities that make the symptoms better or worse

PHYSICAL EXAMINATIONEvaluate Vital Signs:

abnormal nerve response blood pressure movement pulse respirations skin color state of consciousness temperature

EVALUATION OF NON-LIFE-THREATENING INJURIES First rule out life-threatening injury EVALUATION Process involves 4 steps

HOPS History – Injury History Observation Palpation Special Tests

INJURY HISTORY

Trying to determine the injury mechanism

How did it happen? (mechanism of injury)

Where does it hurt? (location of pain)

Did you hear a pop or snap? (sensations experienced)

Have you injured this anatomical structure before” (previous injury)

OBSERVATION compare the uninvolved to the involved

anatomical structure (bilateral comparison)

Signs and Symptoms Look for:

Bleedingdeformity (disfigurement)swelling (edema)discoloration (ecchymosis)Scars oother sign of trauma

PALPATION Physical Inspection of the injury Palpate above and below injury site first. Then palpate injury site. Pinpoint the site of the most severe

pain. (point tenderness) Use bilateral comparison – compare

good side to injured side.

SPECIAL TESTSSpecial tests and functional tests are used to

determine if damage has been done to the anatomical structures

These tests include testing for: joint stability muscle/tendon stability accessary anatomical structures

example: synovial capsules, bursa, menisci

inflammatory conditionsrange of motionpain or weakness in the affected area

EVALUATION FORMAT SOAP

SubjectiveObjectiveAssessmentPlan

SUBJECTIVE asking question about pre-existing or

existing injuriesHow it happened?When it happened?What did you feel?Has this ever happened before?Types of painWhere does it hurt?

OBJECTIVE• Involves visual, physical, and

functional inspectionSwelling - DeformityEcchymosis - SymmetryRange of Motion - ScarsFacial expression - CirculationNeurological tests - BoneSoft tissue - Gait / walkSports-specific movements

ASSESSMENT Try to determine:

Probable cause of the injury

Impressions of injury siteSeverity of injuryTreatment goals

PLAN What immediate and long term action

should be taken to care for the injury?Immediate actionReferralModalities utilizedPreventive techniquesRehabilitation considerationsCriteria for return to active lifestyle

BASIC TREATMENT PROTOCOL Prevention

Rest

Ice

Compression

Elevation

Support

PREVENTION Protect the injury from further damage by removing

the athlete from participation.

RESTAfter evaluation is completed, rest injury for

at least 24 hrs., but could be longer. length of rest dependent on severity of injury.

ICE Apply cold to injured area

to control bleeding and swelling Two equally effective methods:

Ice packs-plastic bags filled with ice covered with a

wet towel.Treatment lasts 15 min. , 6-8 times per day.

Cold water immersion bath-use bath tub/large basin with water temp.

50/60 degrees for 10 min., 6-8 times per day.

COMPRESSIONuse compression wrap to control swelling

begin distally (farthest from heart)spiral the wrap toward the heartremove the wrap every 4 hoursthings to look for if wrap is too tight:

extremities turning blue or pink numbness & tingling of extremities

increased pain

ELEVATION Keep injured body part elevated higher than the

heartallows gravity to keep excessive blood &

swelling out of injured area.

SUPPORT first aid splint crutches for lower extremity injuries sling for upper extremity injuries