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HOPS

HOPS. HOPS. Systematic and standardized procedure used to evaluate injuries. Why? Reduces risk of “missing something” Allows easy communication of findings to all medical personnel. HOPS. H istory O bservation P alpation S pecial Tests

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HOPS

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  1. HOPS

  2. HOPS • Systematic and standardized procedure used to evaluate injuries. • Why? • Reduces risk of “missing something” • Allows easy communication of findings to all medical personnel

  3. HOPS • History • Observation • Palpation • Special Tests • Sometime it is referred to as HIPS (history, inspection, palpation and special tests)

  4. HISTORY • First step • Done before you ever touch the athlete • Use information gained during this phase to guide the rest of the evaluation • Questions should answer the following: • How did injury occur • When did injury occur • Did you hear anything: pops, grating, etc. • Did you feel anything: give out, pop out, burning, numbness, etc. • What have you done for it: ice, heat, NSAIDs • Type and location of pain

  5. INSPECTION • Second part of the evaluation • You still have not touched the athlete • Why do you think that the athletic trainer still has not touched the injured athlete? • This phase can be done as soon as you see the athlete walk in the door, or as you walk onto the field, and can be partially done while taking the history. • Compare everything bilaterally • Why?

  6. INSPECTION • During the inspection you are LOOKING for clues that tell you about the injury • Swelling (type, location, amount) • Discoloration • Deformities • Gait/weight-bearing • Posture • Scars from previous injuries • Bleeding • What should you do if you see bleeding?

  7. Palpation • This is the first time you actually touch the athlete • You use the information you gained during the history and inspection to guide you • Now you are FEELING for clues about the injury • You always palpate the uninjured side first • Why? • Then you palpate the injured side starting away from the area of most pain. • Why?

  8. Palpation • Remember to observe universal precautions if your inspection revealed blood or body fluids • Things you are looking for during palpation • Temperature changes: hot or cold • Deformities • Point tenderness • Crepitice • Swelling (wet diaper vs. water balloon) • Rule out fractures

  9. SPECIAL TESTS • The tests used in this section will be different for each body part that we cover • Remember to perform each test bilaterally • In general the tests are used to determine • Joint range of motion • Muscle strength and function • Ligament stability • Nervous function/integrity

  10. ROM & Muscle Testing • Used to determine if the range of motion of a joint is within normal limits • Always test bilaterally • Three ways to test range of motion– test them in this order • Active—the athlete move the joint themselves • Passive– the athlete is relaxed and you move the joint through the ROM • Resistive-- you apply resistance while the athlete moves the joint

  11. Ligamentous Tests • Tests used to determine the integrity of specific ligaments • We will learn specific tests during future units • Results of these tests, along with the history, inspection and palpation will allow you to “grade” sprains

  12. Grades of Sprains • Grade I • Ligament testing reveals solid endpoint (rope) • Grade II • Ligament testing reveals soft endpoint (bungee) • Grade III • Ligament testing reveals no endpoint (nothing)

  13. Neurologic Testing • Dermatomes: an area of skin mainly supplied by a single spinal nerve • Myotomes: a group of muscle mainly supplied by a single spinal nerve • Reflexes • Peripheral nerve testing

  14. Documentation • Document, document, document! • Remember that one of the most important things an athletic trainer can do is to have accurate documentation of everything they do to and for an athlete • Be sure when performing a HOPS evaluation that you document EVERYTHING!

  15. DOCUMENTATION • What were their answers to any questions that you asked them • What did you find during the observation and palpation • What tests were performed and what was the result • What do you suspect may be wrong • REMEMBER ATHLETIC TRAINERS CAN ONLY EVALUATE, THEY NEVER DIAGNOSE! • What is your plan • Do you recommend they see a doctor • Are you calling 911 • Are you sending them to the ER • Are you continuing treatment in the training room • What specific directions did you give them

  16. Communication • Remember to respect the athlete’s privacy and HIPAA • Only communicate with people directly involved with the athlete– parents, coach, team doctor, etc. • Do not give specific information to the media • Store your evaluation in a secure place – athlete’s secured file, secured computer

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