Recognition, Evaluation, & Management of Athletic Injuries

1. Recognition, Evaluation, & Management of Athletic Injuries Chapter 2

2. Recognition of Injuries • Primary function of an athletic trainer • Know when an injury has occurred • Determine the severity of injury • Apply proper evaluation/treatment procedures and protocols • Control life threatening conditions and activation of emergency medical service • Management of non-life threatening injuries

3. Any of the following exist, Immediate referral is CRITICAL! • Loss of respiratory function • Severe Bleeding • Suspicion of intracranial bleeding and/or bleeding from ears, mouth, nose • Unconsciousness • Paralysis • Circulation or neurological impairment • Shock • Obvious deformity • Suspected fracture/ dislocation • Pain, tenderness, or deformity along vertebral column • Significant swelling and pain • Loss of sensation (motor or sensory) • Loss of motion • When in doubt

4. Student Trainer Responsibilities (in Emergency Situations) • Aware of the causes of serious injuries • Alerting the athletic trainer, administrator, coach, and/or team physician • Recognizing signs of serious injury • Implementing a detailed plan to handle emergency transport • NEVER transport an athlete in a private vehicle

5. Evaluation of Life Threatening Injuries • Survey the scene • Primary survey • Airway • Breathing • Circulation • Approach athlete calm and reassuring manner • Be prepared to clear and maintain airway free • Most comfortable position for breathing • CPR and activate emergency system

6. Secondary Survey (non-life threatening) • History • Mechanism of injury • Onset of symptoms • Location of injury • Quantity and quality of pain • Type and location of any abnormal sensations • Progression of signs and symptoms • Activities that make the symptoms better or worse • Nausea • Weakness • Dyspnea (shortness of breath) 2. Physical Examination • Respiratory rate • Moistness • Color • Temperature of skin • Pulse rate • Abnormal nerve response • Blood pressure • Movement

7. Evaluation of Non-Life Threatening Injuries • H.O.P.S H-History • Mechanism of injury (how did it happen?) • Location of pain (where does it hurt?) • Sensations experienced (did you hear a pop or snap?) • Previous Injury (have you injured this anatomical structure before?) O-Observation • Look for bleeding • Deformity • Swelling • Discoloration • Scars • Other signs of trauma

8. H.O.P.S. 3. P-Palpation (palpate the anatomical structure/joint above and below the injured site. Then the affected area. Pin point the site of severe pain.) • Neurological stability (motor and sensory) • Circulation function (pulse and capillary refill) • Anatomical Structures (palpate) • Fracture Test (palpation, compression, and distraction) • S-Special Tests (looking for joint instability, disability, and pain.) • Joint Stability (stress applied to determine ligament stability) • Muscle/Tendon (stress applied to determine muscle/tendon stability) • Accessory anatomical structures (determine status of accessory anatomical structures, such as synovial capsule, bursa, menisci, etc.) • Inflammatory conditions (determine neurological disorders exist and type of inflammation present, significant clue to type of injury.)

9. Evaluation Format S.O.A.P • S-Subjective Assessment (history) Detailed questions (pre-existing and existing injuries) • Previous injury • How it happened • When it happened • What did you feel • Types of pain • Where does it hurt • Sounds/noises • O-Objective assessment (visual, physical, and functional inspections) • Swelling • Deformity • Gait/walk • Scars • Facial expression • Circulation, neurological test(sensation, reflex, motor) • Bone • Soft tissue • Range of motion • Sports specific movements

10. S.O.A.P • A-Assessment (probable cause and mechanism of injury, impressions of injury site (structures involved), severity of injury, and treatment goals) • P-Plan (immediate action and referral, modalities utilized, preventive techniques, rehabilitation considerations, and criteria for return to active lifestyle)

11. Basic Treatment ProtocolP.R.I.C.E.S • P-Protection (protect that injury from further damage, removing athlete) • R-Rest (after evaluation is completed rest the injury, dependent of severity of injury) • I-Ice (cold to injured area. First 48 hours) • ICE PACKS-15 minutes, with 2 hours in between treatment, 6 or more times a day. • Cold water immersion bath- Temperature between 50-60 degrees, for 10 minutes, with 2 hours between treatment, 6 or more times a day. • C-Compression (compression wraps to control swelling) Begin elastic wrap distally (farthest from heart) to the injury and spiral the wrap toward the heart on the involved extremity. Remove wrap every 4 hours. Signs and symptoms of wrap too tight: blue or pink in color, numbness, tingling, and increased pain.

12. P.R.I.C.E.S • E-Elevation (Keep injured body part elevated higher than the heart.) • S-Support • First aid splint • Crutches • Sling • Brace • Etc.