Evaluating Injuries

1. Evaluating Injuries

2. Objectives • Student will be able to describe the step by step process of evaluating injuries

3. 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

4. Emergency Considerations • There are 2 major considerations in emergency evaluation: • Control of life-threatening conditions and activation of emergency medical services • Management of non-life-threatening injuries

5. . 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

6. 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.

7. Evaluating Injuries • Primary Survey • airway • breathing • circulation

8. Secondary Survey • after primary survey has determined there is no life-threatening condition. • It consists of 2 elements: • History • Physical Examination

9. 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 sensations • progression of signs and symptoms • activities that make the symptoms better or worse

10. Physical Examination • Evaluate Vital Signs: • abnormal nerve response • blood pressure • movement • pulse • respirations • skin color • state of consciousness • temperature

11. 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

12. 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)

13. Observation • compare the uninvolved to the involved anatomical structure (bilateral comparison) • Signs and Symptoms • Look for: • Bleeding • deformity (disfigurement) • swelling (edema) • discoloration (ecchymosis) • Scars o • other sign of trauma

14. 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.

15. Special Tests Special 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 • accessaryanatomical structures • example: synovial capsules, bursa, menisci • inflammatory conditions • range of motion • pain or weakness in the affected area

16. Evaluation Format • SOAP • Subjective • Objective • Assessment • Plan

17. Subjective • asking question about pre-existing or existinginjuries • How it happened? • When it happened? • What did you feel? • Has this ever happened before? • Types of pain • Where does it hurt?

18. Objective • Involves visual, physical, and functional inspection • Swelling - Deformity • Ecchymosis - Symmetry • Range of Motion - Scars • Facial expression - Circulation • Neurological tests - Bone • Soft tissue - Gait / walk • Sports-specific movements

19. Assessment • Try to determine: • Probable cause of the injury • Impressions of injury site • Severity of injury • Treatment goals

20. Plan • What immediate and long term action should be taken to care for the injury? • Immediate action • Referral • Modalities utilized • Preventive techniques • Rehabilitation considerations • Criteria for return to active lifestyle

21. Basic Treatment Protocol • Prevention • Rest • Ice • Compression • Elevation • Support

22. Prevention • Protect the injury from further damage by removing the athlete from participation.

23. Rest • After evaluation is completed, rest injury for at least 24 hrs., but could be longer. • length of rest dependent on severity of injury.

24. 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.

25. Compression • use compression wrap to control swelling • begin distally (farthest from heart) • spiral the wrap toward the heart • remove the wrap every 4 hours • things to look for if wrap is too tight: • extremities turning blue or pink • numbness & tingling of extremities • increased pain

26. Elevation • Keep injured body part elevated higher than the heart • allows gravityto keep excessive blood & swelling out of injured area.

27. Support • first aid splint • crutches for lower extremity injuries • sling for upper extremity injuries