HIPS

1. HIPS UNIT 7- INJURY MANAGEMENT

2. HIPS • Specific injury assessment to evaluate the extent of musculoskeletal injuries • Performed in an ordered sequence to assess the nature, site and severity of an injury • By following a consistent pattern, you are less likely to forget a procedure • HIPS • History • Inspection • Palpation • Special Test

3. PPE /BSI • Before you start the injury assessment you must take precautions to prevent disease transmission • Avoid contact with body fluids • Wear Gloves • Cover cuts • Wear protective coverings • Use breathing devices • Wash hands after treatment • Remove athlete from activity if bleeding and blood on uniform • Use a solution of bleach and water or hydogen peroxide to get blood off uniform

4. History • One of most important steps • Collecting as much information as possible • Ask athlete questions • Ask bystanders questions • Provide clues in determining structures that are injured • Where does it hurt? • What happened? • How did it happen? • How long has it hurt? • Does the joint give away? • Does the joint lock? • Did you hear or feel a pop, crack, snap…?

5. Inspection • This step is purely observational • Always compare bilaterally • Note if holding body part • Note holding body part • Note functional abilities • Limping? • Grimacing? • Look for • Bleeding • Deformity • Swelling • Discoloration • Any sign of injury

6. Palpation • Palpation means to feel or touch • Increase palpation pressure as tolerated • Begin away from injury site • Visualize structures as examine • Compare bilaterally • Palpate • Bones • Muscles • Soft tissue • Ligaments • Tendons

7. Special Tests • There are five areas of special tests • Range of Motion • Stress Tests • Neurological • Circulatory • Functional

8. Special Tests • Range of Motion • Assess in proper sequence- • Active-Passive-Resistive • Compare bilaterally • Active • Movement is performed completely by the examiner • Passive • Movement is performed solely by athlete • Resistive • Athlete is asked to perform movement while the examiner provides resistant • Note any restriction or limitation • Used to determine status of muscle/muscle group • Findings: • Weak and Painless • Possible 3rd degree strain • Weak and Painful • Possible fracture at joint site • Strong and Painful • Possible tear of muscle/tendon • Strong and Pain free • No muscle injury

9. Special Tests • Stress Tests • Designed for almost every body region • Used to determine: • Ligament stability • Muscle imbalance • Muscle tightness • Joint function • Integrity of structures • Neurological Exam • Determine sensory function • Run fingers over area of skin on affected and unaffected area • Apply sharp and dull points to affected and unaffected area • Does it feel the same on both sides?

10. Special Tests • Circulatory • Check pulse distal to injury • When appropriate take pulse, blood pressure and nail bed perfusion • Functional Tests • Determine if athlete can return to sport participation • Done only if no findings were found during special tests • Evaluate motor control and proprioception • Walk, jog, run in straight line, figure 8 and zig-zag • Squat • Throw • Stand on one leg

11. Make a Decision • After completing a HIPS evaluation, a decision of action can be made dependant on: • Extent of injury • Type of care needed • Plan of action • Return to play, re-valuate for follow-through treatment • Can not return to play, ice and re-evaluate • Call 911 • Physical referral