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Sports Injury Assessment

Sports Injury Assessment. Procedures. Primary and Secondary Surveys. It is important to perform a Primary and Secondary survey. Primary Survey (make sure you are safe before you treat) Detect and treat Life Threatening conditions “Treat as you go” ABCDE’s “A” Airway “B” Breathing

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Sports Injury Assessment

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  1. Sports Injury Assessment Procedures

  2. Primary and Secondary Surveys • It is important to perform a Primary and Secondary survey. • Primary Survey (make sure you are safe before you treat) • Detect and treat Life Threatening conditions • “Treat as you go” • ABCDE’s • “A” Airway • “B” Breathing • “C” Circulation • “D” Disability • “E” Expose

  3. “A”IRWAY • An  obstructed  airway  may  quickly lead to respiratory arrest and death. • Assess   responsiveness   and,   if necessary, open the airway.

  4. “B”REATHING • Respiratory  arrest  will  quickly  lead to  cardiac  arrest.    • Assess  breathing, and,   if   necessary,   provide   rescue breathing. • Look   for   and   treat conditions   that   may   compromise breathing,   such   as   penetrating trauma to the chest.

  5. “C”IRCULATION • If  the  patient’s  heart  has  stopped, blood and oxygen are not being sent to  the  brain. • Irreversible  changes will begin to occur in the brain in 4 to 6  minutes;  cell  death  will  usually occur  within  10  minutes. • Assess circulation,and, ifnecessary, provide  cardiopulmonary resuscitation (CPR).   •  Also check for profuse bleedingthatcan be controlled. • Assess and begin treatment for severeshock or thepotentialfor severe shock.

  6. “D”ISABILITY • Serious centralnervoussystem injuries can lead to death.   • Assessthe patient’s level of consciousness and, if you suspect a head or neck injury, apply arigidneckcollar.    • Observe the neck before you cover it up.   • Also do   a   quick   assessment   of   the patient’s   ability   to   move   all extremities.

  7. “E”XPOSE • You cannot treat conditions you have not  discovered.   •  Remove  clothing– especially if the patient is not alert or communicating  with  you–to  see  if you   missed   any   life-threatening injuries. • Protect   the   patient’s privacy,  and  keep  the  patient  warm with a blanket if necessary.

  8. Primary Survey Continued • As soon as the ABCDE process is completed, you will  need  to  make  what  is  referred  to  as  astatusdecision of the patient’s condition. • A status decision is a judgment about the severity of the patient’s condition and whether the patient requires immediate transport to a medical facility without a secondary survey at the scene.   • Ideally, the ABCDE steps, status, and transport decision  should  be  completed  within  10  minutes  of your arrival on the scene.

  9. Secondary Survey • The  object  of  a  secondary  survey  is  to  detect medical and injury-related problems that do not pose an  immediate  threat  to  survival  but  that,  if  left untreated, may do so. • Usually the trauma assessment is about  20  percent  patient  interview  and  80  percent physical  exam.     On  the  other  hand,  the   medicalassessment   is  80  percent  patient  interview  and  20 percent physical exam.   Both the physical exam and patient interview should always be done for all medical and trauma patients. • H.O.P.S.

  10. HOPS- History • History: Attitude, mental condition, and perceived physical state. • Stated by the athlete. • Primary Complaint • Mechanism of Injury • Characteristics of the Symptoms • Limitations • Past History

  11. HOPS - History • Initial and most important step in the evaluation process. • In many instances, the history alone describes the illness or injury. Physical exam only confirms it.

  12. HOPS -HISTORY CONT. • Look at the athlete. • Anxious • Posture • Walk freely or limp • Guarding • Identify the chief complaint • Why is the athlete there to see you. • Review previous medical history • Acute or Chronic • Any previous injury or surgery

  13. HOPS - History Cont. • Review Symptoms • Athlete’s interpretation of injury or illness • When asking about pain use the following PQRST • Provocation • What causes the pain. • Quality • What type of pain • Sharp, aching, dull, burning, etc…. • Region/Radiating • Location of pain, Radiating pain • Severity • Scale of 1 to 10 • Time • When does it hurt, how long, • What makes it better or worse

  14. HOPS - History cont. • At conclusion of History ask yourself was the history AMPLE? • A = Allergies (Bee sting, Penicillin) • M = Medicine • P = Previous Illness or Injury • L = Last thing taken by mouth • E = Events leading up to injury or illness

  15. HOPS- Observation and Inspection • Observation: Measurable objective signs. • Appearance • Symmetry • General Motor Function • Posture and Gait • Deformity, swelling, discoloration, scars, and general skin condition

  16. HOPS- Palpation • Rule out FX (fracture) • Skin temperature • Swelling • Point tenderness • Crepitus • Deformity • Muscle spasm • Cutaneous Sensation (nail bed refill) • Pulse

  17. HOPS- Special Tests • Functional Tests • Active Range of Motion (AROM) • Passive Range of Motion (PROM) • Resisted Manual Muscle Testing (RROM) • Stress Tests • Ligamentous Instability Tests • Special Tests

  18. HOPS- Special Tests • Neurologic Tests • Dermatomes • Myotomes • Reflexes • Peripheral Nerve Testing • Sport-Specific Functional Testing • Proprioception and Motor Coordination

  19. HOPS- Special Tests • Sport-Specific Skill Performance • Throw the football, baseball, softball, javelin... • Kick the soccer ball, football, opponent…

  20. S.O.A.P. Notes • S=Subjective information gathered from the patient • O=Objective • A=Assessment • P=Plan

  21. SOAP- Subjective • History: Attitude, mental condition, and perceived physical state. • Stated by the athlete. • Primary Complaint • Mechanism of Injury • Characteristics of the Symptoms • Limitations • Past History

  22. SOAP- Objective: • Observation: Measurable objective signs. • Appearance • Symmetry • General Motor Function • Posture and Gait • Deformity, swelling, discoloration, scars, and general skin condition

  23. SOAP- Objective • Rule out FX (fracture) Cutaneous Sens. • Skin temperature Pulse • Swelling • Point tenderness • Crepitus • Deformity • Muscle spasm

  24. SOAP- Objective • Functional Tests • Active Range of Motion (AROM) • Passive Range of Motion (PROM) • Resisted Manual Muscle Testing (RROM) • Stress Tests • Ligamentous Instability Tests • Special Tests

  25. SOAP- Objective • Neurologic Tests • Dermatomes • Myotomes • Reflexes • Peripheral Nerve Testing • Sport-Specific Functional Testing • Proprioception and Motor Coordination

  26. SOAP- Objective • Sport-Specific Skill Performance • Throw the football, baseball, softball, javelin... • Kick the soccer ball, football, opponent… • Macarena, Cabbage Patch, Mash Potato

  27. SOAP- Assessment • Analyze and assess the individual’s status and prognosis • Suspected injury Site • Damaged Structures Involved • Severity of Injury • Progress Notes

  28. SOAP- Plan • Immediate treatment given • Frequency and duration of treatments and modalities and evaluation • On-going patient education • Criteria for discharge/return to play

  29. On Field Assessment

  30. On The Field Assessment • History: • Location of Pain • Presence of abnormal neurological signs • Mechanism of Injury • Associated sounds (snap, crack, pop)

  31. On The Field Assessment cont. • Observation: • Check the surrounding area • Body positioning • Movement of the athlete • Level of responsiveness • Primary survey • Inspection for head or neck trauma • Inspection of the injured body part

  32. On The Field Assessment cont. • Palpation • Joints • Bones • Soft tissue • Skin temperature

  33. On The Field Assessment cont. • Functional Testing • Active Range of Motion (AROM) • Passive Range of Motion (PROM) • Resistive Range of Motion (RROM) • Weight Bearing

  34. On The Field Assessment cont. • Stress Testing • Ligamentous stability • Neurological Testing • Cutaneous • Motor

  35. On The Field Assessment cont. • Vital Signs • Pulse • Respiratory Rate • Blood Pressure • Temperature • Skin Color • Pupils • Disposition

  36. On The Field Assessment cont. • Moving the Athlete • Ambulatory Assist • Manual Conveyance • Spine Board • Pool Extraction

  37. Physician Ordered Tests • Blood Test • Radiographs (X-Ray) • Computed Tomography (CT) • Magnetic Resonance Imaging (MRI) • Radionuclide Scintigraph (Bone Scan) • Ultrasonic Imaging • Electromyography (EMG)

  38. Special Tests X-ray MRI

  39. Special Test cont. CT scan Bone Scan

  40. Special Tests cont. Ultrasound Electromyography - EMG

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