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Injury Assessment & Evaluation. http://www.youtube.com/watch?v=VFN90gkKHu4. Objectives. Define assessment and determine its role Define terminology used in injury evaluation. Injury classifications. Acute, traumatic Overuse, mechanical. Objectives.

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injury assessment evaluation

Injury Assessment & Evaluation

http://www.youtube.com/watch?v=VFN90gkKHu4

objectives
Objectives
  • Define assessment and determine its role
  • Define terminology used in injury evaluation
injury classifications
Injury classifications
  • Acute, traumatic
  • Overuse, mechanical
objectives1
Objectives
  • Describe the events of the musculoskeletal evaluation (HOPS)
    • Identify specific components in a history of an injury
    • Describe what is involved in observation & inspection of an injury site
    • Identify principles used in palpation, ROM testing, neurological testing &special tests
differential diagnosis
Differential Diagnosis
  • Diagnosis:
    • definitive determination of disease, injury, or syndrome a person has or is believed to have
  • Differential diagnosis:
    • Method of diagnosing when unique S/Sx lacking
assessment situations
Assessment Situations
  • On-the-field assessment
    • primary survey
    • render a decision regarding injury severity

1. r/o fracture or dislocation

2. Check for joint stability or muscle rupture

3. Control severe bleeding

4. Test for neurological conditions

assessment situations1
Assessment Situations
  • On-the-field assessment
    • is immobilization &/or transportation needed?
    • crowd control: players, coaches, officials
assessment situations2
Assessment Situations
  • Off-the-field assessment
    • decisions

1. Extent of injury

2. Immediate treatment (first aid)

3. Playing status

introduction to assessment
Introduction to Assessment
  • Role of the ATC when emergency care is not required

1. To determine the nature of the illness or injury

2. To determine the need for MD for further exam

3. OR treating the athlete according to routine SO’s

evaluation techniques
Evaluation Techniques
  • HOPS format

1. Consistent, systematic process

2. Format uses subjective information (history)

3. Also objective information (observation & inspection, palpation, and special tests)

assessment terminology
Assessment Terminology
  • Etiology
  • Mechanism of injury (MOI)
  • Pathology
  • Prognosis
  • Sequela
  • Syndrome
  • Signs and symptoms (s/sx)
history
History
  • MOI – mechanism of injury
    • How did the injury occur?
      • Macrotrauma
      • Microtrauma
    • Identifies structures involved
  • Relevant sounds or sensations
history1
History
  • Symptoms
    • Pain
      • Location
      • Type
      • Referred
      • Radicular
      • Daily pain patterns
      • Provocation and alleviation patterns
  • Other symptoms
  • Limitations
examination goals
Examination goals
  • Rule out differential diagnosis
  • Determine clinical diagnosis
  • Identify impairments and functional limitations
observation inspection
Observation & Inspection
  • Introduction
    • observing the injury mechanism
observation inspection1
Observation & Inspection
  • athlete presents complaining of pain/discomfort
  • assessment begins upon presentation/occurrence
  • use discretion
observation inspection2
Observation & Inspection
  • Observation - scan exam
    • assesses general motor function
      • Gait
      • Posture
      • Function
      • Guarding
      • Splinting
    • r/o injuries at other joints/areas
    • note willingness & ability to move
    • general posture
    • consistency in motions
observation inspection3
Observation & Inspection
  • Inspection of injury site
    • Deformities – subtle or gross
    • Swelling – effusion or edema
    • Discoloration – redness or ecchymosis
      • Infection signs
    • scars
    • general skin condition
    • BILATERAL comparison
slide20

Skin temperature Swelling Point tenderness Vascular pulses

Palpation

Crepitus Muscle spasm Deformity Sensory changes

Rule out fracture

palpation strategies
Palpation strategies
  • Sequencing strategy #1
    • Bones
    • Ligaments
    • Muscles and tendons
  • Sequencing strategy #2
    • Palpate all structures
    • Begin away from pain site and progress toward suspected injury.
palpation procedures
Palpation Procedures
  • Hands
  • Begin proximal to specific injury site
  • Palpate painful area last
  • Begin w/light touch
  • Proceed w/deeper pressure
palpation findings
Palpation Findings
  • Tissue temperature
  • Swelling
  • Changes in tissue density
  • Point tenderness & crepitus
    • Trigger points
  • Cutaneous sensation
  • Peripheral pulses
  • Bone palpation & fracture tests