Injury Evaluation Process

1. Injury Evaluation Process

2. Why have a process for evaluation?

3. On-Field Assessment • Instruct coaches and athletes not to move an injured athlete. • Know the rules regarding on field assessment • Goals and Purposes • Rule out life-threatening/serious injuries • Determine the sight and severity • Determine the method of transport

4. On-Field Assessment • Primary Survey • Secondary Survey • History • Observation • Screening • Immediate Action Plan

5. On-Field Assessment • Primary Survey • Airway, Breathing, Circulation • Try to arouse if unconscious • Treat for neck injury if you did not see the injury

6. On-Field Assessment • Secondary Survey • History • Mechanism of injury • Location of the injury • Severity of injury • Observation • Abnormal positioning of the head, neck, or extremities • How is the athlete reacting to the injury? • Does the athlete have bleeding from the head or other signs of head injury? • Observe for internal injuries • Deformity, swelling, or discoloration of the extremities. • Asses for Shock • Pale, cool, clammy skin, rapid and shallow breathing, weak and rapid pulse, nausea, falling blood pressure.

7. On-Field Assessment • Screening • Rapid evaluation techniques • Sensory and motor testing for suspected spinal/nerve injury. • Neurovascular tests for suspected fracture/dislocation • Assessment for head injury if suspected • Orthopedic assessment • Palpation • ROM and strength screen • Special tests • Continued monitoring for shock • Immediate Action Plan • If injury is serious or life-threatening, EMS • If not serious or life-threatening, transport off field for more detailed assessment off the field.

8. Off-Field Athletic Injury Assessment • HOPS • History of the injury • Check life threatening situations • History of the injury • History of the individual • Observation and Inspection • Visual inspection • Palpation • Hands on inspection • Special Tests • Test structural integrity • Functional activity tests

9. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • Check life threatening situations (deal with problems immediately of present) • Consciousness • ABCs: airway, breathing, Circulation • Cervical spine • Traumatic shock

10. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • History of the injury • Most underrated and overlooked aspect of evaluation • Where does it hurt? (have athlete point to it) • When did it happen? • Sudden or gradual • How did it happen? • If hit, how? • Position of body part when, and after, it happened?

11. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • History of the individual • Former injuries? (when, how occurred, see physician, what rehab, etc.) • Level of training? (when start, when and how much increase)

12. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • Observation • Position of body • Look for swelling, deformity, skin coloration, muscle spasm, eye movement, facial expression • Compare opposite sides of body

13. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • Palpation • Tell athlete it may hurt, and why • Begin gently and gradually increase pressure • Correlate athletes reactions to structures palpated • Start away from suspected injury and gradually work toward it

14. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • Test Structural Integrity • Nerves – sensory and motor • Circulation – Feel pulse in injured body part • Musculoskeletal – look for abnormal range of motion and/or pain in and around both injured and surrounding joints. • Active ROM – athlete’s voluntary movements • Passive ROM – athletic trainer provides movement • Resistive ROM – athletic trainer provides resistance • Special tests

15. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • Functional Activity Tests • Use only for mild injuries • Use the injured body part to perform skill • Begin with very simple skills (walking, reaching, etc.) and progress to very complex skills (running and cutting, etc.) • Begin each skill and half speed and progress to full speed • Do not allow any activity that causes pain • Determine if athlete can perform normally • Observe performance, looking for smooth, fluid motion • Question athlete concerning pain or other abnormal feeling.

16. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • Make a decision concerning the nature and severity of the injury • Draw together all of the previous evidence • Based on the decision, use any or all of the following procedures that are dictated by the situation. • Apply emergency first aid • Allow the athlete to continue participation • I.C.E. and rest • Refer to Physician • Confirm evaluation • X-ray and lab test • Recommend/administer definitive treatment

17. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS • Re-evaluate • Throughout rehabilitation • Record Findings

18. Summary of Evaluations On-field evaluation Side line evaluation Clinical evaluation