Standard 7 Objective 1 Period 2 Emily & Peter

HIPS Injury Assessment H = History I = Inspection P = Palpation S = Special Tests

H is for History Record of patient’s condition (Present and Past) Medical – Previous serious alignments, allergies, major surgeries, other doctors involved, places treated Family – Parents alive? Siblings alive? Any genetic diseases (Diabetes & Glaucoma) Social – Living situation, occupation of patient, education & ability to comprehend situation Child with asthma living in smoky, damp, & overcrowded area

I is for Inspection I’s ONLY (eye) part of examination Steps to follow: Lay patient in comfortable position for examination Make sure area of interest is visible & there is decent lighting Note shape & size of body area being examined Record any skin abnormalities, masses, and/or discoloration Stretch marks and/or surgical scars List possible causes of irritated area & diagnosis to further investigate

P is for Palpation Hands-on part of examination Steps to follow: Ask patient to most tender spot & reassure you’ll do your best to make them feel better = higher level of cooperation Using fingertips, gently touch around general area while feeling for true sensitive spots Sensitive spots could correlate to root of problem Apply deeper pressure to localize the spot of extreme tenderness Watch for patient’s facial reactions = Spasms? Guarding? Remove hands slowly and assess findings

S is for Special Tests Range of Motion: Determine whether range is limited, normal, or excessive…Find out location, quality, and intensity of range as well Passive = Tests bones, ligaments, nerves, blood vessels, cartilage, joint capsule Doctor moves joint passively through typical motions & notes any restrictions or hypermobility Patient must be relaxed & describe when pain is felt + in what movements/positions Active = Tests inert & contractile structures Patient moves joint through motions & notes when pain occurs in range Resistive = Tests for strength and contractile tissues (muscles, tendons, and attachments) Patient flexes & doctor tries to resist movement = Patient tries to move doctor Doctor exerts pressure & patient tries to resist movement = Doctor applies pressure while patient tries not to move

S is for Special Tests Part 2 Stress Tests: Tests for injured ligaments Example: Anterior Drawer, Talar Tilt, Cross-Leg Test, External Rotation Stress Test, Squeeze Test Neurological: Tests for neurological damage in patients (Nerves) Example: Pinch Grip Test, Anterior Compartment Syndrome, Pencil Test Functional: Tests for patients’ functional limitation Example: Seated Hamstring Test, Appley’s Compression Test, Lachman’s Test

Decisions Based Off HIPS Assessment Make educated diagnosis, provide appropriate treatment, send patient home in better shape than when they came in

Purpose of HIPS Accurately assess, treat, and care for patients with injuries that cause them discomfort Follow outlined protocol so nothing new is thrown at patient Make a new, life-long patient that will keep coming back to you for treatment

Q: Place in order the steps of an injury assessment (Pick 4) Question #19 Q: Place in order the steps of an injury assessment (Pick 4) Inspection Health Information Palpation Subjective History Protect Special tests Words Given

Take Away: Remember HIPS!!! Answer! History Start by getting to know the patient's medical past Inspection Look over patient body for injury with eyes only Palpation Look over patient body for injury using hands Special Tests Run specific tests to guide examination Take Away: Remember HIPS!!!

Bibliography https://patient.info/doctor/history-and-physical-examination http://medicalassistant.everestcollege.edu/articles/http/how-to-take-a-medical-history https://www.ncbi.nlm.nih.gov/books/NBK420/ http://www.healthline.com/health/physical-examination#what-it-entails3 https://forwardthinkingpt.com/patient-info/ankle/ligamentous-instability-tests/ http://www.healio.com/books/athletic-training/%7B7f1262e2-d182-4b7c-8943- 76202b3bc9c0%7D/special-tests-for-neurologic-examination https://quizlet.com/61440598/functional-special-tests-flash-cards/