Injury Evaluation Process

Why have a process for evaluation?

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

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

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

On-Field Assessment Secondary Survey History Observation 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.

On-Field Assessment Screening Immediate Action Plan Rapid evaluation techniques 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. 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

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

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

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?

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)

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

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

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

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.

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

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