Evaluation of Non-Life Threatening Injuries Sports Medicine I

Non-Life Threatening Injuries Medical evaluation must be comprehensive Medical evaluation must be comprehensive In athletic training setting, two formats of evaluation are used In athletic training setting, two formats of evaluation are used –HOPS –SOAP

HOPS Format Determine if serious injury occurred Determine if serious injury occurred There are four steps There are four steps –H (History) –O (Observation –P (Palpation) –S (Special Tests)

HOPS Format (History) Involves asking questions Involves asking questions Helps ATC in assessing injury Helps ATC in assessing injury Helps MD in a diagnosis Helps MD in a diagnosis Examples Examples –Mechanism of injury (How did it happen?) –Location of pain (Where does it hurt?) –Sensations experienced (Did you hear a pop or snap) –Previous injury (Have you injured this structure before)

HOPS Format (Observation) Compare uninvolved to the involved structure Compare uninvolved to the involved structure Look for Look for –Bleeding –Deformity –Swelling –Discoloration –Scars –Other signs of trauma

HOPS Format (Palpation) Physical inspection of injury Physical inspection of injury Always palpate away from injured site first Always palpate away from injured site first Then palpate affected area Then palpate affected area Should try to pinpoint exact location of pain Should try to pinpoint exact location of pain Use bilateral comparison Use bilateral comparison Examples Examples –Neurological stability (motor and sensory) –Circulation function (pulse and capillary refill) –Anatomical structures (palpate) –Fracture tests (palpation, compression, distraction)

HOPS Format (Special Test) Looking for joint instability, disability and pain Looking for joint instability, disability and pain Examples Examples –Joint stability –Muscle/Tendon –Accessory anatomical structures (bursa, capsule etc.) –Inflammatory conditions

SOAP Format Another standardized procedure that provides comprehensive review of MOI Another standardized procedure that provides comprehensive review of MOI S (Subjective) S (Subjective) O (Objective) O (Objective) A (Assessment) A (Assessment) P (Plan) P (Plan)

SOAP Format Subjective- (history) ask detailed questions Subjective- (history) ask detailed questions Objective- involves visual, physical and functional inspections Objective- involves visual, physical and functional inspections Assessment- reviews probable cause and mechanism of injury Assessment- reviews probable cause and mechanism of injury Plan-Outline of action to care of the injury Plan-Outline of action to care of the injury

Basic Treatment Protocol PRICES PRICES Protection- Protect injury from further damage Protection- Protect injury from further damage Rest- rest the injury (dependent on severity) Rest- rest the injury (dependent on severity) Ice- Aid in controlling bleeding and associated swelling Ice- Aid in controlling bleeding and associated swelling Compression- Compression wrap to control swelling Compression- Compression wrap to control swelling Elevation- keep higher than the heart; helps with excessive swelling Elevation- keep higher than the heart; helps with excessive swelling Support- first aid splint, sling, crutches, etc Support- first aid splint, sling, crutches, etc

ICE Ice Packs Ice Packs –Done using plastic bags filled with ice –Cover with a wet towel –Should be done for 15 min –Two hours between treatments –Six or more times a day Cold Water Immersion Bath Cold Water Immersion Bath Use bathtub or whirlpool Use bathtub or whirlpool Water temperature between 50 and 60 degrees Water temperature between 50 and 60 degrees 10 minutes 10 minutes Six or more times a day Six or more times a day

First Aid Splinting Splints are intended to protect the injury from further damage Splints are intended to protect the injury from further damage –Fixation Splints –Vaccum Splints –Pneumatic (Air) Splints –Traction Splints

Fixation Splints Most common adaptable splints utilized Most common adaptable splints utilized Examples Examples –Board –Wire ladder –SAM –Pillow –blankets

Vacuum Splints Appropriate for dislocations or misaligned fractures Appropriate for dislocations or misaligned fractures Adaptable to any limb angulations Adaptable to any limb angulations

Air Splints Non-displaced fractures Non-displaced fractures No longer the standard of care in athletic injuries No longer the standard of care in athletic injuries

Traction Splints Used for long bone fractures (femur) Used for long bone fractures (femur) Prevent fractured bone ends from touching Prevent fractured bone ends from touching