1. Basic Athletic Training Chapter 2 Recognition, Evaluation, and Management of Athletic Injuries Edited by Gurchiek
PE 282 Introduction to Athletic Training

2. Chapter Objectives Recognize the signs of life-threatening injuries
Identify the protocol in first aid emergency care
Identify the steps in emergency transportation
Describe the components of the injury evaluation formats
Identify types of first-aid splinting equipment
Describe the basic treatment protocol for athletic injuries

3. Recognition 0f
Athletic
Injuries

4. Recognition of Injuries
Certified Athletic Trainers are trained to recognize when an injury has occurred. They are responsible for:
Determining the severity of the injury
Applying proper evaluation/treatment procedures and protocols

5. Evaluation of Injuries
Control life-threatening conditions and activate emergency medical services (EMS)
Management of non-life-threatening injuries

6. First-Aid Emergency Care
American Heart Association
American Red Cross
CERTIFICATION
American Heart Association BLS for health care providers
Cardiopulmonary resuscitation (CPR)
Automated external defibrillator (AED)
American Red Cross Sport Safety Training (SST)

7. First-Aid Emergency Care
Proper evaluation
Certified in cardiopulmonary resuscitation (CPR)
Access to automated external defibrillator (AED)
Use standing orders for emergency action plan (drafted by Certified Athletic Trainer and team physician)

9. See Handouts
For
Emergency
Action
Plans
And
Guidelines

10. Emergency Transportation Procedures
Points to consider
Availability of emergency ambulance service
Severity of injury
Athletic training staff or coaches should never transport injured athletes in a private vehicle because of liability issues
Emergency ambulance services need to be present at events or competitions

11. Evaluation of Injuries
Following a written statement (standing orders and emergency action plan) drafted and approved by your team physician and organization, the proper steps in the evaluation of injury can occur. When serious injury is suspected, begin your evaluation with a survey of the scene and then primary survey.

12. Evaluation of Life-Threatening Injuries
Perform Primary Survey
Airway
Breathing
Circulation
Severe Bleeding other life-threatening conditions
Perform Secondary Survey
History
Physical examination (Head to Toe)

13. More on Primary and Secondary Survey
Primary Survey
Determine status of life threatening or limb threatening conditions
Life threatening conditions (ABC’s or CAB’s)
Other vital signs and severe bleeding
Treat emergency conditions or move on to secondary survey depending on your findings
Secondary Survey
Occurs when primary survey is concluded or deemed unnecessary
No life threatening conditions, patient is breathing and any bleeding is under control
Examination to determine presence of other injuries
Rapid examination to determine seriousness of injury and if and how patient should be moved
Determine nature of injury or illness and identify positive findings for referral to medical professional

14. Evaluation of Non-Life-Threatening Injuries
History, Observation, Palpation, Special Test (HOPS)
History
How did it happen? (mechanism of injury)
Where does it hurt? (location of pain)
What did you hear? (did you hear a pop or snap?)
Previous injury? (have you had injuries in this anatomical structure before or injured the opposite limb?)

15. History, Observation, Palpation, Special Test (HOPS)
Look for bleeding, swelling, discoloration, deformity and compare anatomical structures

16. History, Observation, Palpation, Special Test (HOPS)
Palpate anatomical structures above and below injured site
Palpate affected area
Bones, Ligaments, & Muscles

17. History, Observation, Palpation, Special Test (HOPS)
Special Tests
Joint stability
Muscle/tendon
Range of Motion
Strength

18. Subjective, Objective, Assessment, Plan (SOAP Format)
Subjective Findings
Ask detailed questions like when conducting an injury history
Objective Exam Examination and Findings
Measureable visual, physical, and functional findings
Assessment
Review the probable cause and mechanism of injury based on subjective a objective finding
Plan
Outline appropriate action plan for care & rehab.

19. First-Aid Splinting Equipment
Fixation Splints
Most common adaptable (board, wire ladder, pillow, blankets)
Vacuum Splints
Appropriate for dislocations or misaligned fractures and adaptable to limb angulations
Pneumatic (air) Splints
Suited for nondisplaced fractures, air splints are easy to apply
Traction Splints
Used for long bone injuries (humerus and femur)

21. Key Points When Splinting
Always splint if player needs to be moved when a fracture or joint instability is suspected.
Stabilize the joint above and below the fracture site or the bones above and below the unstable joint.
Check circulation before and after splint application.
Continue to monitor circulation with distal pulse check and check for normal sensation

22. Basic Treatment Protocol Protection, Rest, Ice, Compression, Elevation, Support (PRICES)
Once an injury has occurred, protect from further damage by removing athlete from participation
Rest
Resting the injury is dependent on the severity of the injury. Set the injury at rest

23. Basic Treatment Protocol Protection, Rest, Ice, Compression, Elevation, Support (PRICES)
Apply cold (ice pack 20 minutes every 2 hours)
(Make change in text book on page 20)

24. What is the Purpose of the Cold?
Decreases the death of healthy cells by slowing down cellular metabolism
Decreases pain and spasm

25. Basic Treatment Protocol - PRICES
Compression
Using compression wrap to control swelling. Begin elastic wrap (farthest from heart) and spiral wrap toward heart on the involved extremity. Wraps too tight could interfere with circulation/nerves.
Ice and Compression are more effective in controlling swelling than if used independently
Remove wrap if too tight and reapply – check every 4 hours

26. Basic Treatment Protocol - PRICES
Compression
Using compression wrap to control swelling. Begin elastic wrap (farthest from heart) and spiral wrap toward heart on the involved extremity. Wraps too tight could interfere with circulation/nerves.
Remove wrap every 4 hours.

27. What is the Purpose of Compression
Compression equalizes the pressures inside and outside the cells
Pressure equalization helps prevent the death of healthy cells

28. Basic Treatment Protocol - PRICES
Elevation
Keep injured body part elevated higher than the heart.

29. What is the Purpose of Elevation?
Keeps fluid from being pulled down by gravity to settle around the injury site.
Elevation helps the lymphatic system pull the fluid away from the injury site.

30. Basic Treatment Protocol - PRICES
Support
If necessary, place injured extremity in splint, brace, or some type of support. If injury is lower extremity, crutches may be needed.
This prevents further injury
This decreases movement which causes pain – which causes spasm- which causes more pain.
Alienation may cause long term disuse and atrophy

32. Cycle of Injury Pain Spasm Pain

33. Questions ?