1. Secondary (2°) survey

2. Question of the day
What is the goal of the 1º survey and what are some of the problems that should be ruled out?

3. ANSWER
1º survey= identify life threatening or potentially life threatening problems
Examples include loss of consciousness, airway/breathing compromise, circulatory compromise, severe bleeding, shock.

4. 2° Survey
non-life threatening
more detailed
2 main types
HOPS
SOAP

5. HOPS
History
Observation
Palpation
Strength/Special tests

6. History (Hx) Most important part of exam Questions
Mechanism of injury (MOI)?
Where is pain?
How much pain?
Type of pain?
Acute vs. Chronic?
Better or worse?
Sounds and sensations (pop, crack, etc.)
Numbness and tingling?
Current tx?
By end of Hx, you should have DDx

7. Observation Can be done simultaneously with hx
Look for deformity (obvious), swelling, discoloration
ROM

8. Observation
Observe contributory factors (i.e. knee alignment, shoulder position, gait, etc.)
DON’T JUST TX EFFECT, TX THE CAUSE!!!
Use information to rule out/confirm DDx

9. Palpation Temperature Bony anatomy Soft tissue (muscles, ligaments)
Crepitus, “clicking,” “popping”
Use information to rule out/confirm DDX

10. Strength Testing/Special Tests
Manual Muscle Testing (MMT)
Identify which muscles are injured or are over/under active
Special Tests
all depends on hx, observation, and palpation
By end of this, should have Dx and tx plan

11. SOAP Subjective Objective Assessment Plan First half is HOPS
Second half is more detailed

12. Subjective Same as “History” Subjective- non-measurable
What should we have by the end of this?

13. Objective
Measurable
Includes Observation, Palpation, Strength, and Special Tests
Objective measures are all used to confirm/rule out DDx

14. Assessment Assessment=diagnosis Called assessment for two reasons
initially, AT not allowed to dx
assessment can be more detailed
Ex 1 (diagnosis): 2° ankle sprain
Ex 2 (assessment): athlete presents with decreased ROM, moderate pain, moderate ligamentous laxity, and inability to perform activities of daily living

15. Plan Tx
Modalities
Rehab
Referral
Return to play progression

16. Sideline 2° survey
Less thorough but should still have a good idea of nature of injury
Identify whether it is safe for athlete to return to play by ruling out significant injury
Time is of the essence!!

17. Conclusions 2° survey is much more detailed
non-life threatening injuries
can use HOPS or SOAP (need HOPS for SOAP)
Treat __________ not _____________?
Determine a pattern (doesn’t have to be in perfect order) so it becomes second nature
easy to remember
less likely to miss components
eliminates unnecessary movements for athlete