Injury Evaluation Process

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Injury Evaluation Process
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Why have a process for evaluation?
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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

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On-Field Assessment

• Primary Survey
• Secondary Survey
• History
• Observation
• Screening
• Immediate Action Plan

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On-Field Assessment

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

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On-Field Assessment

• Secondary Survey
• History
• 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.

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On-Field Assessment

• Screening
• 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

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Off-Field Athletic Injury Assessment

• HOPS
• History of the injury
• Check life threatening situations
• History of the injury
• History of the individual
• Observation and Inspection
• Visual inspection
• Palpation
• Hands on inspection
• Special Tests
• Test structural integrity
• Functional activity tests

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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

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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?

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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)

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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

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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

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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 athletes voluntary movements
• Passive ROM athletic trainer provides movement
• Resistive ROM athletic trainer provides
  resistance
• Special tests

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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.

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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

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SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS

• Re-evaluate
• Throughout rehabilitation
• Record Findings