Download INJURY ASSESSMENT

INJURY ASSESSMENT
INJURY ASSESSMENT
The key to injury assessment is to make sure that the injury is not
made worse by the process.
Always begin an assessment with the least invasive method and
progress to manipulation of the injured area.
Always treat an unconscious athlete as if there is a head and/or
spinal injury.
TYPES OF INJURY ASSESSMENT
Primary Injury Survey: Checking for life
threatening injuries.
Secondary Injury Survey: A head to toe
evaluation, trying to find the injury or other
injuries.
Isolated Injury Assessment: You witnessed the
injury; only the area of the injury is assessed and
evaluated.
PRIMARY SURVEY
Assessment of:
•
Airway- Open airway using the head tilt – chin lift method
•
Breathing- Look, listen, and feel for signs of breathing. See the
raise and fall of the chest. If the athlete is face down, put one
hand near the mouth and feel for breathing; put the other
hand on the back to feel the rise and fall of the chest
•
Circulation- Check for a pulse
•
Bleeding and Shock- Body is deprived of oxygen; blood flow
or blood volume is too low to meet the body’s needs
CPR
If athlete does not have a pulse and/or is not
breathing:
•
Use “hands only” CPR
•
100 chest compressions per minute – compress
the chest 2 inches
•
Use the AED (Automated External Defibrillator)
as soon as one is available
SECONDARY SURVEY
Purpose of the secondary survey:
•
Locate all injuries
•
Determine what treatment will be required
(H.O.P.S.)
•
Determine if the athlete will be able to
leave the competition area on their own,
with help, or if EMS needs to be called
H.O.P.S
(H)istory: Provides information about the nature and location of
the injury
(O)bservation: Observing before palpating can avoid
unnecessary pain and determine the need for protective
gloves(Universal precautions)
(P)alpation: Palpating prior to a special test can supply
information to help prevent further injury (EX: Compound
fracture)
Ask  Look  Feel
(S)Pecial Tests: Used to determine the damage of muscle,
tendon, ligament, Etc.
HISTORY
Questions to ask:
• What happened? (When or What were you doing?) –Clinical
• Has this every happened before? Prior history.
• At what speed did the injury happen? This is important because the greater
the speed the greater the chance of injury.
• What was the direction of the force? Result: Twist, hyperextension,
hyperflexion.
• Did you hear any sound?
• What is the type of pain? Sharp, achy, stabbing, throbbing.
• Is the injury painful at rest or only when moved? Does the pain stay in one
place or refer out.
• What is the pain level?
• Is there numbness, pins-and-needles, muscle weakness, paralysis, burning?
OBSERVATION
Based on objective findings (anything observable or measureable)
Compare the uninjured side to the injured side – always starting with the
uninjured.
Look for:
•
Deformity (indicating dislocation or fracture)
•
Swelling (around joints)
•
Bleeding
•
Color changes in the skin (indicating vascular problems or bruising)
•
Gaps in the muscle when it flexes
•
Scars from previous surgeries
PALPATION
Pressure should be firm and slightly unpleasant on the uninjured
and injured side
The evaluation should start on the joint above the injured area
and continue to the next joint below the injured area
Feel for deformities, spasms, or pulsing, breaks in the skin, and
changes in temperature
Check for fractures by tapping on the long bone or using
compression away from the point of pain to see if the pain will
increase.
While palpating watch for facial expressions or wincing
SPECIAL TESTS
Special Tests may reproduce the mechanism of the injury, by
reproducing pain at the injury site
•
Active Range of Motion (AROM): when the athlete moves the
injured body part through a full range of motion – (up/down,
in/out, rotate).
•
Passive Range of Motion (PROM): when the clinician moves
the injured body part through a pain free range of motion,
while the athlete relaxes all muscles.
•
Resisted manual muscle test: Same as PROM, except athlete
does not relax and tries to resist movement.
TYPES OF SPECIAL TESTS
Strength Test
Stability Test
Functional Activity Test
Sports Specific Test
STRENGTH TEST
Compare uninjured side with the injured side for size,
strength, firmness, and muscle mass
Begin by having the athlete contract the injured area
isometrically; then perform the PROM test and the
resisted manual muscle test on the injured area.
STABILITY TEST
This test is used to investigate the ligament laxity
•
The degree of looseness in the ligaments of a joint
The athlete must relax all muscles around the injured
joint
STEPS IN PERFORMING A STABILITY TEST
1.
Always test the uninjured joint first
2.
To start the test support the joint at the distal
(far) end of the joint and use the other hand to
stress the ligaments at the joint.
3.
With the muscles relaxed put enough pressure
on the joint to stretch the ligament fibers
4.
Some laxity is normal. Compare uninjured to
injured.
DEGREES OF SPRAINS
Grade I: Some torn fibers will cause some pain but no
laxity compared to uninjured side.
Grade II: Pain and laxity, laxity only until ligament is
fully stretched.
Grade III: May or may not be pain. There will be
complete instability with no end point to pressure which
may cause a dislocation. This would be a complete
ligament tear.
FUNCTIONAL ACTIVITY TEST
This test determines the level of movement the athlete
can comfortably participate in.
•
Run
•
Jump
•
Sprint
•
Cut
•
Twist
•
Etc.
SPORTS SPECIFIC TEST
This test determines the athletes ability to perform
movements related to a specific sport.
Volleyball  Spike
Basketball  Cut and shoot
Soccer  Cut and kick
Football  Run, throw, tackle