Injury Evaluation Injury Evaluation ProcessProcess

Why have a process for Why have a process for evaluation?evaluation?

On-Field AssessmentOn-Field AssessmentInstruct coaches and athletes not to move an injured athlete.Instruct coaches and athletes not to move an injured athlete.Know the rules regarding on field assessmentKnow the rules regarding on field assessmentGoals and PurposesGoals and Purposes Rule out life-threatening/serious injuriesRule out life-threatening/serious injuries Determine the sight and severityDetermine the sight and severity Determine the method of transportDetermine the method of transport

On-Field AssessmentOn-Field Assessment

Primary SurveyPrimary SurveySecondary SurveySecondary Survey HistoryHistory ObservationObservation ScreeningScreening Immediate Action PlanImmediate Action Plan

On-Field AssessmentOn-Field Assessment

Primary SurveyPrimary Survey Airway, Breathing, CirculationAirway, Breathing, Circulation Try to arouse if unconsciousTry to arouse if unconscious

Treat for neck injury if you did not see the injuryTreat for neck injury if you did not see the injury

On-Field AssessmentOn-Field AssessmentSecondary SurveySecondary Survey

HistoryHistoryMechanism of injuryMechanism of injuryLocation of the injuryLocation of the injurySeverity of injurySeverity of injury

ObservationObservationAbnormal positioning of the head, neck, or Abnormal positioning of the head, neck, or extremitiesextremitiesHow is the athlete reacting to the injury?How is the athlete reacting to the injury?Does the athlete have bleeding from the head or Does the athlete have bleeding from the head or other signs of head injury?other signs of head injury?Observe for internal injuriesObserve for internal injuriesDeformity, swelling, or discoloration of the Deformity, swelling, or discoloration of the extremities.extremities.Asses for ShockAsses for Shock

Pale, cool, clammy skin, rapid and shallow breathing, Pale, cool, clammy skin, rapid and shallow breathing, weak and rapid pulse, nausea, falling blood pressure.weak and rapid pulse, nausea, falling blood pressure.

On-Field AssessmentOn-Field Assessment ScreeningScreening

Rapid evaluation techniquesRapid evaluation techniquesSensory and motor testing for suspected spinal/nerve injury.Sensory and motor testing for suspected spinal/nerve injury.Neurovascular tests for suspected fracture/dislocationNeurovascular tests for suspected fracture/dislocationAssessment for head injury if suspectedAssessment for head injury if suspectedOrthopedic assessmentOrthopedic assessment

PalpationPalpation ROM and strength screenROM and strength screen Special testsSpecial tests

Continued monitoring for shockContinued monitoring for shock

Immediate Action PlanImmediate Action PlanIf injury is serious or life-threatening, EMSIf injury is serious or life-threatening, EMSIf not serious or life-threatening, transport off field for more detailed If not serious or life-threatening, transport off field for more detailed assessment off the field.assessment off the field.

Off-Field Athletic Injury Off-Field Athletic Injury AssessmentAssessment

HOPSHOPS History of the injuryHistory of the injury

Check life threatening situationsCheck life threatening situationsHistory of the injuryHistory of the injuryHistory of the individualHistory of the individual

Observation and InspectionObservation and InspectionVisual inspectionVisual inspection

PalpationPalpationHands on inspectionHands on inspection

Special TestsSpecial TestsTest structural integrityTest structural integrityFunctional activity testsFunctional activity tests

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

Check life threatening situationsCheck life threatening situations(deal with problems immediately of present)(deal with problems immediately of present)

ConsciousnessConsciousness ABCs: airway, breathing, CirculationABCs: airway, breathing, Circulation Cervical spineCervical spine Traumatic shockTraumatic shock

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

History of the injuryHistory of the injury Most underrated and overlooked aspect of evaluationMost underrated and overlooked aspect of evaluation Where does it hurt? (have athlete point to it)Where does it hurt? (have athlete point to it) When did it happen? When did it happen? Sudden or gradualSudden or gradual How did it happen?How did it happen? If hit, how?If hit, how? Position of body part when, and after, it happened?Position of body part when, and after, it happened?

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

History of the individualHistory of the individual Former injuries? (when, how occurred, see Former injuries? (when, how occurred, see

physician, what rehab, etc.)physician, what rehab, etc.) Level of training? (when start, when and how Level of training? (when start, when and how

much increase)much increase)

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

ObservationObservation Position of bodyPosition of body Look for swelling, deformity, skin coloration, Look for swelling, deformity, skin coloration,

muscle spasm, eye movement, facial muscle spasm, eye movement, facial expressionexpression

Compare opposite sides of bodyCompare opposite sides of body

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

PalpationPalpation Tell athlete it may hurt, and whyTell athlete it may hurt, and why Begin gently and gradually increase pressureBegin gently and gradually increase pressure Correlate athletes reactions to structures Correlate athletes reactions to structures

palpatedpalpated Start away from suspected injury and Start away from suspected injury and

gradually work toward itgradually work toward it

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

Test Structural IntegrityTest Structural Integrity Nerves – sensory and motorNerves – sensory and motor Circulation – Feel pulse in injured body partCirculation – Feel pulse in injured body part Musculoskeletal – look for abnormal range of Musculoskeletal – look for abnormal range of

motion and/or pain in and around both injured motion and/or pain in and around both injured and surrounding joints.and surrounding joints.

Active ROM – athlete’s voluntary movementsActive ROM – athlete’s voluntary movementsPassive ROM – athletic trainer provides movementPassive ROM – athletic trainer provides movementResistive ROM – athletic trainer provides resistanceResistive ROM – athletic trainer provides resistance

Special testsSpecial tests

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

Functional Activity TestsFunctional Activity Tests Use only for mild injuriesUse only for mild injuries Use the injured body part to perform skillUse the injured body part to perform skill Begin with very simple skills (walking, reaching, etc.) and Begin with very simple skills (walking, reaching, etc.) and

progress to very complex skills (running and cutting, etc.)progress to very complex skills (running and cutting, etc.) Begin each skill and half speed and progress to full Begin each skill and half speed and progress to full

speedspeed Do not allow any activity that causes painDo not allow any activity that causes pain

Determine if athlete can perform normallyDetermine if athlete can perform normally Observe performance, looking for smooth, fluid motionObserve performance, looking for smooth, fluid motion Question athlete concerning pain or other abnormal Question athlete concerning pain or other abnormal

feeling.feeling.

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

Make a decision concerning the nature and severity of Make a decision concerning the nature and severity of the injurythe injury Draw together all of the previous evidenceDraw together all of the previous evidence Based on the decision, use any or all of the following Based on the decision, use any or all of the following

procedures that are dictated by the situation.procedures that are dictated by the situation.Apply emergency first aidApply emergency first aidAllow the athlete to continue participationAllow the athlete to continue participationI.C.E. and restI.C.E. and restRefer to PhysicianRefer to Physician Confirm evaluationConfirm evaluation X-ray and lab testX-ray and lab test Recommend/administer definitive treatmentRecommend/administer definitive treatment

SUMMARY OF THE ATHLETIC INJURY SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESSEVALUATION PROCESS

Re-evaluateRe-evaluate Throughout rehabilitationThroughout rehabilitation

Record FindingsRecord Findings

Summary of EvaluationsSummary of Evaluations

On-field evaluationOn-field evaluationSide line evaluationSide line evaluationClinical evaluationClinical evaluation