Evaluation of Non-Life Evaluation of Non-Life Threatening InjuriesThreatening Injuries

Sports Medicine ISports Medicine I

Non-Life Threatening Non-Life Threatening InjuriesInjuries

Medical evaluation Medical evaluation must be must be comprehensivecomprehensive

In athletic training In athletic training setting, two setting, two formats of formats of evaluation are evaluation are usedused– HOPSHOPS– SOAPSOAP

HOPS FormatHOPS Format

Determine if Determine if serious injury serious injury occurredoccurred

There are four There are four stepssteps– H (History)H (History)– O (ObservationO (Observation– P (Palpation)P (Palpation)– S (Special Tests)S (Special Tests)

HOPS Format (History)HOPS Format (History)

Involves asking Involves asking questions questions

Helps ATC in Helps ATC in assessing injury assessing injury

Helps MD in a Helps MD in a diagnosisdiagnosis

ExamplesExamples– Mechanism of injury Mechanism of injury

(How did it happen?)(How did it happen?)– Location of pain Location of pain

(Where does it hurt?)(Where does it hurt?)– Sensations Sensations

experienced (Did you experienced (Did you hear a pop or snap)hear a pop or snap)

– Previous injury (Have Previous injury (Have you injured this you injured this structure before)structure before)

HOPS Format (Observation)HOPS Format (Observation)

Compare Compare uninvolved to the uninvolved to the involved structureinvolved structure

Look forLook for– BleedingBleeding– DeformityDeformity– SwellingSwelling– DiscolorationDiscoloration– ScarsScars– Other signs of Other signs of

traumatrauma

HOPS Format (Palpation)HOPS Format (Palpation) Physical inspection Physical inspection

of injuryof injury Always palpate away Always palpate away

from injured site firstfrom injured site first Then palpate Then palpate

affected areaaffected area Should try to Should try to

pinpoint exact pinpoint exact location of painlocation of pain

Use bilateral Use bilateral comparisoncomparison

ExamplesExamples– Neurological stability Neurological stability

(motor and sensory)(motor and sensory)– Circulation function Circulation function

(pulse and capillary (pulse and capillary refill)refill)

– Anatomical Anatomical structures (palpate)structures (palpate)

– Fracture tests Fracture tests (palpation, (palpation, compression, compression, distraction)distraction)

HOPS Format (Special Test)HOPS Format (Special Test)

Looking for joint Looking for joint instability, instability, disability and paindisability and pain

ExamplesExamples– Joint stabilityJoint stability– Muscle/TendonMuscle/Tendon– Accessory Accessory

anatomical anatomical structures (bursa, structures (bursa, capsule etc.)capsule etc.)

– Inflammatory Inflammatory conditionsconditions

SOAP FormatSOAP Format

Another Another standardized standardized procedure that procedure that provides provides comprehensive comprehensive review of MOIreview of MOI

S (Subjective)S (Subjective) O (Objective)O (Objective) A (Assessment)A (Assessment) P (Plan)P (Plan)

SOAP FormatSOAP Format

Subjective- (history) ask detailed Subjective- (history) ask detailed questionsquestions

Objective- involves visual, physical Objective- involves visual, physical and functional inspectionsand functional inspections

Assessment- reviews probable cause Assessment- reviews probable cause and mechanism of injuryand mechanism of injury

Plan-Outline of action to care of the Plan-Outline of action to care of the injuryinjury

Basic Treatment ProtocolBasic Treatment Protocol PRICESPRICES Protection- Protect injury from further Protection- Protect injury from further

damagedamage Rest- rest the injury (dependent on severity)Rest- rest the injury (dependent on severity) Ice- Aid in controlling bleeding and Ice- Aid in controlling bleeding and

associated swellingassociated swelling Compression- Compression wrap to control Compression- Compression wrap to control

swellingswelling Elevation- keep higher than the heart; helps Elevation- keep higher than the heart; helps

with excessive swellingwith excessive swelling Support- first aid splint, sling, crutches, etcSupport- first aid splint, sling, crutches, etc

ICEICE

Ice PacksIce Packs– Done using plastic Done using plastic

bags filled with ice bags filled with ice – Cover with a wet Cover with a wet

toweltowel– Should be done for Should be done for

15 min15 min– Two hours between Two hours between

treatmentstreatments– Six or more times a Six or more times a

dayday

Cold Water Cold Water Immersion BathImmersion Bath

Use bathtub or Use bathtub or whirlpoolwhirlpool

Water temperature Water temperature between 50 and 60 between 50 and 60 degreesdegrees

10 minutes10 minutes Six or more times a Six or more times a

dayday

First Aid SplintingFirst Aid Splinting

Splints are intended to protect the Splints are intended to protect the injury from further damageinjury from further damage– Fixation SplintsFixation Splints– Vaccum SplintsVaccum Splints– Pneumatic (Air) SplintsPneumatic (Air) Splints– Traction SplintsTraction Splints

Fixation SplintsFixation Splints

Most common Most common adaptable splints adaptable splints utilizedutilized

ExamplesExamples– BoardBoard– Wire ladderWire ladder– SAMSAM– PillowPillow– blanketsblankets

Vacuum SplintsVacuum Splints

Appropriate for Appropriate for dislocations or dislocations or misaligned misaligned fracturesfractures

Adaptable to any Adaptable to any limb angulationslimb angulations

Air SplintsAir Splints

Non-displaced Non-displaced fracturesfractures

No longer the No longer the standard of care in standard of care in athletic injuriesathletic injuries

Traction SplintsTraction Splints

Used for long bone Used for long bone fractures (femur)fractures (femur)

Prevent fractured Prevent fractured bone ends from bone ends from touchingtouching