UNIT 7- INJURY MANAGEMENT HIPS UNIT 7- INJURY MANAGEMENT

HIPS Specific injury assessment to evaluate the extent of musculoskeletal injuries Performed in an ordered sequence to assess the nature, site and severity of an injury By following a consistent pattern, you are less likely to forget a procedure HIPS History Inspection Palpation Special Test

PPE /BSI Before you start the injury assessment you must take precautions to prevent disease transmission Avoid contact with body fluids Wear Gloves Cover cuts Wear protective coverings Use breathing devices Wash hands after treatment Remove athlete from activity if bleeding and blood on uniform Use a solution of bleach and water or hydogen peroxide to get blood off uniform

History One of most important steps Collecting as much information as possible Ask athlete questions Ask bystanders questions Provide clues in determining structures that are injured Where does it hurt? What happened? How did it happen? How long has it hurt? Does the joint give away? Does the joint lock? Did you hear or feel a pop, crack, snap…?

Inspection This step is purely observational Always compare bilaterally Note if holding body part Note holding body part Note functional abilities Limping? Grimacing? Look for Bleeding Deformity Swelling Discoloration Any sign of injury

Palpation Palpation means to feel or touch Increase palpation pressure as tolerated Begin away from injury site Visualize structures as examine Compare bilaterally Palpate Bones Muscles Soft tissue Ligaments Tendons

Special Tests There are five areas of special tests Range of Motion Stress Tests Neurological Circulatory Functional

Special Tests Range of Motion Active Passive Resistive Assess in proper sequence- Active-Passive-Resistive Compare bilaterally Active Movement is performed completely by the examiner Passive Movement is performed solely by athlete Resistive Athlete is asked to perform movement while the examiner provides resistant Note any restriction or limitation Used to determine status of muscle/muscle group Findings: Weak and Painless Possible 3rd degree strain Weak and Painful Possible fracture at joint site Strong and Painful Possible tear of muscle/tendon Strong and Pain free No muscle injury

Special Tests Stress Tests Neurological Exam Designed for almost every body region Used to determine: Ligament stability Muscle imbalance Muscle tightness Joint function Integrity of structures Neurological Exam Determine sensory function Run fingers over area of skin on affected and unaffected area Apply sharp and dull points to affected and unaffected area Does it feel the same on both sides?

Special Tests Circulatory Functional Tests Check pulse distal to injury When appropriate take pulse, blood pressure and nail bed perfusion Functional Tests Determine if athlete can return to sport participation Done only if no findings were found during special tests Evaluate motor control and proprioception Walk, jog, run in straight line, figure 8 and zig-zag Squat Throw Stand on one leg

Make a Decision After completing a HIPS evaluation, a decision of action can be made dependant on: Extent of injury Type of care needed Plan of action Return to play, re-valuate for follow-through treatment Can not return to play, ice and re-evaluate Call 911 Physical referral