1. Injury Evaluation Process

2. Why have a process for evaluation?

3. 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

4. On-Field Assessment Primary Survey Secondary Survey History
Observation
Screening
Immediate Action Plan

5. On-Field Assessment Primary Survey Airway, Breathing, Circulation
Try to arouse if unconscious
Treat for neck injury if you did not see the injury

6. On-Field Assessment Secondary Survey History Observation
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.

7. On-Field Assessment Screening Rapid evaluation techniques
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
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.

8. Off-Field Athletic Injury Assessment
HOPS
History of the injury
Check life threatening situations
History of the individual
Observation and Inspection
Visual inspection
Palpation
Hands on inspection
Special Tests
Test structural integrity
Functional activity tests

9. 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

10. 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?

11. 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)

12. 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

13. 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

14. 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 – athlete’s voluntary movements
Passive ROM – athletic trainer provides movement
Resistive ROM – athletic trainer provides resistance
Special tests

15. 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.

16. 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

17. SUMMARY OF THE ATHLETIC INJURY EVALUATION PROCESS
Re-evaluate
Throughout rehabilitation
Record Findings

18. Summary of Evaluations
On-field evaluation
Side line evaluation
Clinical evaluation