1. Injury Assessment & Evaluation Procedures
Primary Survey
-ABCs
Secondary Survey
- HOPS

2. Step One: SAFETY Does the scene appear to be safe?
Is practice still going on?
What are others in the area doing?
Is there a shooter on the roof? Or what may have caused the player to drop down?
Look carefully around the scene!

3. Step Two: Primary Survey
Goal  recognize and evaluate all injuries for each individual patient.
This is systematic and follows a specific procedure.
A – Check LOC (level of consciousness)
Call the patient to elicit a response
Is the patient awake or unconscious?
If responsive, ask their name, what happened, the location, and what hurts.
If no response, “tap and shout”
If no response, pinch finger webs. If nothing, they are unconscious.

4. Step Two: Primary Survey
B – Check Airway, Breathing and Circulation (ABCs)
Airway – check for obstruction
Breathing –
Look for the chest to rise
Listen for breath sounds from the nose & mouth
Feel for the air on your cheek
Circulation – check for pulse gently on the side of the throat with first & second finger

5. Step Three: Secondary Survey
The “Evaluation”
Done once it has been established that the pt. does not have any life-threatening injuries
There are 3 different formats:
HOPS
HIPS
SOAP

6. Step Three: Secondary Survey
H.O.P.S.=  History, Observation, Palpation/Physical Exam, Special Tests, which will be focus of today's lesson.
H.I.P.S. = History, Inspection, Palpation/Physical Exam, Special Tests
S.O.A.P.= Subjective information, Objective Information, Assessment, Plan is used to assist in documentation of injuries, daily treatments, weekly / Bi-weekly summaries PRN(as needed)**
* We will focus on the HOPS Format for assessing injuries
** We will discuss S.O.A.P. notes in a later section.

7. H = HISTORY
In this portion of the evaluation the information comes mostly from the patient. It includes medical history (hx) of the patient and Sign & Symptoms (S/S).
What to find out:
Who they are? ………..Patient’s Name
What Happened? How did injury occur
Where did it happen? Did it happen on a field, court, locker room etc
Any Previous Medical History (Hx)?....Has the body part ever been injured before
What is your primary Complaint?..... What is the worst thing about the injury

8. H = HISTORY cont.
Type / quality of Pain they are having?....Is it sharp, achy, throbbing etc
Location of pain?.....Have patient point to location of pain!;
Pain Scale 0 to 10. Have patient state a number giving a level of pain he/she is in: 0 = no pain ,  10 = Worse pain ever!!!;
Does pain increase with activity, if so what?
What has the patient done in the past to address his/her pain.
Any snapping/cracking/ popping sensations (this is called crepitus)
ACTIVITY- Pair up and ask your partner about an injury he/she sustained in the past. Have them answer the History questions.

9. O= OBSERVATION
O: Observation= Visually looking at the injury. This refers to physical signs of injury that are recognized by the ATC or other medical Professionals.
Why do you think that the athletic trainer still has not touched the injured athlete?
Looking for:
Swelling (type, location, amount)
Discoloration
Deformities
Gait/weight-bearing
Posture
Scars from previous injuries
Bleeding
What should you do if you see bleeding?

10. O = OBSERVATION cont.
Discoloration/Ecchymosis: Black & Blue skin Yellowing in later stages
Position  / Posture of an Athlete
Holding / Guarding (protecting) a body part
Grasping a body part “SCREAMING USUALLY”
Decorticate, Decerebrate
ALWAYS Compare Involved side with Uninvolved (CONTRALATERAL) side whenever possible.
Why is this necessary?

11. O = OBSERVATION Cont.
Bicep - partial tear Scapula Winging

12. What do you notice in the above pictures?
O = OBSERVATION cont.
What do you notice in the above pictures?

13. P = PALPATION This is the first time you actually touch the athlete
You use the information you gained during the history and inspection to guide you
Now you are FEELING for clues about the injury
You always palpate the uninjured side first
Why?
Then you palpate the injured side starting away from the area of most pain.

14. P = PALPATION cont.
Remember to observe universal precautions if your observation revealed blood or body fluids
Things you are looking for during palpation
Temperature changes: hot or cold
Deformities
Point tenderness
Crepitus
Swelling (wet diaper vs. water balloon)
Rule out fractures

15. P = PALPATION cont.

16. S = SPECIAL TESTS
The tests used in this section will be different for each body part that we cover
Remember to perform each test bilaterally
In general the tests are used to determine
Joint range of motion
Muscle strength and function
Ligament stability
Nervous function/integrity

17. S = SPECIAL TESTS cont. ROM & Muscle Testing
Used to determine if the range of motion of a joint is within normal limits
Always test bilaterally
Three ways to test range of motion– test them in this order
Active—the athlete move the joint themselves
Passive– the athlete is relaxed and you move the joint through the ROM
Resistive-- you apply resistance while the athlete moves the joint

18. ROM/Special Testing cont.

19. Ligament Testing
Tests used to determine the integrity of specific ligaments
We will learn specific tests during future units
Results of these tests, along with the history, inspection and palpation will allow you to “grade” sprains

20. Grades of Sprains Grade I
Ligament testing reveals solid endpoint (rope)
Little to no swelling/loss of function
Grade II
Ligament testing reveals soft endpoint (bungee)
Grade III
Ligament testing reveals no endpoint (nothing)

21. Grades of Sprains cont.