Chapter 20 INJURY EVALUATIONS INJURY EVALUATION PHASES n

Chapter 20 INJURY EVALUATIONS

INJURY EVALUATION PHASES n Primary Survey u Discovering and correcting life-threatening situations n Secondary Survey u If not immediately life-threatening, these are the next steps u Performed on the field, sideline or in athletic training room

EVALUATION Rule #1 BE CALM

PRIMARY SURVEY - LOC n LOC - level of consciousness u By talking (Are you okay? ) or rubbing collarbone, sternum, or tap shoulders u Never use ammonia u No response, call 911

PRIMARY SURVEY – ABC’s n Airway u Try not to move victim more than absolutely necessary u If no known neck injury, do head tilt – chin lift u If neck injury is suspected, jaw thrust u May have to remove facemask or equipment

PRIMARY SURVEY – ABC’S n Breathing u Look (chest rise and fall) u Listen (breath sounds or gurgling) u Feel (for breath on cheek) u If you have all of these, check respiratory rate (how fast? ) and respiration volume (how deep? )

PRIMARY SURVEY – ABC’s n Circulation u Check pulse in carotid artery u Normal/Average rate is 60 -80 bpm

If they can tell you something is wrong, they are conscious have their ABC’s

PRIMARY SURVEY - Bleeding Look for obvious, outward signs of bleeding n Be suspicious of internal bleeding n Types of Bleeding 1. Arterial Bleeding – very rapid, may pump, bright red, and life-threatening 2. Venal Bleeding – also rapid but a more steady flow, darker red 3. Capillary bleeding – oozing, gradual flow n

SECONDARY SURVEY

SECONDARY SURVEY n What are vital signs? u Different “tests” that assess an individual’s level of functioning u Need to know what normal ranges are t if the test results are too high or too low problem

SECONDARY SURVEY – VITAL SIGNS n Body Temperature – feel the skin u Normal – 98. 6 degrees u Can take temperature in ear, mouth, armpit or rectally

SECONDARY SURVEY – VITAL SIGNS n Pupils – shine light into eyes to assess potential brain injury u Normal round, equal, and get smaller with light u PEARL – Pupils Equal And Responsive to Light

SECONDARY SURVEY – VITAL SIGNS n Motor and Sensory Function u Can they move and feel extremities? n State of Consciousness u Can they respond to questions and commands?

SECONDARY SURVEY – VITAL SIGNS n Skin Color – looking for red, white, or blue u Red – heat stroke u White – illness, heat exhaustion u Blue – lack of oxygen in blood

SECONDARY SURVEY – VITAL SIGNS n Pulse – heart beat u Take in wrist (radial) or neck (carotid) u Normal pulse – 60 -80 beats per minute

SECONDARY SURVEY – VITAL SIGNS n Respirations – rate of breathing u Normal respirations – 10 -12 breaths a minute

SECONDARY SURVEY – VITAL SIGNS n Blood Pressure u Systolic – number on top t Pressure when heart contracts u Diastolic – number on bottom t Pressure when heart is at rest u Normal – 120 / 80

SECONDARY SURVEY DAILY INJURY EVALUATIONS n Need to know: u Anatomy u Mechanisms Of Injuries (MOI) – cause of injury t What are examples? u Signs and symptoms of injuries

DAILY INJURY EVALUATIONS n History n Observation n Palpation n Special Tests

HOPS - HISTORY n n Past History u Has this happened before? Current History u Chief Complaint – what is problem? u Where does it hurt? Point with one finger u What were you doing? u MOI, show with good body part u Unusual sounds and sensations, popping

HOPS - HISTORY n Current History– con’t u Pain t Quality – description (dull, burn, ache) t Radiating – does it go anywhere else t Severity – scale of 0 - 10 t Time – how long has it hurt u What sport or activity are they doing

HOPS - OBSERVATION n n n Looking at body part and appearance Want to compare to opposite side Looking for: u Swelling u Scars u Discoloration u Deformity u Gait - walking u Guarding - holding

HOPS - PALPATION Touching n Have to know your anatomy n Start away from sorest area and work towards pain – helps gain trust n Need to develop a system u Bones first, and then soft tissue n

HOPS – SPECIAL TESTS n Range of Motion (ROM) u Moving a joint u Active t Athlete moves body part themselves u Passive t You move body part to end range u Resisted t Strength testing

HOPS – SPECIAL TESTING n Stress Tests u These are specific tests that look for specific injuries

HOPS – SPECIAL TESTS n Neurological Tests u Sensation t Light and sharp touch u Movement and Strength u Reflexes

HOPS – SPECIAL TESTS n Sport Specific Activity u Start with easy activities and work your way to more complex activities