Recognition, Evaluation and
Management
Chapter 2
Recognition of Injuries
 Primary function of athletic trainers is to
recognize an injury when it happens, determine
its severity, and apply proper evaluation.
 Two major considerations:
 Control life threatening conditions
 Management of non-life threatening injuries
Question
 A gymnast slipped off the springboard on an approach to a
vault and collided full force into the horse. As the on-site
athletic trainer, you observe the gymnast lying motionless on
the floor. Based on this information, is it appropriate to
activate 911?
 While the condition of the gymnast may eventually warrant
activation of the institution’s emergency medical plan, there
is not sufficient information at this point to activate the plan.
It is important that the athletic trainer assess the athlete’s
condition to determine whether activation of the emergency
medical plan is necessary.
Referral to a Physician
 No breathing
 Suspected fracture or
 Severe bleeding
 Suspicion of intracranial
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bleeding
Unconscious
Paralysis
Circulation and neurological
impairment
Shock
Obvious deformity
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dislocations
Pain, tenderness, or
deformity on spine
Significant swelling or pain,
Loss of sensation
Loss of motion
Doubt about the severity of
the injury.
Student Athletic Trainers in Emergency
Situations
 Becoming aware of the causes of serious injuries
 Making sure equipment and the playing area is
safe.
 Alerting the athletic trainer and coach of
potential dangers
 Recognizing serious injuries
 Assisting in EMS activation, splint use, crowd
control.
First Aid Emergency Care
 Follow the American Red Cross standards that
will be taught to you in this class.
 All coaches and athletic trainers are certified in
CPR and First Aid.
Emergency Transportation Procedures
 Two points to consider:
 Availability of ambulance services
 Severity of an injury
 EMTs are skilled, practiced, professionals who
routinely handle medical emergencies.
 They have the proper equipment to handle the
medical emergencies.
Questions
 In assessing the condition of the injured gymnast, what
sequential process can be used to determine if the central
nervous system(brain/spinal cord) and/or cardiorespiratory
systems are critically injured?
 What conditions warrant activation of the emergency
medical plan, including summoning EMS?
Evaluation of Life Threatening Injuries
 When a serious injury is suspected, begin an
evaluation with the primary survey
 Airway
 Breathing
 Circulation
 Make sure you are calm during this.
 Once the primary survey is complete, a
secondary survey is doing including a history and
physical exam of the injury.
Evaluation of Non-Life Threatening
Injuries
 Once a life- threatening injury is ruled out, medical
evaluation of the injury should be more involved.
 There are several commonly used abbreviations to help
remember all the important aspects of the evaluation:
 HOPS: History, Observation, Palpation, Special Tests
 SOAP: Subjective, Objective, Assessment, and Plan
HOPS
 History: How did it happen?
Where does it hurt? What did you hear? Previous injury?
Observation: Look for bleeding, swelling, discoloration,
deformity and compare anatomical structures
Palpation (to touch): Palpate anatomical structures above and
below injured site (start away - work toward); Palpate
affected area//Bones, Ligaments, & Muscles
Special Tests: Joint stability; Muscle/tendon//Range of
Motion, Strength
SOAP
 Subjective Findings: Ask detailed questions like when
conducting an injury history
Objective Exam Examination and Findings: Measureable
visual, physical, and functional findings
Assessment: Review the probable cause and mechanism of
injury based on subjective a objective finding
Plan: Outline appropriate action plan for care & rehab.
Example-History
 A female high school long jumper sustains an ankle injury
during practice and immediately reports to the athletic
training room. What questions should be asked to identify the
cause and extent of this injury?
 In attempting to determine the cause and extent of injury,
the female long jumper should be asked questions pertaining
to the following: primary complaint (i.e., what, when, and
how questions), mechanism of injury (i.e., position of the
ankle at the time of injury and the direction of force),
characteristics of symptoms (i.e., nature, location, severity,
and disability), unusual sensation (i.e., sounds and feelings),
related medical history, and past injuries/treatment.
Example-Observation
 A detailed history of the injury has been gathered from the long
jumper. The information suggests a sprain of her right ankle. In the
continued assessment of this individual, observation and
inspection should be performed. What observable factors might
indicate the seriousness of injury?
 Observable factors relative to the injured sight that might indicate
the seriousness of the injury sustained by the female long jumper
include deformity, swelling, discoloration, and signs of previous
injury. It is important to perform a bilateral inspection of the
injury site as well as of the surrounding area. In addition,
observation of general presentation, including the presence of
guarding or antalgic gait, will provide important information
concerning the nature of the injury
Basic Treatment Protocols
 After the eval, often the treatment is going to be similar
and may or may not include physician referral.
 PRICES
 Protection – protect injury from further damage
 Rest – length depends on the injury
 Ice – 15 to 20 minutes
 Compression – elastic wrap to control swelling
 Elevation – higher than the heart if possible
 Support – splint, crutches, or sling
First Aid Equipment
 Fixation Splint – Most common – board, SAM, pillow, etc.
 Vacuum Splints – conform to the injury
 Air Splints – No longer used often
 Traction splints – Long bone fractures, used by EMS
10 Key Points for Splinting
Inspect for open wounds or deformity
2. Check pulse, motor, and sensation
3. Cover wounds
4. Do NOT move the athlete
5. Select proper splint
6. Place splint beside the injured extremity
7. Apply the splint with minimal movement
8. Secure the splint with straps
9. Check pulse, motor, and sensation again
10. Apply cold and document the time.
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