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UNIT 7- INJURY MANAGEMENT
HIPS
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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
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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
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History
One of most important steps
Collecting as much information as possible
Ask athlete questionsAsk bystanders
questionsProvide 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…?
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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
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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
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Special Tests
There are five areas of special tests Range of Motion Stress Tests Neurological Circulatory Functional
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Special Tests
Range of Motion Assess in proper
sequence- Active-Passive-Resistive
Compare bilaterally
Active Movement is performed
solely by athlete
Passive Movement is performed
completely by the examiner
Resistive Athlete is asked to
perform movement while the examiner provides resistance
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
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Special Tests
Stress Tests 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?
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Special Tests
Circulatory 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
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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