HOPS and Fracture Care Flashcards
What is HOPS?
- non emergency on-field assessment
- when witnessed injury and the head/spine are not involved, or unwitnessed when head/spine have been ruled out
What does HOPS stand for?
H - History
O - Observations
P - Palpation
S - Special tests
what do you ask about during history?
Mechanism of Injury (MOI)
- how did it happen?
- what position were they in?
- what forces were applied?
Signs and Symptoms
- pain - location, type (achy, sharp, burning), severity (1-10)
sensations (tingling, numbness) and sounds (snap, crack, pop)
previous history of injury
- new or re-injury
what Observations do you look for?
swelling
bruising
bleeding
deformity
others: symmetry, general motor function, posture and gait abnormalities
what do you do during the palpations step?
using your hands to palpate around an injured area and feel what tissue is injured - bone, ligament, muscle
- obtain consent from the athlete
- compare bilaterally
- start away from the injury site and work towards injured area, palpating injured area last
- be methodical - bone first, rule out fracture, then soft tissue - muscles, tendons, ligaments
what are key things to look out for when palpating?
- deformity
- point tenderness
- swelling (soft/squishy/fluid)
- temperature (heat = ?)
- crepitus
- muscle spasms
- sensation
- pulse
what are 3 types of special tests?
AROM, PROM, RROM
AROM
active range of motion
- athlete performs the movement (no resistance)
- pain? ROM?
PROM
passive range of motion
- you move the affected area for the athlete
- pain? ROM? end feel?
RROM
resisted range of motion
- athlete performs movement against resistance
- break/isometric vs dynamic/isotonic resistance
(start with isometric resistance)
pain? strength/weakness?
HOPS review
history: MOI (method of injury), external forces, severe twisting/rotation/shearing, signs and symptoms, previous history
Observations: deformity, swelling, bruising, bleeding
Palpation: consent, rule out fracture, start away from injury
special tests: willingness to move, ROM, pain
what are some general rules for return to play
80-90% Full ROM
80-90% full strength
100% confidence/psychological readiness
are they able to be effective in their position?
(can perform sport specific movement patterns and forces - acceleration/deceleration, change of direction, plyometrics, load, etc.)
to return or not to return to play? (yes vs no)
if YES:
do they need support? i.e tape
If NO:
EAP or remove from field?
how to move from field (full weight-bearing, partial weight bearing or non-weight bearing)?
WHEN IN DOUBT SIT THEM OUT
EAP or transport?
arrange safe transport to nearest x-ray clinic
though to say, consult with lead therapist to confirm, but if conscious eap not needed, unless severe fracture
fractures
know difference between open and compound
closed vs simple
fracture tests
palpation
percussion/tap test
compression
tuning fork
distraction
x-rays
steps for splinting (5)
immobilize in the position found
support/limit ROM of joint above and below
test sensation/motor/circulation before and after applying the splint
keep fracture site accessible/visible
refer to medical support/x-rays
