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
