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KNPE331 > Week 4 > Flashcards

Week 4 Flashcards

1
Q

How do we know if an emergency condition is ruled out?

A
  • Alert
  • ABCs
  • No concerning head/spine MOI
  • C-spine and head assessment clear
    *next is non-urgent conditions assessment
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2
Q

Non-urgent conditions

A
  • sprains
  • strains
  • simple fractures
  • contusions
  • abrasions/minor lacerations
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3
Q

On-field assessment HOPS

A

H- history
O- observations
P- palpation
S- special test

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4
Q

History taking- SAMPLE

A
  • signs and symptoms
  • allergies
  • medications
  • past medical history
  • last oral intake
  • events leading up to injury
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5
Q

History taking- PQRST

A

(all about pain)
- provoke
- quality
- region/radiate
- severity (1-10)
- time

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6
Q

PQRST- Provoke

A
  • what makes it worse?
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7
Q

PQRST- Quality

A
  • sharp, dull, achy, bruning
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8
Q

PQRST- Radiate

A
  • does it shoot anywhere?
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9
Q

PQRST- Severity

A
  • out of 10
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10
Q

PQRST- Time

A
  • when did pain start? intermittent?
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11
Q

Questions to ask about symptoms (SAMPLE)

A
  • what happened?
  • where does it hurt?
  • did you hear or feel anything?
  • did it give out?
  • PQRST for pain
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12
Q

Questions to ask about allergies (SAMPLE)

A
  • do you have any?
  • if so, do you have an epi-pen, where is it?
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13
Q

Questions to ask about medications (SAMPLE)

A
  • are you on any?
  • what are they?
  • what are they for?
  • were they prescribed? is it safe to take them?
  • could they be dampening symptoms?
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14
Q

Questions to ask about past medical history (SAMPLE)

A
  • do you have any medical conditions?
  • have you been feeling sick lately?
  • do you have any previous injuries?
  • have you hurt this are before?
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15
Q

Questions to ask about last oral intake (SAMPLE)

A
  • low blood sugar?
  • dehydrated?
  • what did they have and when?
    *imp to know if surgery is required
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16
Q

Questions to ask about events leading up to injury (SAMPLE)

A
  • what happened?
  • did they collide with someone?
  • piece together what happened
  • looking for MOI to indicate possibilities of injury
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17
Q

Observations (HOPS)

A
  • what do you see?
  • what’s around the athlete?
  • what position are they in?
  • expose injury site
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18
Q

What to check for in observation of injury site

A
  • bruising/discolouration
  • swelling
  • deformity
  • bleeding
  • rashes/hives
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19
Q

Palpations (HOPS)

A
  • have athlete show location (can they use one finger? do they motion to an area with hand?
  • check distal circulation
  • is the location warm vs other side?
  • do you feel a divot or deformity vs other side?
  • check above and below injury
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20
Q

Index of suspicion

A

Once you have gone through HOP, consider what structure you suspect is injured:
- muscle
- ligament
- bone

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21
Q

Special tests - muscle/tendon

A
  • have tissue contract
  • resisted testing 1-5
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21
Q

Special tests- ligament

A
  • test to open the joint it stabilizes
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22
Q

Special tests- bone

A
  • fracture testing
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23
Q

Kendall’s resisted muscle testing

A
  • rate the quality of strength out of 5 and mark with a * if it elicits pain
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24
Q

Kendall’s resisted muscle testing- grade 0

A
  • no visible or palpable contraction
25
Q

Kendall’s resisted muscle testing- grade 1

A
  • visible or palpable contraction without motion
26
Q

Kendall’s resisted muscle testing- grade 2

A
  • full range of motion, gravity eliminated
27
Q

Kendall’s resisted muscle testing- grade 3

A
  • full range of motion against gravity
28
Q

Kendall’s resisted muscle testing- grade 4

A
  • full range of motion against gravity, moderate resistance
29
Q

Kendall’s resisted muscle testing- grade 5

A
  • full range of motion against gravity, maximal resistance
30
Q

Ligament testing

A
  • testing for level of instability
  • what motion should that ligament limit?
31
Q

Fracture Test 1: Tap testing

A
  • gentle tap at location on bone away from suspected fracture site
  • vibration from tapping will elicit pain if there is a fracture
32
Q

Should we do a tap test for a fracture if we see a deformity?

A
  • not necessary
33
Q

Fracture test 2: Compression test

A
  • compress two ends of bone together
  • elicits pain if there is a fracture
34
Q

Compression test direct technique

A
  • either end of long bone
35
Q

Compression test indirect technique

A
  • compress bones around the smaller bone with suspected fracture (ie. carpals, tarsals)
36
Q

What is an alternative compression test method?

A
  • press on bones more proximally (ie. radius and ulna)
37
Q

Fracture test 3: Tuning fork

A
  • bang the end of the tuning fork off shoe/hard surface
  • place base of tuning fork on bone with suspected fracture, away from fracture site
  • resulting vibration may cause pain
38
Q

Sideline assessment

A
  • more detailed than on-field HOPS assessment
39
Q

What is included in sideline assessment?

A
  • rule out joint above and below
  • full physiological ROM for the joint
  • 3 special tests to rule out/confirm
  • more extensive palpation
40
Q

Physiological ROM

A
  • adduction, abduction, flexion, extension etc.
  • know which movements joints perform to do sideline assessment
41
Q

What are the intra-articular movements required for the physiological ROM to take place? (accessory movement)

A
  • roll
  • spin
  • glide
42
Q

Are accessory movement tested in sideline assessments?

A
  • no but would be essential to check in clinical analysis
43
Q

Fundamental arthrokinematics- roll

A
  • multiple points along one rotating articulate surface contact multiple points on another articular surface
44
Q

Fundamental arthrokinematics- glide

A
  • a single point on one articular surface contacts multiple points on another articular surface
45
Q

Fundamental arthrokinematics- spin

A
  • a single point on one articular surface rotates on a single point on another articular surface
46
Q

What ROM would you do for a sideline assessment?

A
  • active ROM
  • overpressure the end of range if full and pain-free
47
Q

What must occur for return to play?

A
  • ROM must be full and resisted testing must be 80%
48
Q

Questions to ask during a side line assessment for special tests

A
  • what other structures could bone involved?
  • what other structures need to be ruled out? (ie. ligament, muscle/tendon, bone/joint, nerve)
49
Q

Questions to ask and what to do during a sideline assessment for palpations

A
  • what other structures may be involved?
  • starts above and below injured structure and work towards it
  • layers of anatomy
  • determine the extent of injured structure
50
Q

Impression- what to include in documentation

A
  • severity (ie. degree)
  • structure
  • injury
  • assessment done
  • treatment provided
  • plan
51
Q

What to include in plan

A
  1. RTP decision
  2. Immediate care
  3. Educate
  4. Communicate
  5. Transport
  6. Referral
52
Q

Sideline management for a sprain

A
  • ice and elevation
  • wrap to support, approximate tissues, provide compression
  • crutches for weight-being extremities
53
Q

Sideline management for strain

A
  • ice and elevation
  • wrap for compression
  • pressure pad over tissue to approximate ends and provide compression
  • crutches
54
Q

Sideline management for contusions

A
  • ice
  • donut pad
  • wrap padding with herringbone technique
  • no massage
55
Q

Sideline management for fractures

A
  • splint (SAM or speed splint)
  • need to splint joint above and below
  • monitor for shock
  • refer for imaging
  • ice based on condition and monitor
56
Q

Sideline management for abrasions

A
  • clean wound
  • telfa/non-stick pad and cover roll
57
Q

Sideline management for minor lacerations

A
  • clean wound
  • telfa/non-stick pad and cover roll
  • steri-strips
58
Q

Principles of wrapping

A
  • purpose?
  • ask yourself which structures am I supporting?
  • any abrasions/blisters that need to be covered?
  • sensitivities?
  • have athlete in comfortable position
  • cap refill distal to wrapped area
59
Q

What are the different wrapping techniques?

A
  1. Spiral wrap
  2. Herring bone/figure 8
60
Q

Spiral wrap

A
  • overlap by half
  • equal distribution of pressure
61
Q

Herring bone/figure 8

A
  • used over area needing more compression
  • wrap up the leg, around and back down for X-effect

KNPE331 (4 decks)

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