KNPE331 > Week 4 > Flashcards

Week 4 Flashcards

(66 cards)

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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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22
Q

Special tests- ligament

A
  • test to open the joint it stabilizes
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23
Q

Special tests- bone

A
  • fracture testing
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24
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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25
Kendall's resisted muscle testing- grade 0
- no visible or palpable contraction
26
Kendall's resisted muscle testing- grade 1
- visible or palpable contraction without motion
27
Kendall's resisted muscle testing- grade 2
- full range of motion, gravity eliminated
28
Kendall's resisted muscle testing- grade 3
- full range of motion against gravity
29
Kendall's resisted muscle testing- grade 4
- full range of motion against gravity, moderate resistance
30
Kendall's resisted muscle testing- grade 5
- full range of motion against gravity, maximal resistance
31
Ligament testing
- testing for level of instability - what motion should that ligament limit?
32
Fracture Test 1: Tap testing
- gentle tap at location on bone away from suspected fracture site - vibration from tapping will elicit pain if there is a fracture
33
Should we do a tap test for a fracture if we see a deformity?
- not necessary
34
Fracture test 2: Compression test
- compress two ends of bone together - elicits pain if there is a fracture
35
Compression test direct technique
- either end of long bone
36
Compression test indirect technique
- compress bones around the smaller bone with suspected fracture (ie. carpals, tarsals)
37
What is an alternative compression test method?
- press on bones more proximally (ie. radius and ulna)
38
Fracture test 3: Tuning fork
- 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
39
Are tuning forks accurate?
- high proportion of false positives - value in ruling out a fracture, but not ruling in
40
Sideline assessment
- more detailed than on-field HOPS assessment
41
What is included in sideline assessment?
- rule out joint above and below - full physiological ROM for the joint - 3 special tests to rule out/confirm - more extensive palpation
42
Physiological ROM
- adduction, abduction, flexion, extension etc. - know which movements joints perform to do sideline assessment
43
What are the intra-articular movements required for the physiological ROM to take place? (accessory movement)
- roll - spin - glide
44
Are accessory movement tested in sideline assessments?
- no but would be essential to check in clinical analysis
45
Fundamental arthrokinematics- roll
- multiple points along one rotating articulate surface contact multiple points on another articular surface
46
Roll example
- humeral head rolling on glenoid fossa
47
Fundamental arthrokinematics- glide
- a single point on one articular surface contacts multiple points on another articular surface
48
Glide example
- knee flexion - femur on tibia
49
Fundamental arthrokinematics- spin
- a single point on one articular surface rotates on a single point on another articular surface
50
Spin example
- rotation of the radius on the humerus during forearm pronation and supination
51
What ROM would you do for a sideline assessment?
- active ROM - overpressure the end of range if full and pain-free
52
What must occur for return to play?
- ROM must be full and resisted testing must be 80%
53
Questions to ask during a side line assessment for special tests
- what other structures could be involved? - what other structures need to be ruled out? (ie. ligament, muscle/tendon, bone/joint, nerve)
54
Questions to ask and what to do during a sideline assessment for palpations
- 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
55
Impression- what to include in documentation
- severity (ie. degree) - structure - injury - assessment done - treatment provided - plan
56
What to include in plan
1. RTP decision 2. Immediate care 3. Educate 4. Communicate 5. Transport 6. Referral
57
Sideline management for a sprain
- ice and elevation - wrap to support, approximate tissues, provide compression - crutches for weight-being extremities
58
Sideline management for strain
- ice and elevation - wrap for compression - pressure pad over tissue to approximate ends and provide compression - crutches
59
Sideline management for contusions
- ice - donut pad - wrap padding with herringbone technique - no massage
60
Sideline management for fractures
- splint (SAM or speed splint) - need to splint joint above and below - monitor for shock - refer for imaging - ice based on condition and monitor
61
Sideline management for abrasions
- clean wound - telfa/non-stick pad and cover roll
62
Sideline management for minor lacerations
- clean wound - telfa/non-stick pad and cover roll - steri-strips
63
Principles of wrapping
- 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
64
What are the different wrapping techniques?
1. Spiral wrap 2. Herring bone/figure 8
65
Spiral wrap
- overlap by half - equal distribution of pressure
66
Herring bone/figure 8
- used over area needing more compression - wrap up the leg, around and back down for X-effect
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