When doing an on field assessment a good word of wisdom is to remember the acronym TOTAPS. This stands for
- Talk
- Observe
- Touch
- Active Movements
- Passive Movements
- Skill
Assessing the injury
Injuries need to be evaluated as soon as possible using D.R.A.B.C. (Danger, Response, Airway, Breathing, Circulation) to determine their severity. If emergency treatment is not needed, T.O.T.A.P. S. is an effective tool for further assessment.
Talk
Ask the player what happened.
Where does it hurt?
What kind of pain is it?
Observe
Look at the affected area for redness or swelling.
Is the injured side different from the other side?
Touch
Touch will indicate warmth for inflammation. Touch also assesses pain.
Active movement
Ask the injured player to move the injured part without any help.
Passive movement
If the player can move the injured part, carefully try to move it through its full range of motion.
Skill test
Did the active and passive movement produce pain? If no, can the player stand and demonstrate some of the skills from the game carefully?
If an injury is identified, remove the player from the activity immediately.
The above guidelines do not apply for assessing head injuries/concussion or suspected spinal injury. For suspected spinal injury, the player must be kept lying flat and immobile until professional help is available.
When an injury is found!
Immediate injury treatment A soft tissue injury such as a sprain, strain or bruise identified using T.O.T.A.P.S should immediately be treated with the
R.I.C.E.D. procedure:
Rest
Rest reduces further damage stop activity as soon as the injury occurs.
Avoid as much movement of the injured part as possible to limit further injury.
Dont put any weight on the
injured part.
Ice
Ice cools the tissue and reduces pain, swelling and bleeding.
Place ice wrapped in a damp towel onto the injured area dont put ice directly onto bare skin.
Hold the ice pack firmly in place with a bandage.
Keep ice on the injury for 10 minutes every hour or so for the first 48 hours.
Compression
Firm bandaging helps to reduce bleeding and swelling.
Ensure that bandaging is not so tight that it cuts off circulation or causes tingling or pain past the bandage.
Bandage the injury between ice treatments.
Elevation
Elevation helps to stop bleeding and reduce swelling.
Raise the injured area on a pillow for comfort and support.
Keep the injured area raised as much as possible.
Diagnosis or Referral
Consult the appropriate medical professional especially if you are worried about the injury, or if the pain or swelling gets worse.
If the pain or swelling has not gone down significantly within 48 hours, also seek treatment.
During the initial phase one should also avoid any
H.A.R.M factors
Avoid the H.A.R.M-ful factors for 72 hours after the injury:
Heat
Heat increases the bleeding at the injury site.
Avoid hot baths and showers, saunas, hot water bottles, heat packs and liniments.
Alcohol
Alcohol increases bleeding and swelling at the injury site, and delays healing.
It can also mask the pain of the injury and its possible severity, which may result in the player not seeking treatment as early as they should.
Running
Running or any form of exercise will cause further damage.
Players should not resume exercise within 72 hours of an injury unless a medical professional says it is all right to exercise.
Massage
Massage causes an increase in bleeding and swelling, and should be avoided within 72 hours of the injury.
If the injury is massaged within the first 72 hours, it may take longer to heal.
I have also attached a simple overview document that is used as a common starting point for sports trainers etc. This gives you an overview of the types of things the sports physio or sport trainer should consider when taking on a team responsibility.
Best of Luck
Totaps
Linear Mode
