During warm-ups for a varsity football game, the athletic trainer is suddenly summoned to the far corner of the field where she is told a cheerleader has been injured. The athletic trainer runs to the area where she sees a large group of cheerleaders and spectators crowded around an individual on the ground. A quick glance shows the cheerleader is not moving and is not responding to shouts from his fellow cheerleaders.
The athletic trainer quickly notes that the athlete’s right ankle and elbow are deformed but have no obvious signs of bleeding. The cheerleader does not respond to the athletic trainer’s voice commands.
Imagine you are the athletic trainer. What are your priorities in managing this athlete? How would you proceed?
Evaluation of the injured or ill athlete consists of conducting a physical examination and obtaining a complete set of vital signs. Physical examination can be either a focused body systems approach or a global head-to-toe approach. Each chapter in this text will concentrate on emergency care of a body system, but because most injuries in athletics are traumatic, a head-to-toe approach is best suited for the global examination and will be used here. A head-to-toe approach is also the most commonly used method for physical examination by emergency medical services (EMS). Because EMS will almost always be summoned for a critically injured or ill athlete, it is best to utilize the same type of system to facilitate a smooth transition of care and get the athlete to the hospital quickly.
A physical examination has four components: inspection, palpation, percussion, and auscultation (Fig. 2-1). Inspection involves a close examination of the injured area looking for deformity, contusions, abrasions, swelling, and bleeding. Palpation involves touching the injured area to note abnormal findings such as deformity or crepitus. Percussion consists of tapping the injured area to elicit tympanic sounds. Percussion is used for thoracic and abdominal injuries and is difficult to perform in the athletic arena. Auscultation refers to listening to lung sounds with a stethoscope and, although difficult in a noisy environment, ...