Week 1 Eval

Vital signs (respiration)

rate increased or decreased

20-25 children

12-20 adults

deep or shallow

regular or irregular

vital signs (Pulse)

60-100 children

60-80 adults

depends on activity level

vital signs (BP)

120/80

lower better

vital signs (skin color)

red = heatstroke, increased BP

white = lower circulation, shock, hemorrhage

blue = cyanosis or lack of O2

vital sigs (pupil rx)

PEARL

pupils equal and reactive to light

sample

signs and symptoms

allergies

medications

past medical history

last oral intake

events leading up

HIPS (history)

chief complaint

etiology = cause

pathology = what’s happening in body

history of present problem

time sequence

location of symptoms

participation characteristics

persona management

pain descriptions

HIPS (inspection and observation)

discoloration

deformity

swelling

posture

gait

symmetry

facial expressions

movement analysis

scars/wounds

gait deviations (analgic)

painful or limping

gait deviations (trendelenburg)

issue with superior gluteal nerve or glute med issue

gait deviations (glute med lurch)

lean to side mid stance

gait deviations (hip hiking)

pulling hip in air one side

gait deviations (circumduction)

leg goes in circle no PF/DF

gait deviations (pocket gait)

use hand to push back

gait deviations (vaulting)

oppo hip hike, oppo toes

gait deviations (foot drag)

dragging foot

palpation

use pads of fingers

perform systemic and repeatable sequence

cephal caudal (top to bottom)

prox to distal

medial to lateral

close to far from injury

palpation systemically

bones

ligaments

muscles/tendons

vascular

neurological

palpation objectives

swelling

pain

crepitus

deformity

temp change

masses

lymph nodes

sensory nerve eval

HIPS (special testing)

don’t diagnose

not all tests learned necessary

record ROM, end feels, painful movements

start uninjured side first

most painful test last

rule out multiple injuries/sxs

rule out fracture (tuning fork, ultrasound, fulcrum, percussion/tap test)

ROM

goniometer or tape measure

APR (active)

apply over pressure as needed

APR (passive)

bone to bone

spasm

capsular

springy block

tissue approx

tissue stretch

empty

APR resistive

break or brake test

resist thru entire ROM

position yourself at mech advantage