SAIM System
Report Injury
Data Table
About
Report Injury Page
Unique Identifiers
Initials:
Sex:
Select Sex. . .
Male
Female
Other
Date of Birth
Date of Injury
Nature Of Injury
Nature Of Activity:
Nature Of Injury:
Select Nature of Activity...
Education, including school sports
Sport – game
Sport - training
Leisure/play
Other
Unknown
Select Nature of Injury...
fracture (broken bone/bone stress injury/stress fracture)
dislocation/subluxation
sprain/ligament injury
meniscus or cartilage injury
muscle rupture/tear/strain
tendon injury/rupture/ tendinopathy/ bursitis
haematoma/contusion/bruise
abrasion
laceration/wound/cut
concussion (with/without loss of consciousness)
nerve injury
dental injury
eye injury
Injury to internal organ
Heart attack/condition
Respiratory condition – eg asthma
Medical condition – ie diabetes, epilepsy
Other
unknown
Mechanism Of Injury:
Area of Injury:
Select Mechanism of Injury...
Overuse
Struck by or collision with another player or object
Collision with fixed object/equipment
fall/ slip/trip/ stumble on same level
Sudden or rapid acceleration and deceleration
Jumping, including landing from jump
Temperature related
Other
unknown
Select Area of Injury...
head/face
neck/cervical spine
breastbone/ribs/upper back
abdomen
low back/pelvis
shoulder/collarbone
upper arm
elbow
forearm (between elbow & wrist)
wrist
hand/fingers/thumb
hip/groin
thigh
knee
lower leg (between knee & ankle)
ankle
foot/toe
General – non-specific
Location Associated With Injury:
Place Where Injury Occured:
Sport or Recreational Activity:
Select Mechanism of Injury...
Home, including garden and out buildings
School, including kindergarten and schoolyard
Street/highway
Sports and athletics area
Gymnasium
Countryside (water, sea)
Unknown
Other
Select Sport or Recreational Activity. . .
Baseball
Basketball
Cycling
Boxing
Football (Soccer)
Football (Australian Rules)
Football (Gaelic)
Football (Touch)
Golf
Gymnastics
Grid iron
Hockey
Tennis
Martial arts
Skating
Surf life saving
Diving
Dancing
Volleyball
Weightlifting
Wrestling
Mountaineering
Track and Field
Circuit-based exercise
Resistance training
Running
Swimming
Walking
Netball
Cricket
Archery
Rugby
Lacrosse
Hiking
Snow-boarding
Horse riding
Sailing
Surfing
Softball
Wind-surfing
Aerobics
Rowing
Climbing
Canoeing
Kayaking
Rafting
Wood-chopping
Polo
Hurling
Motor sports
Wheelchair basketball
Wheelchair rugby
Lawn bowl
Bocce
Bowling
Fishing
Equestrian activities
Shooting
Badminton
Fencing
Squash
Ice and snow sports
Curling
Combat sport
Cue sport
Orienteering
School sport
Water sport
Other
Additional Injury Information:
Type of Injury:
Time of Injury:
Select Type Of Injury...
new injury
aggravated existing injury
recurrent injury (same type & site less than 2 months after return to full participation)
illness
Other
unknown
Ground Surface:
Severity Of Injury:
Select Type Of Injury...
Bitumen/asphalt
Wooden
Synthetic/rubber
Concrete
Natural turf
Artificial turf
Ice
Other
Unknown
Select Severity Of Injury...
No apparent injury
Minor or superficial (e.g. bruises, minor cuts)
Moderate, requiring some skilled treatment (e.g. fractures, sutures)
Severe, requiring intensive medical/surgical management (e.g. internal haemorrhage,
Punctured organs, severed blood vessels)
Data Entered By:
Select Data Entered By. . .
self – i.e. the injured person
health professional (includes nurse, doctor, allied health professionals)
sports first aid/ sports trainer
parent or guardian
Other
unknown
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