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BACKGROUND INFORMATION Over the years, athletic training has evolved into a specialization within sports medicine. Its major concern is the health and safety of athletes. In order to learn about the prevention and care of injuries, we first must learn the role of everyone on the sports medicine team.
Chapter 1The Athletic Trainer and The Sports Medicine Team • FIRST AID: Is the immediate care or treatment that is given to an injured or ill person before professional medical aid can be obtained. • ATHELETIC TRAINING: An allied health profession that is concerned with the health and safety for athletes and the physically active.
Who is Physically Active? Athletes? Blue Collar Workers? Recreational Participants? Mom’s? Gas Station Attendants? Insurance Sales Person? ETC.
ATHLETIC TRAINING • Athletic Trainer: a specialist in athletic training concerned with the complete health care of the athlete.
ATHLETIC TRAINING • The athletic trainer provides a major link between athletics and the medical community.
ATHLETIC TRAINING • The athletic trainer is responsible for injury prevention, emergency care, and rehabilitation of sports related injuries.
History and Background of Athletic Training • Prior to NATA in 1950 • Greek and Roman Period • Intercollegiate Sports • First NATA in 1938-44 • WWII • NATA formed in Kansas City in 1950 • Growth and Development Since 1950
SPORTS MEDICINE • Definition: A generic term used to describe a group of professions that assist in the health and performance of the athlete • Areas of Specialization in Sports Medicine • Medical disciplines • Athletic training • Physical therapy • Exercise physiology • Biomechanics • etc.
Sports Medicine Organizations • American College of Sports Medicine • International Federation of Sports Med • American Orthopedic Society for S. M. • National Strength & Conditioning Assoc. • Sports Physical Therapy Section of APTA • NCAA Comm. On Competitive Safeguards and Medical Aspects of Sports • NATA
THE SPORTS MEDICINE TEAM • Athletic Trainer: most directly responsible for all phases of health care in an athletic environment. • Team Physician: directs the medical care of the athlete and the care given by the athletic trainer. • Orthopedic Physician: directs care of the musculoskeletal injuries. • Other Physicians
THE SPORTS MEDICINE TEAM • Coaches • Biomechanists • Exercise Physiologists • Administrators (Athletic Director) • EMT’s & Paramedics • School Nurse • Physical Therapist
THE SPORTS MEDICINE TEAM • Nutritionist • Psychologist • Chiropractor • Others …… • All are responsible to work together to provide proper health care and a safe environment for the athlete.
Responsibilities of the Team Physician • First, to serve as an advisor and director to the athletic trainer or coach. • Physical exams and medical histories • Diagnosing injuries and determining the health status of the athlete • Deciding on return to play • Attend practices and games • Committed to sports and the athlete
Responsibilities of the Coach • In the absence of an athletic trainer and team physician, the coach must assume the direct responsibility for the health of the athlete.
Responsibilities of the Coach • “Coaches must demonstrate a high profile for safety, and show that they really care”. • Respect the skills and insight of the athletic trainer and physician, who must have the last word concerning injuries. • Know legal responsibilities for injuries
Roles and Responsibilities of the Athletic Trainer • Performance Domains • Prevention of athletic injuries • Evaluation and assessment of injuries • Immediate care of injuries • Treatment, rehabilitation and reconditioning of injuries • Health care administration • Professional Development
Roles and Responsibilities of the Athletic Trainer • Education Council Competency Domains • Acute care • Assessment and evaluation • General medical conditions & disabilities • Health care administration • Nutritional aspects of injury/illness • Pathology of injury/illness
Roles and Responsibilities of the Athletic Trainer • Education Council Competency Domains • Pharmacological aspects of injury/illness • Professional development • Psychological intervention and referral • Risk management and injury prevention • Therapeutic exercise • Therapeutic modalities
Athletic Trainer Roles and Responsibilities of the • Injury Prevention and Risk Management • Ensuring appropriate training & conditioning • Monitoring environmental conditions • Managing protective equipment • Counseling about proper nutrition • Appropriate medication education & use
Athletic Trainer Roles and Responsibilities of the • Recognition, Evaluation, and Assessment of Athletic Injuries • Conducting Physical Examinations • Understanding the pathology of injury/illness • Utilizing Evaluation Procedures • Referring to medical specialists
Athletic Trainer Roles and Responsibilities of the • Immediate Care of Injury and Illness • Initial assessment • Administering appropriate first aid • Providing emergency care
Athletic Trainer Roles and Responsibilities of the • Treatment, Rehabilitation & Reconditioning • Designing rehabilitation programs • Therapeutic exercise • Rehabilitative equipment • Manual therapy • Supervising rehabilitation programs • Incorporating therapeutic modalities • Education and counseling of injuries
Athletic Trainer Roles and Responsibilities of the • Organization and Administration • Record keeping • Ordering equipment and supplies • Supervising personnel • Establishing policies of operation • Maintaining athlete data • Organizing insurance issues
Athletic Trainer Roles and Responsibilities of the • Professional Development and Responsibilities • Being a lifelong learner of the field • Maintaining CEU’s for certification • Educate the public • Involvement in professional organizations
Employment Settings for the Athletic Trainer • Public and Private High Schools • Colleges and Universities • Professional Teams • Sports Medicine Clinics • Industrial Settings • Hospitals • Health and Fitness Centers • Other Future Directions???
Establishing a System For Athletic Training Health Care • Develop a plan • A planning process with those involved • A mission statement must be decided • Develop a policies and procedures manual • Design an athletic training facility • Size • Location • Storage facilities • offices
Establishing a System For Athletic Training Health Care • Design an athletic training room • Special services section • Treatment area • Electrotherapy area • Hydrotherapy area • Rehabilitation area • Taping area • Examination area • Records area
Establishing a System For Athletic Training Health Care • Other concerns (PP Manual) • Who do you serve? • Facility and personnel coverage? • Insurance? • Emergency telephone? • Budgetary concerns? • Security and safety issues? • Emergency management? • Access to other health care providers?
Establishing a System For Athletic Training Health Care • Other Concerns (PP Manual) • Record keeping • Medical records • Injury reports • Treatment logs • Personal information • Injury evaluation • Etc.
Establishing a System For Athletic Training Health Care • Other Concerns (PP Manual) • Preparticipation exams • Physician exam • Station exam • Medical history • Maturity assessment • Orthopedic screening • Medical records
History Orthopedics Vital signs Vision ENT Skin Cardiovascular Urinalysis Drug Testing? Blood tests Cardio-Respiratory Neurological Lymphatic / Abdomen and Reproductive Pre-season Physical Exams
Sport Disqualification • Certain injuries or conditions may warrant concerns relative to continued participation. However, the athletic trainer, coach, or even the physician can only recommend. The ADA of 1990 clearly states that the individual athlete and/or parents is the only person who can make the final decision.
Collecting Injury Data • The Incidence of Injuries • Accident: an unplanned event resulting in loss of time, property damage, injury, disablement, or even death. • Injury: damage to the body that restricts activity or causes disability. • Risk of injury is determined by the type of sport and the amount and level of participation. • The type of injury can also be expected by the sport and level of participation
Collecting Injury Data • Incidence of Injuries • Sports Classifications • Collision • Contact • Non-contact • Injury classifications • Fatalities • Catastrophic injuries • Musculoskeletal injuries (contusions, strains, etc.) • Acute vs Chronic • Incidence: knee ankle upper extremity
Collecting Injury Data • National Injury Data Collecting Systems • National Safety Council • American Football Coaches Association • NCAA Nat. Survey of Catastrophic Injury • NATA • Others • Using Injury Data • Modify rules • Education of risks • Evaluate protective equipment
Professional Preparation of the Athletic Trainer • Professional Educational Programs • Approved Curriculums: NATA/CAAHEP • Internship programs (not after 2004) • Certification Req. NATABOC Exam • Continuing Education Requirements (CEU) • State Regulations (Licensure) • Future Directions for Athletic Training
Legal Concerns • Liability: being legally responsible for the harm one causes another person. • Negligence: the failure to use ordinary and reasonable care. • Torts: are legal wrongs committed against the person or property of another • Omission • Commission
Legal Concerns • Statutes of Limitation: sets a specific length of time that individuals may sue for damages from negligence (1-3 years). • Assumption of Risk: assuming the risk of participating in an activity while knowing the dangers of the activity.
Reducing the Risk of Litigation • Warn athletes of the potential dangers of the sport • Supervise regularly • Properly prepare and condition athletes • Properly instruct athletes in the skills of the sport • Use proper and safe equipment and facilities • Establish good personal relationships with the athletes • Develop and follow an emergency plan • Be aware of the athletes health status and medical history
Reducing the Risk of Litigation • Keep good records of injuries and rehabilitation • Document efforts to create a safe playing environment • Obtain written consent to provide health care • Maintain confidentiality of medical records
Reducing the Risk of Litigation • Use only the therapeutic methods and medicine that you are qualified to give. • Work cooperatively with the coach and team physician when selecting equipment. • Do not permit injured players to participate • Purchase professional liability insurance • Use common sense when making decisions
Insurance • Managed care • Primary health insurance • Standard policy • PPO • HMO • Secondary health insurance • Accident insurance • Professional liability insurance • Catastrophic insurance
Third-Party Reimbursement for Athletic Trainers • This is a new development • It is very time consuming • The A.T.C. must file insurance claims immediately and correctly • The A.T.C. must use Current Procedural Terminology (CPT) codes published by the AMA • Third-Party Reimbursement Research at IWU
