Medical Aspects of Sport: Test 1 Material

Establishing negligence

A dude of care existed between the person injured and the person responsible for that injury Conduct of the defendant fell short of that duty of care The defendant caused the injury to occur Resultant damages either persona, property or punitive

Emergency action plan

A plan must exist for accessing emergency personnel which includes transportation of athletes to emergency facilities Meeting with outside personnel is necessary to determine roles and rules regarding athlete and equipment care Must have knowledge of local and community health services and agencies int he event of referrals

Emergency telephones

Accessibility to phones in all major areas of activity Should be able to contact outside emergency help and be able to call for additional athletic training assistance Radios, cell, and digital phones provide a great deal of flexibility

Discuss the role of the team physician as an important member of the sports medicine team

Advise and supervise athletic trainer Compiling medical histories and conducting physical exams Diagnosing injury Deciding on disqualification Attending practice and games High quality care

List some of the professional sports medicine organizations

American Academy of Podiatric Sports Medicine American College of Sports Medicine American Council on Exercise American Medical Association

Create an athletic injury management checklist for a sports medicine team to minimize chances of injury

Arrange for physical examinations and pre participation screening Arrange for appropriate training and conditioning Monitor environmental and field conditions Select and maintain properly fitting protective equipment Educate parents, coaches and athletes about the risks Teach proper techniques Be certified in CPR/AED Be certified in first aid

Athletic injury management checklist

Arrange for physical exams and pre participation screening Ensure appropriate training and conditioning Monitor environmental and field conditions to ensure safe participation Select and maintain properly fitting protective equipment Educate parents, coaches, and athletes about the risks Teach proper techniques Certified in CPR/AED and first aid

Standards of reasonable care

Assumes that a person is of ordinary and reasonable prudence Bring commonsense approach to the situation Must operate within the appropriate limitations of once educational background

The team physician

Athletic trainer works under direct supervision of physician Compiling medical histories and conducting physical exams Diagnosing injuries Attending practices can games Maintain consistently high quality care

Anyone providing any level of heath care to an injured athlete must know limitations:

Avoid overstepping boundaries Must be aware of practice acts of various healthcare groups

Liability

Being legally responsible for the harm one causes another person Must be certain you are ware of all rules and regulations relative to healthcare in a given state

Human performance

Biomechanics Exercise physiology Sport nutrition Sport psych Fitness training

Athletic healthcare in recreational sports activities

Can be competitive but also leisure City and community based recreational leagues and teams Often include fitness-oriented events Sometimes recreational athlete will hire a personal fitness trainer If injure occurs they are more likely to consult with a family physician, athletic trainer, sports chiropractor, or a sports physical therapist

Example of athletic health care facility policy

Cleated shoes are not allowed Game equipment must remain outside Shoes must be kept off treatment tables Athletes should shower before receiving treatment Roughhousing and profanity are not allowed No food or smokeless tobacco

The coach- injury prevention and management

Construct injury prevention conditioning programs Must provide high quality and properly fit protective equipment Apply proper first aid if necessary Be CPR/AED and first aid certified

Personal information card

Contains contact information for family and personal physician Contains insurance information

Record keeping

Critical responsibility of healthcare program Necessary for accurate, timely assessment and evaluation of practices Documents all practices to assure that responsibilities and expectations are being met Records should include medical records, injury reports, insurance information, injury evaluations, progress notes, equipment inventories, annual reports

Personal Fitness Trainer

Design a comprehensive exercise program to meet an individual's needs and goals while also considering a person's health history No single standard qualification for a person to practice as a fitness trainer ACSM, NASM, NSCA, and ACE have specific requirements, mandatory testing/retesting, renewal periods, and continuing education for certifications All personal fitness trainers should be certified in CPR/AED and in basic first aid Strongest growth segment of the fitness industry Working with a variety of client populations

What considerations should the coach make to ensure that his athletes will be competing under the safest possible conditions when there is no athletic trainer

Design effective S&C program Ensure safety equipment is of highest quality, properly fitted, and properly maintained Able to apply proper first aid Certified in CPR/AED and first aid Aware of environmental factors that might adversely affect the athlete

Athletic health care facility design

Design will vary drastically based on number of athletes, teams, and various needs of the program Size- varies between settings, must take advantage and manage space effectively, interact with architect relative to needs of program and athletes Location- outside entrance, double door entrances and ramps are ideal, proximity to locker rooms and toilet facilities Distinct areas- taping and bandaging, injury treatment and rehab equipment and or therapeutic modalities, wet area, physicians examination room, office space

Developing a budget

Different settings= different size budgets and space allocations Equipment needs and supplies vary depending on the setting Continuous planning, inventory and prioritizing is necessary to effectively manage monetary allocations to meet programmatic goals

Administering pre-particiaption examinations

Done prior to the start of practice to identify athletes that may be at risk, establish a baseline, reveal conditions that may warrant disqualification, and satisfy insurance and liability issues Examination by personal physician or stage examination with a team of nine ( 2 physicians, 2 non-physicians, 5 managers/student athletic trainers) required for 30 athletes

What special impact can other members of the sports medicine team have in providing healthcare for the athlete

Ensure proper nutrition Monitor mental state Provide consent for minors

Ordering supplies and equipment

Expendable items- supplies that cannot be reused (first aid and injure prevention supplies Equipment- items that can be used for number of years that are fixed or non-fixed

Providing coverage

Facility personnel coverage (budgetary converts may be a limiting factor) Sports coverage (different institutions have different levels of coverage based on personnel and risks involved with sports

Athletic health care facility policies

Facility should be used only for prevention and care of sports injuries Rules must be established in the interest of sanitation Policies regarding environmental conditions and emergency protocols should also be set

FERPA regualtions

Family educational rights and privacy act protects proverb of students educational records Provides parents certain rights with respect to inspection of child's educational records Rights transfer to child when 18 or upon entering school beyond high school School must have written permission to release information

Athletic healthcare in organized activities

Generally competitive Involves teams, leagues (secondary schools, collegiate, and professional teams) Players of the sports medicine team (coach, athletic trainer, physician) are employed on full or part time College setting may also have nutritionist, sports psychologist, strength & conditioning coach, massage therapist

The athletic administrator

Has a significant impact on the sports medicine team Responsible for hiring personnel that have the necessary credentials and are willing to work as a team Must also oversee and develop policies and procedures, risk management, and emergency action plans Responsible for the budget and for funding all aspects of an athletic healthcare program (salaries, supplies, equipment, and insurance) Commitment of the administrator can have a tremendous impact on the success of the athletic program

Athlete's priority

Health and Safety

HIPAA regualtions

Health insurance portability and accountability act Regulates how any members of the sports medicine team can share health information concerning an athlete Provides athletes with access to their medical records and control over how their health information is sued and disclosed Athlete can provide blanket authorization for release of specified medical infuriation on a yearly basis that states what, who, and time

Employing a certified athletic trainer in secondary schools

Hiring a certified athletic trainer in a faculty athletic trainer capacity Employing a centrally placed certified athletic trainer for the school district Contracting with a clinic to provide a certified athletic trainer

Injury evaluation and progress notes

Injured athlete should be evaluated by and athletic trainer or physician If not available, a coach should encourage athlete and parents to set appointment with a local physician for injury assessment, diagnoses, and documentation

What are the responsibilities of an ATC?

Injury prevention and health promotion Clinical examination and diagnoses Acute care of injury and illness Psychosocial strategies and referrals Therapeutic intervention Healthcare administration Professional development and responsibility

What are the specific roles of the athletic trainer in overseeing the total health care of the athlete

Injury prevention and health promotion Clinical examination and diagnoses Acute care of injury and illness Psychosocial strategies and referrals Therapeutic intervention Healthcare administration Professional; development and responsibility

What kind of information should be included in records

Injury report Treatment report Waiver Progress notes Medical history Personal individual info card Injury evals Forms for release of medical records

Injury report

Injury reports serve as future reference Reports can set light on events that may be hazy following an incident Necessary in case of litigation All reports should be filed in the athletic heath care facility (filed out in triplicate-school health office copy, physician copy, team/at copy)

Negligence suits

Involving coaches, athletic trainers, school officials and physicians have increased in frequency and amount of damages awarded

What is the difference between a trainer, certified athletic trainer, personal fitness trainer, and strength and conditioning coach

Main goals People they work with Trainer- animals, dogs, horses Cert AT- injury prevention, assessment, treatment Personal trainer- fitness S&C coach- increasing S&C gains

Division of cleaning responsibilities

Maintenance crew- sweep floors daily, clean and disinfect sinks and tubs, mop hydrotherapy room, empty waste baskets Athletic training/ coaching staff- clean treatment tables, disinfect hydrotherapy modalities daily, clean equipment regularly

Supply and Equipment inventory

Managing budget and equipment/supplies is critically important Inventory must be taken yearly in order to effectively keep tract of: new equipment that is needed, equipment that needs to be replaced, and equipment needing to be replenished

Injury care/management professionals

Massage therapy Orthotist/prosthetists Athletic training Sport pt Practice of medicine

The pre-particiaption examination

Medical history- complete prior to exam to identify past and existing medical conditions, update yearly and closely review by medical personnel, collect medical release and insurance information at the same time Physical examinations- should include assessment of height, weight, body comp, blood pressure, pulse, vision, skin, dental, ear, nose, throat, heart, lungs, abdomen, lymphatic, genitalia, maturation index, urinalysis and blood work Maturity assessment- means to protect young physically active athletes, methods (circumpubertal, skeletal, dental), tanners five stage assessment is most expedient Orthopedic screening- part of physical exam or separate, can take less than 90 seconds, various degrees of detail concerning exam Sport disqualification- certain injuries and illnesses warrant special concern when dealing with sports, recommendations can be made, American with disabilities act, potential disqualifying macros should be determined during the exam

The coach

Must be aware of the responsibilities of each individual associated with the team (if there is no athletic trainer, this becomes even more critical) Coach must understand limits of their ability to function as a health care provider in the state in which they are employed All coaches should be certified in CPR/AED and in basic first aid

S&C coaches relationship with athletic trainer

Must work with the athletic trainer when it comes to modifying a strength training program relative to injury The athletic trainer dictates what the athlete can and cannot do when engaging in a S&C program S&C coaches typically not available in high school so the athletic trainer or team coach typically assume this role in these situations which requires program development and overseeing the weight room

Torts may emanate from

Nonfeasance Malfeasance Misfeasance

Additional budget considerations

Other operating costs- telephone and postage expenses, contracts for outside services, purchases relative to liability insurance and professional development, clothing to be work in the facility Purchasing systems- direct buy or competitive bidding

Family and the sports medicine team

Parents will also be involved at the high school and middle school level Athletic trainer must be prepared to deal with multiple healthcare providers at parent's request Must also be sure that athlete and family are familiar with health insurance portability and accountability act (HIPPA)

How can pre participation exams be set up to most efficiently clear 200 athletes for competition

Parts of exam- medical history, physical exam, maturity assessment Practitioners for station exams- 2 physicians, 2 non-physicians, 5 student workers, managers, student coaches, assistant coaches

The coach- coaching

Possess appropriate coaching licenses and certifications Have understanding of skill techniques and environmental factors associated with sport Continuing education through ASEP or NCACE Function as a coach

How should the sports medicine team work together to provide optimal health care for the athlete

Pre participation exams from physician ATC monitoring the practices and games S&C coach making a correct program

Keeping facilities clean

Preventing spread of infectious disease is everyone's responsibility Must adhere to OSHA standards and guidelines Cleaning responsibilities are divided between athletic training staff and maintenance personnel

Relationship between the sports medicine team and athlete

Primary concern should be that of the athlete Close communication between all parties involved is critical Must work to develop solid working relationships Each member will have to gain trust and confidence in the skills and abilities of each other Imperative that the athlete is kept well informed

Hiring an ATC in secondary schools

Problems occurring later from improperly managed injuries could be avoided with proper care and management NATA says all secondary schools should provide the services of a full-time, on-site, certified athletic trainer American academy of pediatrics adopted a policy recommending employment of athletic trainers in the high school setting

Establishing health habits for the athlete

Promotion of good health and hygiene is critical Are the athletes cleared to participate Is each athlete insured Does the athlete promptly report injury and illness Does the athlete follow good living habits Do they avoid sharing clothes and towels Does the athlete exhibit good hygiene practices Does the athlete avoid common drinking sauces

What are the responsibilities of a coach or fitness professional who becomes responsible for caring for an athlete when an athletic trainer is not available

Provide first aid and CPR when needed Monitor environment Ensure equipment is good

Where S&C coaches can be certified in CPR/AED

Red cross, national safety council, or American heart association

Recreation specialists role

Required to ensure that the environment is soft Should an injury occur to the participant, they should be able to provide immediate and correct first aid and then refer for additional medical assistance All recreation specialists should be certified in CPR/AED and in basic first aid

Who are these recreation specialists

Serve as an advisor to local and state recreation and part commissions to manage comprehensive recreation programs in a variety of setting Develop budgets for recreation programs Serve as liaisons between parks director and recreation leaders Plan, organize, and manage various actives; may also direct special activities or events Responsible for daily operations of the recreation program Provide instruction and coach groups in specialties Lead and instruct campers in outdoor-oriented forms of recreation Work in acute healthcare settings; working to treat and rehabilitate individuals with specific health conditions Utilize leisure actives to improve and maintain client's general health and well-being May also provide interventions that help to prevent further medical problems

Treatment log

Sign in to keep track of services Daily treatments can be recorded Can be sued as legal documentation in instances of litigation Subject to HIPPA and FERPA regulations

How may this space be best used and what type of equipment should be purchased to maximize the effectiveness of the facility

Specific areas designed for: taping, injury treatment/rehab, wet area, physicians exam room, office space Equipment purchases: hot/cold tun, treatment tables, stim, protective equipment, first aid material

Annual report

Summary of athletic health care function Can be used to evaluate/ recommended potential charges for program Includes # of athletes served, survey of # and type of injuries, analysis of program, recommendations for future improvements

Suggestions for maintaining a sanitary environment

Sweep the gymnasium floors daily Clean and disinfect drinking fountains, showers, sinks, urinals, and toilets daily Air our and sanitize lockers frequently Clean wrestling mats and wall mats daily Urge the use of clean dry towels each day for each individual athlete Issue individual equipment and clothing to each athlete to avoid skin irritations Do not allow swapping of equipment and clothing Launder and change clothing frequently Allow wet clothing to dry throughly

Hiring a certified athletic trainer in secondary schools

The athletic healthcare team should have a designated athletic healthcare providers who is educated and qualified to Determine the individual's readiness to participate Promote safe and appropriate practice, competition, and treatment facilities Advise on the selection, fit, function, and maintenance of athletic equipment Develop and implement a comprehensive emergency action plan Establish protocols regarding environmental conditions Develop injury and illness prevention strategies Provide for on-site recognition, evaluation and immediate treatment of injury and illness, with appropriate referrals Facilitate rehab and reconditioning Provide for psychosocial consultation and referral Provide scientifically sound nutritional counseling and education Participate in the development and implantation of a comprehensive athletic heath care administrative system

Negligence

The failure to use ordinary or reasonable care

Release of medical records

The release of medical records cannot occur without written consent A waiver is needed for release

Sport medicine organization goals

Upgrade field by devising and maintaining a set of professional standards (code of ethics), bring professionals together for exchange of ideas and research for advancement of profession, and provide opportunities for individuals to work collaboratively toward single purpose

The athletic trainer

Works with athletes from time of injury to resolution Directly responsible for all phases of healthcare in an athletic environment May be employed in a variety of settings (colleges/universities/secondary schools, sports medicine clinics/corporate settings, amateur/professional athletics, military/NASA/NASCAR/performing arts, equipment sales/marketing Mist have extensive formal academic preparation and supervised practical experience The Board of Certification sets academic coursework and clinical experience requirements Upon meeting the education guidelines applicants are eligible to sit for the BOC examination Passing the certification examination= BOC certification as an athletic trainer which is the credential of the ATC

Sports medicine

a broad field of healthcare related to physical activity and sport

What areas of specialization are encompassed under the general heading for sports medicine?

biomechanics exercise physiology sport nutrition sport psych fitness training massage therapist orthotist prosthetist athletic training sport pt practice of medicine

Nonfeasance

fail to perform legal duty aka act of omission

How does the fitness professional relate to the sports medicine team

focus= improving performance Argument can be made that by an athlete achieving a higher level of fitness, injuries are less likely to occur The relationship between performance enhancement and injury prevention is critical

Two parts of sports medicine umbrella

human performance and injury care/management

Misfeasance

improperly perform something the person has a legal right to do

What is the clinical application of sports medicine aimed at

improving and maintaining functional capacities for physical labor, exercise, and sports

Torts

legal wrongs committed against a person

Recreation specialists plan, organizes, and oversees

leisure actives and athletic programs in local recreation camp and part areas, in playground, in health clubs and fitness centers, in the workplace, and in theme parts

ACSM definition of sports medicine

multidisciplinary approach to health management or achievement of full potential

S&C coaches relation to sports medicine team

oversee fitness of an athlete often employed at the collegiate level for both team and individual training sessions typically certified by the NSCA All S&C coaches should be certified in CPR/AED and in basic first aid

Sports medicines generally focuses on areas of

perfomance enhancement, injury care, prevention, and management

Malfeasance

performs action that is not his/hers to legally perform aka act of commission

Other members of the sports medicine team

physicians dentist podiatrist nurse/nurse practitioner pa sports chiropractors pt massage therapist orthotist/prosthetist equipment personnel exercise physiologist biomechanics nutritionists sport psychologist emergency medical specialists s&c coach referees

Personal fitness trainers providing increasing services in

post-rehabilition training sports conditioning special medical needs weight management

Where S&C coaches can be certified in first aid

red cross or national safety council

What is critical for athletes

treatment and prevention

Potential for violation

well-trained professionals that may not be healthcare professionals and attempt to provide treatment and care