High School

NFL AT Pilot Grant Program

By Yuri Hosokawa, MAT, ATC, Director of Communication, Director of Education

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Korey Stringer Institute at the University of Connecticut is proud to announce our role in the NFL Athletic Trainer Grant Pilot Program, which is open for applications from October 19, 2016 through December 16, 2016.

 

As part of the Play Smart. Play Safe. campaign the NFL pledged on September 14, 2016, the NFL is heading up a pilot grant program in four states – Arizona, Illinois, Oklahoma and Oregon.  Up to 150 public high schools across the four pilot states will be awarded a $35,000 grant over the course of a 3-year period to assist with securing athletic trainer (AT) services.

 

School administrators, or their designee, may apply if their school meets the following criteria:

  • A public high school with an interscholastic football program in Arizona, Illinois, Oklahoma or Oregon.
  • Minimal or no current athletic training program. Minimal is defined as care provided by an athletic trainer only for football games or competitions played at home.

 

As NFL Commissioner Roger Goodell stated in his letter, “… we know that having an athletic trainer on the sidelines at a high school game can be pivotal for how health and safety issues are handled. But many of our nation’s schools lack the resources to pay for one. Accordingly, we plan to expand the size of our athletic trainer program, funding additional athletic trainers for high schools that need them. Our long-term goal is to raise awareness about the important role athletic trainers can play in high school athletics.”

 

KSI will lead the administration of the NFL Athletic Trainer Pilot Grant Program as well as conduct research on the program’s impact, specifically the impact of athletic trainers on student athlete health outcomes. We hope that by bringing our expertise to this program, we can assist not only the schools who may hire ATs for the first time in their school history, but also to serve as the support system for the ATs who are accepting jobs in these schools in order to develop successful and sustainable athletic training programs across the nation.

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To find out more about the pilot grant program, visit: www.athletictrainergrant.com.

#AT4ALL

Athletic Trainers in the Secondary School Setting

By Rachel VanScoy, Assistant Director of Sports Safety Policies

#AT4ALL Value Model

Athletic Trainers are health care professionals who work under the direction of a licensed physician and who specialize in the prevention, recognition, emergency care, treatment, and rehabilitation of sports related injuries. A recent study reported that only 37% of high schools in the United States provide full-time athletic training services.1 Seventy of the public secondary schools acknowledge the importance of athletic training services and provide some level of medical coverage.1 With the increasing number of sports participation and sports related injuries in the high school setting, it is essential that appropriate medical coverage is available. It is important to understand what services and coverage athletic trainers’ provide.

Athletic trainers do not just provide “coverage” during sporting events but provide quality health care to active individuals on and off the field. During emergencies, athletic trainers are onsite to provide immediate care to potentially life-threatening conditions and are trained to provide prompt treatment to help prevent sudden death (i.e., sudden cardiac arrest, exertional heat stroke). Furthermore, athletic trainers provide a link of communication between physicians, coaches, parents, and school nurses. Care of an athlete not only includes physical care but also psychosocial care. A safe environment is created which can result in an athlete confiding in the athletic trainer. Athlete trainers are trained to recognize potential problems (i.e., eating disorders) and can refer to the appropriate medical or professional services.

Additionally, athletic trainers work towards the prevention of injuries and sudden death. Before participation, athletes are screened using medical questionaries’ and preparticipation physical examinations. Athletic trainers are trained to identify potential risk factors and can make appropriate referrals for further screening. The preparticipation screening also allows athletic trainers to identify at risk individuals (i.e., Sickle cell trait, asthma, diabetes). Risk mitigation can be accomplished though educating parents, coaches, athletes, and administrators, as well as, through injury prevention programs. Off the field athletic trainers develop, practice and implement Emergency Action Plans (EAPS) and Policy, and Procedure manuals. A few examples of the policies that athletic trainers develop are heat acclimatization, concussion, lightning, hydration, and environmental (i.e., cold and hot weather) policies. Athletic trainers are responsible for ensuring policies are implemented and followed.

Athletic trainers provide on and off field services to continually maintain health and safety in sports. Described above are just a few of the many services athletic trainers provide at the high school level. For more information, visit the National Athletic Trainers’ Association (NATA) webpage for the Secondary School Setting.

 

References

  1. Pryor RR, Casa DJ, Vandermark LW, et al. Athletic Training Services in Public Secondary Schools: A Benchmark Study. Journal of Athletic Training. 2015;50(2):156-162. doi:10.4085/1062-6050-50.2.03.

 

Medical Experts Look Beyond Law to Make Youth Sports Safer (ABC News/AP)

To toughen safety standards in youth sports, medical experts are turning away from lawmakers and toward high school sports associations to implement policies and procedures to prevent deaths and serious injuries.

The National Athletic Trainers’ Association and the American Medical Society for Sports Medicine completed two days of meetings and programs with representatives from all 50 state high school athletic associations Friday at the NFL offices in Manhattan. The goal was to have decision-makers return to their states and push high schools to put into place recommendations on how best to handle potentially catastrophic medical conditions such as heat stroke, sudden cardiac arrest and head and neck injuries.

Some states, such as Arkansas, have passed laws requiring schools to meet certain standards, but Doug Casa, director of athletic training education at the University of Connecticut, said high school associations should be first to act because they have more flexibility to move quickly.

“Trying to get a state law passed, one, can take a long time but two, sometimes a lot of things get attached to the laws that weren’t the original intention. Also, they’re written by people who don’t truly understand the nuances of a football practice or how sports work into the system of a school year. Those are nuances that the state high school association totally gets,” Casa said.

In 2013, best practice recommendations were published in the Journal of Athletic Training, but many states are still lagging in implementation of those guidelines. They include having a full-time athletic trainer on staff, having automated external defibrillators in every school and accessible to all staff members, and having an emergency action plan for managing serious and potentially life threatening injuries. Funding is often cited as the reason schools, many of which are already struggling to make ends, meet fail to implement these recommendations.

According to the NATA and AMSSM, only 37 percent of high schools in the United States have full-time athletic trainers. Only 22 percent of states meet the recommendation that every school or organization that sponsors athletics develop an emergency action plan. Only 50 percent of states have met recommendations that all athletic trainers, coaches, administrators, school nurses and other staffers have access to an automated external defibrillator.

Casa said just 14 states meet the minimum best practices with regard to heat acclimatization, but the ones that have adopted them since 2011 have had no athlete deaths from heat stroke.

Casa cited Georgia, Arkansas, Texas, North Carolina and New Jersey as states that have been leaders in implementing the recommendations.

Jason Cates, a member of the executive committee of the Arkansas Athletic Trainers’ Association who led reforms in Arkansas after a high school basketball player died of sudden cardiac arrest in 2008, said that while legislation can be help to move programs forward, it can also create problems with legal liability.

“At what point in time are we going to legislate ourselves out of sports?” he said. “I think in some states, in some instances (legislation) is the way to go, but my hope is people just get it.

Casa acknowledged legislation is often necessary to fund programs.

With legislation comes politics and give and take. Kevin Guskiewicz, professor and co-director of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at the University of North Carolina, said that doesn’t come easy for medical professionals.

“It’s hard for people like us that are medical people to compromise on anything because we think we should have it all,” he said. “So that’s where we’re beating our fists on the table at state capital buildings as we’re debating why we need it all. I did learn a lot about compromise.”

 

Source: ABC News/AP

Protecting High School Athletes From Preventable Deaths (WBUR)

Listen to Dr. Casa’s Interview with NPR here.

 

Doug Casa, chief operating officer of the Korey Stringer Institute, says the highest number of sports-related deaths in the U.S. are among the 7 million high school athletes.

Casa, along with the National Athletic Trainers’ Association, is asking all 50 states to adopt safety procedures to safeguard athletes. Casa joined Bill Littlefield to discuss his efforts to make high school sports safer.

BL: Doug, how many athletes are we talking about in a given year?

DC: In a given year, if we just focus on high school, you usually see between 20 and 30 deaths. We’re also very focused on what we call “catastrophic injuries” that may not lead to death. And those will number in the hundreds.

BL: You focus your study on four causes of death: sudden cardiac arrest, head injuries, heat stroke and complications from the sickle cell trait. How did you narrow it down to just those four?

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Kids … find the tests pretty easy to beat,” says the founder of a group that aims to prevent steroid use.

DC: It’s a good question. I mean, the research has shown that those four causes of death actually are about 90 percent of all the deaths that we see in high school and college sports. So it’s not to say there aren’t other things that could be dangerous to an athlete, like lightning strikes or something called hyponatremia or asthma.

But those four that I mentioned, all four of these conditions can be prevented. And in the case of heat stroke, for instance, death is 100 percent preventable if treated properly. And in the case of cardiac conditions, if an AED [automated external defibrillator] is placed on within a minute, they’re 90 percent preventable.

BL: In 2013, I understand that along with the National Athletic Trainers’ Association, you recommended that all 50 states adopt guidelines to protect athletes from sudden death. But in 2015, only 22 percent of states have done that. Why is it so difficult to get everybody on the same page when it comes to something so basic as player safety?

I’ve been an expert witness on 35 cases where deaths have happened in sport … and in almost all the cases, the death was preventable with relatively simple, simple policies and procedures.

– Doug Casa, Korey Stringer Institute

DC: It depends on which particular policy we’re speaking of. I mean, some states have moved forward faster, for instance, like with some concussion policies as an example.But they’ve been a little slower, maybe, with heat acclimatization policies or AED policies. Because at the high school level, you have to change policies on a state-by-state level. It’s not like the NCAA, or the NFL, or professional governing bodies where one organization will influence everyone.

I really think the last three-to-five years have been just a total, monumental shift in the thought process, and we’ve seen a lot of substantial changes. As an example, with heat acclimatization, in 2011 we had zero states that met the minimum guidelines for heat acclimatization, which is kind of the key step to prevent heat stroke deaths. And now we’re at 14 states. And it might not seem like a lot, but of those 14 states, 10 of them are in the Southeast, and we still have not had a heat stroke death in any of those 14 states that have followed those policies. So that’s powerful ammunition for those other states to move forward and adapt some of these policies.

BL: I find it hard to understand how something so commonsensical as “Hey, let’s have some acclimatizing to heat conditions” could ever be controversial anywhere.

We don’t want to stop until we have 50 states, although my wife keeps convincing me we don’t need Alaska for heat acclimatization.

– Doug Casa, Korey Stringer Institute

DC: I wouldn’t say it’s controversial. Sometimes change takes a little bit of time because they have to change what they’ve done for the last 50 years. In high school football they like to start out and have their two-a-day practices, and a lot of times it’s a change of a mindset for them.

So I do agree with you, it’s very common sense, it’s very simple changes and the amazing thing is it costs so money at all. So when we usually get a chance to sit down and meet with them individually, most make progressive changes. Fourteen states meet the minimum standards, but, to give credit, another 20 have made substantial changes in the right direction.

BL: You know, Doug, I haven’t known you for very long but I can tell you are the ultimate “glass half-full” kind of guy if you’re talking about 14 states are on board, and you’re talking about progress. 

DC: Well, I guess my way of looking at it is 90 percent of all heat stroke deaths in America happen in concentrated states in the Southeast region of the country. So probably saving three or four kids lives every summer just by the states we’ve gotten on board — so that makes me feel pretty good for those families. But yeah, we don’t want to stop until we have 50 states, although my wife keeps convincing me we don’t need Alaska for heat acclimatization.

But I mean that’s just one example. There’s a lot of really simple things we can do to keep kids safe. I mean, AEDs is a great example. It’s only $1,000 for an athletic department to have one nearby. Cardiac’s the leading cause of death in sport in America and to have an AED there is almost a foolproof way of saving someone’s life. It’s really a pretty small cost when you think of the benefit.

BL: Especially when you’re thinking in terms of a $60 million high school football stadium.

DC: That, or when you think about the lawsuits that emanate when deaths do occur that are preventable. I’ve been an expert witness on 35 cases where deaths have happened in sport, especially at the high school level. And in almost all the cases, the death was preventable with relatively simple, simple policies and procedures that would have protected that kid that passed away.

 

Source: Only a Game

Pressing Need for Full-Time Athletic Trainers in High Schools (UConn Today)

Last year, 15 high school athletes died playing or practicing sports and thousands more suffered injuries, some of them career-ending.  Many of those fatalities and long-term injuries could have been averted, say researchers with UConn’s Korey Stringer Institute, if more school systems hired full-time athletic trainers and adopted other important health safety protocols.

On Thursday (March 26), members of the Institute joined leaders from the National Athletic Trainers’ Association (NATA) and the American Medical Society for Sports Medicine (AMSSM) in a “call to action” to promote the need for more athletic trainers and other critical safety measures in high schools across the country.

The groups made their case at a news conference at National Football League headquarters in New York. The NFL is a core sponsor of UConn’s Korey Stringer Institute (KSI), which is dedicated to preventing sudden death in sport due to exertional heat stroke and other catastrophic conditions.

“It is vital for schools to have appropriate sports medicine care during games and practices to ensure the safety of high school student athletes,” says kinesiology professor Douglas Casa, chief operating officer of the KSI and director of athletic training education  at UConn. The Korey Stringer Institute is affiliated with the College of Agriculture, Health, and Natural Resources.

The joint news conference was a major milestone for the Korey Stringer Institute, which has been advocating for more full-time athletic trainers and better medical coverage for young athletes since it opened in Storrs in 2010. Casa and the KSI team have been conducting a nationwide education campaign to get states to adopt better health and safety protocols for athletes. Early in the process, Casa helped craft NATA’s landmark position statement on preventing sudden death in secondary school athletics that was endorsed by 16 organizations including AMSSM, which is the national governing body for team physicians, and the National Federation of State High School Associations.

Thursday’s event included a first-ever work session with key stakeholders in high school sports medicine from all 50 states. The group discussed strategies for strengthening medical coverage for student athletes. Casa said future sessions are already planned for 2016 and 2017.

“Adopting these measures and putting them into practice will potentially help save lives and reduce injury,” says Jim Thornton, NATA president. “These recommendations are vital and reinforce our commitment to safety today.”

Currently, only 12 percent of all states require that schools have a detailed emergency action plan in place for critical incidents involving athletes. Only 14 of the 50 states meet minimum best practices in regard to protecting athletes from heat stroke, such as limiting practices on extremely hot days and allowing athletes to gradually adjust to working out in the heat. Half of the states have automated external defibrillators at school-sanctioned athletic events.

The decisions made in the first 10 minutes after a catastrophic incident will often be the difference between life and death. — Doug Casa”

On the positive side, access to athletic trainers at high schools has doubled over the past two decades. Currently, about 70 percent of public high schools around the country have athletic training services, compared to about 35 percent in 1994.

“While the percentage of secondary schools with athletic trainer services has increased dramatically, school districts should begin or continue to hire athletic trainers to improve coverage for appropriate care,” says Casa, a competitive-long distance runner and international expert on exertional heat stroke. “The decisions made in the first 10 minutes after a catastrophic incident will often be the difference between life and death.”

Yet schools without athletic trainers continue to rely on coaches, administrators, athletic directors, and others to provide on-site medical care. Only about 37 percent of schools around the country have at least one athletic trainer on staff as a full-time employee, according to a recent study conducted by the KSI in conjunction with NATA.

Riana Pryor, director of research for the KSI, says a reliance on school faculty and other staff to recognize and treat sports injuries and related medical emergencies puts athletes’ lives at risk. Athletic trainers undergo years of training in such areas as athlete conditioning, injury prevention, emergency action planning, and injury treatment before becoming certified in the field, she says. In addition, athletic trainers are taught to identify the symptoms of potentially deadly conditions such as exertional heat stroke, cardiac conditions, and exertional sickling, which is a medical emergency involving reduced blood flow that occurs in athletes carrying the sickle cell trait.

Pryor and her research team at the KSI contacted all 14,951 public secondary schools in the United States as part of their athletic trainer survey. Many schools were contacted multiple times with about 8,500 providing data. The study, published in the February 2014 issue of the Journal of Athletic Training, found that schools with athletic trainer services used them at competitions more than practices. This gap in medical coverage exists despite the fact that many injuries happen during practices where athletes often perform grueling drills and exercise longer than during games.

With an estimated 7 million secondary school students participating in organized sports around the country each year and approximately 1.4 million high school sports injuries reported annually, having proper medical care and monitoring for those students is critical, says Pryor, a certified athletic trainer with a master’s degree in exercise and sports science, who served as the lead author of the study.

“The more athletic trainers we have in our high schools,” Pryor says, “the safer sports practices and games become.”

 

Source: UConn Today

Safety symposium finds optimism, room for improvement in state policies (USA Today)

NEW YORK – Awareness of health issues in youth and high school sports is quite high, and there is better access to life-saving materials, knowledge and planning than there has been, but young athletes continue to die in ways that would be preventable if treated more responsibly.

That message from a panel of medical experts on Thursday applies to a full range of potentially catastrophic health incidents in teens, including sudden cardiac arrest, heat stroke, and concussive events, inclusive of any incident that causes brain or neck injuries.

The one constant is proper medical oversight must be available and in far too many cases is not. That is a problem the panel hopes to address as part of two days of meetings here with representatives from the athletic bodies of all 50 states.

“You should cringe when you read that a kid died of heat stroke this summer, because it was a tub ice and an athletic trainer who kept that kid from having dinner with his family that night,” Douglas Casa, the COO of the Korey Stringer Institute at the University of Connecticut told a media briefing at the NFL offices. “Heat stroke is 100% survivable if treated properly, if you put an athlete in a cold water immersion tub on site immediately afterward. You have to cool first, transport second. … But diagnosis has to be done on site by an athletic trainer.”

According to the experts— including Casa; Jonathan Drezner, Seattle Seahawks team physician and director of the University of Washington Medicine Center for Sports Cardiology; Kevin Guskiewicz, University of North Carolina Matthew Gfeller Foundation Director; Jason Cates, head athletic trainer of Arkansas’ Cabot Public Schools, and Roman Oben a former NFL player who now serves as the league’s head of high school and youth football — one of the major problems plaguing the youth safety landscape is a lack of proper planning.

The statistics are not pretty. According to the Stringer Institute, only 22% of states meet the recommendation that every school or organization that sponsors athletics develop a plan for managing serious and or potentially life-threatening injuries. A mere 12% of states meet the recommendation that every school have a written plan that is distributed to all staff members, while only 10% fulfill the recommendation that the plan is specific to each venue and includes maps or specific directions to that venue.

When combined with an ongoing dearth of skilled medical professionals overseeing sports activities on campuses, it’s clear that even having all the right tools on campus can be insufficient in preventing death or serious injury due to sudden events.

“When you recognize sudden cardiac arrest, apply CPR and use an Automatic External Defibrillator that is on campus, the survival rate is above 80 percent,” Drezner said. “The survival rate of sudden cardiac arrest in the general public is 8 percent. When there is public access to defibrillators, survival rate is around 50 percent. Every school must have an emergency action plan that will accompany having all of the tools.

“An emergency action plan should be written and practiced at least annually, just as we practice fire drills. Sudden cardiac arrest is largely preventable if we are prepared.”

In fact, Cates could speak to those precise circumstances. In January 2008, Parkview High School basketball player Anthony Hobbs collapsed during a game at his school and died shortly thereafter. He had been transported to a local hospital but there was no AED at Parkview at the time. Two years later one of Hobbs’ teammates, Chris Winston, collapsed on the very same court that had claimed Hobbs’ life. This time the school was prepared. An AED installed just weeks before the incident was used before Winston was transported to a hospital.

Winston survived.

The panel focused on proper training and technique as opposed to the nature of sports themselves when discussing injuries. When asked about the recent retirement of San Francisco 49ers linebacker Chris Borland, all responded with an acknowledged respect for his decision but a wariness to use one man’s choice as a bellwether of reason, instead noting that, “every concussion is unique, like snowflake.” Borland cited concern over the long-term effect of concussions as the main reason he left after one season.

All five panelists either do, or said they would, allow their sons to play football.

The panel agree there is room for improvement, nationwide. Casa cited Georgia, Arkansas, Texas, North Carolina and New Jersey as states with policies that have proved quite effective and could serve as models for other states. Texas was lauded for passing the first bill that mandated AEDs be installed in all schools, while Washington passed a similar measure requiring a comprehensive approach to concussions and brain trauma.

Whether those practices can be spread to other willing states remains to be seen. In the meantime, there were passionate calls for improvements where they could be made quickly, in terms of both staffing and exerting reasoned rationality when dealing with youth sports.
“If a secondary school can afford to field a football, lacrosse or soccer team, there is no excuse for not being able to field a certified athletic trainer who can manage these emergency plans,” Guskiewicz said. “There are far too many schools that do not field certified trainers.”
Added Oben: “As a parent of two boys who play tackle football, an 11-year-old fifth grader and 13-year-old eighth grader, I’m the parent safety coach for my kids’ league. I’ve hosted parent safety education nights. It’s not so much about x’s and o’s, it’s about teaching the parents, particularly moms, about what we’re doing to ease their concerns and educate them about what we’re doing to keep their children safe. We all have to do our part. … We all have to make a collective impact. Coaches, athletic trainers, school administrators all have to do our part to make this work. And we have to continue to to hire appropriate medical experts.”​
Source: USA Today