Athletic Trainer

2017 NATA Meeting Preview

Rachel Katch, MS, ATC 

Associate Director of Military and Occupational Safety

 

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On June 26th – 29th, members of both the Korey Stringer Institute’s (KSI) staff and Medical & Science Advisory Board will be traveling to Houston, Texas to present at the National Athletic Trainers’ Association (NATA) 68th Clinical Symposia & AT Expo. Topics for dissemination range from the most up-to-date biomechanical research, to preventing sudden death in sport, all the way to new ground-breaking research regarding insurance costs for athletic trainers. No matter the topic, these presentations will provide those in attendance with evidence based research and information pertinent to enhancing the athletic training profession. Specific dates, times, and locations for each presentation being disseminated by the KSI staff and Medical & Science Advisory Board members are available below in Table 1. Hope to see you at the NATA Clinical Symposia, and always, please make sure to come and see us at our KSI booth at the AT Expo!

 

KSI Medical & Science Advisory Board Presentations

Lindsay DiStefano, PhD, ATC, from the University of Connecticut (UConn) will be disseminating multiple presentations during the course of the symposium. One presentation is titled, “Anterior Cruciate Ligament Injury Prevention Strategies: Translation of Research Findings into Clinical Practice,” and focuses on introducing the most current ACL injury prevention research and the evidence behind it. Additionally, Dr. DiStefano has a feature presentation during the session, “Lower Limb Preventative Training Programs Best Practice,” titled, “Effectiveness of Lower Limb Preventive Training Programs at Reducing Injuries.” This presentation will focus on educating attendees about the effectiveness, best practices, and implementation of preventative training programs.

 

Kevin Guskiewicz, PhD, ATC from the University of North Carolina – Chapel Hill will be presenting, “Catastrophic Traumatic Injuries in Sport,” during the session titled, “Catastrophic Sports Injury and Illnesses Among US College and High Schools.” This is a feature presentation alongside Douglas Casa, PhD, ATC, FNATA who will also be speaking during this session with a presentation titled, “Catastrophic Heat and Exertional-Related Conditions Among Athletes.” This session will focus on the incidence and characteristics of catastrophic events, and evidence-based policies and recommendations to minimize the risk of these events in the future.

 

From the University of South Florida, Rebecca Lopez, PhD, ATC will be presenting, “Exertional Heat Illness in Younger Athletes,” as well as a learning lab titled, “Recognition and Treatment of Exertional Heat Stroke.” The purpose of the first evidence-based forum is to provide clinicians with the best evidence-based clinical practice regarding the prevention, recognition, treatment, and return to play for the most common exertional heat illnesses. Second, the learning lab will focus on providing clinicians with the knowledge and opportunity to practice rectal thermometry and cold water immersion in a safe learning environment.

 

Also from the UConn, Stephanie Mazerolle, PhD, ATC, FNATA in the session, “A Multi-Level Examination of Career Intentions and Work-Life Balance,” will be presenting, “Individual Elements that Influence the Development of Career Planning and Work-Life Balance.”  This is a feature presentation that will examine and discuss research available regarding alternative therapies utilized in the clinical setting to promote work-life balance. Additionally, Brendon McDermott, PhD, ATC from the University of Arkansas will be presenting, “Exertional Heat Illness in Younger Athletes.” This committee session will focus on providing clinicians with the best evidence-based clinical practice regarding the prevention, recognition, treatment, and return to play for the most common exertional heat illnesses.

 

Lastly, Kevin Miller, PhD, AT, ATC from Central Michigan University will be presenting, “New Advances in Exertional Heatstroke Diagnosis, Treatment and Prevention.” This special topic presentation will discuss recent experimental studies that address the necessity of equipment removal prior to initiating cold-water immersion; whether cooling garments can prevent the onset of hyperthermia or affect hydration status; whether temperate water can be used to effectively cool hyperthermic humans; and how far into the rectum Athletic Trainers should insert a thermometer to obtain the most valid data.

 

KSI Staff Presentations

Multiple KSI staff will be presenting in a session titled, “Enhancing Safety of Secondary School Athletics Through Policy Change,” including Alicia Pike, MS, ATC, Robert Huggins, PhD, ATC, and William Adams, PhD, ATC. Individually, their presentation titles are, “Examining Sport Safety Policies in Secondary Schools: An Analysis of States’ Progress Toward and Barriers to Policy Implementation,” “State High School Athletics Policy Change Successes and Barriers: Results from the Collaborative Solutions for Safety in Sport Meeting,” and, “Current Status of Evidence-Based Best Practice Recommendations in Secondary School Athletics,” respectively. This feature presentation will provide participants with evidence describing the barriers associated with implementing policy change from a state administrative level and the steps that have been made to initiate change to protect secondary school student athletes.

 

Additionally in a session titled, “The Secondary School AT Value Model, Minimizing Cost and Maximizing Safety from an Insurance Perspective,” Yuri Hosokawa, MAT, ATC, and Robert Huggins, PhD, ATC, will be disseminating their respective presentations titled, “Optimizing the Direction of Care: A Secondary Insurance Claims Analysis,” and, “We Can’t Afford to Hire an AT…You Can’t Afford Not To! Reducing Risk, Saving Money, and Saving Lives.” In this committee session presented by the NATA Initiative, the speakers will: (1) discuss ways athletic training services may directly benefit multiple entities (insurance providers, policy holders, and school districts), (2) critically assess the secondary insurance cost to identify unnecessary medical costs, and (3) minimize the financial burden of secondary schools through injury prevention and appropriate risk management.

 

Lastly, Robert Huggins, PhD, ATC will present, “An Overview of the Secondary Schools ATLAS Project: Where Are We Now?” in the session, “Out of the Fire and Into the Frying Pan.” This committee session presented by the Secondary School Athletic Trainers’ Committee will outline the use of the ATLAS project to show the concentration of secondary school athletic trainers and its value for potential networking within and between states and organizations.

 

Table 1. List of Presenters

Presenter

Presentation Title

Time / Location

 

TUESDAY, JUNE 27th, 2017

 
Rebecca Lopez, PhD, ATC Exertional Heat Illness in Younger Athletes 8:15 AM

BCC, Room 370

Stephanie Mazerolle, PhD, ATC, FNATA Individual Elements that Influence the Development of Career Planning and Work-Life Balance 8:15 AM

BCC, General Assembly A

Brendon McDermott, PhD, ATC Exertional Heat Illness in Younger Athletes 8:15 AM

BCC, Room 370

Kevin Miller, PhD, AT, ATC New Advances in Exertional Heatstroke Diagnosis, Treatment and Prevention 10:45 AM

BCC, Grand Ballroom C

Rebecca Lopez, PhD, ATC Recognition and Treatment of Exertional Heat Stroke 1:30 PM

BCC, Room 342

Robert Huggins, PhD, ATC An Overview of the Secondary Schools ATLAS Project: Where Are We Now? 2:10 PM

BCC, Grand Ballroom A

  WEDNESDAY, JUNE 28th, 2017  
Kevin Guskiewicz, PhD, ATC Catastrophic Traumatic Injuries in Sport 7:00 AM

BCC, General Assembly A

Douglas Casa, PhD, ATC, FNATA Catastrophic Heat and Exertional-Related Conditions Among Athletes 7:30 AM

BCC, General Assembly A

Lindsay DiStefano, PhD, ATC Anterior Cruciate Ligament Injury Prevention Strategies: Translation of Research Findings into Clinical Practice 7:30 AM

BCC, Room 370

  THURSDAY, JUNE 29th, 2017  
Lindsay DiStefano, PhD, ATC Effectiveness of Lower Limb Preventive Training Programs at Reducing Injuries 10:45 AM

BCC, General Assembly B

Robert Huggins, PhD, ATC “We Can’t Afford to Hire an AT”… “You Can’t Afford Not To!” Reducing Risk, Saving Money, and Saving Lives 10:45 AM

BCC, Grand Ballroom B

 

Yuri Hosokawa, MAT, ATC Optimizing the Direction of Care: A Secondary Insurance Claims Analysis 11:15 AM

BCC, Grand Ballroom B

William Adams, PhD, ATC Current Status of Evidence-Based Best Practice Recommendations in Secondary School Athletics 3:30 PM

BCC, General Assembly A

Robert Huggins, PhD, ATC State High School Athletics Policy Change Successes and Barriers: Results from the Collaborative Solutions for Safety in Sport Meeting 4:00 PM

BCC, General Assembly A

 

Alicia Pike, MS, ATC Examining Sport Safety Policies in Secondary Schools: An Analysis of States’ Progress Toward and Barriers to Policy Implementation 4:30 PM

BCC, General Assembly A

Bishop Lynch High School Athletic Trainer Talks about AEDs

Written by Mike Hopper, ATC, Head Athletic Trainer at Bishop Lynch High School, Dallas, TX

AED Mike Hopper

Bishop Lynch High School is a co-educational Catholic high school that is a member of the Diocese of Dallas and a member of the Texas Association of Parochial and Private Schools (TAPPS). Bishop Lynch is a “Safe Sports School” as recognized by the National Athletic Trainers’ Association. The availability of AEDs on our campus is just one example of Bishop Lynch providing excellence in Athletic Healthcare.

Recently, the question was asked on Twitter by the Korey Stringer Institute “Are you prepared for sudden cardiac arrest? Where is the closest AED from where you are right now?” I took a quick picture on my phone of the unit that is permanently posted on the wall just inside of my Athletic Training Room. That is only one unit that currently sits within those 4 walls. Regularly, there are 3 units that are maintained within that facility, however currently we have 5 units there. Two of these units will be deployed elsewhere on campus in the coming months. KSI was understandably amazed and curious how we had 5 AEDs on our campus. But, we actually have 11 of these units posted throughout our 22-acre campus. So, then the question was: How did Bishop Lynch manage to have that many units on our campus and how can other schools learn from us?

Twitter AED KSI

Twitter AED Mike

I don’t know the full story, but I will say that we are dedicated to having these units within reach and we are dedicated to having a plan to attack sudden cardiac arrest with immediate response and treatment. When I came to BL in August 2014, we had 7 units on campus. Six of these were posted within athletic facilities. The seventh unit has been moved more than once this school year. BL is in midst of major renovations and that unit has floated multiple times before finding its current place. That location has become its new permanent home as this winter we acquired additional units for elsewhere in the building.

There are currently 9 AEDs deployed on our campus. We have units in our end-zone weight room building that serves the weight room and wrestling room in that building plus the baseball field a short distance away. Conceivably this unit also covers the track and football stadium. The fieldhouse in the corner of the same endzone hosts a unit on the wall providing coverage for the football stadium and track. Outside of the “competition gym” a unit is posted in plain sight that provides coverage for the main gym, the dance studio across the hall, and the weight room upstairs in that same building. Upstairs and a short distance away we have a brand new unit that was recently installed near the business office and two classrooms. Our “Legacy Gym” sits just feet away from the new “competition gym” and hosts a unit of its own posted on the wall outside our satellite Athletic Training Room. As we begin to enter the academic end of campus, we have a unit (previously mentioned) that sits outside of the theater. This is also located close to the main office and the cafeteria. Another brand new unit was deployed recently and is now posted on the wall right outside of the nurse’s office. This gives us 7 units posted in permanent locations.

Two more units are located inside of the Fieldhouse Athletic Training Room and these units are portable. This allows the Athletic Training Staff to transport the AEDs to the sideline or dugout of games. Our softball team currently plays off-campus and we are able to take a unit to their games without jeopardizing the safety (and liability) of our campusWe also take an AED with us whenever we travel with our football teams. With approximately 150 people that make up our travel party for a varsity football game, we believe that carrying this unit is necessary at all times.

I currently have two more units sitting in my office that are brand new and still inside of their boxes along with their cabinets. These units are awaiting the completion of new construction. One unit will be installed in the coming weeks as we prepare to open up a new building with 12 classrooms and the last unit will be installed before the 2015-2016 school year when that phase of renovations is completed.

I know that in our athletic facilities we are less than a minute from an AED at all times. There is not a single place that somebody can’t have an AED in hand instantly. The furthest point from an athletic standpoint from an AED is centerfield on the baseball field to the Haggar Building AED in the endzone. That is approximately 500 feet away. But on a game-day, there is a unit in the home dugout cutting that distance down by about 100-150 feet. Academically, we are currently a little bit further away than that in a couple of locations, however that will change in a couple of weeks. Our new unit will cut down that distance significantly. My biggest concern is in our parking lots, which are at the far ends of our campus. Just the other day I brought up this concern to our security staff and we will be addressing this.

Great, so you have 11 AEDs on campus? But do you have staff to use them?

This is a great question. While the AEDs are simple enough to be used by just about anybodyit is still critical that trained personnel respond to a sudden cardiac event. Accordingly, and as required by TAPPS, our entire coaching staff is required to maintain current CPR/AED certification. Additionally, we have a school nurse on campus each day along with one full-time Certified Athletic Trainer and one part-time Certified Athletic Trainer. Our security staff also is required to maintain CPR/AED certification. So in short, we have staff onsite at all times trained to respond to a cardiac event.

How do you maintain 11 AEDs? Who is in charge of that and who pays for that?

This is another great question. And one that we recently figured out. We have three units that are 4 years old, four units that are 3 years old and four units that are brand new. In the past, the replacement pads were simply purchased out of an account and nobody really thought about it too much. But as you can imagine, with 11 units, this is a costly venture. And so the school nurse and I have asked for a specific answer moving forward. We did not want this to be a year-by-year decision. Basically, each year we will spend the equivalent to what it would cost to purchase a new unit every yearBut it’s a small price to pay and our school administration agrees with thisFor this reason, the nurse’s budget will grow each year to accommodate this specific expense. We share joint responsibility for proposing those needs each year and I have taken on the responsibility of maintaining the units. This includes walking past them throughout the week along with testing them once a month. I have made up a spreadsheet with our entire inventory that includes expiration dates and also have a checklist in each case that I check off each month.

11 AEDs, a full staff of trained personnel, emergency action plans for athletics and campus-wide, combined with EMS being located only minutes away and the major trauma center less than 15 minutes away, we believe that Bishop Lynch is well-prepared for a sudden cardiac event on our campus. While we hope to “waste” a lot of money over time, we believe it’s a small price to pay should somebody on our campus collapse.

Every Athlete Deserves an Athletic Trainer. Every Friar Athlete Has One.

 

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

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