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ATHLETIC TRAINING STUDENT HANDBOOK

Colorado Mesa University Athletic Training Program

Table of Contents SECTION I – Overview of the Colorado Mesa University Athletic Training Program ................. 5

Mission Statement ....................................................................................................................... 5 Admission Requirements ............................................................................................................ 5 Transfer Students ........................................................................................................................ 5 Academic and Clinical Instruction Plan ...................................................................................... 6 Athletic Training Program Goals ................................................................................................ 7 Learning Progression Utilized by the Athletic Training Program .............................................. 7 Academic Standards for Retention in the Athletic Training Program ........................................ 9

Student Retention/Suspension/Dismissal Policy .................................................................... 9 Reasons for Suspension or Dismissal ................................................................................... 10 Appeal Process ...................................................................................................................... 12 Athletic Training Student Grievance Process ....................................................................... 12

Becoming a Certified Athletic Trainer and State-by-State Considerations .............................. 13 Supervision ............................................................................................................................... 13

Travel .................................................................................................................................... 14 Chain of Command for the Athletic Training Program ............................................................ 15 Athletic Training Student Job Descriptions .............................................................................. 16 Alternative Experiences Rotations ............................................................................................ 17

Athletic Training Program Alternative Rotation Guidelines ................................................ 18 SECTION II – National Athletic Trainers’ Association Code of Ethics ...................................... 20 SECTION III – Athletic Training Student Rights and Privileges ................................................. 22

Volunteer Status of Athletic Training Students ........................................................................ 22 Non-Discriminatory and Diversity Statements ......................................................................... 22 Health Policy Statement ............................................................................................................ 23

Risk of Injury While Completing Field and Clinical Experiences and Insurance Coverage 23 Student Services ........................................................................................................................ 24 Financial Aid ............................................................................................................................. 24

Scholarships .......................................................................................................................... 24 Student Assist (Athletic Training Student Administrative Assistant) .................................. 25 Food and Lodging Accommodations While Traveling ......................................................... 25 Symposium/Conference Opportunities ................................................................................. 25

Program Expenses to Students .................................................................................................. 26 SECTION IV – Guidelines for Professional Practice ................................................................... 27

General Expectations of Athletic Training Students................................................................. 27 Desire to Learn ...................................................................................................................... 27 Commitment ......................................................................................................................... 27 Professional Conduct ............................................................................................................ 28

Code of Conduct ....................................................................................................................... 28 Attendance ............................................................................................................................ 28 Dating and other social interactions ...................................................................................... 28

Athletic Training Program Student Handbook Revised 12/2013


Substance Use and Abuse ..................................................................................................... 28 Use of Alcohol ...................................................................................................................... 29 Confidentiality of Medical Information (Patient Privacy) .................................................... 29 Telephone/Computer Use ..................................................................................................... 29 Staff Computers .................................................................................................................... 29 ATC Offices .......................................................................................................................... 29 Respectability ........................................................................................................................ 29 Use of Modalities .................................................................................................................. 29

Dress Code and Professional Appearance ................................................................................ 30 Appropriate Attire ................................................................................................................. 30 Consequences of not following dress code/body piercings rules .......................................... 32

Athletic Training Room Responsibilities.................................................................................. 32 Hours ..................................................................................................................................... 32 Recording of Approved Hours for the Clinical Experience Classes ..................................... 32 Field and Clinical Experience Contact Hours Policy ............................................................ 32 Schedules .............................................................................................................................. 33 Recordkeeping ...................................................................................................................... 33 Injury Reports........................................................................................................................ 33 Treatment Records ................................................................................................................ 33 Application of Tape and Wraps ............................................................................................ 33 Biohazardous Waste Protocol ............................................................................................... 34 Modalities and Rehabilitation Equipment ............................................................................ 35 Non-Sexual Evaluation Guidelines ....................................................................................... 35 Cleaning ................................................................................................................................ 35 Game-day and Practice Duties .............................................................................................. 35 Individual Equipment ............................................................................................................ 35

SECTION V – Emergency Procedures ......................................................................................... 37 Communication Signals ............................................................................................................ 37 Emergency Equipment .............................................................................................................. 38 General Emergency Plan ........................................................................................................... 38 Suspected Spinal Injury Protocol .............................................................................................. 38 Concussion Management Protocol ........................................................................................... 43 Cardiorespiratory Emergencies ................................................................................................. 50 Policy on Automated External Defibrillator Availability and Use ........................................... 51 Inclement Weather Guidelines .................................................................................................. 51

General Policy ....................................................................................................................... 51 Lightning ............................................................................................................................... 52 Heat Index/ High Humidity ................................................................................................... 54

Heat Illness Protocol ................................................................................................................. 54 ADHD Policy ............................................................................................................................ 55 Asthma Policy ........................................................................................................................... 55 Sudden Cardiac Death Policy ................................................................................................... 55 Medication Policy ..................................................................................................................... 55 Allergic Reactions/Anaphylaxis ............................................................................................... 56



Shock......................................................................................................................................... 56 Dislocations, Fractures .............................................................................................................. 56 Open wounds requiring sutures................................................................................................. 56 Urgent/Non Emergent Guidelines ............................................................................................. 57 Referral to the Team Physicians ............................................................................................... 57 Referral to the Student Health Center ....................................................................................... 58

Appendix A – Athletic Training Phone List ................................................................................. 59 Appendix B – Instructions for Completing Field Experience Log ............................................... 60 Appendix C – Emergency Action Plans ....................................................................................... 61 Appendix D – Staph and MRSA ................................................................................................... 67 Appendix E – Communicable Disease Policy .............................................................................. 71 Appendix F – Approved Treatment Methods ............................................................................... 72 Appendix G – NATA Blood Borne Pathogens Guidelines ........................................................... 77



SECTION I – Overview of the Colorado Mesa University Athletic Training Program

Mission Statement The mission of the Athletic Training Program at Colorado Mesa University is to provide a comprehensive athletic training education that focuses on the physically active. Our curriculum combines didactic and clinical learning experiences in a variety of settings. Educational preparation will focus on the prevention, recognition, evaluation, treatment, and rehabilitation of athletic injuries. We strive to provide an environment that fosters the development of skills and knowledge needed to challenge the board of certification examination and to pursue the various career opportunities available to certified athletic trainers. Admission Requirements Students must have a 2.75 GPA in all college courses and have completed the following courses with a C or better to be eligible for entrance into the Colorado Mesa University Athletic Training Program: KINE 234 – Prevention and Care of Athletic Injuries KINE 240 – Introduction to Clinical Athletic Training BIOL 209 – Anatomy and Physiology I BIOL 209L – Anatomy and Physiology I Lab Students with a GPA below 2.75 are encouraged to reapply to the program, but admittance is not guaranteed. Additional required materials: Physical TB test Immunization records Technical Standards CPR / First Aid certification Transfer Students Transfer students and Colorado Mesa students with previous experience in Athletic Training and a letter of recommendation from a Certified Athletic Trainer may be admitted into the program if they can demonstrate the required basic skills and associated knowledge covered in KINE 240- Introduction to Clinical Athletic Training.


Colorado Mesa University Athletic Training Program Academic and Clinical Instruction Plan The Colorado Mesa University Athletic Training Program is a 2.5 year clinical program starting the spring semester of the student’s sophomore year. Basic technical skills required for entrance into the program are taught and evaluated in KINE 240 – Introduction to Clinical Athletic Training. The Field and Clinical Experience courses have didactic, laboratory and clinical requirements. A student must successfully demonstrate performance of all psychomotor skills and clinical proficiencies associated with the field and/or clinical experience before moving on to the next course in the sequence. Entry into the Athletic Training Education Program as a sophomore: students accepted into the Athletic Training Program following the fall semester of their sophomore year will register for KINE 252 – Principles of Evaluation and Assessment and KINE 253 – Fundamentals of Clinical Athletic Training. During subsequent semesters they should register for the following courses:

Junior Year Fall Semester Spring Semester KINE 309 Anatomical Kinesiology Electives KINE 367 Field Experience in AT 1 KINE 303 Exercise Physiology KINE 368 Clinical Experience 1 KINE 303L Exercise Physiology Lab KINE 374 Lower Body Assessment KINE 373 Upper Body Assessment KINE 420 Therapeutic Modalities KINE 378 Clinical Experience 2 Gen. Ed. Natural Sciences with Lab KINE 410 Rehabilitative Exercises KINE 430* Medical Conditions &

Pharmacology in Sports *Can be taken either junior or senior year.

Senior Year Fall Semester Spring Semester Electives Electives KINA Activity KINE 370 Biomechanics KINE 405 Sports Nutrition KINE 370L Biomechanics Lab KINE 467 Field Experience in AT 2 KINE 430* Medical Conditions &

Pharmacology in Sports KINE 468 Clinical Experience 3 *Can be taken either junior or senior year. Transfer students – in the event that a student transfers to Colorado Mesa University and is accepted into the Athletic Training Program following their sophomore year, they will be required to complete KINE 252 and KINE 253 during the July prior to taking the Junior year courses outlined above. Inability to do so will necessitate them beginning the Athletic Training Program the following January. On a yearly basis consult your academic planning sheet to make sure you are still on track.


Colorado Mesa University Athletic Training Program Planning sheets can be obtained from the Athletic Training Program Director. Please keep in mind the following considerations: Field and Clinical Experiences courses must be completed in order: KINE 367, 368, 378, 467, 468, and 478. KINE 373 and 374 must be completed before taking KINE 468. KINE 410 is only offered during spring semesters. KINE 420 is only offered during fall semesters. KINE 430 is offered every semester, including summer, online and should be taken during the junior or senior year. Athletic Training Program Goals Graduates of this program will:

1. Understand evidence-based practice concepts and their application. 2. Possess the ability to develop and implement strategies and programs to prevent the

incidence and/or severity of injuries and illnesses, optimizing patient overall health and quality of life.

3. Possess strong clinical examination and reasoning skills, based on an understanding of anatomy, physiology, and biomechanics that will enable them to accurately formulate a differential diagnosis.

4. Be knowledgeable and skilled in the evaluation and immediate management of acute illnesses and injuries.

5. Be knowledgeable and skilled in the development and implementation of therapeutic interventions designed to maximize a patient’s participation and health-related quality of life.

6. Recognize abnormal social, emotional and mental behaviors in their patients and possess the ability to intervene and refer these individuals as necessary.

7. Understand risk management, health care delivery mechanisms, insurance, reimbursement, documentation, patient privacy, and facility management.

8. Embrace the need to practice within the limits of state and national regulation using moral and ethical judgment, while working collaboratively with other health care providers, referring patients appropriately when such a referral is warranted.

Learning Progression Utilized by the Athletic Training Program Novice to Technician to Clinician Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program Webster’s Dictionary defines a novice a person who is new to the circumstances, work, etc., in which they are placed. Upon entering the KINE 240 – Introduction to Clinical Athletic Training course, all potential athletic training students will be considered as a novice. Webster’s Dictionary defines a technician as a person who is trained or skilled in the technicalities of a subject. After completing KINE 240, KINE 253, KINE 367, KINE 368 and KINE 378 all students in the Athletic Training Program shall be competent technicians. They will know how to perform assigned injury prevention, treatment, and rehabilitation skills/tasks. Stedman’s Medical Dictionary defines a clinician as a health care professional engaged in the care of patients. A technician may have the ability to perform all of the skills but a clinician can determine when to apply the various skills. After completing KINE 467, KINE 468 and KINE 478 and all formal course work, all students in the Athletic Training Program shall be competent Entry Level Athletic Training clinicians. They will know how to perform an evaluation and, by using evidence based practices, determine what injury, treatment and rehabilitation skills/tasks to utilize for the prevention and care of an injury. A majority of the psychomotor competencies will be taught and evaluated in KINE 240, KINE 253, KINE 367, KINE 368, KINE 378 and KINE 467. In general, the skills will be presented with a part to whole learning process including adequate practice time with peer review to allow the student to develop competency in the performance of the skill/task in a mock setting. After the student has had the opportunity to truly learn the skill, a preceptor will observe and record the performance of the skill/task as cleared. After this has occurred the athletic training student will be allowed to perform the skill/task on an athlete/patient with local supervision. (See the next Section on Supervision for more information on types of supervision) The skills/tasks/evaluative techniques do not have to be completed in any strict order as assigned to the Clinical and Field Experience courses. If a “teaching moment” occurs and the opportunity to present a skill/task/evaluative technique happens, the preceptor is encouraged to take advantage of the moment. In KINE 468 and KINE 478, students will refine their psychomotor skills, develop critical thinking skills and develop their own system to approach injury prevention, treatment and rehabilitation. All athletic training students are encouraged to perform evaluations and develop treatment and rehabilitation programs at every opportunity. Evidence based practice should be considered but the athletic training students should also be encouraged to experiment and be creative. No two injuries are the same and no two athletes are the same; so the athletic training students must be able to adapt and adjust. All classes taught by the Athletic Training Program faculty will include regular critical thinking and evidence based practice assignments that not only consider factual injury evaluation, treatment and rehab material but also moral, ethical, and administrative situations.


Colorado Mesa University Athletic Training Program Academic Standards for Retention in the Athletic Training Program Student Retention/Suspension/Dismissal Policy Probation - Actively involved in a Clinical Experience course but are required to submit bi-weekly grade checks to the Athletic Training Program Director and will not be allowed to accompany a preceptor during team travel. Suspension – Temporary loss of the privilege to attend and fulfill the requirements of a Field / Clinical Experience course. Suspensions are for the period of one semester (fall or spring). Dismissal – Permanent loss of the privilege to attend and fulfill the requirements of a Field / Clinical Experience course. To remain competitive, the Athletic Training Program maintains low student to instructor ratios. Because of this, we limit the number of students accepted to the program and enforce academic standards for students while they are enrolled in the program. 1) Students failing to maintain a semester GPA of 2.75 will be placed on academic

probation. If the semester GPA remains below 2.75 in the subsequent semester, the student will be dismissed from the athletic training education program.

2) Clinical and Field Experience courses are offered once a year in the following sequence: Junior year KINE 367, 368, 378; senior year KINE 467, 468, 478. Students must satisfactorily complete the didactic component, competencies and proficiencies component, and the hour component of each course before moving on to the next. Failing to satisfactorily complete a Clinical and/or Field Experience Course will result in one semester (Fall or Spring) suspension from the Athletic Training Program until the course can be repeated. All requirements of the course must be completed during the semester that the course is repeated. Failing to successfully complete a second Field and/or Clinical Experience course will result is dismissal from the program.

a) Failing to receive a grade of C or higher in any Field or Clinical Experience

course will result in suspension from the program and the student must retake the course at the next offering and receive a grade of C or better before moving on to the next course in the sequence. b) The clinical competencies and proficiencies associated with each Clinical and

Field Experience course are graded as Pass/Fail. Failure to develop an entry level mastery of all clinical competencies and proficiencies associated with each Clinical and Field Experience course will result in a grade of F. The student will be suspended until the course is offered again and all competencies and proficiencies must be completed prior to moving to the next course in the sequence. In the event that the failure to develop an entry level mastery of all clinical competencies and proficiencies is the result of illness or family



emergency, the student may be allowed to complete the skill mastery between semesters and continue to the next course in the sequence. This option will be considered on a case by case basis with input from all Athletic Training Program faculty and preceptors to which the student is assigned.

c) The Clinical and Field Experience hour requirement associated with each Clinical

and Field Experience course is graded as Pass/Fail. Failure to complete the Clinical and Field Experience hour requirement will result in a grade of F. The student will be suspended until the course is offered again and the hour requirements must be completed prior to moving to the next course in the sequence. In the event that the failure to complete the hour requirement is the result of illness or family emergency, the student may be allowed to complete the hours between semesters and continue to the next course in the sequence. This option will be considered on a case by case basis with input from all Athletic Training Program faculty and preceptors to which the student is assigned.

Reasons for Suspension or Dismissal The following is a list of reasons for suspension or dismissal from the Colorado Mesa University Athletic Training Program. This is not a complete list as someone may discover other actions that have not been experienced or anticipated. The first four (4) reasons listed are grounds for automatic dismissal. 1) Performing assigned field and clinical experiences under the influence of alcohol or

drugs. 2) Unauthorized release of athlete medical records. The unauthorized release of individuals’

medical records is a crime. You cannot discuss an individual’s injury or status with anyone outside the Colorado Mesa University Athletic Training Staff without the injured person’s permission. The only exception is the athletes’ parents if the athlete is under 18 years of age. If you are going to discuss the injury as an example or as a case study, you must keep the players identity anonymous.

3) False representation. Falsely representing yourself regarding status or position with the

Colorado Mesa University Athletic Training staff. You are an athletic training student - make sure people understand this when you present yourself.

4) Sexual misconduct. Using your position as an athletic training student to make advances

toward or take advantage of an individual during an evaluation or treatment will not be tolerated. Complaints will be evaluated and handled on an individual basis. Evidence supporting intentional sexual misconduct will automatically result in dismissal with no possibility of reinstatement, in addition to charges that the victim may wish to file (refer to Non-Sexual Evaluation Guidelines in Section IV).

5) Poor performance. Performance will be evaluated on a regular basis and included in all



rotation evaluations. Repeated exhibition of poor performance will resulted in poor evaluations leading to a grade less than C in a Field or Clinical Experience course. All situations of “poor performance” will be recorded in an incident report and included in the student clinical evaluation. Isolated minor infractions may result in a 1 day suspension from assigned duties and the completion of a reflection paper and recommendations from the student regarding ways to prevent future incidents. Severe or repeated infractions may result in suspension and or dismissal from the program. The areas of evaluation will include but not be limited to the following: a) Punctuality - You are expected to be at your assigned field or clinical experience

at the time scheduled and be ready to perform assigned duties at that time. Failure to comply may negatively impact your grade in the respective course or result in suspension or additional disciplinary actions as deemed necessary by the Athletic Training Program faculty and staff.

i. It is your responsibility to check the assigned clinical or field experience schedule (posted in the athletic training student logbook) and verify the time that you should be at the assigned clinical or field experience. Also, remember that if you are one of the people opening the athletic training room, everything should be ready at the scheduled opening time - which means you should be here 20 or 30 minutes earlier to complete needed preparation.

ii. The clinical and field experience schedule for all athletic training students will reflect workload requirements based on team schedules, individual skills, experiences required, and student availability. If you cannot make a scheduled clinical or field experience, you are expected to notify the Clinical Education Coordinator or the preceptor in charge of the clinical or field experience as soon as possible.

b) Attitude toward and ability to get along with the athletes, coaches, and other

Colorado Mesa Athletic Training Staff members (physicians, physician assistants, certified athletic trainers, and other athletic training students). Athletic training is in part a service profession. Athletic training students should treat all athletes, coaches, and athletic trainers (certified or student) in a respectful, professional manner. You will spend a significant amount of time with the athletes, coaches, and other Colorado Mesa Athletic Training Staff members and you will be required to “get along” with everyone. Even if you feel the individual is not deserving of respect or politeness, you will be expected to be respectful and polite. Rudeness and attitude conflicts that interfere with performance will not be tolerated and are grounds for dismissal.

6) Temporary suspension will occur in the event that a student fails to maintain required

documentation, certifications and/or memberships. The suspension will be removed when Athletic Training Program Student Handbook Revised 12/2013


the required documentation, certifications and/or memberships is supplied. All athletic training students must maintain the following documentation, certifications, and membership.

a) CPR for the Professional Rescuer certification or equivalent – There will be a

mass re-certification class for all Athletic Training Program staff and students during KINE 367 and 467. All Athletic Training Program staff and students will be required to participate in and pass this re-certification.

b) Maintain professional liability insurance.

c) Maintain annual NATA student membership after January of junior year.

d) Maintain personal health insurance e) Comply by the technical standards of the Athletic Training Program.

7) Failure to satisfactorily complete a Field or Clinical Experience course. First occurrence = suspension; second occurence = dismissal. Appeal Process Students who have been suspended or dismissed from the Athletic Training Program may appeal the decision through the Athletic Training Student Grievance Process. If the suspended student is not satisfied with the decision of the Athletic Training Program Grievance Committee the student can proceed with the appeal to the Vice President of Student Affairs. Athletic Training Student Grievance Process Students in the Athletic Training Program are encouraged to resolve conflicts informally in a respectful and professional manner. Should a student conflict arise that cannot be resolved informally, the following chain of command (grievance policy) shall be followed.

1) Assigned preceptor 2) Head Certified Athletic Trainer and/or Clinical Education Coordinator 3) Athletic Training Program Director 4) Athletic Training Program Grievance Committee

The Athletic Training Program Grievance Committee will consist of the Department of Kinesiology Chair, two former Athletic Training Program students not involved with the conflict and two current non-Athletic Training Program students with no relationship to the student(s) involved in the conflict. The former and current student members of the committee will be determined based on the student(s) involved in the grievance. In matters regarding academic suspension as the result of failure to complete the requirements of a course, the student may appeal the decision. The appeal must include a plan for the completion Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program of the course requirements. If the student can justify that extenuating circumstances were a factor the suspension may be removed. The appeal process should begin with the instructor of record and progress through the following list.

1) Instructor of record 2) Athletic Training Program Director 3) Athletic Training Program Grievance Committee

Becoming a Certified Athletic Trainer and State-by-State Considerations To become a certified athletic trainer (ATC), students must pass the Board of Certification (BOC) examination. A BOC examination candidate must be a graduate of (or be eligible in their final semester to graduate from) an Athletic Training Program accredited by the Commission on Accreditation of Athletic Training Education (CAATE). This policy went into effect January 1, 2004. The Athletic Training Program at Colorado Mesa University received Commission on Accreditation of Allied Health Programs (CAAHEP) accreditation on April 10, 2003 and was re-accredited on August 7, 2009 through 2018. In July of 2006 the responsibility for accrediting Athletic Training Programs was moved from CAAHEP to CAATE. It is the responsibility of the Program Director and Clinical Education Coordinator that students receive all requirements for eligibility (e.g., exposure to equipment intensive sport, etc.). The BOC examination is available to take at over 200 ACT testing sites every few months. The certification exam is entirely computer-based consisting of multiple choice questions and scenarios. More information about the certification exam can be found at www.bocatc.org. For more details, see the Athletic Training Program Director. A majority of states, including Colorado, require athletic trainers to complete registration and/or licensure requirements. This typically involves providing evidence of certification from the BOC and passing a licensure exam on questions about the laws and policies of that state to practice as an athletic trainer. Canada has a separate application/certification process for certified athletic therapists. If a student anticipates working in a particular state after graduation, that student should review the laws for that particular state. A basic review of state requirements can be found at www.nata.org. Supervision The CAATE guidelines require that athletic training students have direct supervision at all times during their clinical education (Standard 63). The Athletic Training Program will utilize two forms of direct supervision during the clinical education process: over the shoulder supervision and local supervision. Over the shoulder supervision will be utilized in a situation in which the athletic training student is performing a psychomotor skill on an athlete/patient that they have not fully demonstrated the knowledge and ability to perform on their own. The preceptor is located within arm’s length of


http://www.bocatc.org/

http://www.nata.org/

Colorado Mesa University Athletic Training Program the student and can immediately intervene on behalf of the athlete or the student. Local supervision will be utilized in situations in which the athletic training student is performing a psychomotor skill on an athlete/patient that they have fully demonstrated the knowledge and ability to perform on their own. Athletic training students must have been admitted into the Athletic Training Program and demonstrate the ability to perform a psychomotor skill on their own without assistance or guidance (usually in a mock setting) before they will be allowed to perform the skill on an athlete/patient under local supervision. The distance from the athletic training student and preceptor while working under local supervision may vary based on the risk of harm to the athlete/patient and the confidence level of the athletic training student. The preceptor must be close enough to intervene on behalf of the athlete or athletic training student. It is the goal of the Athletic Training Program to develop the athletic training students’ confidence in their ability to act in an unsupervised setting after graduation. This can only be achieved by allowing the athletic training students to complete evaluations, develop treatment plans, and design rehabilitation programs with minimal influence from the supervising preceptor. After an athletic training student has demonstrated the cognitive knowledge and psychomotor skills to safely perform a task, they should be allowed to complete that task on their own. The preceptor should still oversee the activity in a way that allows the athletic training students’ confidence to grow and still be available to answer any questions the athletic training student may have and intervene if needed. At no time should an athletic training student be allowed to perform athletic training duties involving the assessment, treatment or rehabilitation of an injured athlete without the direct supervision of a preceptor. It will be the responsibility of the preceptor and the athletic training student to insure that this compliance is met. The preceptor should make every attempt to not allow the athletic training student to be in the position of being unsupervised and it is the athletic training student’s responsibility to refrain from performing any athletic training duties if a preceptor is not present. Preceptor supervision is not required for pre-practice/game and post-practice/game duties that do not involve direct interaction with an athlete/patient. Travel It is the goal of the Athletic Training Program that each student will have the opportunity to accompany a preceptor during team travel at least once while in the clinical program. The supervision policy will still be enforced during the travel setting. In the event that a team is traveling without a staff athletic trainer, the Athletic Training Staff will supply the coaching staff with a basic kit containing tape, wraps and wound care supplies, which the coaches may apply themselves or provide to the host athletic trainer(s) to use.


Colorado Mesa University Athletic Training Program Chain of Command for the Athletic Training Program The following is the chain of command and brief explanation of duties for the medical and administrative aspects of the Colorado Mesa University Athletic Training Staff.

Team Physician Staff The team physicians from Western Orthopedics and Sports Medicine, and any consultants they engage, will control the medical protocol and procedures that are followed in the athletic training room. The team physician (or the attending physician in the event that a different physician is involved) has the final say on all athletes’ release to participate. If they determine that an athlete should not participate at any given time, their decision is to be followed and the athlete will not participate. Athletic Director The athletic director or designee in their absence is responsible for the administrative and budgeting aspects of the athletic training room. Head Certified Athletic Trainer The Head Certified Athletic Trainer reports to and follows the recommendation of the team physician staff and the athletic director for their respective areas and works with the head coaches for scheduling purposes. The Head Certified Athletic Trainer is directly responsible for the actions of the Assistant Certified Athletic Trainers and athletic training students. Assistant Certified Athletic Trainers The Assistant Certified Athletic Trainers report to and follow the recommendations of the Head Certified Athletic Trainer, the team physician staff, and the athletic director for their respective areas and work with the head coaches for scheduling purposes. Any Certified Athletic Trainer

Team Physician Staff (Medical)

Athletic Director (Administrative)

Athletic Training Program Director

Head Certified Athletic Trainer Assistant Certified Athletic Trainers

Head Coaches (Scheduling)

Athletic training students

Athletic Training Program Clinical Education Coordinator


Colorado Mesa University Athletic Training Program assigned by the Head Certified Athletic Trainer to cover a specific event or fulfill a designated duty, in either a volunteer or paid capacity, will be considered an Assistant Certified Athletic Trainer on the Colorado Mesa University Athletic Training Staff. Athletic Training Program Director The Athletic Training Program Director is responsible for overseeing the operations of the Athletic Training Program. The Athletic Training Program Director will work with the Head Certified Athletic Trainer and/or the Athletic Training Program Clinical Education Coordinator to ensure that all athletic training students are exposed to the clinical experiences necessary to satisfy the requirements to be eligible to take the Board of Certification examination. The Athletic Training Program Director may also serve as an Assistant Certified Athletic Trainer while supervising athletic training students during their field experiences. Athletic Training Program Clinical Education Coordinator The Athletic Training Program Clinical Education Coordinator is responsible for scheduling which field experiences the athletic training students will be assigned to. The Athletic Training Program Clinical Education Coordinator will work with the Head Certified Athletic Trainer and/or the Athletic Training Program Director to ensure that all athletic training students are exposed to the clinical experiences necessary to satisfy the requirements to be eligible to take the Board of Certification examination. The Athletic Training Program Clinical Education Coordinator may also serve as an Assistant Certified Athletic Trainer while supervising athletic training students during their field experiences. Head Coach The coaching staff is indirectly involved with the chain of command in that the head coach of a sport and his/her designee is responsible for establishing practice and game schedules for which athletic training services are provided. Athletic Training Students The athletic training students report directly to the Head Certified Athletic Trainer, Assistant Certified Athletic Trainers, the Athletic Training Program Director, and the team physician staff regarding their actions, procedures, and protocols for all aspects of their duties. Athletic Training Student Job Descriptions Observational Athletic Training Student Students seeking admission into the Athletic Training Program must complete KINE 240 – Introduction to Clinical Athletic Training or an equivalent independent observation. Athletic Training Student An athletic training student is defined as a student who is officially accepted into the Athletic Training Program. An athletic training student is a student who is completing field and clinical experience courses designed to provide an opportunity to practice clinical competencies under the direction of a designated preceptor. We expect athletic training students in the Athletic


Colorado Mesa University Athletic Training Program Training Program to encourage observational athletic training students and to serve as a resource for them (e.g., being patient, answering questions, demonstrating skills, etc.). If you are not certain how to answer an observational athletic training student’s question, refer them to one of the preceptors. Alternative Experiences Rotations The primary goal of the alternative experience rotations is to expose the athletic training students to what occurs in various settings that athletic trainers may be employed and to fulfill the requirements for exposure to general medical conditions and diverse populations. Alternative Experience Rotation Goals High School Goals

1) Observe and experience the demands and requirements of working in the High School Athletic Training Room

2) Observe and experience working with high school age athletes to allow for a comparison to the college age athlete (physical and psychological differences, manner in which interaction is carried out).

3) Observe and experience the difference in the type, and severity of injuries sustained by the high school age athletes to allow for a comparison to the college age athlete in the same sports.

4) Develop an understanding for and develop the ability to communicate with parents / guardians of the high school athlete.

Out/In Patient Physical Therapy Goals

1) Observe the difference in the approach to individualized patient care with insurance limitations in a Physical Therapy setting as compared to the approach taken in the Athletic Training Room (limited visits, 1on 1 relationship, manner in which interaction is carried out).

2) Observe and appreciate the importance of the record keeping requirements needed to satisfy the guidelines for insurance billing.

3) Observe treatment and rehabilitation of non-athletic related injuries and special medical conditions.

Community Hospital Emergency Room Goals

1) Observe treatment of a variety of emergency situations 2) Observe two nights at the emergency department

Student Health Center/Western Medical Associates General Medical Conditions Goals

1) Develop an understanding of which common viral and bacterial infections, and general medical conditions need to be referred to a physician immediately and which may be treated initially by over-the-counter (OTC) medications.

2) Develop an understanding of the basic OTC treatments for common viral and bacterial infections, and general medical conditions which may be recommended for use.



3) Improve general evaluation skills by assisting staff with physical (height, weight, pulse, and blood pressure), ENT, heart, lung and orthopedic examinations when possible.

Western Orthopedics and Sports Medicine Goals

1) Observe the difference in the approach to individualized patient care, periodic visits, insurance limitations in an Orthopedic Clinic setting as compared to the approach taken in the Athletic Training Room (limited periodic visits, 1on 1 relationship, manner in which interaction is carried out).

2) Observe and appreciate the importance of the record keeping requirements needed to satisfy the guidelines for insurance billing.

3) Observe systematic evaluation and treatment of athletic related and non-athletic related injuries and medical conditions.

4) Assist in note taking, evaluation skills, rehabilitation techniques, brace fitting and cast construction when possible.

Athletic Training Program Alternative Rotation Guidelines Alternative Experiences Rotation Packet Pick-up Two weeks prior to the start of the alternative experience rotation, athletic training students will pick up the Alternative Experiences Rotation Packet from the Clinical Education Coordinator and review the guidelines and goals for the rotation. Prior to the start of the rotation, the student will submit a typed list of their expectations for the rotation. Contacting Clinical Supervisor It is the responsibility of the athletic training student to contact the clinical supervisor at least 1 week before the start of his/her scheduled rotation to set his/her schedule for the rotation. There is a limited amount of time to complete the rotation and many of the clinical supervisors are working with other students also, so understand that when making contacts. Schedule Within the first week of the rotation a tentative schedule for the rotation should be completed and a copy of that schedule given to Clinical Education Coordinator. Hour and Observation requirements The High School rotation requires a minimum of 40 hours of onsite observation/participation during the allotted 4 week period. This time must include being present at a minimum of 3 events. Outpatient Physical Therapy Clinic rotation requires a minimum of 40 hours of onsite observation/participation during the allotted 4 week period. Community Hospital Emergency Room rotation requires two 8 hour rotations of onsite observation during the 2 week period. The observations must be done on a Friday, Saturday or Sunday. Along with the required daily log, you must write a 1 page paper on a specific injury/situation observed during your rotation. Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program Student Health Center and Western Medical Associates rotation requires a minimum of 20 hours of onsite observation/participation during the allotted 2 week period. The Western Orthopedic and Sports Medicine rotation requires a minimum of 40 hours of onsite clinic observation/participation during the allotted 4 week period. This time must include observation of 2 surgeries (you may observe additional surgeries; however, only two count towards your hours). You must maintain a daily hour log showing the time you were at the rotation. This log must be signed by the clinical supervisor to receive credit for the observation. Journal A daily journal must be kept during the rotation with at least one entry for each day present at the rotation. Any new experiences or unusual injuries/conditions that were seen should be noted. The journal must be typed. Remember not to use patient names or any other identifying information in the journal write up. Gender, age, body type, occupation, etc. may be used to describe the person and the history if needed. Student Evaluation It is the responsibility of the athletic training student to print a copy of the student evaluation to give to the clinical supervisor (along with a Colorado Mesa Business Reply Envelope) before the end of the rotation. Clinical Supervisor Evaluation It is the responsibility of the athletic training student to print a copy of the clinical supervisor evaluation to complete and turn in with the log and journal. Return Alternative Experiences Rotation Packet All materials in the Alternative Experiences Rotation Packet (expectations, log, journal, clinical supervisor evaluation) are due within seven days of completing the rotation. Failure to turn in the packet on time will result in a decreased clinical grade.



SECTION II – National Athletic Trainers’ Association Code of Ethics

Preamble The National Athletic Trainers’ Association Code of Ethics states the principles of ethical behavior that should be followed in the practice of athletic training. It is intended to establish and maintain high standards and professionalism for the athletic training profession. The principles do not cover every situation encountered by the practicing athletic trainer, but are representative of the spirit with which athletic trainers should make decisions. The principles are written generally; the circumstances of a situation will determine the interpretation and application of a given principle and of the Code as a whole. When a conflict exists between the Code and the law, the law prevails. Principle 1 Members shall respect the rights, welfare and dignity of all. 1.1 Members shall not discriminate against any legally protected class. 1.2 Members shall be committed to providing competent care. 1.3 Members shall preserve the confidentiality of privileged information and shall not release such information to a third party not involved in the patient’s care without a release unless required by law. Principle 2 Members shall comply with the laws and regulations governing the practice of athletic training. 2.1 Members shall comply with applicable local, state, and federal laws and institutional guidelines. 2.2 Members shall be familiar with and abide by all National Athletic Trainers’ Association standards, rules and regulations. 2.3 Members shall report illegal or unethical practices related to athletic training to the appropriate person or authority. 2.4 Members shall avoid substance abuse and, when necessary, seek rehabilitation for chemical dependency. Principle 3 Members shall maintain and promote high standards in their provision of services. 3.1 Members shall not misrepresent, either directly or indirectly, their skills, training, professional credentials, identity or services. 3.2 Members shall provide only those services for which they are qualified through education or experience and which are allowed by their practice acts and other pertinent regulation. 3.3 Members shall provide services, make referrals, and seek compensation only for those services that are necessary. 3.4 Members shall recognize the need for continuing education and participate in educational activities that enhance their skills and knowledge.


Colorado Mesa University Athletic Training Program 3.5 Members shall educate those whom they supervise in the practice of athletic training about the Code of Ethics and stress the importance of adherence. 3.6 Members who are researchers or educators should maintain and promote ethical conduct in research and educational activities. Principle 4 Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession. 4.1 Members should conduct themselves personally and professionally in a manner that does not compromise their professional responsibilities or the practice of athletic training. 4.2 National Athletic Trainers’ Association current or past volunteer leaders shall not use the NATA logo in the endorsement of products or services or exploit their affiliation with the NATA in a manner that reflects badly upon the profession. 4.3 Members shall not place financial gain above the patient‘s welfare and shall not participate in any arrangement that exploits the patient. 4.4 Members shall not, through direct or indirect means, use information obtained in the course of the practice of athletic training to try to influence the score or outcome of an athletic event, or attempt to induce financial gain through gambling.



SECTION III – Athletic Training Student Rights and Privileges

Volunteer Status of Athletic Training Students All athletic training students associated with the Colorado Mesa University Athletic Training Program will be considered as students volunteering their time while they are gaining experience toward a career goal or fulfilling requirements toward graduation. In the event that certain students may be entitled to financial aid (either in the form of student assistance or scholarship) in conjunction with their field experiences in the athletic training room, the individual will still be considered a volunteer student and not an employee of the Colorado Mesa University Athletic Department. Such aid or assistance is governed by the administrative rules and regulations administered by the Colorado Mesa University Office of Financial Aid. In the event that a student receives a salary or stipend for their field experience as an athletic trainer at an athletic event not hosted by the Colorado Mesa University Athletic Department, he/she will be considered an employee of the event host during that period of time. The field experience schedule for all athletic training students will reflect field experience load requirements based on team schedules, individual skills, and the amount of time you can dedicate to the Athletic Training Education Program. Non-Discriminatory and Diversity Statements The Colorado Mesa University Athletic Training Program and affiliated sites believe in and uphold the university’s non-discriminatory and diversity statement which appears as:

“Colorado Mesa University does not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or Vietnam Era veteran status in admission or access to, or treatment or employment in, its educational endeavors. The college complies with the Civil Rights Act of 1964, Title IX of the Educational Amendments Act of 1972, Sections 503 and 504 of the Rehabilitation act of 1973, Section 402 of the Vietnam Era Veterans Readjustment Act of 1974, the Age Discrimination in Employment Act of 1967, as amended, the Americans with Disabilities Act of 1990, the Civil Rights Act of 1991, and all civil rights laws of the State of Colorado.”

The Colorado Mesa University Athletic Training Program and affiliated sites believe in and uphold the university’s statement on diversity which appears as:

“Colorado Mesa University is a community of scholars in the liberal arts tradition. As faculty we believe that all people, regardless of gender, linguistic heritage, marital status, origin, religion, or sexual orientation, have something worthwhile to contribute and that these contributions benefit us all. Therefore, we intend that within our academic community all cultural differences will be treated with equal respect and tolerance. We desire that our students have the opportunity to appreciate the diversity of our modern world, and we encourage them to partake of the resources available within our community. As faculty we pledge ourselves to provide as many divergent cultural experiences for our students as the resources of the college and the needs of our disciplines allow.”


Colorado Mesa University Athletic Training Program Health Policy Statement

1. Before students begin the clinical experiences in athletic training courses and the off-campus clinical rotations they must sign an official technical standards for admission document stating that they possess: 1) The mental capacity to assimilate, analyze, synthesize, and integrate athletic training concepts into clinical practice, 2) Sufficient postural and neuromuscular control, sensory function, and coordination to perform appropriate physical examinations, 3) The ability to communicate effectively and sensitively with patients and colleagues, and 4) The capacity to maintain composure and continue to function well during periods of high stress.

2. Prior to beginning the clinical experiences in athletic training courses and the off-campus

clinical rotations, students must provide documentation of MMR vaccines, a completed Tuberculosis test, a completed Hepatitis B vaccination series, or documentation that the series has been started, and a completed medical history questionnaire and pre-participation physical examination performed by a qualified physician. The above-mentioned documentation is kept secure in the student’s file, which is located in the Program Director’s office.

3. Athletic training students have access to the various health care services afforded to all

students on campus. These services include the Colorado Mesa University Student Health Services Center, and six free mental health counseling sessions with a mental health center affiliated with the university, should such services be required.

4. All athletic training students are required to maintain a current health insurance policy.

Injuries received while completing clinical rotations at Colorado Mesa University are the responsibility of the student. Injuries received while completing off-campus rotations may be covered by the university workman’s compensation insurance.

5. The Athletic Training Program has committed to making reasonable accommodations to

qualified applicants should the need arise. For example, should a qualified applicant have a medical or physical disability which requires them to use a wheelchair, accommodations such as wider treatment stations or lower taping tables will be made.

6. Should an athletic training student have an active communicable disease, the student shall

be excused from all course and field experience requirements until a qualified physician has deemed the individual to be in a non-contagious state. See Appendix H – Communicable Disease Policy

Risk of Injury While Completing Field and Clinical Experiences and Insurance Coverage As with any activity, there is a chance that you might become injured or exposed to blood borne pathogens while completing your field experiences as a student in the Colorado Mesa University Athletic Training Program. These injuries or exposures may occur when moving supplies or


Colorado Mesa University Athletic Training Program equipment, assisting injured players, evaluating injured players, or by inadvertent involvement in a play or drill. Injuries received while completing clinical rotations at Colorado Mesa University are the responsibility of the student. Injuries received while completing off-campus rotations may be covered by the university workman’s compensation insurance. In the event that an injury or exposure occurs as a direct involvement of your activities as a student in the Colorado Mesa University Athletic Training Program, certain medical expenses for your injury may be covered by the athletic insurance. Except for situations of a true medical emergency, the Head Certified Athletic Trainer must be notified prior to seeking any medical treatment and workers compensation forms must be completed at the Human Resource Office as soon as possible for this coverage to occur. This workers compensation and the athletic insurance coverage are not in effect if you are working as an employee of an event host other than the Colorado Mesa University Athletic Department. All athletic training students are required to maintain a current health insurance policy. Student Services The following student services at Colorado Mesa University are available for your utilization. The Athletic Training Program encourages athletic training students to take advantage of these services should the academic, personal, or professional need arise. 1. Academic Services Department (248-1304) 2. Academic Advising and Career Planning (248-1177) 3. College Success Courses (248-1913) 4. Educational Access Services (248-1801) 5. Peer Tutoring Program (248-1392) 6. Testing and Assessment Center (248-1215) 7. Academic Improvement Series (248-1304) 8. Writing Center (248-1831) 9. Dean of Students Office (248-1366) 10. Math Lab (248-1392) 11. Job Placement Services (248-1366) 12. AWARE Alcohol and Drug Education Program (248-1366) 13. Student Health Center (256-6345) 14. Six Free Mental Health Counseling Sessions (248-1366) Financial Aid Scholarships The Colorado Athletic Trainers' Association (CATA) and the National Athletic Trainers Association (NATA) have scholarships available to athletic training students. Please visit the respective organizations website for more information. Additionally, Colorado Mesa University and the Department of Kinesiology have annual scholarships available to qualified students.


Colorado Mesa University Athletic Training Program Please see the Colorado Mesa University Financial Aid Office for more details. Should funds be available thru the Department of Kinesiology or the Athletic Training Room, scholarships may be awarded to athletic training students based on seniority in the program and need. Student Assist (Athletic Training Student Administrative Assistant) Student Assist This program is limited to available funds that may be distributed to students who do not receive work-study, at the discretion of Athletic Training Program faculty and staff, based on student attitude and performance. If selected for Student Assistance, the student will be given a Request for Student Employment Authorization card with the required information by the Head Certified Athletic Trainer. It is the responsibility of the student to collect the required signatures and deliver the completed card to the Payroll Office. It is the responsibility for the student to complete any and all forms and provide any and all identification required by the Payroll Office to obtain a Student Release to Work slip. The “Student Assist Job” will begin only after a Student Release to Work slip is issued and delivered to the Head Certified Athletic Trainer. All hours worked prior to the receipt of the Student Release to Work slip by the Head Certified Athletic Trainer will be considered as volunteer. Food and Lodging Accommodations While Traveling When an athletic training student travels with a team, they will be entitled to the same food and lodging accommodations as the athletes they are assisting. This will be provided by the sport. Symposium/Conference Opportunities Students may have opportunities to attend symposiums and/or conferences; however, it is the student’s responsibility to register themselves. Students are required to check registration deadlines and register for any and all conferences/symposiums before late fees are imposed otherwise students may be required to pay for all late fees. If students have raised other money, they may apply that to their registration fees.


Colorado Mesa University Athletic Training Program Program Expenses to Students Involvement in the Colorado Mesa University Athletic Training Program will result in some out of pocket expenses to students beyond the customary tuition and fees. Many of these expenses are listed below. 1. NATA Membership Dues $125.00 - annual- 2 years 2. HepB Vaccination Series $87.00 3. Liability Insurance $35.00 - annual- 2 years 4. TB Test $7.00 5. Name tag $5.00



SECTION IV – Guidelines for Professional Practice

General Expectations of Athletic Training Students Desire to Learn The collective goal of the faculty and preceptors at Colorado Mesa University is to teach the athletic training students’ as much as possible while in the program. The athletic training students’ job is to be proactive about his/her education. This means reading textbooks and initiating dialog with the faculty and preceptors. By learning to find information without assistance, one will develop the habits necessary to continually learn throughout his/her career. Time at practices should be spent increasing knowledge, improving skills, and developing a better understanding of the physical demands of that sport. Commitment According to Webster Collegiate Dictionary, there are several definitions for the word “committed”. There are two (2) which may apply to athletic training: (1) “to place in a prison or mental institution” and (2) “to pledge or assign to a particular course or use”. While there is a debate over the appropriateness of definition number 1 for those who wish to undertake a career in athletic training (anyone crazy enough to choose this career should be in a mental institution), there is no doubt that definition number 2 must be present to be a good athletic trainer. There will be many times when you will be assigned to a field experience with athletes, coaches, or sports that you do not like. Other times, you may not feel good and would rather be somewhere else. To survive in this profession, you must possess and exhibit the self-pride, focus, and determination to complete the job that you have been asked to do to the best of your ability, even if you do not want to. For a person to succeed in life, he/she must have a list of priorities and values (both personal and professional). At any time in life your priorities should include your family in a time of need and your religious beliefs. A high priority at this point in your life needs to be your education. Your position as an athletic training student is part of your education. While we would never ask you to desert your family in a time of need, there will be times when you will need to miss a holiday or event with your loved ones, miss a church function, or miss a class to complete your duties during your assigned field experiences. It is part of the commitment - coaches (as a general rule) will not consult with us when they make their schedules. If you want to be an athletic trainer, you do as Jimmy Buffet does and “make the best of a bad situation ‘bout all you can do”. The field experience schedule for all athletic training students will reflect workload requirements based on team schedules, individual skills, experiences required, and student availability. If you cannot make a scheduled field experience, you are expected to notify the Clinical Education Coordinator or the preceptor in charge of the field experience as soon as possible.


Colorado Mesa University Athletic Training Program Professional Conduct Professional conduct refers to the way that you act and interact with and around others while you are completing your field experiences. Gossiping about staff members or athletes, flirtatious acts between staff members and athletes and discriminating against any athlete or staff member for any reason will not be tolerated. In summary:

• Be here on time, dressed appropriately and ready to be an athletic training student • Represent the Athletic Training Program and CMU, in class, the athletic training room,

while traveling, and in your personal life • Be a good student!! • Want to learn • Ask questions • Look for opportunities to learn • Study for all classes • Do not let yourself get behind – let us know if you need help in a class before you get

behind • Be respectful of each other, including your preceptors, course instructors, fellow students

and the student athletes. • Act professionally in your dress, actions, and words • Take care of yourself: eat, sleep, drink responsibly, and wear sunscreen

Code of Conduct Attendance You are expected to arrive on time to all meetings, field experiences, and practices/games/competitions as assigned by the Clinical Education Coordinator. Absences will be penalized in the Clinical Experience courses and/or may result in the student being placed on probation. Dating and other social interactions Dating of student athletes is strongly discouraged and partying, hanging out, or other synonyms of these words and associated activities with student athletes must be in accordance with the NATA Code of Ethics Principle 4.1 (see page 30). You have entered in to a professional program. These activities can compromise your ability to act as a professional with the athletes. If the relationships you develop outside of the athletic training room affect the delivery of health care to athletes, you will be removed from that field experience and/or placed on probation. Athletic training students at Colorado Mesa University may not date high school students during or after their assignment to that high school. Substance Use and Abuse Use, possession, or distribution of any narcotic or other controlled substance by athletic training Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program students on college premises or during college activities (e.g., off-campus field experience, team travel, etc.) except as expressly permitted by law and college regulations is strictly prohibited. Use of Alcohol Athletic training students should never consume alcohol prior to a field experience. Athletic training students traveling with a team are prohibited from consuming alcohol while on the trip. Confidentiality of Medical Information (Patient Privacy) Federal laws restrict the release of an individual’s personal and medical records. Members of the Colorado Mesa University Athletic Training Staff cannot release personal or medical records for any athlete without the written consent of the athlete. The release of personal and medical records will be to involved coaches, physicians and medical facilities only. At no time will any member of the Athletic Training Staff release information to reporters. Telephone/Computer Use Telephones and computers in the athletic training room are for official college business. No personal use during business hours (ie. Facebook, Myspace, e-mail, etc.) Staff Computers Students are never to be on a staff member’s computer without permission. ATC Offices Students are never to be in the offices without an ATC present or permission from an ATC. Respectability We are a staff of individuals working toward the same goal. Work together and do not embarrass a staff member or fellow student in front of an athlete or coach. Be positive and constructive in your dealings with each other. Do not critique any coaches in front of athletes. You are there for health care, not to be a coach. Use of Modalities You are not to administer any electrical current or ultrasound treatment in the absence of a certified athletic trainer. If traveling, you must obtain permission from the host certified athletic training staff before using any modalities in their facility.


Colorado Mesa University Athletic Training Program Dress Code and Professional Appearance The Colorado Mesa University Athletic Training Program is a visible resource on campus. Professionalism is reflected in the appearance of the people in the program. We expect our staff and athletic training students to be clean, neat, and groomed. The following represent appropriate and inappropriate attire. When in doubt, always err on the side of professionalism. Appropriate Attire Clinic and practice coverage Athletic training staff and students will be required to dress in a more professional manner consistent with other medical care facilities (PT clinics/doctors’ offices) and athletic training rooms across the nation. Acceptable attire includes: A Colorado Mesa University t-shirt or polo Khaki long pants without holes or tears

• This includes black, green, tan, or any other subdued color • No bright or flashy colors • No yoga pants or sweats • Black wind pants are acceptable (without holes or tears) • Colorado Mesa University issued or school colored wind pants are also acceptable • Jeans will be acceptable to wear on Fridays if they are free of holes and can be worn

appropriately and allow the ATC/ATS to perform their duties Khaki shorts of appropriate length without holes or tears

• Appropriate length means the tip of your middle finger must touch the bottom of the shorts with the elbows fully extended.

• This includes nice black, green, tan, or any other subdued color • No jean shorts

Workout shorts are appropriate if they are Colorado Mesa University athletic training shorts • Other Colorado Mesa University athletics issued shorts are acceptable as long as they are

not flashy or bright colors Closed toe shoes

• They must have the heel covered (no slippers) and you must be able to run in them General appearance must look appropriate

• Hair combed • Proper oral and body hygiene

Competition coverage

• Polo shirt with an emblem that distinguishes you as part of the Colorado Mesa University Athletic Training Program

o The polo must be appropriately tucked in to pants or shorts the entire time you are working



o Females wearing female polo’s may choose to keep the polo’s untucked as is the design and style of female polo’s

• Pants or shorts (without holes) o No jeans o No shorts for inside events

• Shoes: closed toe that you can run in such as tennis/athletic shoes/dress shoes (for inside events)

• During indoor competitions the preceptor/athletic training student may choose to dress up as is tradition with indoor sports

o Remember you still have to be functional and appropriate • No tennis shoes for indoor events

Inappropriate Attire

• Revealing clothing: halter top, tank tops, and spaghetti-strapped shirts, half shirts revealing waistline

• Pants or shorts with holes • Open toed shoes or sandals • Spandex shorts or tights • Hats while indoors during competition • Yoga pants or sweats

Caps and Sunglasses

• Caps worn at games should represent Colorado Mesa University only and be worn with the bill facing forward

• Sunglasses are permitted during outside events only Grooming and Appearance Your professional appearance will have an impact on how you are received by the players, coaches, physicians, and fans. We expect athletic training students to present themselves in a professional manner with respect to hairstyles and hair color, jewelry, makeup, and body odor. Avoid clothing and jewelry that draws attention – athletes, not athletic trainers, should be the main attraction. If you arrive with inappropriate attire you will be asked to leave and return with the appropriate clothing. Clothing Stains/Damage One thing to keep in mind is the possibility of your clothes being exposed to sweat, blood, or cleaning fluids. They may be damaged. Colorado Mesa University will not assume responsibility for the cleaning or replacement of any garment damaged while completing a field experience as a member of the Colorado Mesa University Athletic Training Program. You should consider the sport you will be assisting and current weather conditions when deciding what to wear.


Colorado Mesa University Athletic Training Program Name Tags Must be worn during off-campus field experiences (e.g., Student Health Center) Body Piercing Only small earrings and small facial piercings may be worn. Studs are recommended. No tongue rings are allowed during field experience or clinical experience hours (including on and off campus hours). These restrictions are for professional and safety issues! Consequences of not following dress code/body piercings rules 1st offense – the athletic training student will receive a warning and will have the opportunity to correct the non-compliance. If not able to do so, the athletic training student will be sent home and five percentage points will be deducted from their clinical course grade. With each additional offense the athletic training student will be sent home and five percentage points will be deducted from their clinical course grade. Athletic Training Room Responsibilities Hours In general, the athletic training room hours vary depending on season schedules. The student’s schedule will depend on sport assignments. Recording of Approved Hours for the Clinical Experience Classes The athletic training student logbook is designated for recording approved hours for the clinical experience classes only. These hours include pre and post-practice or game treatments and taping, practice or game observation, attending staff meetings, and the performance of some administrative duties. The student shall record the time started, the time ended, and the total time in quarter hour increments. The sport assisted with and the activity involved should also be entered. Athletic training students employed as Athletic Training Student Administrative Assistants will have two (2) separate time logs. More detailed instructions for completing the athletic training student logbook are located in Appendix D. Field and Clinical Experience Contact Hours Policy

– Scheduling of Field Experience hours will vary due to exposure requirements and planned activities/events.

– In general o Students will not acquire more than 20 hours of Field Experience per week.

Depending on the rotation a student may exceed 20 hours, however the average of the weeks should not exceed 20 hours.

o Students will work with the preceptor and other students on the same rotation to develop their own schedule based on the demands of the rotation.



o Students will be assigned weekend (Friday, Saturday, Sunday) events based on exposure requirements and planned activities/events. Events may require more or less time depending on the sport. In general, the student working an event is expected to be present in the Athletic Training Room or at the event site from the time pre-event preparation begins until after post event treatments and cleanup is complete. Pre-event arrival times and anticipated post event duty completion times will be posted with the schedule

Schedules Field experience schedules will be periodically posted as needed. These schedules will generally cover an extended period of time with daily athletic training room and event coverage. It is the responsibility of each athletic training student to check the schedule each day he/she works to see if there have been any time changes or date changes. Coaches usually will not consult with us when they make or change schedules; you have to be ready and able to adapt. If you are scheduled to cover a game or practice and the time changes from the original schedule, you are still responsible for coverage at the new time. If you are unsure of your schedule, ask. Recordkeeping Records of all treatments and rehabilitation exercises performed shall be kept in Sportsware. Remember that this information is the personal medical history of the person treated and cannot be distributed without the individuals’ permission. In the event that the Sportsware program is not available (e.g. malfunctioning computer), all treatments should be written down for future entry. Injury Reports Injury reports must be completed for any treatment performed on the athlete (i.e, ice, cold bath, e-stim, etc). An initial injury report should be completed at the time of the initial evaluation with any follow-up re-evaluations completed as needed. Daily changes in the condition of an injury can be noted on the athletes' treatment record. Treatment Records All treatments and rehabilitative exercises performed in the athletic training room, at practices, games, or on trips should be recorded in Sportsware. Application of Tape and Wraps The athletic training staff will decide what type (if any) of wrap or tape will be applied. Individuals with a chronic ankle joint instability or recent injury should be taped. All ankle taping must be preceded by the pre-ankle taping exercises, lower leg proprioceptive program, and/or ankle strengthening exercises. Any ankle taping requiring heavy elastic tape such as Elastikon or AC Tape (with the exception of an Achilles taping without ankle instability) must be applied directly to the skin.


Colorado Mesa University Athletic Training Program Biohazardous Waste Protocol In any situation during which there is a potential for exposure to blood borne pathogens (BBP), proper protective equipment must be worn. Nitrile gloves will be available for use when cleaning and or dressing any open wound. A barrier gown and facemask with eye shield should be worn in any situation where they are needed. These items, as well as cleaning supplies, will be kept in the biohazardous cleanup (red) bags and be readily available at all practices and games. Husky 891 will be the cleaning solution used to decontaminate surfaces and uniforms. Control 35 or antiseptic bio-hand cleaner should be used for washing skin that may have been exposed to a BBP. A copy of the current OSHA Guidelines are available in the Head Certified Athletic Trainers Office. Occupational Safety and Health Administration (OSHA) Recommendations and Guidelines Students in KINE 240-Introduction to Clinical Athletic Training or those completing a an independent observation are required to attend a Blood Borne Pathogens (BBP) lecture and pass a written test regarding the material prior to having any physical contact with the athletes. It is the student’s responsibility to understand and follow the OSHA guidelines. Colorado Mesa University Athletic Training staff members and athletic training students will utilize “universal precautions” when in any situation where they may come in contact with any body fluid other than sweat. “Universal Precautions” include the use of personal protective equipment (PPE) and proper disposal of materials that have been exposed to a potential pathogen. All athletic training students officially accepted into the Athletic Training Program require vaccination for the Hepatitis B virus (HBV), at their own expense, prior to the beginning of their involvement in the clinical courses and rotations. See NATA Blood Borne Pathogens Guidelines for Athletic Trainers (Appendix L). A copy of OSHA guidelines and recommendations is located in the Head Athletic Trainers Office. In the event of an exposure to BBPs while engaged in the duties of a volunteer athletic training student, the incident must be reported to the preceptor supervising the activity. If antibody testing is indicated, it is the financial responsibility of the student. Contaminated Materials Reusable supplies - Reusable supplies such as towels or elastic wraps which have been contaminated by fluids containing a possible BBP should be placed in the marked “Contaminated Towel” container to assure that proper handling of the material is carried out during the laundry process. Biohazardous waste - All biohazardous waste will be disposed of in a properly labeled container.


Colorado Mesa University Athletic Training Program This is to include any dressings, bandages, or wound care materials that have been contaminated by blood or other body fluids. Modalities and Rehabilitation Equipment The athletic training staff, within the guidelines established by the team physicians, controls the use of the modalities and rehabilitation equipment. Athletic training students should not let the athletes dictate what treatment is done. See Approved Treatment Methods - Appendix F

Non-Sexual Evaluation Guidelines At all times you must be conscious of the possibility that your actions during an evaluation may be interpreted as a form of sexual misconduct. If the “victim” feels that they have been violated, then you did something wrong. It is your responsibility to explain and get permission from the athlete before completing any visual inspection, palpation, range of motion, strength or stress tests which may be misinterpreted as sexual in nature. If possible, have additional witnesses present during all evaluations to verify the events that occurred. Complaints will be evaluated and handled on an individual basis. Evidence supporting intentional sexual misconduct will automatically result in dismissal with no possibility of reinstatement, in addition to charges that the victim may wish to file. Avoid comments intended as jokes that may be interpreted as sexual harassment. Cleaning All athletic training students completing field experiences/clinical classes are responsible for cleaning. All tabletops, counters, rehabilitation equipment, and modalities will be cleaned as needed, or once daily, with Husky 891. Ultrasound heads and non-foam muscle stimulation pads will be cleaned with an alcohol swab after each use. Water coolers and ice chests will be cleaned with Control 35 following each use. The floor should be swept as needed during the day and will be cleaned by the custodial staff daily. All students will be assigned cleaning duties on a weekly basis throughout the semester. Failure to perform the expected cleaning duties will be reflected in your clinical grade. Game-day and Practice Duties Game-day duties will be assigned during pre-game preparation and will be determined by available personnel and the sport participating. Practice duties will be assigned during pre-practice preparation and will be determined by available personnel, the sport(s) practicing and any other activities that may be occurring. Individual Equipment Upon beginning the Field Experiences courses, athletic training students will be issued a fanny


Colorado Mesa University Athletic Training Program pack, scissors, mouth-to-mask resuscitation device, and pen light. In addition to this emergency equipment, it is recommended that you also maintain a fresh supply of nitrile gloves, first aid supplies, and tape. The objective behind the fanny pack is to allow you a way to keep a small amount of anything you might need to handle a mild injury during a practice or game without having to run to where the medical kit is. You are personally responsible for the issued equipment and it must be returned at the termination of your involvement with the Colorado Mesa University Athletic Training Program. If equipment is lost, you are responsible to pay for replacement of the equipment. The replacement cost for this equipment is $95. You will be issued a staff t-shirt to wear during practice and treatment times. You will also be issued an official event shirt to be worn only during events at which you are scheduled to cover.



SECTION V – Emergency Procedures

Communication Signals Ambulance - phone (thumb to ear, fifth finger to mouth) Injury description:

Head, neck, or back - left forearm vertical in front of chest fist closed Head injury - R hand on L fist Neck injury - R hand around L wrist Back injury - R hand up and down L forearm Fracture/dislocation - X with forearms above head Upper ext. - R hand across chest Lower ext. - R hand on leg

Equipment:

Stretcher - both arms abd/add in transverse plane (safe) O2 - hand over mouth Immobilizer bag - one arm in shoulder flexion to 90 degrees in front of or in abduction to 90° beside the body Biohazard bag - hand on back of head Vacuum splints - arms across chest AED - right fist to right upper chest, left hand to left lower chest Dr. - motion Additional students - hand in air with number of fingers, then hand to head same number of times


Colorado Mesa University Athletic Training Program Emergency Equipment Designated emergency equipment such as medical kit, vacuum splints, crutches, immobilizer bag, bio-hazard bag, oxygen, and stretcher should be present and readily available at all games and at high risk practices. This equipment should be inspected daily for completeness and functional ability. Equipment check-off lists for each bag are kept on file. It is the responsibility of the athletic training student(s) assigned to a particular practice or event to check/stock the equipment. General Emergency Plan All injuries requiring immediate medical attention (with the exception of possible spinal injuries or head injuries resulting in loss of consciousness lasting longer than 5 minutes) will be referred to Community Hospital Emergency Room (12th and Walnut - 256-6404 / 242-0920). Possible spinal injuries or head injuries resulting in loss of consciousness lasting longer than 5 minutes will be transported by ambulance to St. Mary’s Hospital Emergency Room. The reason that these injuries will be referred to St. Mary’s is the potential need for certain trauma care that is not available at Community Hospital. The team physicians should be notified if an athlete is referred to either Emergency Room. These injuries include but may not be limited to spinal injuries, respiratory emergencies, cardiorespiratory emergencies, severe concussions, dislocations, possible fractures to large bones, unstable fractures to small bones, lacerations requiring sutures, any injury resulting in a gross deformity, anaphylactic reactions, or if the athlete remains in a hysterical mental state. The decision to transport to the hospital by ambulance or by private vehicle will be based on the stability of the injury and the availability of proper equipment. All possible spinal injuries should be transported by ambulance utilizing appropriate immobilization methods.

For a complete review on emergency procedures and considerations, review the NATA position papers provided electronically in the Athletic Training Download folder located on the H drive. Emergency Action Plans for specific venues are located in Appendix C. Suspected Spinal Injury Protocol General Guidelines

• Any athlete suspected of having a spinal injury should not be moved and should be

managed as though a spinal injury exists. C-spine in-line stabilization should be maintained.

• The athlete's airway, breathing, circulation, level of consciousness and neurological status should be assessed. If airway is impaired, maintain c-spine in-line stabilization simultaneously with airway using a modified jaw thrust maneuver. If the athletes



breathing is inadequate, assist ventilations with bag-valve-mask and supplemental oxygen.

• EMS should be activated.

• The athlete should not be moved until immobilized unless absolutely essential to maintain airway, breathing and circulation. If the athlete must be moved, the athlete should be placed in a supine position while maintaining spinal immobilization.

• In a situation where it may not be appropriate for on-site medical personnel to transfer the athlete to a spine board prior to EMS arrival (lack of enough qualified help or other factors), the rescuer(s) should maintain in-line stabilization, place a rigid cervical collar on (if possible), and continue to monitor baseline vital signs and complete secondary evaluation while awaiting EMS.

o If you do not feel comfortable leading, assisting, or performing any tasks asked of you, voice your concerns and remove yourself for the safety of the athlete.

Spine Immobilization

• If possible, a correctly sized rigid cervical collar should be placed on athlete prior to moving.

• When moving a suspected spine-injured athlete, the head and trunk should be moved as a unit by securing the athlete to a spine board. The maneuvers that should be used to place the athlete on the spine board are:

o Supine log roll technique o Prone log roll technique (push or pull) o Lift and slide technique (3 person) o Lift and slide technique (6 person)

See CMU Immobilization Techniques Attachment below

• The rescuer controlling c-spine stabilization will be in command of log roll maneuver and spine board immobilization.

• Once positioned onto long spine board, the athlete's torso and legs should first be secured, using spider straps. One of the athlete's arms should be left free from spine board straps to facilitate vital sign monitoring and IV access. Athlete's wrist may be secured together in front of the body with velcro strap or tape.

• Once torso and legs are secured, the head should be secured last. If necessary, padding should be applied under the athlete's head to fill any voids and maintain neutral in-line position. The head should be secured with lateral restraint pads and then secured to board with tape or orange straps over forehead and at chin.

• Following securing athlete to board, neurological status should be reassessed.



• The secondary survey should be completed with baseline vital signs (reassessed every 5

minutes), and a head-to-toe survey.

• Athlete should be transported to the most appropriate emergency medical facility and head team physician and appropriate subspecialist(s) notified.

Additional Guidelines for Care of Spine-Injured Football Athlete

• The facemask should be removed prior to transportation, regardless of current respiratory status. Tools for facemask removal (FM Extractor, Trainers Angel, electric screwdriver) should be readily accessible. They are in both the football and lacrosse helmet removal kits

• All loop straps of the facemask should be cut and the facemask removed from the helmet, rather than being retracted.

• The football helmet and chin strap should only be removed if:

1. the helmet and chin strap do not hold the head securely, such that immobilization of the helmet does not immobilize the head;

2. the design of the helmet and chin strap is such that, even after removal of the facemask, the airway cannot be controlled nor ventilation provided;

3. the facemask cannot be removed after a reasonable period of time; 4. the helmet prevents immobilization for transportation in an appropriate manner.

• If the helmet must be removed, spinal immobilization must be maintained while removing. In most circumstances, it may be helpful to remove cheek padding and/or deflate air padding prior to helmet removal.

• The front of the shoulder pads can be opened to allow access for CPR and defibrillation. Cut the sternal plate strings and spread apart the pads.

• Should either the helmet or shoulder pads be removed – or if only one of these is present – appropriate spinal alignment must be maintained.

Procedures for Training in Spine Immobilization: Personnel should review signs and symptoms of spine injury and complete a training session each year with in-line stabilization, rigid cervical collar application, log roll maneuver, and long spine board packaging. Personnel providing football medical coverage should review facemask removal with appropriate tools, helmet removal and shoulder pad removal. Colorado Mesa University-- Spine Immobilization Techniques

Taken directly from the NATA Position Statement: Acute Management of the Cervical Spine Injured Athlete. Journal of Athletic Training 2009;44(3):306–331


Colorado Mesa University Athletic Training Program Remember that there are many challenges that may arise during the process. The athletes’ size, where they are located, how many people are at your disposal, and the position they are found in are all determining factors in deciding which technique to use. Use the technique that the group is comfortable with. Supine Log Roll Technique When transferring an athlete found in the supine position to a spine board, the supine log-roll technique may be used.

• The rescuer in charge (rescuer 1) provides cervical spine stabilization. • Ideally, 3 additional rescuers are positioned on 1 side of the athlete, with rescuer 2 at the

shoulders and thorax, rescuer 3 at the hips, and rescuer 4 at the legs. Rescuer 5 is positioned on the opposite side of the athlete with the spine board.

• Rescuers 2 through 4 reach across the athlete and, on command from rescuer 1, carefully roll the athlete toward them while rescuer 5 positions the spine board at a 45 degree angle beneath the athlete.

• On command, rescuers 2 through 4 slowly lower the athlete as rescuer 5 controls the spine board.

• Throughout this process, rescuer 1 provides all commands while maintaining manual cervical spine immobilization.

• The supine logroll technique may also be used for the athlete found in the side-lying position.

Prone Log-Roll Technique (Push and Pull) When transferring an athlete found in the prone position to a spine board, the prone log-roll technique may be used. Two variations to this technique are the prone log-roll pull and prone log-roll push.

• In the prone log-roll pull, the rescuer in charge (rescuer 1) provides cervical spine stabilization, crossing his or her hands initially, so that when the roll is complete, the hands are uncrossed.

• Ideally, 3 additional rescuers are positioned on 1 side of the athlete, with rescuer 2 at the shoulders and thorax, rescuer 3 at the hips, and rescuer 4 at the legs.

• Rescuer 1 directs the other rescuers to position themselves on the appropriate side of the athlete. In some instances, the athlete may be prone with the head turned to 1 side. In this case, rescuer 1 directs rescuers 2 through 4 to position themselves on the side opposite the athlete’s face. Rescuer 5 is positioned on the same side as the other rescuers, holding the spine board at the feet of the athlete.

• Rescuers 2 through 4 reach across the athlete and, on command from rescuer 1, carefully roll the athlete by pulling toward them.

• When the athlete is pulled onto his or her side, rescuers 1 through 4 pause while rescuer 5 carefully slides the spine board between rescuers 2 through 4 and the athlete.

• On command, rescuers 2 through 4 slowly lower the athlete as rescuer 5 controls the spine board.

• Throughout this process, rescuer 1 provides all commands while maintaining manual cervical spine immobilization.



• It may be difficult for rescuer 5 to slide the spine board between the athlete and rescuers 2 through 4 without touching each other’s arms and possibly jeopardizing their hold on the athlete. To address this issue, an alternative technique is the prone log-roll push, shown in Figure below.

Lift-and-Slide Technique (6 person and 3 person) An alternative to the log roll is the lift-and-slide transfer technique. Variations include the 6–plus-person lift and the straddle lift and slide. In contrast to the log roll, in which the athlete is rolled to a side-lying position and the spine board is positioned beneath him or her, with the lift-and slide technique the athlete is simply lifted off the ground to allow for spine board placement.

• The premise behind the lift-and-slide technique is that the work of lifting the athlete is handled efficiently by involving 4 to 7 rescuers. In addition, this technique avoids rolling the injured athlete over the arm, as well as over possibly bulky protective equipment, and, therefore, this technique may be extremely effective at minimizing structural interference that could result in unwanted spinal column movements.

• The lift and-slide technique may only be used for supine athletes, whereas a prone athlete must be log rolled for transfer to a spine board.

• The 6–plus-person lift is shown below. • A disadvantage of this procedure is that it requires 6 additional rescuers. • An alternative lift technique may be used with 3 rescuers who straddle the athlete rather

than lifting from the side; this is referred to as the straddle lift and slide.



• With the straddle lift and slide, rescuer 1 provides cervical spine stabilization. • Three additional rescuers straddle the athlete, with rescuer 2 at the upper torso, rescuer 3

at the hips and pelvis, and rescuer 4 at the legs. • On command from rescuer 1, rescuers 2 through 4 lift the athlete approximately 6 inches

(15.24 cm) off the ground while rescuer 5 slides the spine board beneath the athlete. • On command, rescuers 2 through 4 slowly lower the athlete onto the spine board.

Throughout this process, rescuer 1 provides all commands while maintaining cervical spine immobilization.

6 person lift

3 person lift Concussion Management Protocol POLICY STATEMENT: This document outlines procedures to assist in the management of concussions and the safe return-to-play for athletes at Colorado Mesa University. **NOTE: A multifaceted approach to concussion management is suggested. As a result, the information provided by this protocol and the tools it references should be taken into consideration on a case-by-case basis, with an emphasis on “the whole picture.” Therefore, in certain cases, modifications to this protocol may be deemed appropriate by the athletic training staff.

ENTITIES TO WHOM THIS POLICY APPLIES: Colorado Mesa University Athletics Staff, Student-Athletes, Team Physicians, and First Responders.


Colorado Mesa University Athletic Training Program PURPOSE: To develop an articulate and thorough method for the recognition, evaluation, and management of student-athletes who have sustained a concussion. More specifically, to:

a) ensure the proper diagnosis and management of concussions; b) prevent second-impact syndrome, which results when a second concussion is

sustained while an individual is still recovering from an earlier concussion and which may cause permanent brain damage or even death;

c) and monitor student-athletes’ recuperation in hopes of preventing prolonged recovery DEFINITION: According to the 3rd International Conference on Concussion in Sport (Zurich, 2008)1:

Concussion is defined as a complex pathophsyiological process affecting the brain, induced by traumatic biomechanical forces. Several common features that incorporate clinical, pathologic, and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include: 1. Concussion may be caused either by a direct blow to the head, face, neck, or elsewhere on the body with an

‘impulsive’ force transmitted to the head. 1. Concussion typically results in the rapid onset of short-lived impairment of neurologic function that

resolves spontaneously. 2. Concussion may result in neuropathological changes but the acute clinical symptoms largely reflect a

functional disturbance rather than a structural injury. 3. Concussion results in a graded set of clinical symptoms that may or may not involve loss of

consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course; however it is important to note that in a small percentage of cases however, post-concussive symptoms may be prolonged.

4. No abnormality on standard structural neuroimaging studies is seen in concussion.

No two concussions are the same, even for a single athlete. As a result, at the time of injury, it is impossible to predict the duration and severity of symptoms that athlete will experience. For this reason, it has been recommended that the severity of a concussion should not be graded until all symptoms have resolved.2

1. The Pre-participation Evaluation (PPE) a. Incoming Athletes:

i. The PPE for incoming athletes will contain the NOCSAE Concussion Survey.

ii. ATC’s will review the NOCSAE Concussion Survey and any positive responses will be further assessed via a face-to-face interview conducted by ATC’s.

iii. Any concerns will subsequently be addressed with the team physician’s, following which individualized diagnostic and management plan will be formulated.

b. Returning Athletes: i. Will be administered the NOCSAE Concussion Survey at the first team

meeting in August 2013. 1. This will ensure that all returning athletes have consistent data on

concussion history, as compared to incoming athletes in 2013. ii. Any concerns will subsequently be addressed with the CMU team

physicians, following which individualized diagnostic and management plan will be formulated.



2. Baseline Neurocognitive Testing

a. Currently, we do not possess the human resources to accurately obtain and validate baseline ImPACT™ data.

b. Therefore, baseline ImPACT™ test will be performed for the following athletes: i. Those with diagnosed and documented attention deficit disorder (ADD),

attention deficit hyperactivity disorder (ADHD) / learning disabilities (LD).

ii. Those with a history of any prior concussions, regardless of chronology. iii. Those with concussions during the summer prior to each season, including

returning and incoming athletes (who may have had an injury concerning for concussion after completing their initial PPE):

1. Athletes who may need baseline ImPACT™ testing will be identified by 2 questions posed by ATC’s at the first pre-season meeting:

a. “Did you have a head injury during the summer?” b. “Were you diagnosed with a concussion by a healthcare provider

during the summer?” 2. Those who have had injury concerning for concussion (whether

diagnosed or not) will be administered the NOCSAE Concussion Survey at the first team meeting.

3. This questionnaire will be evaluated by the Athletic Training Staff and following a face-to-face interview with athletes, team physicians will be consulted as needed to ascertain the need for baseline ImPACT™ testing.

3. Recognition of Concussion (common signs and symptoms of sports-related concussion) a. Signs (observed by others):

i. Athlete is dazed or stunned ii. Confusion

iii. Disorientation –unsure about surroundings (time of day or contest), score, opponents name)

iv. Altered coordination v. Forgetfulness

vi. Balance problems vii. Personality change

viii. Responds slowly to questions ix. Forgets events prior to hit (retrograde amnesia) x. Forgets events after the hit (antegrade amnesia)

xi. Loss of consciousness (LOC; any duration) b. Symptoms (reported by athlete):

i. Headache ii. Nausea or vomiting



iii. Vision changes: 1. Blurry vision 2. Double vision (diplopia) 3. Light (photophobia)

iv. Ear symptoms: 1. Ringing in the ears (tinnitus) 2. Sound sensitivity (phonophobia) 3. Sensation of tilting and whirling in stable surroundings (vertigo)

v. Feels “sluggish”, “fatigued” and “foggy” vi. Concentration problems

vii. Memory problems viii. Psychological –including aggression, depression, altered sleep, emotional

instability, irritability c. General cognitive status will be determined by the Standard Assessment of

Concussion (SAC) Test: i. Rationale includes:

1. SAC Test is a valid sideline assessment of cognition. 2. It is not a diagnostic tool, or a substitute for clinical or

neuropsychological evaluation. 3. There is no change in data by using either forms A, B, or C. 4. There is no change – high school vs. college OR practice vs games. 5. 85% of athletes score > 25 at baseline. 6. Following concussion –Score drops ~ 3-4 points

Remove from activity d. If an athletic trainer (staff or student) or coach suspects the athlete has sustained a

concussion, the athlete should be removed from activity immediately. e. Athlete should not be allowed to return to activity that day.

4. Referral for further management

a. Either during or after contests, ATC’s will activate EMS and facilitate transport (by EMS personnel) to nearest emergency department for:

i. Athletes with witnessed loss of LOC (of any duration): 1. These athletes will be spine boarded prior to transport.

ii. Athletes with symptoms of a concussion who either develop new symptoms or signs or whose symptoms and signs worsen on serial, sideline assessments.

iii. Athletes who exhibit any of the following signs or symptoms: 1. Decreasing level of consciousness. 2. Deterioration of neurological function. 3. Decrease or irregularity in pulse and respirations. 4. Unequal, dilated, or unreactive pupils. 5. Any signs or symptoms of associated injuries, spine or skull fracture,

or bleeding (nasal or ear discharge of CSF, bruising of orbits, bruising over mastoid [Battle’s sign]).



6. Mental status changes: lethargy, difficulty maintaining arousal, confusion or agitation.

7. Seizures. 8. Cranial nerve deficits.

b. Either during or after contests, athletes who are symptomatic but stable, and yet need further emergent evaluation:

i. May be transported by the involved ATC, with or without student athletic trainers / parents, to the nearest emergency department.

ii. The option of transportation by EMS personnel will always be offered. Parents may transport if they so desire. The parents will be educated of the potential risk factors that could occur during transport. They will be instructed to go straight to the appropriate emergency room.

c. Coaches responsibilities: i. During home contests:

1. If an ATC is attending to another injury, all head injuries will be reported by coaches immediately to the ATC, and / or team physician for medical assessment and further management.

ii. During travel without ATC’s: 1. Coaches will take to each contest:

a. Health insurance information. b. Signed waivers from athletes > 18 years of age, allowing

them to notify medical information to parents, either on-site or via telephone.

2. If an athlete has an injury concerning for concussion, coaches will seek assistance from the host site ATC.

3. If the host site ATC is unavailable, coaches will: a. Activate EMS (as needed). b. Contact the ATC at CMU in charge of their sport, in order

to initiate prompt management. c. Notify the parents of the injury and potential concussion.

i. If a waiver allowing coaches to communicate with parents is unavailable and the athlete is alert, coaches will obtain verbal permission from the athlete prior to communicating with parents.

d. Advise parents of the need for formal evaluation by a health care provider prior to travel to Grand Junction or to any other destination.

e. Accompany athlete and parents, or designate an assistant coach to accompany athlete and parents, to the nearest emergency department.

4. If the ATC is unavailable, and the athlete’s parents cannot be reached, coaches will:

a. Activate EMS (as needed). b. Refer athletes to the nearest emergency department.



c. Accompany athlete and parents, or designate an assistant coach to accompany athlete and parents, to the nearest emergency department.

d. Remain with the athlete or advise designated assistant coach to remain with the athlete until discharge from the emergency department or until the parents arrive at the emergency department.

e. Contact the ATC at CMU in charge of their sport, in order to initiate prompt management upon return to CMU.

5. Coaches will not allow athletes with injuries concerning for concussion to drive home, either as the passenger or driver, until medically cleared by a health care professional.

5. Role of the Certified Athletic Trainer

a. Assess injury. b. Counsel athletes:

i. On the potential for significant brain damage with a single and multiple concussions.

ii. On the importance of good sleep hygiene, diet, and adequate fluid replacement, and avoidance of all alcoholic beverages.

iii. On “Home Instruction Sheet”, review warning signs, and provide emergency phone numbers (Emergency Department, ATC, Team Physicians).

iv. To refrain from any and all physical activity until medical clearance. c. Maintain appropriate documentation regarding assessment, referral, and

management of the injury. d. Referral to the Team Physician for “diagnosis” of concussion. e. Accompany and remain with the athlete at the Emergency Department until either:

i. Athletes’ safety and a medical plan have been established –with a plan for aided transport from the emergency department to either their home or dormitory.

ii. Athlete is discharged from the emergency department. iii. Athletes’ parents arrive at the emergency department.

f. Provide coordinated care with: i. Athlete:

1. Assessment and documentation of “symptom check” on daily basis.

2. ImPACT™ testing: a. Initial test will be performed 2-3 days after injury and

development of symptoms concerning for concussion. b. A normal test, along with documentation that an athlete has

zero symptoms and a normal neurological examination, will allow the athlete to commence a return to play protocol (as per Zurich Guidelines).



c. Repeat testing may be performed no sooner than every 5 day’s for athletes whose initial test was abnormal or for those who had / have persistent symptoms during initial / repeat testing.

d. Between stages 3 and 4 of return to play protocol (as per Zurich Guidelines).

e. Additional testing as needed and as directed by team physicians’.

ii. Health Care Team (Team Physicians, Neuropsychologist, Vestibular Therapist):

1. Communication following each clinic visit. 2. Obtain and file physician’s notes in athlete’s medical records in the

Athletic Training Room. iii. Teachers:

1. Help establish academic accommodations. 2. Provide academic accommodations form to athlete and teachers. 3. Communicate with teachers regarding compliance with

accommodations and progress during recovery from concussion. iv. Athlete’s parents:

1. If athlete is a minor. 2. As needed, if athlete is > 18 years of age, after verifying signed

waiver granting permission for communication.

6. Return to Activity Guidelines: a. Return to activity (RTA) guidelines:

i. Entirely symptom free at rest including: 1. Lack of symptoms following attendance at school classes and

academic assignments. 2. No negative feedback from teachers as documented on “Teacher

Data Form”. 3. Documented normal neurological examination by trained health

professionals. 4. Normal head imaging (CT, MRI as needed) and / or medical

clearance by Neurologist / Neuropsychologist. 5. Normal ImPACT™ test data:

a. Without reliable change indices from baseline to post-concussion testing (if reliable baseline is available).

b. Compared to normative data (if reliable baseline is unavailable) using either grades or standardized test scores (STS; preferable if available):

i. A/B student, High STS = 65th percentile or higher ii. B/C student, Average STS = 35th percentile or

higher



iii. D/F student, Low STS, LD, ADHD = 20th percentile or higher

ii. Written clearance by Team Physician for RTA as per Zurich and NATA guidelines.

iii. All stages RTA will be supervised by ATC. iv. Miscellaneous considerations:

1. Progression during various stages of RTA will be individualized. 2. Athletes with a prior history of concussion, those who had an

extended duration of symptoms, or those participating in a collision or contact sport may be progressed more slowly at the discretion of the medical staff.

3. Athletes, coaches and parents will be counseled on factors that may slow the rate of progression through various stages of RTA including:

a. Sport. b. Athletes involved in contact sports, with a previous history

of concussion and extended duration of symptoms. c. Duration and character of symptoms. d. Athlete age.

References:

• McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on Concussion in Sport 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Clin J Sport Med 2009; 19:185.

• McCrea M et al. The standardized assessment of concussion (SAC): Manual for administration, scoring, and interpretation. Clinical Instrument and Manual published and distributed by Brain Injury Association (BIA), Washington DC, 1997.

• Evans, RW. Concussion and mild traumatic brain injury. Up-To-Date. Accessed March 3rd, 2013.

• www.impacttest.com. Accessed March 4th, 2013. • Flanagan, DP and Caltabiano, LF. Test scores: A guide to understanding and using Test

Results. Helping Children at Home and School II: Handouts for Families and Educators. National Association of School Psychologists. Accessed on August 7th, 2013.

• SAT® Percentile Ranks. Accessed on August 7th, 2013. http://media.collegeboard.com/digitalServices/pdf/research/SAT-Percentile-Ranks-2012.pdf

Cardiorespiratory Emergencies Emergency respiratory equipment consisting of the bag-valve-mask (BVM) resuscitator will be kept in the “Immobilizer Bag”. The immobilizer bag should be present and readily available at all games and at any high-risk practice. For football and lacrosse, a pair of Trainers Angels and/or FM extractor, designated for the use of cutting facemask clips, will be in the purple bag. Oxygen will also be available at all game situations involving high-risk sports. Any suspected Athletic Training Program Student Handbook Revised 12/2013

http://www.uptodate.com/contents/concussion-and-mild-traumatic-brain-injury/abstract/57



http://www.impacttest.com/

http://media.collegeboard.com/digitalServices/pdf/research/SAT-Percentile-Ranks-2012.pdf

http://media.collegeboard.com/digitalServices/pdf/research/SAT-Percentile-Ranks-2012.pdf

Colorado Mesa University Athletic Training Program cardiorespiratory or respiratory emergency shall be referred to Community Hospital Emergency Room or the nearest emergency medical facility. The decision to transport by ambulance or private vehicle will depend on the condition of the individual, proximity to the emergency medical facility, and response time of the local EMS. Policy on Automated External Defibrillator Availability and Use In the Maverick Center, automated external defibrillators (AED) are located in Brownson Arena, the work room (cast/pad room) and the Monfort Family Human Performance Lab. As part of the emergency plan for home events, an AED will be made available. In accordance with the National Athletic Trainers’ Association Position Statement: Emergency Planning in Athletics, the use of an AED in the event of a cardiac emergency is limited to those who have received formal training in its operation. Inclement Weather Guidelines Severe weather includes but is not limited to: heavy rain, blizzard conditions, hail, extreme cold (wind chill index below 0 degrees F), extreme heat (temperature above 110 degrees F), tornado, and lightening (flash to bang interval of less than 30 sec. or lightning detector reading of 0-8 miles). For contests, game officials (following NCAA rules) will determine if a contest is delayed due to weather. In the event of lightning, the officials will be notified if the lightning detector has a reading of 0-8 miles. For practices when severe weather occurs, ALL Colorado Mesa Athletic Department outdoor practices will be discontinued and the participants will be instructed to enter the Maverick Center or the nearest solid structure. It will be responsibility of the Head Coach or the Coach in Charge and an assigned Athletic Training Staff member (if present) at the practice to monitor the weather conditions. The Athletic Training Staff member will make recommendations to the Head Coach or the Coach in Charge regarding the discontinuation of practice. The decision to discontinue practice will be made by the Head Coach or Coach in Charge. The Lightning detector will be taken to all outdoor events and any outdoor practice when the weather conditions indicate that a threat of lightning may exist. l. General Policy In the case of inclement weather (i.e. Thunderstorms/Lightning, Hail, Hurricane, Tornado), it will be under the direct discretion of the on-site Certified Athletic Trainer to determine if the practice/game fields should be evacuated. Exceptions will be made for practices/events, whereby the head coach will have to suspend activity in the absence of an Athletic Training staff member.


Colorado Mesa University Athletic Training Program Lightning Lightning is a dangerous phenomenon. The athletic training staff has developed a lightning policy to minimize the risk of injury from lightning strike to Colorado Mesa University athletes, coaches, support staff and fans. To monitor lightning the Athletic Training Staff will utilize both the Flash-Bang method and a Sky Scan Lightning Detector. Athletic teams that practice and compete outdoors are at risk when the weather is inclement. For this reason the following guidelines, adopted from the NCAA and NATA, must be observed if it appears that lightning is possible for the area:

1. If inclement weather is forecasted for the area or sighted in the area, an athletic trainer will get a weather update via the National Weather Service. Internet sites are as follows:

http://www.weather.com/ http://www.accuweather.com/ http://www.lightningsafety.com/

2. Lighting detectors will be situated on the outside fields during the possibility of inclement weather. If lighting is detected and the severe weather signal is illuminated, with two subsequent readings within 30 seconds on the detector at 3-8 mile range regardless of the presence of visible lightning, all athletes and personnel must evacuate the fields and/ tennis courts and seek shelter. The nearest safe shelter is Brownson Arena. (applies to soccer(s), tennis(s), baseball practice field, softball, football practice field).

3. If the lightning detector is not present, use the countdown or "Flash Bang" method. To use the Flash Bang method, count the seconds from the time lightning/flash is sighted to when the clap/bang of thunder is heard. Divide this number by 5 and equals how far away (in miles) the lightning is occurring. For example, 20 second count = 4 miles). As a minimum, the NCAA and the National Severe Storms laboratory (NSSL), strongly recommend that all individuals have left the athletic sites and reach a safe location by the flash-to-bang count of 30 seconds (6 miles). However, lightning can strike as far as 10 miles and it does not have to rain for lightning to strike. Activities will be terminated at the 40 seconds or 8 miles.

4. If lightning is in the immediate area, the Certified Athletic Trainer will notify the head coach as to the status of the inclement weather and of need to take shelter. Teams may return to the field once the lightning detector has detected no activity in the 3-8 mile range or 30 minutes from last sight of lightning.

5. If no safe structure is within a reasonable distance, then other safe areas include: enclosed buildings, fully enclosed metal vehicles with windows up (no convertibles or golf carts Unsafe shelter areas: water, open fields, dugouts, golf carts, metal objects (bleachers, fences, etc.), individual tall trees, light poles. AVOID BEING THE HIGHEST OBJECT IN AN OPEN FIELD. ***Athletes/coaches etc. should not stand in groups or near a single tree. There should be 15 ft between athletes (NLSI, 2000).


http://www.weather.com/

http://www.accuweather.com/

http://www.lightningsafety.com/


Note: sports with metal equipment. Golfers drop your clubs and remove shoes, baseball/softball drop bats and remove shoes, tennis drop rackets.

If unable to reach safe shelter, assume a crouched position on the ground with only the balls of the feet touching the ground, wrap your arms around your knees and lower your head. Minimize contact with the ground, because lightning current often enters the victim through the ground rather than by a direct overhead strike. Do not lie flat! If safe shelter is only a short distance away, it’s been suggested to run for shelter, rather than stay in middle of field.

6. If a person feels that his/her hair standing on end, they should immediately crouch as described in item # 5. If someone is struck by lightning, activate the Emergency Action Plan. A person struck by lightning does not carry an electrical charge; immediately initiate the EAP and begin the primary survey. If possible move victim to a safe location.

7. Avoid using the telephone except in emergency situations. People have been struck by lightning while using a land-line phone. A cellular phone or a portable phone is a safe alternative to land-line phones, if the person and the antenna are located within a safe structure, and if all other precautions are followed.

Event Procedures

Prior to Competition: A member of the Athletic Training staff will greet the officials, explain that we have means to monitor lightning, and offer to notify the officials during the game if there is imminent danger from the lightning.

Announcement of Suspension of Activity: Once it is determined that there is danger of a lightning strike, the Athletic Training staff member will notify the head coach and official and subsequently summon athletes (via horn or whistle) from the playing field or court.

Evacuation of the playing field: Immediately following the announcement of suspension of activity all athletes, coaches, officials and support personnel are to evacuate to an enclosed grounded structure (CMU/Gymnasium/Locker rooms).

Evacuation of the stands: During competition once the official signals to suspend activity, a member of the Sports Information staff will announce via the PA system something like: “May I have your attention. We have been notified of approaching inclement weather. Activity will cease until we have determined it is safe and the risk of lightning is diminished. We advise you to seek appropriate shelter at the following areas: CMU Lobby/Gymnasium. Though protection from lightning is not guaranteed, you may seek shelter in an automobile. Thank you for your cooperation.”

Resumption of Activity: Activity may resume once a member of the Athletic Training staff gives permission. Thirty (30) minutes AFTER the last lightning strike or activity using the Flash-Bang-Method and no activity in the 3-8 mile range.

Away events: apply the home/facility EAP or modify the CMU guidelines that apply accordingly.


Colorado Mesa University Athletic Training Program Heat Index/ High Humidity During summer and early fall and late spring, high temperatures and high humidity are present. The Heat Index (HI) reading is an accurate method of determining environmental conditions, which would predispose and athlete to heat illness. Daily measurements via thermometer/sling psychrometer are taken before each practice during periods of extreme heat and humidity. One must follow these guidelines when calculating the Heat Index:

• Measure the HI at the specific playing site. • Measure the HI in the middle of the practice field, not in a shaded area or next to

buildings. • Measure and record the HI every 45-60 minutes during a practice session and every 20-25

minutes if reading is > 85. HEAT INDEX RECOMMENDATIONS

Below 80 Chance of heat illness is low, but still possible with prolonged exposure.

80 to 85 Add additional breaks.

85 to 90 Add additional water breaks. Pay attention to high risk athletes.

Above 90 Chance of heat illness is greatly enhanced. Practice in full uniform should not be conducted. Watch all athletes closely, add water breaks and shorten practice time.

** If Heat Index reaches 105 to 130 degrees extreme caution must be taken and practice(s) may be postponed to a cooler part of day (6-10 AM or 7-10 PM).

Heat Illness Protocol In an effort to prevent heat illness, athletic training students are to monitor the wet bulb globe temperature (WBGT) index. The certified athletic trainer will make recommendations to the head coach or coach in charge during inclement weather. Athletic training students should encourage athletes to drink water during breaks and should keep a watchful eye for signs/symptoms of heat exhaustion (e.g., cramping, headache, pale skin, etc.). Heat Stroke Recognition:

• Altered Mental Status o If you can’t hold an intelligible conversation or the athlete makes comments that

are not relevant to the situation • If the athlete is still sweating, heat stroke should not be ruled out

o In 75% of the cases an athlete with heat stroke is still sweating sometimes profusely



o If they are not sweating that is still a definite indicator that the athlete could have heat stroke

• Do not rely on the look of the skin • Heat stroke can have a sudden onset • An athlete with a fever of 100.5-101 and higher should not practice

Treatment Actions/Protocol:

• Check ABC’s/C-spine precautions • Contact EMS – direct them to the rapid cooling area • Notify closest ATC • Transport the athlete to the rapid cooling area via golf cart • Remove clothing and equipment while in transport • Take rectal temperature (≥ 104° Fahrenheit is life threatening) • Coolers will be full of ice next to the tub • Dump coolers into tub • Immerse in cold tub (35 – 40° Fahrenheit) if core temperature is above the normal

parameters • Monitor ABC’s/Vital Signs/rectal temperature • Notify team physician once stable and cooling has initiated • Assist EMS and Transport

When in doubt about the severity of a heat illness, the best course of action is to immerse in cold water. A person that does not have heat stroke will usually begin to shiver, and will probably be able to tell you that the water is too cold.

ADHD Policy This policy is currently under review and revision. Asthma Policy This policy is currently under review and revision. Sudden Cardiac Death Policy This policy is currently under review and revision. Medication Policy Over the counter (OTC) medications may be given to athletes by a staff ATC or by clinical athletic training students who have completed the procedure of pharmaceutical distribution in KINE 368 – Clinical Experiences I under the following guidelines. Note: the same guidelines Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program apply for prescription drugs and iontophoresis.

1. Ask the athlete if they have ever had an allergic reaction to any medication. If the athlete has a history of reaction to the medication or a similar medication, do not give them any.

2. Receive permission from a staff ATC or member of the team physician staff. 3. Allow the athlete to read the label for the medication 4. Dispense only the recommended amount listed on the label. Do not exceed the single

dose or daily maximum. 5. Record the date, time, athlete’s name, complaint, unit, and dose in the drug log.

Allergic Reactions/Anaphylaxis Any severe allergic reaction resulting in breathing difficulties and/or immediate or delayed moderate edema should be immediately referred to nearest emergency medical facility. If the athlete has no history of reactions to Benadryl, give the athlete two (2) Benadryl by mouth. Some athlete’s may have a documented allergy to bee stings and the athletic training staff will have a spare Epi-pen on hand. This should be administered using the manufacturer’s instructions. If accessible, provide supplemental O2, elevate the athlete’s legs above their head, and place a blanket on the athlete.

Shock Any illness or injury in which the signs and/or symptoms of shock (cool, pale, moist, clammy skin and rapid, weak pulse) are present should be immediately referred to the nearest emergency medical facility. If accessible, provide supplemental O2, elevate the athlete’s leg above their head, and place a blanket on the athlete. Dislocations, Fractures Dislocations, possible fractures to large bones, and unstable fractures to small bones should be immobilized, ice (if possible) should be applied, and the athlete should be referred for medical attention. Athletic training students should not attempt to move or reduce any dislocations or fractures. In the event that a tooth is avulsed, the tooth should be placed back in the socket it came from, in a tooth preservation kit or in a glass of milk whichever method is appropriate and available. Open wounds requiring sutures Lacerations in which multiple tissue layers are visible and/or which the borders do not approximate should be referred for evaluation and sutures. Use steri-strips to close the wound until proper care can be provided. As a general rule for wounds that may require sutures, a period of no longer than six hours should elapse between the time the wound is experienced and when the wound receives suturing. In the event that the cornea of the eye is lacerated, cover the eye and refer for evaluation. Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program Urgent/Non Emergent Guidelines Use the following guidelines for treating urgent and non-emergent illness or injury. Nerve injury without a history of spinal injury

Ice, immobilize, support area with decrease strength if needed

Nausea, flu, possible food poisoning Pepto Bismol, tums, fluids

Diarrhea

Immodium, fluids Fever

Acetaminophen Nasal congestion

Sudafed Motion Sickness

Benadryl Allergy, Allergic Reactions without Anaphylaxis

Benadryl, hydrocortisone cream Acute musculoskeletal injuries (contusions, strains, sprains)

ICE, immobilize if needed Open wounds not requiring sutures Clean with betadine and/or peroxide, apply steri-strips if needed, antibiotic ointment, cover Referral to the Team Physicians Non-emergency injuries should be referred to the team physician staff as soon as possible. Generally, this will occur during the physician staff regularly scheduled visits to the athletic training room. If the athlete needs to see the physician staff before the next scheduled visit, then the Certified Athletic Trainer responsible for the athlete will coordinate scheduling an appointment in the office at Western Orthopedics and Sports Medicine (245-0484). Anytime an athlete is referred to any physician, a blank copy of a Medical History Release form and a Physician Referral Record form should be sent with the athlete. The Physician Referral Record form should be completed by the physician and returned to the athletic training room to


Colorado Mesa University Athletic Training Program be placed in the athletes’ records. Referral to the Student Health Center General illnesses or medical conditions such as colds, flu and skin conditions should be referred to the student health center or the athletes Primary Care Physician if they have one in the Grand Junction area. The athletes should make their own appointment to meet their schedule and the athlete is responsible for all associated charges. A blank copy of a Medical History Release form and a Physician Referral Record form should be sent with the athlete. The Physician Referral Record form should be completed by the physician and returned to the athletic training room to be placed in the athletes’ records. Illnesses and conditions affecting an athlete’s participation should be recorded in the individual’s records and the Team Physician staff should be notified.



Appendix A – Athletic Training Phone List Physician Groups and Clinics Colorado Mesa University Student Health Center---------------------------------------------------- 256-6345 Western Medical Associates----------------------------------------------------------------------------- 241-7600 Western Orthopedics and Sports Medicine ----------------------------------------------------------- 245-0484 Colorado West Otolaryngologists----------------------------------------------------------------------- 245-2400 Alphabetical List William Cobb, M.D., Infectious Disease-------------------------------------------------------------- 464-5611 Chris Copeland , D.O., Orthopedic Surgery---------------------------------------------------------- 245-0484 M. Larry Copeland, D.O., Orthopedic Surgery------------------------------------------------------- 245-0484 Mitchell T. Copeland, D.O., Orthopedic Surgery---------------------------------------------------- 245-0484 Michael Corbett, D.D.S , General Dentistry---------------------------------------------------------- 245-4324 Joel Dean, D.O., Neurology---------------------------------------------------------------------------- 243-8328 Jerry Gage, D.O., Neurology--------------------------------------------------------------------------- 243-8328 Stephen Kelly D.M.D., Oral and Maxillofascial Surgery------------------------------------------- 245-2222 Richard Knackendoffel, D.O., Orthopedic Surgery-------------------------------------------------- 245-0484 Thomas Moore, Jr., D.O., Family Practice------------------------------------------------------------ 241-7600 Steven O’Dell, D.O., General Surgery----------------------------------------------------------------- 243-9340 Charles Rademacher, D.O., Internal Medicine------------------------------------------------------- 434-8570 Duane Hartshorn, M.D., ENT--------------------------------------------------------------------------- 245-2400 Kurt Spriggs, D.O., Cardiology------------------------------------------------------------------------ 244 8708 Terry Sweet, D.C., Chiropractor----------------------------------------------------------------------- 241-1199 Daniel Thompson, D.O., Family Practice------------------------------------------------------------- 241-7600 Mark Twardowski, D.O., Internal Medicine---------------------------------------------------------- 241-7600 Peter Walsh, D.O., Gastroenterology------------------------------------------------------------------ 242-6600 Hospitals Community Hospital, 2021 N. 12th-------------------------------------------------------------------- 242-0920 Emergency Room------------------------------------------------------------------------------------ 256-6404 St. Mary’s Hospital, 2635 N. 7th----------------------------------------------------------------------- 244-2273 Emergency Room------------------------------------------------------------------------------------ 244-2551 Physical Therapists - Allied Health St. Mary’s Out Patient Rehab--------------------------------------------------------------------------- 244-6100 (Scott Coleman PT, Eric Spear PT, Erin Glavan ATC) Therapy Works {Community Hospital Out Patient Physical Therapy}(Terry Brown, P.T.)---- 241-0362 Orthotics Foot Support Group (Gerhard Rill, C.PED)----------------------------------------------------------- 434-2727 Pharmacy Orchard Pharmacy -------------------------------------------------------------------------------------- 243-3400 Rite Aid Pharmacy -------------------------------------------------------------------------------------- 243-3125 Poison Control Center (St. Mary’s)-------------------------------------------------------------------- 244-2558



Appendix B – Instructions for Completing Field Experience Log KINE - Course Number of Clinical Experience Class currently enrolled in - (KINE 368, 378, 468, 478) MONTH - current month, a new log should be started the 1st of each month PREVIOUS HOURS - total hours completed prior to the current log for the currently enrolled class CURRENT HOURS - total hours included on this log TOTAL HOURS - total hours completed - previous hours + current hours Procedure for daily completion of log. 1) Use one line for each time period; if you work more than one shift on a day, use a

separate line for each shift. 2) IN - OUT - the time in and out recorded should be recorded as the nearest quarter hour.

Ex: 1:20=1:15, 1:25=1:30, 1:30=1:35, 1:30=1:37, 1:38=1:45, 1:40=1:45 3) TOTAL - total time worked recorded to quarter hour. Ex.: 1:30-4:45 = 3-1/4 4) Field Experience Setting - log time spent each day in the following settings,

ATR - Athletic Training Room (pre/post practice or game, rehab, etc) Prac/Game - time at practice or game

5) SP - sport or activity worked. Ex: treatments =TX, Volleyball=VB, Football=FB, Cross

Country=XC, Men's Basketball=MB, Women's Basketball=WB, Softball=SB, Baseball=BB, Women's Tennis=WT, Men's Tennis=MT, Woman's Golf=WG, Men’s golf=MG, Woman's Soccer=WS, Men’s Soccer=MS, Women’s Lacrosse=WLAX, Men’s Lacrosse=MLAX, Swimming/Diving=SW, Track and Field=T&F

1) COMMENTS - list comments regarding the days activities - unusual injury that occurred, new knowledge or insight gained.



Appendix C – Emergency Action Plans Emergency Action Plans

A SERIOUS INJURY IS ANY CONDITION WHEREBY THE ATHLETE'S LIFE MAY BE IN DANGER OR RISKS PERMENANT IMPAIRMENT. THESE INJURIES INCLUDE BUT ARE NOT LIMITED TO: CERVICAL SPINE INJURIES, HEAD INJURIES, LOSS OF LIMB, SERIOUS BLEEDING, SHOCK, SERIOUS FRACTURES, HEAT STRESS AND CARDIOVASCULAR ARREST.

The emergency procedures are applicable at the following locations at Colorado Mesa University: Bergman Practice Fields, Softball Stadium, Elliot Tennis Center, Walker Field, Brownson Arena, Hamilton Recreation Center, El Pomar Natatorium, Wrestling Room, Weight Room, Copeland Family Athletic Training Room, Stoker Stadium, Suplizio Field, and Canyon View Park.

Emergency Personnel: Athletic Trainers and Athletic Training Student(s) are on site for practice and competition; additional sports medicine staff is accessible from the athletic training room (located in the Maverick Center). Team Physicians are on site or on call. EMS is available by calling 911. The athletic training staff is certified by the American Red Cross in Emergency Response.

Colorado Mesa University Athletic Training Staff must be aware of any emergency that has occurred within the athletic department.

Athletic Training Staff

Head Athletic Trainer: Josh Fullmer, ATC (office 970-248-1809) (cell 970-623-0907)

Assoc. Head Athletic Trainer: Mickey Wilcock, ATC (office 970-248-1203) (cell 801-376-0675)

Asst. Athletic Trainer: Naomi Brown, ATC (office 970-248-1003) (cell 907-978-2095)

Asst. Athletic Trainer: Ryan Dean, ATC (office 970-248-1985) (cell 307-760-2624)

Asst. Athletic Trainer: Shannon Hattervig, ATC (office 970-248-1356) (cell 605-391-6713)

Asst. Athletic Trainer: Jessica Maxwell, ATC (office 970-248-1799) (cell 970-773-3771)

Asst. Athletic Trainer: Adam Neff, ATC (office 970-248-1032) (cell 970-260-8868)

Emergency Communication: Via 2-way radio and cellular phone(s). Phones and radios will be on site with Certified Athletic Trainers and student athletic trainers during practices and events. When using campus phones you must dial 9 to get an outside line, then number. Local EMS is 911.

Emergency Equipment: Supplies (AED, Oxygen, Spine Board, Cervical Collar, Crutches, Splint Bag, Kits, and OSHA biohazard Materials) located on field and gymnasium with the home team Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program and Certified Athletic Trainer. Additional emergency equipment is accessible from the athletic training room in the Maverick Center.

VENUE DIRECTIONS (see maps) 1. Stoker Stadium. Enter the Lincoln Park complex from 12th Street. Proceed through the parking lot and up to the Southwest gate on the football side. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See Map 1, #1) 2. Suplizio Field. Enter the Lincoln Park complex from North Avenue side. Proceed through the parking lot and up to the North gate on the baseball side. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See Map 1, #2)

3. Bergman Practice Fields-Football. From Orchard Ave, go South on Cannell Ave, go East on Mesa Ave. Football practice field will be on the North side of street. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 2, # 1)

4. Bergman Practice Fields-Baseball. From Orchard Ave, go South on Cannell Ave, baseball field is on the corner of Orchard Ave and Cannel Ave. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 2, # 2)

5. Softball Stadium. From Orchard Ave, go South on Cannell Ave. Softball field is located on the East side of Cannell Ave, on the corner of Cannell Ave. and Mesa Ave. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 2, # 3)

6. Walker Field. Turn off Orchard Ave. between the Soccer Stadium and the Tennis Courts and to the southwest gate. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 3, #1)

7. Canyon View Park. (Baseball) Instruct emergency medical services (EMS) personnel to report at the west gate of 750 24 Rd, Grand Junction, Colorado. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 4)

8. Brownson Arena. Turn off Orchard Ave. between the Soccer Stadium and the Tennis Courts. Park outside Saunders Field house at the Northeast entrance. Proceed up the stairs and into the Gym. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 3, #2)

9. Hamilton Recreation Center. From North Ave, heading toward 12th Street: Turn north (toward campus) onto 12th Street. Turn left into top level of parking garage (right before soccer field). Drive along fire lane. Enter through south doors by parking garage, next to sand volleyball pit, left of the parking lot. From 12th Street, heading south, toward North Ave: Turn right after soccer field, onto the top level of the parking garage. Drive along fire lane. Entry through south doors by parking garage, next to sand volleyball pit, left of parking log. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 3, #3) 10. Wrestling Room. From 12th Street, heading south, toward North Ave: Turn right (west) onto Orchard Ave. Turn left into the parking lot between the baseball field and tennis courts. Enter the doors on the north of the building and the wrestling room is first door on the left. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 3, #5) 11. Copeland Family Athletic Training Room. From North Ave, head toward 12th Street: Turn north (toward campus) on Cannell Ave. Turn right after the parking lot (on your right), just before the softball field. Take the fire lane up and around the softball and football fields to the athletic training room (on the right, just past the glass human performance lab, and before the Orchard Ave parking lot). Enter the ATR through the large double doors into the


Colorado Mesa University Athletic Training Program garage. From 12th Street, heading south, toward North Ave: Turn right (west) onto Orchard Ave. Turn left into the parking lot between the baseball field and tennis courts. Follow the fire lane up to the athletic training room (first left, just before the glass human performance lab). Enter the ATR through the large double doors into the garage. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 3, #4) 12. El Pomar Natatorium. From North Ave, head toward 12th Street: Turn north (toward campus) on Cannell Ave. Turn right after the parking lot (on your right), just before the softball field. Take the fire lane up to the pool, park by the windowed wall. From 12th Street, heading south, toward North Ave: Turn right(west) onto Orchard Ave. Turn left into the parking lot, between the baseball field and tennis courts. Follow the fire lane up to the pool, park by the windowed wall. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 2, # 4) 13. Varsity Weight Room. From 12th Street, heading south, toward North Ave: Turn right (west) onto Orchard Ave. Turn left into the parking lot between the baseball field and the tennis courts. Follow the fire lane up to the athletic training room (first left, just prior to the glass human performance lab). Enter through the doors on the Orchard Ave side of the building, around the corner from the ATR. Take the elevator at the end of the hallway, proceed to the basement. Stair entry into weight room is directly across from elevator. There is a ramp into the weight room opposite this point. Make an immediate right than left, go through the door at the end of the hallway on the left and enter the weight room. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. 14. Elliott Tennis Center From 12th Street, heading south, toward North Ave: Turn right (west) onto Orchard Ave. Turn left (south) into the parking lot next to tennis courts. Personnel (Certified Athletic Trainers, Athletic Training Students, or Coaches) will be situated at various locations for directing EMS to scene. (See map 3, #6)

RELATED EMERGENCY SITUATIONS

Fire In case of fire, follow these instructions: 1. Evacuate building immediately by following nearest exit sign. 2. Exit in a calm and orderly fashion through nearest fire exit. 3. Call 911 4. If smoke is present, crawl low to escape. 5. If you cannot escape, stay in room, stuff door cracks and vents with wet towels or clothes. 6. Call 911 and let dispatcher know your location

Poisoning

1. Check scene to make sure it is safe 2. Remove victim from source of Poison 3. Check for life threatening situation 4. If victim is conscious, ask questions to get more information. 5. Look for poison container and take it with you to telephone 6. Call Poison Control Center or 911 7. Give care according to directions of PCC or 911. 8. Find out what type of poison did the victim ingest


Colorado Mesa University Athletic Training Program 9. How much poison did victim ingest? 10. When did the poisoning take place? Map 1 Stoker Stadium #1 Suplizio Field #2

Map 2 Bergman Practice Fields, Softball Stadium, El Pomar Natatorium

1 2



Map 3 Walker Field, Brownson Arena, Elliott Tennis Courts, Hamilton Recreation Center, Wrestling Room, and Copeland Family Athletic Training Room.

Map 4

4 2-3

1

2

1

3

6

5

4


Colorado Mesa University Athletic Training Program Canyon View



Appendix D – Staph and MRSA

COLORADO MESA UNIVERSITY ATHLETIC TRAINING and SPORTS MEDICINE Staph and MRSA in Athletics: Recognition and Prevention What is “Staph” / MRSA?:

Staphylococcus aureus, often referred to as “staph”, is a common type of bacteria that can live harmlessly on the skin or in the nose of 25 to 35 percent of healthy people (this is often referred to as being “colonized” with the germ). Occasionally, staph can cause an infection. Staph bacteria are one of the most common causes of skin infection in the United States, but most of these infections are minor, such as pimples or boils. Most of these infections can be treated without antibiotics, however, some staph infections can cause serious infections, such pneumonia, bloodstream, bone, and joint infections, and surgical wound infections. In the past, most serious staph bacterial infections were treated with a certain type of antibiotic related to penicillin. In recent years, treatment of these infections has become more difficult because staph bacteria have become resistant to various antibiotics. These resistant bacteria are called methicillin-resistant staphylococcus aureus (MRSA). According to the Centers for Disease Control (CDC) 1% of the population is colonized with MRSA. MRSA is one type of skin infection among several that are of concern in competitive sports.

Who Gets “Staph” / MRSA?:

“Staph” infections, including MRSA, have been traditionally associated with outbreaks in health-care facilities, but they are becoming increasingly common in student-athletes participating in close contact sports (e.g. football, wrestling, lacrosse, etc.), although anyone, including coaches, staff, etc. who come into contact with colonized individuals, can contract the infection. “Staph” and MRSA are spread either by direct physical contact or indirect touching of contaminated objects. This includes touching, using, and/or sharing sheets, towels, clothes, equipment, dressings, personal items, bar soap, etc. which have been used by someone who has “staph” and/or MRSA, along with poor hygiene habits (e.g. hand-washing, showering, etc.)

What Does “Staph” / MRSA Look Like?

“Staph” and/or MRSA usually first presents as some type of skin or soft tissue infection such as pimples, abscesses, pustules, and/or boils (see pictures below). Some can be red, swollen, painful, and/or have pus or other drainage. The pustules may be confused with insect bites initially, and may also be associated with existing turf burns and/or abrasions.



What to Do: Without proper referral and care, more serious infections may cause pneumonia, bloodstream, bone, and/or joint infections, and/or surgical wound infections. If you or anyone you know has what appears to be what looks like “staph” and/or MRSA, please contact the Colorado Mesa University athletic training room as soon as possible for evaluation.

Prevention of “Staph” and/or MRSA:

Although treatable, there can be complications associated with “staph” and MRSA infections, making prevention the best measure to combat these infections. The Centers for Disease Control suggest the following measures for preventing staphylococcal skin infections, including MRSA:

1. Practice good hand hygiene by washing hands frequently and in a thorough fashion with soap and warm water or using an alcohol-based hand sanitizer.

2. Take a shower with hot water and wash with soap (liquid antibacterial soap, not bar soap) following all activities (e.g. strength & conditioning sessions, practices, and competitions).

3. Avoid sharing towels, equipment, razors, soap (use liquid soap instead of bar soap), etc. 4. Use a barrier (e.g. clothing or a towel) between your skin and shared equipment. 5. Wipe surfaces of equipment before and after use. 6. Clean and properly cover any open wounds such as turf burns, abrasions, lacerations, etc. with an

appropriate bandage at all times. 7. Avoid whirlpools, hydrotherapy pools, cold tubs, swimming pools, and other common tubs if you have an

open wound. 8. Maintain clean facilities and equipment. 9. Do not ignore skin infections, pimples, pustules, abscesses, etc. Report these to a Athletic Training

staff member and/or physician immediately. (above information was taken from the University of Maryland and Sports Medicine 2006)

COLORADO MESA UNIVERSITY ATHLETIC TRAINING and SPORTS MEDICINE MRSA In order to maintain proper sanitary conditions within Colorado Mesa Athletic Training facilities and to prevent the outbreak of Methicillin-resistant Staphylococcus aureus (MRSA) and other harmful infections, the following procedures will be in place.

The individual(s) responsible for cleaning and disinfecting the area will adhere to Universal Precautions at all times and wear PPE as needed;


Colorado Mesa University Athletic Training Program Treatment / Taping Tables, Weight Room / Rehabilitation Equipment, Countertops, Stools, etc.-

1. Treatment tables, taping tables, rehabilitation equipment, countertops, stools, etc. must be cleaned every day and/or following a possible contamination using Husky 891 Arena Disinfectant (Canberra Corporation, 3610 Holland_Sylvania Rd., Toledo, Ohio 43615 (419)841-6616) or other appropriate cleaner.

• Pour Husky 891 Arena Disinfectant into the spray bottle with a 1oz:1 gal dilution. • A 1:10 diluted bleach solution can be used to clean hard surfaces only,

2. Clean / Disinfect tables, equipment, countertops, stools, etc. in the following manner: a) Spray the Husky 891 solution on the surface to be cleaned; b) For non-porous surfaces, allow the solution to sit on the surface for ten (10) minutes; and c) Wipe down the surface with a towel.

Coolers-

1. Coolers must be cleaned and disinfected every day following use, or as needed following every possible contamination using a Control 35 or other appropriate cleaner.

2. Coolers are to be cleaned in the following manner: a) Spray Control 35 inside and outside the cooler and inside and outside the cooler top / lid. b) Let germicide stay on cooler for 10 minutes c) Partially fill the cooler with hot water. d) Thoroughly rinse the cooler and cooler top / lid using hot water e) Allow the hot water to circulate through the cooler spigot for rinsing. f) Coolers should be towel dried and then allowed to air dry. g) Store coolers upright. Cooler tops / lids should be placed on top at an angle to allow for

ventilation.

Water Bottles, Water Bottle Lids & Carriers, Pouring Pitchers, Etc.- 1. Water bottles, water bottle lids and carriers must be cleaned and disinfected every day following use, or as

needed following every possible contamination using a Control 35 or other appropriate cleaner. Water bottles, water bottle lids and carriers are to be cleaned using the following method:

a) Fill sink half (1/2) full of warm water. Add in quarter (1/4) cup of bleach. b) Submerge the water bottles, water bottle lids and carriers into sink. c) Allow materials to soak for 10-15 minutes Use the assigned scouring brush to thoroughly scrub

the inside and outside of the water bottles, water bottle lids and carriers, pouring pitchers, etc. d) Thoroughly rinse all items with hot water. e) Store water bottles upside down on the drain rack. Place carriers in the designated area(s) f) Store water bottle lids on the lip of the drain rack. g) Store pouring pitchers upside down in the designated storage area(s).

Towels-

• Cloth towels should only be used on a single patient and should be laundered following every use. • Disposable towels should be used whenever feasible on the field / court and should be disposed of after

a single use.

Hydrocollator Packs / Covers- • A cloth and/or disposable towel should be placed between the patient and the hydrocollator pack /

cover. • Hydrocollator covers should be laundered every day and/or following a possible contamination.

Soft Goods-

• Soft goods (e.g. neoprene braces / sleeves, knee / elbow / forearm / shin pads, splints, lace-up ankle braces, walking boot liners, cast shoes, back braces, etc.) should be laundered upon return to the



athletic training facility BEFORE being returned to inventory and/or administered to another student athlete.

o Soft goods that cannot be laundered (e.g. Wrist splints, Simply Stable shoulder brace, Aircast

ankle braces, hard splints, etc.) should be disinfected using the aforementioned guidelines for treatment / taping tables, weight room / rehabilitation equipment, etc.

Whirlpools-

1. Whirlpools shall be cleaned on a daily basis, or as needed following every possible contamination; 2. Whirlpools are not to be used by student-athletes with open or draining wounds; 3. Whirlpools are to be cleaned using Husky 891 Arena Disinfectant (Canberra Corporation, 3610

Holland_Sylvania Rd., Toledo, Ohio 43615 (419)841-6616) AND a 1:10 diluted bleach solution. 4. Whirlpools are to be cleaned in the following manner:

a. Spray the whirlpool with Husky 891 cleaner in and around the sides of the whirlpool; b. Allow the cleaner to sit for ten (10) minutes; c. Using the long-arm brush and hot water, scrub all surfaces of the whirlpool, including the bottom,

sides, turbine, etc. d. Rinse the tank very well with hot water and allow it to drain; e. Towel dry

5. Whirlpool turbines are to be cleaned using household bleach by allowing the bleach solution to circulate through a running turbine with hot water for ten (10) minutes.



Appendix E – Communicable Disease Policy Any student suspected of or diagnosed with any of the following contagious diseases will be referred to the Student Health Center for further diagnosis and treatment. The student will be allowed to return to their assigned rotation when released by the Student Health Center or attending physician. A written copy of a Release to Return to Work/Activity must be presented to the Athletic Training Program Director, Clinical Education Coordinator, and the preceptor supervising the rotation.

• Chickenpox (Varicella )

• Coxsackie Virus (Hand, Foot and Mouth Disease )

• Diphtheria

• Fifth Disease (Parvovirus)

• Haemophilus Influenza Type b

• Hepatitis (A,B,C)

• Impetigo

• Infectious Mononucleosis (Epstein-Barr Virus)

• Measles

• Meningitis (Bacterial or Viral)

• Mumps

• Pediculosis (Lice)

• Pertussis (Whooping Cough )

• Pneumonia

• Respiratory Syncytial Virus Infection (RSV)

• Ringworm

• Rubella (German Measles )

• Scabies

• Staphylococcus Infections ( including MRSA)

• Streptococcal Infections

• Tuberculosis

Additional information regarding the individual diseases is available at http://health.mesacounty.us/disease/index.cfm http://www.cdphe.state.co.us/dc/index.html http://www.health.state.ny.us/diseases/communicable/


http://www.health.state.ny.us/diseases/communicable/chickenpox/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/chickenpox/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/hand_foot_mouth/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/hand_foot_mouth/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/diphtheria/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/fifth/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/fifth/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/haemophilus_influenzae/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/hepatitis/hepatitis_a/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/impetigo/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/mononucleosis/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/mononucleosis/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/measles/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/mumps/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/pediculosis/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/pertussis/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/pertussis/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/respiratory_syncytial_virus/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/ringworm/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/rubella/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/rubella/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/scabies/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/streptococcal/group_a/fact_sheet.htm

http://www.health.state.ny.us/diseases/communicable/tuberculosis/fact_sheet.htm

http://health.mesacounty.us/disease/index.cfm


Appendix F – Approved Treatment Methods Colorado Mesa University Athletic Training Room Approved Treatment Methods Listed below are treatment methods approved for use in the Colorado Mesa University Athletic Training Room under the indirect supervision of the Team Physicians from Western Orthopedics and Sports Medicine. General guidelines for injury treatment in the Colorado Mesa University Athletic Training Room: 1) All acute injuries will be treated with cold therapy for the first 48 – 72 hours. Forms of cold therapy include but are not limited to:

a) Ice b) Cold water immersion (45-65 degrees F) c) Cold whirlpool (55-65 degrees F) d) Ice massage e) Other methods of cold therapy with a low risk of frostbite and or hypothermia

The standard treatment time will be 15-20 minutes. 2) Post-acute and chronic injuries may be treated with heat therapy prior to activity. Forms of heat therapy include but are not limited to:

a) Moist heat (hydrocollator) b) Warm water immersion c) Warm whirlpool d) Ultrasound e) Contrast treatment (alternating heat and cold) f) Other methods of heat therapy with a low risk of thermal injury or hyperthermia

The standard treatment time will be 15-20 minutes. 3) Electrical stimulation may be used to treat acute, post-acute and chronic injuries within current accepted guidelines and protocols such as those posted in the Colorado Mesa University Athletic Training Room. Forms of electrical stimulation include but are not limited to:

a) Pre-Modulated b) Interferential c) High Voltage Galvanic d) Bi-Phasic e) Microcurrent f) TENS g) Surface EMG for muscle function testing h) Low Voltage Galvanic (Iontophoresis) i) Other clinically proven safe and effective waveforms

The standard treatment time will be 15-30 minutes but may be extended if standard protocols for the particular waveform indicate a longer treatment time.


Colorado Mesa University Athletic Training Program 4) Range of Motion exercises may be utilized to increase flexibility to rehabilitate an injured area back to its pre- injury state, equalize pre-existing muscle imbalances, decrease chance of injury, and improve performance. Forms of Range of Motion (ROM) exercises include but are not limited to:

a) Passive ROM b) Active Assisted ROM c) Active ROM d) PNF stretching e) Static stretching (without or with weights) f) Light ballistic stretching g) Plyometrics h) Ball exercises i) Other clinically proven safe and effective stretching techniques

4) Strengthening exercises may be utilized to increase strength to rehabilitate an injured area back to its pre- injury state, equalize pre-existing muscle imbalances, decrease chance of injury, and improve performance.

Forms of strength training include but are not limited to:

a) Isometric exercises b) Isotonic exercises c) Isokinetic exercises d) Manual resistance e) Resistance tubing f) Plyometrics g) Other clinically proven safe and effective strengthening techniques


Colorado Mesa University Athletic Training Program Electrical Stimulation Protocols

Treatment time - 15-30 minutes unless otherwise stated Interferential - select target or sweep depending on size of area and/or specific point tenderness Ramp - 2.0 for initial treatments , progressively decrease to .5 as athlete tolerance increases

PAIN CONTROL - ACUTE PAIN CONTROL – CHRONIC

Interferential or Premodulated Interferential or Premodulated Frequency - High Frequency – Low Intensity level - Sensory Intensity level – Sensory Microcurrent Microcurrent Pads Pads Frequency -.3 Hz Frequency -.3 Hz Polarity - Bipolar Polarity - Bipolar Intensity - 50 mA Intensity - 50 mA Time - 20 -30 minutes Time - 20 -30 minutes Probe High Volt Frequency - 4 Hz Pulse rate range - High Polarity - Negative Polarity - Negative or Alternating Intensity - 300 mA Contract/Relax - Continuous Time - 15-30 seconds per point Intensity level - Sensory High Volt Biphasic Pulse rate range - Low Frequency - 80 - 130 Hz * Polarity - Alternating Contract/Relax - Continuous Contract/Relax - 10/10 Intensity - Sensory Intensity level - Noticeable contraction

PAIN CONTROL - SUB-ACUTE Biphasic Frequency - 10 Hz * Interferential or Premodulated Contract/Relax - Continuous Frequency - Alternating Intensity - Noticeable contraction minus 20% Intensity level - Sensory Frequency - 50 Hz Contract/Relax - 10/10 Microcurrent Intensity - Noticeable contraction Pads Frequency -.3 Hz SPASM - ACUTE Polarity - Bipolar Intensity - 50 mA High Volt Time - 20 -30 minutes Frequency - Low , 2 Polarity - Negative , negative pad distal High Volt Contract / Relax – Continuous Pulse rate range - Low Intensity - Noticeable contraction Polarity - Negative or Alternating Contract/Relax - Continuous Biphasic Intensity level - Noticeable contraction minus 20% Frequency - 50 Hz Contract / Relax - 10/10 Biphasic Intensity - Noticeable contraction Frequency - 10 Hz Contract/Relax - Continuous Premodulated Intensity - Sensory Frequency – Low, Intensity - Noticeable

contraction Athletic Training Program Student Handbook Revised 12/2013


EDEMA - ACUTE EDEMA- POST ACUTE, CHRONIC High Volt High Volt Frequency - High Frequency - High

Polarity - Negative , negative pad distal Polarity - Negative, negative pad distal

Contract / Relax - Continuous Contract / Relax - Continuous Intensity - Sensory Intensity - Sensory Bucket Bucket Frequency - 128 Frequency - 2 Polarity - Pads negative Polarity - Pads negative Continuous Continuous Intensity - Sensory Interferential or Premodulated Biphasic Frequency - High Frequency - 10 Hz Intensity level - Sensory Contract/Relax - Continuous Intensity - Noticeable contraction Microcurrent Frequency - 50 Hz Pads Contract / Relax - 10/10 Frequency -.3 Hz Intensity - Noticeable contraction Polarity - Bipolar Intensity - 50 mA Russian Time - 20 -30 minutes Frequency - 50 Hz Contract / Relax - 10/10 Biphasic Intensity - Noticeable contraction Frequency - 80 - 130 Hz * Contract/Relax - Continuous Intensity - Sensory

ATROPHY PREVENTION MUSCLE STRENGTHENING AND RE-

EDUCATION

Russian Russian Frequency - 50 Hz Frequency - 50 Hz Contract / Relax 10/10 or 10/30 Contract / Relax 10/10 or 10/30 Intensity - Strongest tolerable

contraction Intensity - Strongest tolerable

contraction Biphasic Biphasic Frequency - 50 Hz Frequency - 50 Hz Contract / Relax 10/10 or 10/30 Contract / Relax 10/10 or 10/30 Intensity - Strongest tolerable

contraction Intensity - Strongest tolerable

contraction Frequency - 50 Hz

High Volt with probe - Localized Stimulation

Contract / Relax - Continuous - Manual control 10 on / rest


Colorado Mesa University Athletic Training Program Frequency - 50 Hz ULTRASOUND Contract / Relax - Continuous - Manual

control 10 on / rest depth of penetration

Intensity - Strongest tolerable contraction 1 MHz - 5 cm - deep tissue 2 MHz - 2.6 cm - palpable tissue

3 MHz - 1.5 cm - easily palpable tissue or underlying bone

Area of treatment - 2-4 times the size of the sound head

Treatment time - 5-10 minutes (times increases with area of treatment



Appendix G – NATA Blood Borne Pathogens Guidelines

NATA Blood Borne Pathogens Guidelines for Athletic Trainers May 11, 1995 The NATA recognizes that blood borne pathogens such as HIV, HBV, and HCV present many complex issues for athletic trainers, athletic administrators and others involved with the care and training of athletes. As the primary health care professional involved with the physically active, it is important for athletic trainers to be aware of these issues. The NATA therefore offers the following guidelines and information concerning the management of blood borne pathogen-related issues in the context of athletics and settings in which the physically active are involved. It is essential to remember, however, that the medical, legal and professional knowledge, standards and requirements concerning blood borne pathogens are changing and evolving constantly, and vary, in addition, from place to place and from setting to setting. The guidance provided in these guidelines must not, therefore, be taken to represent national standards applicable to members of the NATA. Rather, the guidance here is intended to highlight issues, problems and potential approaches to (or management of) those problems that NATA members can consider when developing their own policies with respect to management of these issues. Athletic Participation Decisions regarding the participation of athletes infected with blood borne pathogens in athletic competitions should be made on an individual basis. Such decisions should be made following the standard or appropriate procedures generally followed with respect to health-related participation questions, and taking into account only those factors that are directly relevant to the health and rights of the athlete, the other participants in the competition, and the other constituencies with interests in the competition; the athletic program, the athletes, and the sponsoring schools and organizations. The following are examples of factors that are appropriate in many settings to the decision-making process: The current health of the athlete The nature and intensity of the athlete's training The physiological effects of the athletic competition The potential risks of the infection being transmitted The desires of the athlete The administrative and legal needs of the competitive program Education of the Physically Active In a rapidly changing medical, social, and legal environment, educational information concerning blood borne pathogens is of particular importance. The athletic trainer should play a role with respect to the creation and dissemination of educational information that is appropriate to and particularized with respect to that athletic trainer's position and responsibilities. Athletic trainers who are responsible for developing educational programs with respect to blood borne pathogens should provide appropriate information concerning: The risk of transmission or infection during competition The risk of transmission or infection generally


Colorado Mesa University Athletic Training Program The availability of HIV testing The availability of HBV testing and vaccinations Athletic trainers who have educational program responsibility should extend educational efforts to include those, such as the athletes' families and communities, who are directly or indirectly affected by the presence of blood borne pathogens in athletic competitions. All educational activities should, of course, be limited to those within athletic trainers' scope of practice and competence, be within their job descriptions or other relevant roles, and be undertaken with the cooperation and/or consent of appropriate personnel, such as team physicians, coaches, athletic directors, school or institutional counsel, and school and community leaders. The Athletic Trainer and Blood Borne Pathogens at Athletic Events The risk of blood borne pathogen transmission at athletic events is directly associated with contact with blood or other body fluids. Athletic trainers who have responsibility for overseeing events at which such contact is possible should use appropriate preventative measures and be prepared to administer appropriate treatment, consistent with the requirements and restrictions of their job, and local, state, and federal law. In most cases, these measures will include: Pre-event care and covering of existing wounds, cuts and abrasions Provision of the necessary or usual equipment and supplies for compliance with universal precautions, including, for example, latex gloves, biohazard containers, disinfectants, bleach solutions, antiseptics, and sharps containers. Early recognition and control of a bleeding athlete, including measures such as appropriate cleaning and covering procedures, or changing of blood-saturated clothes Requiring all athletes to report all wounds immediately Insistence that universal precaution guidelines be followed at all times in the management of acute blood exposure Appropriate cleaning and disposal policies and procedures for contaminated areas or equipment Appropriate policies with respect to the delivery of life-saving techniques in the absence of protective equipment Post-event management including, as appropriate, re-evaluation, coverage of wounds, cuts, and abrasions Appropriate policy development, including incorporation, with necessary legal and administrative assistance, of existing OSHA and other legal guidelines and conference or school rules and regulations Athletic Training Student Education NATA encourages appropriate education of and involvement of the student athletic trainer in educational efforts involving blood borne pathogens. These efforts and programs will vary significantly based on local needs, requirements, resources and policies. At the secondary school level, educational efforts should include items such as the following:


Colorado Mesa University Athletic Training Program Education and training in the use of universal precautions and first aid for wounds Education regarding the risks of transmission/infection from the participants that they care for Education on the availability of HIV testing Education on the availability of HBV vaccinations and testing Education of parents or guardians regarding the students' risk of infection At the college or university level, education efforts should include items such as those listed above, and, additionally, as appropriate, the following: Education in basic and clinical science of blood borne pathogens Discussions regarding the ethical and social issues related to blood borne pathogens The importance of prevention programs Education concerning the signs and symptoms of HBV and HIV, as consistent with the scope of practice of the athletic profession and state and local law Universal Precautions and OSHA Regulations Athletic trainers should, consistent with their job descriptions and the time and legal requirements and limitations of their jobs and professions, inform themselves and other affected and interested parties of the relevant legal guidance and requirements affecting the handling and treatment of blood borne pathogens. Athletic trainers cannot be expected to practice law or medicine, and efforts with respect to compliance with these guidelines and requirements must be commensurate with the athletic trainer's profession and professional requirements. It may be appropriate for athletic trainers to keep copies of the Center for Disease Control regulations and OSHA regulations and guidelines available for their own and others' use. Medical Records and Confidentiality The security, record-keeping, and confidentiality requirements and concerns that relate to athletes' medical records generally apply equally to those portions of athletes' medical records that concern blood borne pathogens. Since social stigma is sometimes attached to individuals infected with blood borne pathogens, athletic trainers should pay particular care to the security, record-keeping, and confidentiality requirements that govern the medical records for which they have a professional obligation to see, use, keep, interpret, record, update, or otherwise handle. Security, record-keeping, and confidentiality procedures should be maintained with respect to the records of other athletic trainers, employees, student athletic trainers, and athletes, to the extent that the athletic trainer has responsibility for these records. The Infected Athletic Trainer An athletic trainer infected with a blood borne pathogen should practice the profession of athletic training taking into account all professionally, medically, and legally relevant issues raised by the infection. Depending on individual circumstances, the infected athletic trainer will or may wish to: Seek medical care and on-going evaluation Athletic Training Program Student Handbook Revised 12/2013

Colorado Mesa University Athletic Training Program Take reasonable steps to avoid potential and identifiable risks to his or her own health and the health of his or her patients. Inform, as or when appropriate, relevant patients, administrators, or medical personnel HIV and HBV Testing Athletic trainers should follow federal, state, local and institutional laws, regulations, and guidelines concerning HIV and HBV testing. Athletic trainers should, in appropriate practice settings and situations, find it advisable to educate or assist athletes with respect to the availability of testing. HBV Vaccinations Consistent with professional requirements and restrictions, athletic trainers should encourage HBV vaccinations for all employees at risk, in accordance with OSHA guidelines. Withholding of Care and Discrimination NATA's policies and its Code of Ethics make it unethical to discriminate on the basis of medical conditions. American Academy of Pediatrics. Human immunodeficiency virus [acquired immunodeficiency syndrome (AIDS) virus] in the athletic setting. Pediatrics. 1991;88:640-641. American Medical Association, Department of HIV, Division of Health Science. Digest of HIV/AIDS Policy. Chicago, IL: Department of HIV, American Medical Association; 1993:1-15. American Medical Society for Sports Medicine and American Academy of Sports Medicine. Human immunodeficiency virus (HIV) and other blood-borne pathogens in sports. American Journal of Sports Medicine. In Press. Benson MT, ed. Guideline 2H: blood-borne pathogens and intercollegiate athletics. NCAA Sports Medicine Handbook.1993;24-28. Michigan Department of Public Health. Michigan recommendations on HBV and/or HIV infected health care workers. Triad. 1992;4:32-34.


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