romeo high school athletic training department · selection, fit, function and maintenance of...
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RomeoHighSchoolAthleticTrainingDepartment
Includes:
WhatisanAthleticTrainer?InjuryReporting
PolicyfortheEvaluationandManagementofConcussionsReferralsHeatIndex
EmergencyActionPlan
KaylaPhillips,ATCRomeoAthleticTrainer
[email protected]#(586)281-1146
RomeoHighSchoolAthleticTrainingDepartmentWhatisanAthleticTrainer?
AsdefinedbytheNationalAthleticTrainers’AssociationAthletictrainers(ATs)arehighlyqualified,multi-skilledhealthcareprofessionalswhocollaboratewithphysicianstoprovidepreventativeservices,emergencycare,clinicaldiagnosis,therapeuticinterventionandrehabilitationofinjuriesandmedicalconditions.Certifiedathletictrainersprovideon-siterecognition,evaluationandimmediatetreatmentofillnessesandinjuries–bothacuteandcatastrophic;determineanindividual’sreadinesstoparticipateinactivities;promotesafeandappropriatepracticeandcompetitions;educatestudentsabouthealthylifestylesandpropernutrition;developexerciseregimens;developinjuryandillnesspreventionstrategies;advisehowtopreventillnessorinjuryduringphysicalactivity;providequality,adviseontheselection,fit,functionandmaintenanceofathleticequipment;developandimplyacomprehensiveemergencyactionplan;facilitateandperformrehabilitationandreconditioning;andparticipateinthedevelopmentandimplementationofacomprehensiveathletichealthcaresystem.BenefitsATsprovideforParents
• Createaninvaluableresourceforaccessingthemedicalcommunity.• Facilitateopencommunicationbetweenthestudent-athletes,parents,physicians,
coaches,andschooladministrators.• Provide“in-house”medicalcare,savingmoneyandtimeoffworktotransportthe
student-athleteelsewhere.• Serveasanothersetofeyesandearstomonitorthestudent-athletesbothonandoff
thefield.o AthleticTrainersareoftenthefirsttonoticeorhearwhensomethingiswrong.o Alsouniqueopportunitytoknowthestudent-athlete’spersonalityinaway
othermedicalprovidersareunableto,allowingtoknowwhentheyaren’t“actingthemselves.”
BenefitsATsprovideforStudent-Athletes• Providequick,accessiblecaretoallowreturntosportquickerandsafer.• Giveadviceonhealthylifestyles,propernutrition,anddevelopingindividualized
exerciseregimens.• Offerlifeskillseducation.
o Ex.Questionsregardingcareerchoicespertainingtothemedicalfield.• Assistwithcommunicationwithcoachesandparents.• Encouragement,support,anddedicationtoeachandeverystudent-athletebothonand
offthefield!!
FormoreinformationvisittheNationalAthleticTrainers’Associationwebsite.
RomeoHighSchoolAthleticTrainingDepartmentInjuryReporting
DayofInjuriesTheRomeoAthleticTrainerisresponsiblefortrackingandrecordingofinjuries.Itisvitalthattheathletictrainerismadeawareofanyandallinjuriesthatoccurduringpracticesorgamesregardlessoflocation.Coachesarerequestedtocalltheathletictrainerwheninjuriesoccuriftheathletictrainerisn’tonsitealready.Ifinjuriesoccuratawaygameseitherthecoachorathleteshouldreporttheinjurybeforethenextdayofpractice;ideallythenightoffsorecommendationsonimmediatehomecarecanbeprovided.Thiswillhopefullysavethestudent-athleteandtheirfamiliesfromtakingunnecessarytripstothehospitalorprolonginghealing.Doctor’sVisitsIfastudent-athleteistakentothedoctorsatanypoint,foranything,thereMUSTbeadoctor’snotegiventotheathletictrainerdescribingwhythestudentwasseenandifthereareanyrestrictionsorfullclearanceforactivity.Thisisforliabilityandsafetyreasons.IfthereisnotetheathletewillNOTbeallowedtopracticeuntiloneisproduced.AthletesResponsibilityItisuptotheathleteattheendofthedaytoalerttheathletictrainerofanyinjuriestheyhave.Theyalsoneedtolookoutfortheirteammatesiftheynoticethereisaproblemandmakesuretotellacoachortheathletictrainerimmediately.ParentsResponsibilityIftheirchildisexperiencinganinjury,theyarewelcometoreachouttotheathletictraineratanytime.Ifaninjuryworsensafterbeingsenthomebytheathletictrainer,contacttheathletictrainerforsuggestions.Itisultimatelyuptothefamilyiftheyfeeltheirchildneedstobetakentoanemergencydepartmentortoseeaphysician(remembertheremustbeanote).Ifthereiseveradiscrepancyormisunderstandingregardingthecareoftheathlete,theparentisaskedtocontacttheathletictrainertosetupagoodtimetodiscusstheproblemindetail.DailySign-InRecordsStudent-athletesarerequiredtosigninwhenreceivingtreatmentsintheAthleticTrainingRoom(ATR).Thishelpskeeprecordsoftreatmenttimesandtypes.CurrentlyweareusingaChromebookfromRHS,itmuststayintheATRandanystudentfoundremovingitwillbereportedtotheAthleticDirectorfordisciplinarymeasures.
RomeoHighSchoolAthleticTrainingDepartmentPolicyfortheEvaluationandManagementof
ConcussionsDefinitionAnyheadinjuryshouldbeclassifiedasa“concussion”anytimethereistraumatothehead,faceorneckofanathlete(ortraumatothebodywhichcausesawhippingofthehead)resultinginanyoneormoresymptomslistedbelow.TheredoesNOTneedtobelossofconsciousnessinordertobeclassifiedasaconcussion.Itisimportanttonotethataconcussionor“mildtraumaticbraininjury”(MTBI)isametabolicinjuryaffectingthebrainchemistry;itisNOTastructuralinjury,whichwouldbedetectedonCTscanorMRI.Therefore,referraltoahospitalemergencydepartmentisnotnecessarilywarrantedinmostcasesofMTBI.
• Concussiontypicallyresultsintherapidonsetofshort-livedimpairmentofneurologicalfunctionthatresolvesspontaneously.However,insomecases,symptomsandsignsmayevolveoveranumberofminutestohourstodays.
• Resolutionoftheclinicalandcognitivesymptomstypicallyfollowsasequentialcourse.However,itisimportanttonotethatinsomecasessymptomsmaybeprolonged.
Possiblesignsyoumayobserveifyourchildsustainsaconcussion:Balanceproblems LossofconsciousnessNausea/vomiting Slow,slurredspeech
Abnormalorinappropriateemotions Amnesia(memoryloss)Disorientation Dazedappearance
Changeinmentalstatus Sensitivitytolightand/ornoise
Possiblesymptomsyouchildmaycomplainoffollowingaconcussion:Headache Feeling“foggy”or“fuzzy”intheheadDizziness Lightheadedfeeling
Feelingexcessivelytiredorfatigue RinginginearsDoubleorblurredvision Sensitivitytolightand/ornoiseDifficultyconcentrating Difficultysleeping
Symptomsthatrequireimmediatelytransportationtoemergencydepartment
viaemergencyvehicleLonglastinglossofconsciousness SignsofinjurytospineorskullfractureDecreasinglevelofconsciousness Decreaseorirregularityinpulse
Unequal,dilatedornonreactivepupils DecreaseorirregularityinrespirationSeizureactivity Deteriorationofneurologicfunction
AthleticManagement“PostConcussionSyndrome,”orPCS(anabnormallylongrecoverytime)canoccurifanathletecontinuestoengageinphysicalactivity,orexcessivementalactivitywhilethebrainisstillrecoveringfromtheinitialconcussion.Therefore,accordingtoMichiganstatelaw,itisthepolicyoftheRomeoSchoolAthleticTrainingDepartmentthatanyathletewhoexhibitssigns,symptoms,orbehaviorsconsistentwithaconcussionshallbeimmediatelyremovedfromthecontestandshallnotreturntoplayuntilclearedbyanappropriatehealthcareprofessional.Aconcussedstudent-athleteisineligibletoreturntoanyathleticmeetorcontestonthesamedaytheconcussionissustained.Aslongastheathleteisexperiencinganyconcussionsymptoms,itisrecommendedthatheorsheNOTengageinanyphysicalexertion,includingrunning,weightlifting,andPhysicalEducationclasses,untildirectedtodosobyhisphysicianandtheRomeoAthleticTrainer.Suchexertioncanimpedethebrainchemistryfromreturningtonormal.EveryonehasaRoleCoachesneedtorecognizewhenathlete’sperformanceorbehaviorchangesandimmediatelyremovethemfromharmsway.Thenalerttheathletictrainerofconcerns.Thecoachmustnotallowtheathletetoreturntoplayunlessapprovedtodosobytheathletictrainer.Athletesneedtorecognizewhenateammate’sperformanceorbehaviorchangesfollowingatraumaticeventandalertacoachorathletictrainer.Parentsneedtorecognizesignsandsymptomsofaconcussionandreportconcernsasappropriate.Supportingappropriatephysicalandcognitiverest,especiallywhileathome.CertifiedAthleticTrainerneedstoeducatestaff/parents/coaches/athletesonconcussions.Theyareresponsibleforsidelineassessmentsandmakingindividualizedposttraumaclinicalassessmentsinthebestinterestoftheathlete’shealth.ItistheirjobtovalidateasymptomaticreportandapprovecontinuationontoReturn-to-Play(RTP)progression.TheymustoverseetheRTPandperformre-assessmentseachday.Finalreleasetofullparticipationisuptotheathletictrainersallowance.CareNotesforHomeFollowingaconcussionthatdoesnotrequireimmediatetransfertoaemergencydepartment(whicharemost)theathleteshouldnotbeleftaloneforthefirstfourhourstobeobserved.Ifanyofthesymptomsworsenparentsarewelcometocontacttheathletictrainerforrecommendationsortaketheirchildtotheemergencydepartment.Pleaseallowtheathletetosleepunlessdirectedotherwise,thereisalsononeedtowakethemupthroughoutthenight;theirbrainneedsrest.Computer,tablet,phone,andtelevisionscreentimeshouldbelimitedtoallowfullrestofthebrain.Excessivenoiseandlightshouldbeavoided.AllformsofphysicalactivityshouldbediscontinueduntilapprovedbyRomeoAthleticTrainer.
CommunicationGuidelinesWhentheathletictrainerisnotifiedofaconcussion,theywillnotifytheparents,andarrangefortransportationhomeifneeded.Onthatsameday,theywillnotifythestudent-athlete’sschoolcouncilorandcoachifneeded.Itisrequestedthatthecouncilorthenalerttheindividualteachersthattheinjuryhasoccurred.Theathletictrainerwillfollow-upwiththeparentsorathletethenextday.Asnewinformationismadeavailable,theathletictrainerwillcommunicatetocouncilorandcoaches.AcademicManagementInsomecases,itmaybenecessarytomakemodificationstothestudent-athlete’sacademicdemands,suchasallowingextratimeforassignmentsandexams,avoidanceofloudhallwaysandlunchrooms,andminimizingtheamountofreadingandhomeworkthatisrequired.Thiswillbedeterminedonacase-by-casebasis,andwillbecommunicatedbytheathletictrainersthroughthestudent-athlete’scouncilor.NeurocognitivetestingTheRomeoSchoolAthleticTrainingDepartmentutilizesaneurocognitivetestingsoftwareprogramknownas“ImPACT.”Thisisacomputer-basedtest,whichassessesneurocognitivefunctionsuchasimmediateanddelayedmemory,reactiontime,andmotorprocessingspeed.Werequireeveryathletetotakeabaselinetestbeforeparticipatinginanycompetitiveplay.All9thgraders,11thgraders,andnewRomeoathleteswilltakeabaselinetestduringtheirfirstseasonofparticipating.Ifaconcussiondoesoccur,theathletewilltakeapost-injurytestoncesymptomfreeforatleast24hours.Dr.MichaelMcMillanwillcomparetheresultsofthepost-injurytesttothebaselinetesttohelpdetermineiftheathleteisreadytobegintheReturn-to-Playprogression.PhysicianReferralBecausephysicalrestandmentalrestaretheprimarytreatmentsinthefirstfewdaysofaconcussion,itisnotalwaysnecessarytobeseenbyaphysicianimmediatelyafteraconcussion.Anathlete’sfamilymaychoosetoseeaphysicianafteraconcussionissustained;however,theMHSAAPost-ConcussionConsentForm(whichwillbegiventoathleteand/ortheirparent/guardianfollowingtheconcussionbytheRomeoAthleticTrainer;picturedbelow)mustbecompletedandhavesignedoffunconditionalclearancetounrestrictedactivity.DuetothisrequirementitmaybeinthefamiliesbestinteresttowaituntiltheImPACTtestispassedandReturn-to-Playhasstarted.TheformmustbeonfileintheAthleticTrainingroombeforereturntogameplayisallowed.RomeoAthleticDepartmentrequiresaM.D.orD.O.tograntpermissionandsignoffontheconsentform.TreatmentPlanEveryconcussionisdifferentandthereforetreatmentplanswillbeindividualizedbutwillfollowtheoutlinedReturn-To-Play,itmaytakedifferentstudent-athletesshorterorlongerthanotherstocomplete.Finalclearanceisuptotheathletictrainer.
Return-to-Play(RTP)GuidelinesOnceaconcussionhasresolved,thestudent-athletemaybegintoworktowardsreturningtohissportThismustbeagradualprocesstomakesurethathe/sheisabletohandlethephysicalexertionaswellasthebalanceandcoordinationdemandsofthesport.Followingaconcussion,astudent-athletemustmeetthefollowingcriteriabeforetheyareabletobegintheRTP:
1. He/shehasreturnedtofulldaysinschoolwithnoreturnofsymptomsandisabletohandlefullacademicworkloadwithnoaccommodations.
2. Satisfactoryreturntobaselinestatusonapost-injuryImPACTtest
Return-to-PlayProgressionNOACTIVITY
Completephysicalandcognitiverestuntilclearedbyathletictrainer
Step1 Lightaerobicexercise(e.g.,stationarybicycleorlightjogging)• 10-20minutes,lightresistance,lowspeed• Abdominalworkout
Step2 Individual,Sport-Specifictraining• Sport-specificdrills(individualorwithonpartner,NONcontact)• Throwing/catchingshootingongoal/basket,running,dribbling
andshootingbaskets/lay-ups,skatingwithstick/puckhandlingdrills,volleying
• Agilitydrills• Noheadimpactactivitiesallowed.
Step3 NON-contactpractice/drillswithteam.Thisstageconsistsofanythingthatthestudent-athletecandoinpracticewithouttheriskofcontactorcollisionwithanotherplayerorreceivingaball(batting,headersinsoccer,etc.).Resistance(weight)trainingmaybeinginthisstageaswell.
Step4 FULL-contact,full-intensitypracticewithteamStep5 Full-contactgameplayassumingMD/DOhassignedoffonfull
activity.*Student-athleteswillonlycompleteonestageperday.IfANYsymptomsreturn,thereturntoplayprogressionisimmediatelysuspended.Oncesymptomfreetheprogressionisstartedonthestepleftoffat.
RevisionsofPolicyThispolicyhasbeencreatedbasedoffinformationgatheredfromthe“Consensusstatementonconcussioninsport:the4thInternationalConferenceonConcussioninSportheldinZurich,November2012,”AmericanAcademyofPediatrics,NationalAthleticTrainers’AssociationandMHSAAPolicies.Thepolicyiscontinuallybeingupdatedasnewinformationandrecommendationsaremade.
RomeoHighSchoolAthleticTrainingDepartmentReferrals
HealthQuestPhysicalTherapyDuetoanamazingrelationshipwithHealthQuest,itisrecommendedthatanystudent-athletesneedingphysicaltherapygothere.Theirphysicaltherapistsprovideone-on-oneattentionandpersonalizedtreatmentplansthatincludemanualtherapy,thesofttissuework(GrastonTechnique®),exerciseandstretches,ahomeprogramtospeed-uphealing,andmuchmore.TheRomeoAthleticTraineralsoworksattheclinicthroughouttheweekandhasrelationswiththephysicaltherapistsallowingforamoreconnectedcareplanbetweentheschoolandtheclinic.ThroughthisrelationshipweareabletogetRomeoathletesinquickertobegintreatmentsasquicklyaspossible.HealthQuestassistsinprovidingtheathletictrainingserviceforRomeoSchools,wethankthemfortheirsupportandservicesprovided.SportsMedicinePhysicianRomeoAthleticDepartmenthasarelationshipwithDr.YusaffromCenterforAdvancedOrthopedics.RomeoathleteswhoarereferredforfurtherevaluationwillbegivenDr.Yusaf’snumber.Whencallingtosetupanappointment,mentiontheathleteisaRomeoathleteforquickerscheduling.OtherReferralNeedsTheRomeoAthleticTrainerwillassistinfindinganyotherreferralneedsstudent-athletesmayneed.
RomeoHighSchoolAthleticTrainingDepartmentInclementWeatherProtocol
ThisprotocolisbasedoftherequirementsoftheMHSAAandisaRomeoDistrictpolicy.Thesoundofthunderand/orthesightoflightningareanautomaticgamesuspension.Thefieldmustbeclearedandthespectatorsarerequiredtoseekshelter.Thedelayinthecontestwilllastaminimumof30minutesfromtheLASTsoundofthunderoroccurrenceoflightening.Thispolicymustbestrictlyfollowed.Thereisnodebate.Severeweatherintheformofrainorsnowmaymakethefieldunplayableandthereforefollowsthesamepolicies.Thesuspension/delaytimeforcontestsstartbetween10:00a.m.and3:00p.m.cannotexceed3hours;forcontestsstartedbetween3:01p.m.and6:59p.m.thedelaycannotexceed1½hours;and,contestsstartedafter7:00p.m.shouldnotexceedonehour.Contestspostponedwillbemadeupatthenextavailabledate.AnyquestionsorconcernsshouldbedirectedtotheAthleticDirector.
RomeoHighSchoolAthleticTrainingDepartmentHeatIndex
ThisprotocolisbasedoftherequirementsoftheMHSAAandistodecreasethechancesofstudent-athletessufferinganyheatrelatedillnesses.Certaincoacheswillbeprovidedadigitalslingpsychrometertotaketemperatureandhumidityreadingsatthesiteoftheactivity.Theywillberesponsibleformeasuring,recording,andturningincompletedformsintotheathleticofficeeveryweek.TheAthleticTrainerandAthleticDirectorwillalsobetrackingheatindex,butduetonotbeingabletobeateachindividualsite,itisuptothecoachtoknowthepolicyaswell.
• Watermustbeavailableatallgames,practices,andcompetitions.Restperiodsshouldbegivenevery45-60
• HeatIndexbelow80degrees-thereisnocombinationofheatandhumiditythatwillresultinneedtocurtailactivity.
• HeatIndexabove80degrees:mustbechecked30minutesbeforestartand60minutesafterstart.LEVEL1
• HeatIndex95-99:amplewatermustbeavailabletheentiretime,waterbreaksevery30minforatleast10mininlength,icewatertowelsavailable,(helmetsoff)LEVEL2
• HeatIndex99-104:amplewatermustbeavailabletheentiretime,waterbreaksevery30minforatleast10mininlength,icewatertowelsavailable,alteruniforms,alwayschangetodryt-shirtandshort,reducepracticetimeandorchangepracticetimes,helmetsshouldberemovedwhennotincontact,recheckHeatIndexevery30min,orsuspendactivity.LEVEL3
• HeatIndexabove104:NOACTIVITYinnon-airconditionedarea.LEVEL4Therecordsheethasroomfortwoheatindexchecksperdayoftheweek.Ifmorere-checksarecompletedtheyshouldstillberecordedbelow.