Transcript You are WORTH it!... Tools for the College AT

April Reed, MS, ATC, CSCS
Assistant Athletics Director, Head Athletic Trainer, Azusa Pacific University
Carolyn Greer, MA ATC
Associate Director for Sports Medicine, Head Athletic Trainer , University of San Diego
Fran Babich, ATC
Instructor, Butte College
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CUATC FWATA REPRESENTATIVES
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April Reed, Chair [email protected]
Fran Babich, CC
Darin Voigt, NAIA
Marilyn Oliver, NCAA DIII, ATEP
Josh Davis, NCAA DIII, Assistant AT
Vanessa Yang, NCAA DII
Carolyn Greer, NCAA DI AA
Matthew Harrelson, NCAA DI
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 College-University
Value
Model
 NATA AMCIA
 BOC Facility Standards
 CUATC 10/10 Presentations
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Created by NATA Committee on Revenue/
CUATC/ College Value Model Workgroup
Meant to help ATs maintain and improve their
positions
Meant to create more AT jobs in
college/university setting
Help ATs pair their value with institutional
values
Expand the knowledge of our jobs from
“coverage” to “care” provided
 Medical
Services
 Risk Minimization
 Organizational/Administrative
Value
 Cost Containment
 AT Influence on Academic
Success
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Injury Evaluation and Treatment
Injury Rehabilitation and Reconditioning
After hours/On-call consultation and
injury/illness management
Outside Medical Provider Services
Team Physician Services
Diagnostic Testing
Exclusive medical provider contracts
Injury prevention programs
Ancillary medical services
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PREVENTION, EVALUATION Re-Evaluations,
TREATMENT, REHABILITATION,
PPE: Orthopedic, FMS, Gen Med.
General Prevention: Orthopedic, GEN MED,
Nutritional, etc..
Coordination of MD, PT, Strength/
Conditioning, etc..
On Call
Others on campus provided for: Coach,
Admin, etc.
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Injury Prevention & Care Policies
Environmental monitoring
Emergency Action Plans
Functional Movement Assessments/Assessment of
pre-existing conditions
Mental Health Counseling referrals
Nutrition suggestions and referral
Safe Facilities
Create/Maintain appropriate medical referral system
Review epidemiologic and current evidence-based
research for clinical outcomes assessment
Design and application of preventive and post-injury
taping, bracing and padding
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Protective Equipment Selection, Fitting & Use
Recommendations for sport rule changes
Make appropriate play/no-play decisions
First Aid/CPR training
Infection control
Facilitate PPEs
Practice/event coverage
Knowledge of and recommendations for institutional
and governing body drug testing
Budget management to provide adequate resources
to purchase risk reduction supplies
Using communication and interpersonal skills to
create trust between student-athletes, coaches,
administrators and the athletic training staff
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Comprehensive medical screening
Movement Screening
ACL prevention programs
Body Comp Testing
Concussion Baseline/Neurocognitive Testing
Dental Protection: Custom mouth guards
Preventative Bracing Programs: Custom Knee,
Ankle
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Injury records
Credential maintenance
Pre-participation examination (PPE)
Sports Medicine Team relations
Emergency Action Plans (EAPs)
Insurance
Quality Control
Drug Testing
Risk Management
Education
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PPE
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Scheduling MDs
Coordinating Team Rosters
Scheduling Teams
Sending out paperwork
Receiving and processing paperwork
SPORTS MEDICINE TEAM RELATIONS
◦ Coordinating designated team physician
◦ Coordinating with Orthopedics
◦ Coordinating with other Specialities: ENT,
Opthomalogists, PTs, Dental, Chiropractic, Massage
etc….
 Insurance
Premiums
 Staffing and Workload
Management
 Medical Services
 Budget Management
 Fund Raising
 Academic Success
 Contracts
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Advise athletic administrators, business office
or other university staff on issues related to
appropriate athletics insurance coverage
Monitor utilization of athletic department
insurance benefits
Keep accurate records to assure insurance
coverage and payment
Assist with creation of discount arrangements
with outside medical/allied health services
providers, and sometimes pro bono care
 Student
Retention/APR
 Life Skills
 Conditions Affecting
Learning/Psychological issues
 Counseling
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Recognition of potential problems and issues
inhibiting student-athlete retention
◦ Trouble in classes
◦ Issues with professors
◦ Determination of Major
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Liaison and referral to campus services: career
center, learning center, student life, academic
advisors
Impartial observer whose jobs are not based on
win/loss records. Student-athletes seek AT’s out
for advice beyond injury management
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Mentoring as a role model and instructor in healthy lifestyle choices
Recognition of potential problems and issues related to life skills
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Communication issues ( Dating, roommates, family, friends, team dynamics)
Conflict resolution issues
Housing Issues
Dating/relationship problems
Career decisions
Job/financial issues
General Healthcare and well being
Life Balance
Time management
Stress management
Life challenges/tragedies
Homesickness
Liaison to campus services IE: career center, student life
Treatment or assistance with care of non-sport related conditions that can
affect play and continued academic engagement:
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Depression
Eating disorders
Self-mutilation
Self-disclosed or test-revealed substance use/abuse issues
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Customize it to your Institution and your
needs
Educate your administrators
Find out what they value, speak their
language
Educate your staff
Educate the next generation of ATs
Pair it with other tools (AMCIA, BOC, Hours
Log)
USE IT!!
APPROPRIATE MEDICAL COVERAGE FOR
INTERCOLLEGIATE ATHLETICS
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The AMCIA document will help evaluate an
institution’s ability to deliver health care to its
student/athletes.
Use of this document demonstrates that an
institution has done due diligence with selfevaluation of the medical delivery system and that
all stakeholders (AD, risk manager, CEO, athletic
trainers, coaches and physicians) are on the same
page and in agreement with the system in place.
It is not meant to be a stand-alone document but
to work in concert with each institution’s needs.
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The trend in college athletes: more teams,
more non-traditional seasons, more strength
and conditioning, and more “captains”
practices
This equates to more exposures for the
athlete
AMCIA provides a tool to quantify the amount
of medical care needed
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More than basic emergency care
Encompasses other health care services for
ongoing daily health care, may include:
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PPE
Prevention
Evaluation
Rehabilitation
Psychosocial
Administration
Professional Development
Other
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Committee recommendations came out in
2000 with revisions in 2003 and 2007
Online worksheet was developed in 2011 with
mentors to assist
Original formula and revisions were made
based on epidemiological studies that tracked
injury rates and treatments in 50 colleges and
universities across 5 divisions
Currently being reviewed by the CUATC
National Committee.
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Variables considered for the formula were
related to the sport and:
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Likelihood of injury
Severity of injury
Care required
Other factors that affect the ATC’s time
Time = measured in HCU (Health Care Units)
which is modeled from FTE (full-time
equivalent for teachers)
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Constants
◦ Estimated health care load per AT is 12 health care
units (HCU)
◦ Each sport has an assigned base Health Care Index
(HCI): value derived from injury rates (IR) and
treatments
◦ Each sport assigned base value also represents the
risk of catastrophic injury (CI)
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Variables
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Travel
Squat Size
Days in Season
% of Year Participating
Administrative Duties
Formula
◦ Worksheet that allows AT to enter institution
specific information to determine needs
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Be informed. Read the whole AMCIA document
be able to answer questions
Be conservative in your numbers, but make sure
they fit your setting/institution
Strategies for Using the document: Large
Schools, Small Schools.. PDF online
In conjunction with Value Model, Recording of
Hours, Etc.
Maybe not more staffing, less expected coverage
Mentors available online
nata.org/appropriate-medical-coverageintercollegiate-athletics
FOLLOWING STATE AND
FEDERAL REGULATIONS
FOR HEALTH CARE
FACILITIES
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The Evolution of Athletic Training Facilities
Board of Certification- Online evaluation tool
Spring/Summer 2013
◦ “The delivery of healthcare in the United States is
heavily regulated. Numerous organizations, local,
state and federal, are responsible, often
overlapping, for ensuring the quality of facilities
where healthcare services are delivered through
the promulgation of regulations and standards.”
Copyright © 2012 Board of Certification (BOC)
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Identified the need for the development of a
document for athletic trainers and their
healthcare delivery
July 2011: as part of the Vision Quest project
of the BOC, CAATE, and the NATA developed
an ad hoc group
Experts chosen to develop educational
materials and tools to ensure legal provision
of athletic healthcare
State licensure
Athletic Training, Physician, Physical Therapy, Pharmacy
State/Local Board of Health
AAAHC
Accreditation Association for Ambulatory Health Care
ACSM
American College of Sports Medicine
ADA
Americans with Disabilities Act
BOC
Board of Certification, Inc.
CAATE
Commission on Accreditation of Athletic Training Education
CARF
Commission on Accreditation of Rehabilitation
CDC
Centers for Disease Control and Prevention
CMS
Centers for Medicare & Medicaid Services
DEA
Drug Enforcement Administration
FDA
US Food and Drug Administration
FERPA
Family Educational Rights and Privacy Act
HIPAA
Health Insurance Portability and Accountability Act
JCAHO
The Joint Commission
NAIA
National Association of Intercollegiate Athletics
NATA
National Athletic Trainers' Association, Inc.
NCAA
National Collegiate Athletic Association
NFHS
National Federation of State High School Associations
NJCAA
National Junior College Athletic Association
OSHA
Occupational Safety and Health Administration
PPACA
Patient Protection and Affordable Care Act
Title IX
Title IX, Education Amendments of 1972
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Americans with
Disabilities Act (ADA)
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◦ Accessibility, nondiscrimination
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Display of Licenses and
Certifications
Emergency
Management(NATA,
NCAA)
◦ EAP
◦ Means of Egress
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Employee Safety (CDC,
OSHA)
◦ BBP; PPE, no open-toed
shoes
◦ Facility/Personal hygiene
◦ Workplace violence
Facility Safety (OSHA)
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Electrical Safety
Fire Safety/prevention
Walking/working surfaces
Hazards
Hazardous Materials (OSHA)
◦ Disposal: biohazard/sharps
◦ Storage/handling/MSDS
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Patient Safety and
Supervision
◦ Supervision
◦ Reporting adverse events
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Records Storage (FERPA,
NATA, HIPPA)
◦ Storage and dissemination of
medical records including EMR
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Aquatic Safety
(OSHA)
◦ Pools/therapy pools
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Medications (DEA,
FDA) (OTC/Rx)
◦ Storage and
documentation
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Medical Devices
◦ Lead Cord Safety
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Public Safety
◦ Public access AED
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OSHA (includes but
not limited to):
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Ergonomics
Lighting
Radiation safety
Machine safety
Noise exposure
Plumbing
Ventilation
Private exam area
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Emergency planning
(NATA, NCAA)
◦ Venue specific EAP’s
◦ Phone access
◦ Adequate and accessible
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Legal (BOC)
◦ Under direction of MD
◦ Malpractice insurance
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Organizational (NATA,
OSHA)
◦ Policies and procedures
◦ Maintenance of
equipment
◦ Cooler cleaning
◦ Potable Water and Hoses
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Record keeping
◦ Paper and electronic
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Standards
◦ BOC Standards of
Professional Practice
◦ State practice act (if
applicable)
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Available late spring/summer
◦ A resource that a template/checklist for athletic
trainers to use as a resource to ensure that their
facilities and their education meets industry
standard
◦ BOCATC.ORG website or NATA.ORG
◦ Intended not only for the collegiate setting, but
athletic training rooms
WHAT : Preset PPT, approx. 10
slides, meant to be delivered in 10
minutes
 WHO: Coaches, Administrators, SA
 WHERE: Found on the NATA website
http://www.nata.org/accessread/member/10-10-presentations
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Asthma in Athletes
Concussions in Intercollegiate Athletics
Diabetes Mellitus
Drug Testing, Supplements, and Banned
Substances
Emergency Action Planning
Environmental Considerations
Exertional Heat Illness
The Female Athlete Triad
Pregnancy in Student-Athletes
Sickle Cell Trait and Intercollegiate Athletics
Sudden Cardiac Arrest in Intercollegiate Athletics
 Concussion
Follow up- CDC
Education
 Mental Health: Anxiety, ADHD,
Mood Disorders, Depression
 Suicide Triage/Prevention
 Rhabdo
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your policies, specific
procedures
 Add your pics
 Tweak them to fit the needs of
your Institution/Department
Are you prepared?
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Sudden cardiac death occurs in 1:43,000 NCAA
student-athletes per year
The chance of survival decreases by 10% every
minute after collapse
The average EMS response time is 6-8 minutes
The single greatest factor affecting survival is the
time from cardiac arrest to defibrillation (shock)
AEDs improve survival through early defibrillation
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Student-athletes are required to have a preparticipation physical examination.
The traditional screen includes:
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Some schools perform EKG (electrocardiogram)
to increase detection of athletes with at-risk
conditions
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History (chest pain or passing out with exercise)
Physical exam (blood pressure, heart sounds)
Appropriate experience and resources are important for
EKG screening to be utilized effectively
Insert institutional screening policy here if applicable
Written Emergency Action Plan for
SCA
Emergency communication system
Trained responders in CPR/AED
AED locations – all staff awareness
(In Season and OUT)
Access to early defibrillation
(<3-5 min collapse to shock)
Practice and review of the
response plan at least annually
Integrate AEDS into local EMS
system
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FEC North West 1st Floor- Wall Mount
Weight Room- Wall Mount
Sports Medicine Fall- FB, SOC
Sports Medicine Spring- SB/TN(match), TK, BB
Health Center
Campus Safety Vehicles
Essential elements of an emergency
action plan include:
• All venues have a specific plan, Know it,
have it readily available
• Methods of communication
• Personnel requiring CPR and AED training
• Locations of AEDs for early defibrillation
• Practice and review of the response plan
Emergency Personnel:
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ATC on site for games and in season practices.
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ATS/SMA on site for games and in season practices, when available.
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CPR/AED Certified Head Coach on site for all games and practices
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Additional athletic training staff accessible from the Stadium athletic training room
Emergency Communication:
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Cell phone as primary.
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Press box land line as back-up.
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Radio System
Emergency Equipment:
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In Season Practice- Athletic Training Kit, Vacuum Splints/Ambu Bag, Ice
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Off Season Practice- First Aid Kit
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Game- Athletic Training Kit, Ice, Spine board, Vacuum Splints/Ambu Bag, Biohazard Kit
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Additional emergency equipment accessible from the Stadium athletic training facility 626-815-6000 Ext. 3212.
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AED available in atrium of Cougar Dome via wall mount.
Roles of First Responders:
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1. Immediate care of the injured or ill student-athlete
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2. Emergency equipment retrieval
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3. Activation of emergency medical system (EMS)
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a. 911 call (provide name, address, telephone number; number of individuals injured; condition of injured; first aid treatment; specific directions;
other information as requested
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b. Notify campus safety at (626) 815-3256 or via an ATC radio on channel 4
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4. Direction of EMS to scene
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a. Open appropriate gates
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b. Designate individual to "flag down" EMS and direct to scene
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c. Scene control: limit scene to first aid providers and move bystanders away from area
Venue Directions:
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The baseball stadium is located APU’s Main Campus at 901 E. Alosta across the street from the McDonald’s on Alosta. Enter campus from Alosta.
Citrus and Alosta are the nearest cross streets.
Environmental Conditions:
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Lightning:
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Safe Shelter Location: Baseball Locker Room, Engstrom Hall, Cars (not convertibles or golf carts)
Chain of Survival
Early
Early
Early
Recognition
CPR
AED
Improved
Survival
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SCA should be suspected in any athlete
who is collapsed and unresponsive
SCA should be suspected in any nontraumatic collapse
Brief seizure-like activity is common
after collapse from SCA
Seizure = SCA until proven otherwise
Occasional gasping is not normal
breathing… think SCA
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CPR can double or triple
the chance of survival
< 1/3 of SCA victims
receive bystander CPR
2010 AHA guidelines
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Hands-only CPR
Chest compressions
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Push hard, push fast (100
per minute)
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AEDs provide a means of early defibrillation
and the potential for effective management
of SCA
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Athletes
Students
Staff
Spectators
Coaches
Officials
Visitors
2007
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Suspect SCA in any
collapsed and
unresponsive
athlete
An AED should be
applied as soon as
possible for rhythm
analysis and shock
if indicated
Drezner; Heart Rhythm 2007
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Recognize SCA
Call for help / Call 9-1-1
Begin chest compressions (CPR)
Retrieve the AED
Apply and use the AED as soon as possible
Continue CPR until EMS arrives
Inter-Association Task Force Recommendations on
Emergency Preparedness and Management of Sudden
Cardiac Arrest in High School and College Athletic
Programs: A Consensus Statement. Journal of
Athletic Training 2007;42(1):143–158
NCAA Health and Safety
• http://www.ncaa.org/wps/portal/ncaahome?WCM_GLOBAL_
CONTEXT=/ncaa/ncaa/academics+and+athletes/personal+
welfare/health+and+safety/raising+awareness+of+sudden
+cardiac+collapse+in+sports
 THANK
THE NATA, CUATC
NATIONAL COMMITTEE,
VARIOUS COMMITTEES
 THANK FWATA
 Let us know how we can help
you!