FIRST AID AND ATHLETIC TRAINING
EARLY HISTORY OF THE ATHLETIC TRAINER
CHAPTER #1
Greek Civilization - organized sports began
Athen Society - professional athletes evolved
1.) Gymnasts: trained their pupils the skills of a sport.
2.) Trainers: were those people who helped the athletes reach top physical condition.
Roman Empire - the fall of the roman empire concluded any trust or interest in sports activities.
Renaisance - sports slowly regained popularity
Late 19th Century - the beginning of athletic training as we know
it begain with intercollegiate athletics.
1.) They gave massages
2.) They prescribed home remedies
20th Century Athletic Training - is now one of the fastest growing fields of employment and they are now concerned with all aspects of the athletes health and safety.
1917 - the first athletic training text book was written
1930 - the first attempt to organize the NATA
1938 - the first NATA journal was written
1942 - death of the NATA due to the war
1950 - the NATA was founded in Kansas City, Missouri
1954 - the American College of Sports Medicine was founded
1956 - development of the NATA districts and the publishing
of the new NATA journal
1958 - development of an NATA educational curriculum
1969 - first schools of an NATA approved program
Indiana State (Mel Blikenstaff & Pinky Nool)
University of Arizona
Mankato State (Gordon Graham)
Univ. of New Mexico (Jeff Todene)
1979 - 23 schools have NATA approved undergraduate programs
1984 - began the start of athletic training majors
1986 - Illinois passed the Athletic Trainers Act
1989 - 70 undergraduate and 13 graduate NATA approved programs
1993 - Indiana passed the Athletic Trainers Act
1995 - Illinois State Licensure
2004 - Athletic Training Education Accreditation
Pinky Nool - the first athletic trainer who felt that A.T.
should also be physical therapists
Charles Kramer - first developed Kramer Atomic balm and other inventions which helped the athletic trainer do their job
SPORTS MEDICINE AND ATHLETIC TRAINING
SPORTS MEDICINE: A multi-disciplinary field including the physiological, biomechanical, psychological, and pathological phynomena associated with exercise and sports.
: A group of professionals who work to improve and maintain a persons functional capacities, prevent and treat diseases and injuries related to sport and exercise.
SPORTS MEDICINE PROFESSIONALS
0.) Athletic Trainer
1.) Physicians
2.) Exercise Physiologists
3.) Physical Therapists
4.) Optomotrists
5.) Dentists
6.) Biomechanists
7.) Podiatrists
8.) Pediatricians
9.) Opthamologists
10.) Coach and others ....
The coach, physical education teacher, athletic trainer, parent, athlete and the professionals in the field of sports medicine must unerstand the risks that are inherent in sports. Therefore they must also work very closely together to ensure that all injuries are properly managed.
SPORTS MEDICINE ORGANIZATIONS
1.) NATA (National Athletic Trainers Association) (1950) - established national standards for athletic trainers
2.) Federation of Sports Medicine - 1st organization (1928)
3.) American College of Sports Medicine - studies all aspects
of sports (Medicine and Science in Sports)
4.) Orthopedic Society For Sports Medicine - highly concerned with research and education (American Journal of Sports Medicine)
5.) American Academy of Pediatrics of Sports Committee
- dedicated to children involved in sports
6.) American Physical Therapy Association - set the standards for sports medicine clinics around the U.S.
7.) National Strength and Conditioning Association
Research:
How do the various methods of injury research affect sports
and the number of sports injuries?
a.) equipment failures- NOCSAE (ex. helmets)
b.) types of injuries- rule changes
c.) number of injuries- strategy changes
d.) causes and solutions- others ......
ATHLETIC TRAINER: A health professional working as the catalyst in the field of sports medicine and is responsible for the total health care of athletes and recreational activists.
QUALIFICATIONS OF THE ATHLETIC TRAINER
1.) College graduate
2.) Certified in CPR and First Aid
3.) NATA Certification
a.) NATA approved program
- classes (first aid & CPR, health, anatomy and physiology, kinesiology, exercise physiology,
basic A.T. & advanced A.T. and others ....)
- 800 hours of experience under an A.T.,C.
b.) Internship program
- classes (same)
- 1500 hours of experience under an A.T.,C.
RESPONSIBILITIES OF THE ATHLETIC TRAINER
1.) Prevention of athletic injury
a.) physical exams
b.) training and conditioning of the athletes
c.) selecting and fitting protective equipment
d.) controlling enviornmental hazzards
e.) Nutrition, drugs, medicinals, ergogenic aids
2.) Evaluation (not diagnosis) of athletic injury
a.) history
b.) observation
c.) palpation
d.) check range of motion
e.) check muscle strength
f.) special tests
g.) neurological exam
h.) referral
3.) First aid and emergency care:(the most important resp.)
4.) Treatment, rehabilitation and counseling: a gradual training regimen after an injury or surgery to return the athlete quickly using modalities and exercise.
5.) Organization, administration and education:
a.) inventory of supplies and equipment
b.) keeping injury and treatment records
c.) supervision of student trainers
d.) maintane a clean and safe training room
6.) Professional Development:CEU's
EMPLOYMENT OPPORTUNITIES (advantages and disadvantages)
1.) Secondary schools
2.) School districts
3.) Colleges or universities
4.) Professional and amateur teams
5.) Sports medicine clinics
6.) Hospitals
7.) Business wellness programs
8.) Health clubs and YMCA's
9.) Olympics and others
HEALTH CARE ADMINISTRATION IN ATHLETIC TRAINING
CHAPTER #2
Developing a Policies and Procedures Manual: for the day to day
operations of the athletic training program
1.) Who is to be served by the athletic training staff.
a.) athletes
b.) faculty and staff
c.) community
d.) physicians (outreach)
2.) Who is going to provide coverage
a.) ATC/L
b.) students
c.) nurses
3.) Training room policies
a.) hygiene and sanitation
b.) services
c.) student A.T. education
d.) record keeping
injury reports (data), treatment logs, injury evaluation and progress notes, medical records
e.) emergency procedures
4.) Budget concerns
a.) supplies
b.) equipment
c.) purchasing system (direct or bid process)
d.) physician contracts
e.) liability insurance
f.) memberships and CEU's
THE INCIDENCE OF INJURIES:
Accident: an unplanned event capable of resulting in loss of
time, property damage, injury, disablement or death.
Injury: damage to the body that restricts activity and/or causes disability
a.) 90% = muscle contusions or strains and joint sprains
b.) 10% = microtrauma complications (infections etc.)
fractures, and severe chronic conditions
c.) knee = 1st highest incidence of injury * why?
d.) ankle = 2nd highest incidence of injury * why?
e.) upper limb = 3rd highest incidence of injury *why?
THE CAUSES OF SPORTS RELATED INJURIES
1.) Extrinsic factors
a.) exposure to an injury situation
b.) amount of practicing and training
c.) enviornmental conditions
d.) equipment
2.) Intrinsic factors
a.) age and gender
b.) neuromuscular structure, body type and players skill
c.) the players mental and psychological abilities
SPORTS DIVISIONS:
1.) Collision Sports: when athletes use their bodies to deter or punish the opponent as part of the sport.
* Mostly Acute Injuries
a.) Football - the nations most injurious sport
- 125,000 knee injuries each year
- head injury fatalities = majority
- neck injury fatalities or plegia = 20%
- internal injury fatalities = 9%
* all injuries are decreasing
b.) Ice Hocky
- shoulder injuries = 34.5%
- upper extremities = 28.8%
- lower extremities = 33.8%
- incisions and lacerations 28.9%
- contusions = 19.4%
c.) Rugby
d.) Wrestling
e.) Boxing
2.) Contact Sports: involve some contact but is not the emphasis of the sport
a.) Basketball
b.) Baseball and Softball
c.) Soccer, Lacrossee and Field Hockey
d.) Water Polo
3.) Non-Contact Sports * Mostly Chronic Injuries
a.) Track and Field
b.) Gymnastics
c.) Skiing
d.) Tennis and other racquet sports
e.) Swimming
LEGAL CONCERNS AND INSURANCE ISSUES
CHAPTER #3
Legal Concerns:
1.) Liability: the state of being legally responsibe for the
harm one causes another person
2.) Negligence: conduct that results in the creation of an
unreasonable risk of harm to others, either by ...
a.) doing something that a reasonable prudent person would not do(commission) or
b.) fails to do something that a
reasonable prudent person would do under similar circumstances (ommission)
3.) Assumption of Risk: the legal responsibility to accept the usual and normal hazzards present in sports
4.) Torts: legal wrongs which are committed against the person or property of another
5.) Malfeasance: wrongdoing or misconduct (commission)
6.) Misfeasance: the performance of a lawful action in an
illegal or improper manner
7.) Nonfeasance: failure to do what ought to be done (ommission)
@ watch the video "Sports on Trial"
Insurance Issues:
1.) Primary health insurance
2.) Secondary health insurance
a.) accident insurance
b.) professional liability insurance
c.) catastrophic insurance
3.) Managed Health Care
a.) HMO's
b.) PPO's
c.) standard policy
d.) Indemnity plan
ORGANIZATION AND ADMINISTRATION
CHAPTER 26
TRAINING ROOM
1.) Size and Construction
a.) space for equipment and number of athletes
- 1,000 - 1,200 sq. feet for colleges & universities
- pre-game preparation
b.) windows - for ventilation and light
c.) floors - durable and non-slip texture
d.) drainage - for hydrotherapy area
2.) Location
a.) between locker rooms
b.) 3 entrances - 2 locker rooms and outdoors
c.) wide doors - to bring in injured athletes ....
3.) Illumination
a.) flourescent lights for distribution & even lighting
b.) color of the walls enhances lighting
4.) Special Service Sections: portions of the athletic
training room should be divided into special sections
a.) treatment area
- 4 to 6 treatment tables
- space for modalities (heat, ice, massage etc.)
b.) electrotherapy area (20% of total area)
- 2 to 3 treatment tables
- space for modalities (U.S., diathermy, E.S., etc.)
- grounded outlets & GFI 3 - 4 feet above the floor
c.) hydrotherapy area (15% of total area)
- sloped floor for drainage with non-slip surface
- 2 to 3 whirlpools, sink and shelves
- GFI with wires hidden off of the floor
d.) exercise rehabilitation area (separate from T.R.)
- resistance equipment
- space for exercise
e.) taping, bandaging, and orthotics area
- 3 to 4 high tables
- storage cabinets (tape, pre-wrap, tape prep etc.)
f.) physician exam room
- examining table, cabinet (medicinals etc.)
- availability of privacy
g.) records area - filing system or computer based
system
5.) Storage Facilities
a.) storage cabinets in the training room
b.) storage closet for bulky equipment
c.) storage garage for cart and other big items
6.) Athletic Trainers Office
a.) 10 x 15 feet
b.) located where the whole training room can be seen
c.) computer, desk, telephone, records, books etc.
PROGRAM OPERATIONS
1.) Who Should Be Served?
a.) the athlete
-during season or the whole year (times it is
open)
-what extent should the care be? (illness /
rehab)
- costs (medications, braces, taping etc.)
b.) the institution
- who? (professors, coaches, students, relatives)
- legal concern (liability etc.)
- costs / medical referral
c.) the community
- legality / insurance
-abused services / costs of services and
equipment
2.) Hygiene and Sanitation: cleanliness and prevention of infection (responsibility of A.T.'s and housekeeping)
a.) Training room policies
- no cleats or game equipment allowed
- athletes shower before receiving treatment
- no food, tobacco, horseplay or profanity
- others .....
b.) Gymnasium
-cleanliness and sanitation (uniforms, towels
etc.)
-free of germs, blood, sweat, body fluids
etc.
-equipment safe (BB rims and floor, football
pads)
c.) The athlete - encourage good health habbits
- medical clearance
- injury reporting and insurance
-good habbits (sleep, nutrition, care for
sickness)
-showers and discourage drinking from the same
cup
- others .....
3.) Facility Personell Coverage
a.) A full time A.T.,C. is a necessity
- mornings (rehabilitation)
-afternoons (treatment, practice prep. &
coverage)
- night (game coverage)
b.) All sports should be covered in some capacity
- home - vs - away
- high risk - vs - low risk sports
c.) Physician availability at high risk events
BUDGET CONCERNS
In most cases a budget of sufficient size to allow an athletic trainer to perform an efficient job of athletic training is scarce.
Budgetary meeds will vary considerably within programs
- high school, college, pro, clinics, hospitals etc.
Budget records should be kept on file for use in projecting
the following years budgetary needs.
Expenditures for individual items vary in accordance with
different training philosophies (ie. tape -vs- ankle braces)
An annual inventory must be conducted before ordering new
supplies and equipment.
1.) Supplies: are expendable and are usually for injury
prevention, first aid and injury management.
(ex. tape, germicides, bandaids, prewrap, tape prep,
ultrasound gel, elastic tape, pepto bismol, etc.)
2.) Equipment: non-expendable items
fixed - not usually removed from the training room
- (ice machine, exercise devices, modalities)
non-fixed - can be removed from the training room
-(blankets, scissors, training kits, crutches
etc.)
3.) Purchasing Systems: methods of purchase
a.) direct purchase: from a single local vendor and
usually includes small or emergency purchases
b.) competitive bids: get quoted prices from competing
vendors or companies for large purchases
4.) Additional Budget Considerations: other costs that may
be included in the operation of a training room and
program (telephone, postage, physician contracts,
liability insurance, professional organizational
memberships, journals, travel expenses, clothing etc.)
ADMINISTERING PREPARTICIPATION HEALTH EXAMS: to identify if an athlete is at risk before he or she participates in a sport.
1.) Medical History: should be completed before the physical
exam
a.) its purpose is to identify any past or existing
medical problems.
b.) participation release forms and insurance
information
2.) Physical Examination: should include assessment of
height, weight, body composition, blood pressure, pulse, vision, ear, nose and throat, heart and lung function, abdomen(hernia), lymphatics, genetalia, urinalysis & blood work.
3.) Maturity Assessment: Tanners' five stages of assessment
a.) sexual characteristics .....
b.) physical characteristics .....
c.) mental characteristics .....
stage #1(pre-puberty) stage #2(puberty) stage #3(post-puberty)
- non-contact & - fastest bone- collision & high
low intensity sports growth intensity sports
- 1st - 6th grade - 7th - 12 grade - 12th - adulthood
4.) Orthopedic Screening: assess strength, range of motion,
and stability at various joints.
5.) "Station Examination": provides a detailed examination
of a lot of athletes in a short period of time.
a.)2 physicians (abdomen, ear, nose, throat,
orthopedic)
b.)2 nurses (weight, height, B.P., blood work,
vision)
c.)2 A.T.,C.'s (body comp., release and insurance
forms)
* physical examination form (pg. 833)
6.) Sport Disqualification
a.) athlete who has lost 1 of a pair of organs (eyes,
kidneys, etc.) should not play collision/contact
sports.
b.) heart malfunction
c.) athlete who does not pass an orthopedic exam
d.) athlete with any life threatening condition (aids?,
mononucleosis, previous concussions etc.)
RECORD KEEPING: and up to date files are a necessity
1.)Medical Records - physician exams, physicals, x-rays,
etc.
2.) Injury Reports - a record for future reference which are
filed in the athletic trainers office along with all
medical referral forms
3.)Treatment Log - a sign in for treatment or services and
be used as legal documents in a court case
4.)Personal Information file - provides a means of
contacting the family, personal physician and
insurance information
5.) Injury Evaluation and Progress Notes
a.) Subjective history of the athlete and injury
b.) Objective evaluation of the injury by the A.T.,C.
c.) Assessment of the injury
d.) Plan for treatment and management (goals etc.)
6.) Supply and Equipment Inventory - for use during the year
7.) Annual Report - includes the # of athletes served,
injuries, inventory, and analysis of the program
8.) Computer Use - for record keeping, paper work, nutrition
counseling, body composition & injury profiles etc.
CURRENT NATIONAL INJURY DATA GATHERING SYSTEMS: the collection
systems that tabulate the incidence of sports injuries.
1.) National Safety Council
2.) Annual Survey of Football Injury Research
3.) National Center for Catastrophic Sports Injury Research
4.) NCAA Injury Surveillance System (collected from ATC’s)
5.) National Football Head and Neck Injury Registry
6.) National Electronic Injury Surrvelence System (NEISS)
* National Operating Committee on Sports Athletic Equipment
- Consumer Product Safety Act (CPSA) - was established by
The government to enforce safety standards of consumer products and also monitors the injuries caused by them.
INSURANCE REQUIREMENTS: are essential for everyone involved to
prevent the dramatically increasing number of law suites.
1.) General Health Insurance: which covers illness, hospital
visits, emergency care (usually family insurance)
a.) may include catastrophic insurance
b.) many companies cover "preventative care"
- HMO's: Health Maintanance Organizations
- usually pay 100% of medical costs only if
you use their services or it is an emergency
- premiums are lower
-PPO's: Preferred Provider Organizations: provide discount health care for a limited # of
places
2.) Accident Insurance: covers accidents on school grounds
3.) Personal Liability Insurance: usually provided for the
employee of schools or organizations against claims of
negligence.
4.) Catastrophic Insurance: pays for expenses of certain
injuries which have reached $25,000 and are extended for a lifetime.
1.) Student Insurance ($500.00 which covers deductable)
2.) Parents Health Insurance
3.) IWU Sports Insurance
* does contain Catastrophic Insurance
Primary Coverage vs Secondary Coverage
* It should be policy that an athlete can not participate in
athletics unless they have health insurance.
BANDAGING AND TAPING
CHAPTER #8
Dressing: A covering to provide protection or support for an
injury or wound.
Types:
1.) gauze (sterile/non-sterile)
2.) non-adherent pads (sterile/non-sterile)
3.) bandaid
Bandage: A strip of cloth or other material used to cover
a wound, secure a dressing, or provide protection and compression.
Types:
1.) gauze
2.) cotton cloth (ankle wrap)
3.) elastic roller bandage/wrap
4.) cohesive elastic bandage/wrap
5.) triangular and cravat bandage
6.) athletic tape
7.) elastic tape
Application:
1.)proper amount of pressure (check circulation)
2.)overlapped by ½
Taping: a linen adhesive tape has adhering qualities, lightness,
and strength for many purposes. (grades, widths etc.)
Purposes:
1.)holding wound dressings
2.)support and protection of injured areas
Using Adhesive tape in Sports:
1.)preparation (clean, shave, tough skin, underwrap)
2.)proper taping technique
3.)tearing tape
4.)Rules for taping
a.)proper anatomical position