Wednesday, October 10, 2012

Youth Sports Safety: 5 Questions Every Parent Should Ask, #2


There are a variety of health care providers out there that may be able to help to your child at any given time, but I am advocating for the availability of athletic trainers because of the specific combination of skills and training they can provide.  In doing so, I am not minimizing the care a person trained as an Emergency Medical Technician (EMT) or a layperson trained in first and CPR can provide.  Often times, athletic trainers, EMTs and others need to cooperate in emergencies in order to have a successful outcome for the individual who requires assistance.  I simply hope to demonstrate the key combination of knowledge and skills an athletic trainer can provide.

The three key organizations you need to be aware when understanding the knowledge and skills of an athletic trainer are the National Athletic Trainers’ Association (NATA), the Board of Certification, Inc. (BOC), and the Commission on Accreditation for Athletic Training Education (CAATE).  Knowing what resources these organizations provide and how to access them will be important when advocating for an athletic trainer for your organization.  CAATE focuses on the requirements for the education of entry-level athletic trainers (ATs) and now post-professional training for ATs.  The BOC is responsible for administering the national exam that ATs must pass to practice as athletic trainers and assuring ATs meet necessary continuing education requirements and abide by the required standards of practice.  This organization can also provide you access to information regarding individual state licensure requirements for ATs.  The NATA is the professions’ advocacy group, working to improve and promote the profession of athletic training through research, governmental advocacy, and professional promotion among others.  The NATA is also responsible for developing and disseminating many of the key position statements made available throughout this post.

Athletic Trainers must graduate from an accredited athletic training education program (typically a Bachelor’s degree) and pass a national examination sponsored by the Board of Certification, Inc. in order to practice as an athletic trainer.  In reality, almost 70% of athletic trainers have earned a Master’s degree.  In all but a few states, athletic trainers must also be registered, certified or licensed (the designation depends on the legislation within that state) with their state in order to practice in that specific state.  When seeking out the services of an athletic trainer it is important that they can provide proof of their national certification, state licensure and CPR/AED certification.  If a person, referring to him or herself as an athletic trainer cannot provide this documentation, s/he may not have the complement of skills listed below and may not be an athletic trainer as defined in your state.

Athletic Trainers certified by the Board of Certification, Inc. are equipped with a full complement of skills that can be advantageous to parents who want to be sure that their children are safe during sports participation.  These skills are grouped into five domains:

Injury/Illness Prevention and Wellness Protection

Athletic trainers have the ability to assess a situation and take steps to minimize the potential for injury or illness for participants.  It can range from moving extra equipment to a safe place so participants do not run into it and risk being injured or assessing the heat index to determine if the weather is appropriate for practice and to what degree.  For example, a coach may remember to remove extra equipment, but they may or not be trained in the decision-making required to be sure key precautions are taken when practicing in hot and humid conditions.  The best way to treat heat illness is to prevent it, by changing your practice time, increasing water breaks, and decreasing the amount of equipment worn.  An athletic trainer can help coaching staffs make the correct decisions in these situations, among many others and provide a safe participation environment.

Clinical Evaluation and Diagnosis

Athletic trainers have the ability to evaluate athletes who are injured or become ill during participation and make the appropriate decisions on the immediate care they may require.  ATs may also decide whether continued participation is warranted, often a conflict of interest for coaches in the heat of a contest.  Immediate care decisions can include basic first aid such as RICE (rest, ice, compression, and elevation) or even referral to a specialist for follow up care.  In the worst case, athletic trainers are qualified to recognize when Emergency Medical Services (EMS) must be activated for immediate transport to a local hospital.

Immediate and Emergency Care

As mentioned above ATs can recognize when EMS needs to be activated.  ATs are trained to take the appropriate intermediate steps necessary until EMS arrives to maximize the potential of a positive long-term outcome for the participant requiring assistance.  Athletic trainers have the skills and techniques to recognize and treat a variety of emergent conditions including sudden cardiac trauma, concussions, head/neck injuries, heat illness, exertional rhabdomyolosis (sickle cell trait), and fractures, among others.  These situations are probably the most worrisome for parents and I believe it is important to have someone available who can handle such a wide variety of emergencies.

 Treatment and Rehabilitation

Athletic trainers provide initial treatment for injuries, but in situations where long-term rehabilitation may be required, can also provide rehabilitative services.  The ability to provide these services will depend on the setting in which the athletic trainer is employed and your state legislation which describes if and how these services can be provided by an athletic trainer.

Organizational and Professional Health and Well Being

Athletic trainers have a Standards of Professional Practice (BOC) and Code of Professional Ethics (NATA), ensuring that the best care possible will be provided to all patients.  Additionally, athletic trainers are required to participate in annual continuing education to remain up-to-date in their clinical practice.  Regular participation in continuing education is necessary to maintain the ATC© credential.  This practice assures that athletic trainers are using current best practices when caring for participants.

To learn more about the specific knowledge and skills an athletic trainer can offer you and your organization review the National Athletic Trainers’ Association document, “Athletic Training Services:  An Overview of Skills and Services Provided by Athletic Trainers.”  Coaches and other medical personnel such as EMTs may not have this specific range of knowledge and training making athletic trainers an ideal option for improving sports participation safety for athletes of all levels.

When considering adding an athletic trainer to your high school or sports league staff it is important to remember the following:
  • Athletic trainers always work under the direction of a physician (which means your league/district must have a medical director for the AT to work under).
  • When hiring an AT confirm s/he has the appropriate credentials to provide the care you require and expect.
    • To verify the professional credentials of an athletic trainer with the BOC, click HERE.
    • To verify the registration, certification or licensure status of an athletic trainer most states provide an online search option at the state licensing website.
    • To verify current CPR/AED certification request a copy of their card (front & back)
  • When an AT works with minors (children under 18) certain non-emergency decisions require a parent’s consent.  Where appropriate be sure signed informed consent forms are available in the case of an emergency and a parent cannot be reached.
  • Have clear expectations for the AT (and parents) when the AT will be available and working.  For example, when will coverage be provided?  Events only?  Practice and events?  If an AT is covering simultaneous events/practices is there a hierarchy of when and how these concurrent events will be covered?
The National Athletic Trainers’ Association advocates for the availability of athletic trainers at all events and venues:

In an effort to safeguard athletes in organized sports and minimize injuries at both practices and competitions, the NATA recognizes that athletes of all ages and levels of participation should have equitable access to the health care services delivered by a highly qualified, licensed or otherwise regulated, academically qualified professional athletic trainer. NATA believes that the minimum standard of health care for athletes should include employing an athletic trainer who is directed by a physician, having emergency action plans, and establishing safety and medical protocols and procedures at every public and private sports venue and for every sporting event.” 


QUESTION #3:  Is there someone trained in CPR/AED available at all times?... will be addressed in the next post. 

Submitted by Heather L. Clemons, MS, MBA, ATC

No comments:

Post a Comment