IS THERE AN ATHLETIC TRAINER AVAILABLE?
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.”
KEY POSITION/OFFICIAL STATEMENTS TO BE
AWARE OF FROM THE NATA:
- Full-time, on-site athletic trainer coverage for secondary school sports
- NATA recommends athletic health care providers adopt a “Time Out” system before sporting events
- National Athletic Trainers’ Association Position Statement: Preventing Sudden Death in Sports
- National Athletic Trainers’ Association Position Statement: Preventing Pediatric Overuse Injuries
- For other statements addressing a range of topics including concussion, heat illness, head/neck injuries, eating disorders, and steroids among others, click HERE.
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
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