San Felipe Del Rio CISD. Athletic Training. Procedures Manual

Transcription

1 San Felipe Del Rio CISD Athletic Training Procedures Manual Adopted on July 25, 2014 Athletic Director: Ric Smith Head Athletic Trainer: Brad Dixon, LAT/ATC 1

2 Table of Contents Statement of Purpose.3 Section I - Regulations Governing the Certified Athletic Trainer b. Texas Regulations.. 3 c. CPR Certification... 4 d. Other Certifications. 5 Section II - Athletic Trainer Job Descriptions a. Head Athletic Trainer.. 5 b. Assistant Athletic Trainer 5 e. High School Student Assistants...5 Section III - Athletic Trainer Evaluation a. Evaluation Procedure (Head Athletic Trainer)...5 b. Evaluation Procedure (Assistant Athletic Trainer) 6 c. Evaluation Instrument for Head Athletic Trainers.... Appendix A1 d. Evaluation Instrument for Assistant Athletic Trainers...Appendix A2 Section IV - Team Physicians a. Roles and Responsibilities 6 b. Standing Orders 7 c. Team Physician Standing Orders Form..... Appendix B. Section V - Coverage of Athletic Contests and Practices a. Varsity football..7 b. Junior Varsity and/or B-team football 7 c. Other home contest coverage. 7 d. Practice coverage...7 e. Coverage of athletic events during scheduled school holidays..7 Section VI - Training Room Policies, Procedures, and Facilities a. Training Room Rules b. Training Room Facility Guidelines.. 8 c. Return to Play Guidelines. 8 -Concussions... Appendix E &..8 d. Examination of Opposite Sex Student Athletes e. Over-the-Counter Medications....8 f. Inhalers. 9 g. Emergency Insect Sting Kits..9 Section VII - Emergency Procedures and Transportation Policy for Injured Athletes a. The Emergency Plan.. 9 b. Basic Emergency Equipment. 9 c. Transporting the Ill or Injured Athlete. 10 Section VIII - Documentation and Record Keeping a. Student Athlete Records b. Training Room Records c. Regular Reporting Section IX Weather and Lightning Guidelines a. Severe Weather and Lightning Guidelines b. Severe Heat Guidelines...12 Heat Index.. Appendix C c. Severe cold guidelines

3 Statement of Purpose The purpose of this document is to provide general guidelines, with minimum standards, for Licensed Athletic Trainers employed by the SFDRCISD. Each Licensed Athletic Trainer is encouraged to work with his/her principal, athletic director, team physician(s), coaching staff, and other appropriate personnel to establish additional guidelines for their particular school. Section I Regulations Governing the Licensed Athletic Trainer Head Athletic Trainers employed by the SFDRCISD must be licensed by the State of Texas. a. Texas Regulations - Athletic Trainers in Texas are required to be certified by the state through the Department of Health (TDH). - To become certified as an Athletic Trainer in Texas and individual must: 1. Possess a Bachelor s or Master s degree from an accredited college or university 2. Successfully pass the state athletic training licensure exam. - Once licensed by the State of Texas, Athletic Trainers must maintain their state licensure through continuing education. Licensure must be renewed every year. - Texas continuing education requirements for Athletic Trainers: 1. A licensee that is on a one-year renewal cycle must complete 30 clock-hours of continuing education during each three-year period as described in this subsection. In addition to the 30 clock-hours of continuing education, a licensee must also successfully complete a cardiopulmonary resuscitation (CPR) techniques course and an automated external defibrillation course during each three-year period. The three-year period begins on the first day following the issuance month and ends on the last day of the licensee's renewal month. The initial period shall begin with the date the board issues the license certificate and ends on the last day of the third renewal cycle. 2. A licensee that is on a two-year renewal cycle must complete 40 clock-hours of continuing education during each two-year period. In addition to the 40 clock-hours of continuing education, a licensee must also successfully complete a cardiopulmonary resuscitation (CPR) techniques course and an automated external defibrillation course during each two-year period. The two-year period begins on the first day following the license issuance month and ends upon the expiration date of the license. - Continuing education credit undertaken by a licensee for renewal shall be acceptable if the experience falls in one or more of the following categories: 1. academic courses at a regionally accredited college or university related to sports medicine; 2. clinical courses related to sports medicine; 3. in-service educational programs, training programs, institutes, seminars, workshops and conferences in sports medicine or athletic training; 4. instructing or presenting education programs or activities without compensation at an academic course, inservice educational programs, training programs, institutes, seminars, workshops and conferences in athletic training or sports medicine not to exceed five clock-hours each continuing education period; 5. publishing a book or an article in a peer review journal relating to athletic training or sports medicine not to exceed five clock-hours each continuing education period; 3

4 6. serving as a skills examiner at the state licensure examination not to exceed one clock-hour of continuing education credit for each examination date for a maximum of six clock-hours of credit each continuing education period; or 7. successful completion of a self-study program in athletic training or sports medicine, not to exceed eight clockhours each continuing education period. - Continuing education experience shall be credited as follows. 1. Completion of course work at or through an accredited college or university shall be credited for each semester hour on the basis of two clock-hours of credit for each semester hour successfully completed for credit or audit as evidenced by a certificate of successful completion or official transcript. 2. Parts of programs which meet the criteria of clinical or in-service programs of this section shall be credited on a one-for-one basis with one clock-hour of credit for each clock-hour spent in the continuing education experience. 3. A clock-hour shall be 50 minutes of attendance and participation in an acceptable continuing education experience. 4. Successful completion of self-study courses is evidenced by a certificate of completion presented by the publisher, or sponsoring organization of the self-study program. 5. Approval by the continuing education committee must be obtained for each continuing education program as described in subsection (c) of this section, unless continuing education credit is granted by a national, regional or state health care professional association. - Reporting Procedures 1. All reporting activity is the responsibility of the Athletic Trainer. All reporting will be done in conjunction with the renewal date of licensure by the State of Texas. Athletic Trainers are re-licensed every two years. All documentation will be returned to TDH with the renewal application. 2. The required documentation is a photocopy of the continuing education attendance cards signed by a member of the CEU group provider. A photocopy of a current CPR card from either the American Red Cross or the American Heart Association. - Enforcement 1. The Athletic Trainer will not be licensed at the two-year renewal date without the proper documentation showing proof of continuing education. All documentation must be current at the time of renewal. - All Athletic Trainers employed by the SFDRCISD will make documentation of state licensure available to the following upon their request: the building level principal; athletic director; the superintendent; the Board of Education; and other school district personnel as designated by the superintendent and/or Board of Education. In addition, a copy of this licensure will be kept on file in the athletic trainer s personnel record at the SFDRCISD Office of Personnel. c. CPR Certification - Athletic Trainers employed by the SFDRCISD shall be certified by the American Red Cross or the American Heart Association in Cardio-Pulmonary Resuscitation (CPR). - Other individuals working under the supervision and direction of the Licensed Athletic Trainer should also be certified in Cardio-Pulmonary Resuscitation (CPR). It shall be the responsibility of each individual Athletic Trainer to insure that this training is completed and that documentation is kept on file in the school s training room. 4

5 b. Other Certifications - Athletic Trainers employed by the SFDRCISD who hold additional certifications and/or licensure such as Physical Therapist; Emergency Medical Technician; Massage Therapist; Strength and Conditioning Specialist; etc., shall maintain such certification/licensure as prescribed by federal, state, and professional guidelines and laws. Documentation should be kept on file in the SFDRCISD Human Resources and by the Athletic Trainer who possesses these additional certifications and/or licenses at all times. Section II Athletic Trainer Job Descriptions a. Head Athletic Trainer see job description available in Human Resources b. Assistant Athletic Trainer see job description available in Human Resources c. High School Student Assistant - High school students working as Student Assistants may only work under the supervision of the Head Athletic Trainer, the Head Athletic Trainer s designee, or the Assistant Athletic Trainer. - High School Student Assistants must adhere to the following guidelines: 1. The Student Assistant must be academically eligible according to UIL Rules and/or school district regulations. Students who are not eligible will attend study hall 2 days each week during ineligibility. 2. Student Assistants are expected to be prompt, professional, and dependable as they are a representative of their school. 3. Student Assistants are expected to become certified in Cardio-Pulmonary Resuscitation (CPR). 4. Student Assistants shall cover athletic games and practices as assigned by the Head Athletic Trainer, his/her designee, or the Assistant Athletic Trainer. 5. Student Assistants may only use the taping and wrapping techniques approved by their supervising Licensed Athletic Trainer(s). 6. Student Assistants may not begin any treatment or rehabilitation process without the supervision and/or approval of a Licensed Athletic Trainer. 7. Student Assistants may not discuss an athlete s illness or injury with anyone other than sports medicine/training room staff members directly involved in the care of that athlete. 8. Student Assistants must follow all rules and regulations found in the Student Assistant Manual. Section III Athletic Trainer Evaluation a. Evaluation Procedure Head Athletic Trainer - All Head Athletic Trainers shall be evaluated at least once each school year. - The Head Athletic Trainer shall be evaluated using the Athletic Trainer Evaluation found in Appendix A1 of this booklet. - The evaluation shall be completed by the Principal, his/her designee, and/or Athletic Director. 5

6 - The Head Athletic Trainer shall also complete the evaluation instrument. - Evaluations shall be turned in to the Principal, his/her designee, and/or the Athletic Director for review. The Head Athletic Trainer will be given an opportunity to review the evaluations and a meeting will be scheduled with the Principal, his/her designee, and/or the Athletic Director to discuss the results of the evaluation. - Copies of these evaluations shall be kept on file in the Head Athletic Trainer s employment file. - The Head Athletic Trainer shall have the right to respond to any and all findings of the evaluation in writing and have that response placed in his/her employee file along with the evaluations. b. Evaluation Procedure Assistant Athletic Trainer - All Assistant Athletic Trainers shall be evaluated at least once each school year. - The Assistant Athletic Trainer shall be evaluated using the Athletic Trainer Evaluation found Appendix A1 of this booklet. - The evaluation shall be completed by the following individuals: 1. The building level Principal, his/her designee, and/or Athletic Director; 2. The Head Athletic Trainer 3. The Assistant Athletic Trainer shall also complete the evaluation instrument. - Evaluations shall be turned in to the Principal, his/her designee, and/or the Athletic Director for review. The Assistant Athletic Trainer will be given an opportunity to review the evaluations and a meeting will be scheduled with the Principal, his/her designee, the Athletic Director, and/or the Head Athletic Trainer to discuss the results of the evaluation. - Copies of these evaluations shall be kept on file in the Assistant Athletic Trainer s employment file. - The Assistant Athletic Trainer shall have the right to respond to any and all findings of the evaluation in writing and have that response placed in his/her employee file along with the evaluations. Section IV Team Physicians a. Roles and Responsibilities - The primary role of the Team Physician(s) is to provide medical direction and supervision to the Licensed Athletic Trainer at Del Rio High School and Del Rio Middle School. This medical direction and supervision may come in the form of general written and/or oral standing orders and/or protocol signed by the team physician(s). - Other roles and responsibilities of the Team Physician may include the following depending on the arrangements the physician(s) have with each individual school s Licensed Athletic Trainer: 1. Insure that a complete medical history and current medical records are kept on student athletes. 2. Determine an athlete s fitness for athletic competition through physical examinations. 3. Determine if an athlete may return to play following an injury. 4. Diagnose and treat injuries and illnesses that are referred to them by the Athletic Trainer. 5. Direct and advise the Athletic Trainer on health matters. 6. Act as a clinical instructor to the Head Athletic Trainer, Assistant Athletic Trainer, and/or other Training Room staff members and students. 6

7 7. Attend athletic events and practices when requested by the Head Athletic Trainer and/or arrange for attendance by other qualified physicians or medical personnel. 8. Determine when, on medical grounds, a student-athlete should be medically disqualified from participation in athletics or a given sport. 9. Work closely with the school s administration, athletic department staff, athletic training staff, and other affiliated health professionals to maintain consistently high standards of care for the athletes at the school the team physician(s) is affiliated with. b. Standing Orders - Athletic Trainers employed by the SFDRCISD and student assistants working under the supervision of said athletic trainers shall follow the written and/or verbal standing orders of their designated team physician. - Athletic Trainers shall complete, with their team physician(s), the standing orders form (Appendix B) and keep this form on file in the school s athletic training room. Section V Coverage of Athletic Contests and Practices a. Varsity Football - All Varsity football games (home and away) will be covered by an Athletic Trainer. b. Junior Varsity Football and/or B-Team Football - Home Junior Varsity and Freshman Team football games will be covered by an Athletic Trainer. If Athletic Trainer is not available then a Student Athletic Trainer will be used to cover the event. - Away Junior Varsity and Freshman Team football games will be covered by Student Assistants. If Student Assistant is unable to travel with the team, the team shall be given appropriate first aid supplies and the Athletic Trainer should attempt to contact the host school s Athletic Trainer (if they employ one) and arrange for that Athletic Trainer to assist with any injuries that may be incurred by the visiting team players. c. Other home event coverage - Athletic Trainers shall make every effort to cover as many home events as possible when they are scheduled. Coverage of home athletic events, other than the aforementioned, shall be determined individually by the school s Athletic Trainer and should be based on the level of risk for each sport being played and also upon the availability of qualified staff. d. Practice coverage - Practice coverage shall be determined by each school s Athletic Trainer. Coverage shall be based upon the level of risk involved in the sports that are in-season and also upon the availability of qualified staff. e. Coverage of athletic events during scheduled school holidays - Athletic Trainers employed by the SFDRCISD are only contractually obligated to provide athletic training coverage for home athletic events held during the calendar school year. If a school wishes to have an event during the summer time and an athletic trainer is not present at the school due to contractual obligations, the athletic trainer or the athletic training budget should be compensated for services rendered. Athletic trainers should work closely with their Athletic Director to insure that, if a summer event is scheduled, there is appropriate medical coverage available should the athletic trainer choose not to work the event. NOTE. On-campus contests/practices shall always take precedence over off-campus athletic contests/practices. Section VI Training Room Policies, Procedures, and Facilities a. Training Room Rules 7

8 - All Athletic Trainers shall establish training room rules and these rules shall be posted in the training room of each school. - b. Training Room Facility Guidelines - Each school s athletic trainer shall be responsible for the general upkeep of the training room facility. This shall include the following: 1. Regular cleaning of the training room facility to insure a healthy medical environment; 2. Regular maintenance and safety checks of modality equipment, including calibration; 3. Maintaining the training room in such a way as to indicate to the general public that they are used as a medical facility. c. Return to Play Guidelines - Each athletic trainer shall establish, in conjunction with their team physician, return to play guidelines. - While return to play decisions may be shared by numerous individuals including the athlete, parent, coach, athletic trainer, personal physician, and team physician, the FINAL authority for return to play should be the team physician of record for the school. - When a concussion is the injury in question, SFDRCISD student/athletes will follow the SFDRCISD Return-to- Play Protocol established by the Concussion Oversight Team (COT) in appendix E. Note: SFDRCISD reserves the right to impose additional restrictions on its athletes if it feels it is in the best interest of the student-athlete even if this is in opposition to any current physician s note. d. Examination of Opposite Sex Student Athletes - It is recommended that Athletic Trainers make a concerted effort to have an adult witness or witnesses present when examining athletes of the opposite sex whenever it is possible. The examination shall be conducted in a manner which does not constitute physical contact of a sexual nature. - In the event that an opposite sex athlete must be examined, and there is no witness available, such examinations should be done in an area of the training room that is open and accessible to all. All actions and findings should be properly documented on the student athlete s injury report. - In the event that a private examination is necessary due to the nature of the injury or the part of the body injured, the Athletic Trainer must always secure an adult to witness the examination. This must be an individual of the same sex as the student athlete and may include a coach or other designated adult. All actions and findings should be properly documented on the student athlete s injury report, including the name and position of the witness. e. Over-the-Counter Medications - Athletic Trainers may provide over the counter medications to student athletes provided the following procedures are followed at all times: 1. You have written permission from the student athlete s parents to give them the medication. 2. The medication is indicated for the student athlete s condition and you have verified that they are not known to be allergic to it. 3. You have written standing orders from your team physician to give the medication. 4. You properly log the student s name, condition, medication they received, and dosage, in your daily treatment log, on their injury report, or in a medication log book. 8

9 Note: Over-the-counter medications may include, but are not limited to, acetaminophen, ibuprofen, cold and allergy medications, antacids, throat lozenges, cough suppressants, and anti-diarrhea medications. f. Inhalers - Athletic trainers should be familiar with which athletes in their athletic programs have respiratory problems or may be asthmatic. If these athletes use an inhaler, the athletic trainer should work with the student athlete s family and their personal physician in making arrangements have an extra inhaler available for the athlete to use should they forget theirs. - Athletic Trainers should follow all current SFDRCISD policies and guidelines concerning the storage and use of these medications. g. Emergency Insect Sting Kits - Many student athletes participating in athletics are severely allergic to stinging insects. Athletic trainers should be familiar with who these students are and what their level of sensitivity is. This information should also be made available to the coaching staff of the team(s) that athlete participates on. - Athletic trainers should work with student-athletes and their parents to insure that the athlete has the appropriate Emergency Insect Sting Kit available should their allergy require immediate injection of epinephrine or other like medications. The athletic trainer may wish to ask the student-athlete to provide them with an extra kit, should the athlete not have one with them. - Athletic trainers should also work with their team physicians in order to obtain an Emergency Insect Sting Kit that would be available in the event of an athlete suffering an allergic reaction. - Athletic Trainers should follow all SFDRCISD policies and guidelines concerning the storage and use of these medications. Section VII Emergency Procedures and Transportation Policy for Injured Athletes a. The Emergency Plan - Each school s Athletic Trainer shall, in conjunction with his/her school s administration and athletic staff, develop an Emergency Plan for their school. See Appendix D - All athletic personnel shall be aware of the emergency plan and basic emergency procedures - The Emergency Plan shall include the following: 1. ambulance coverage at ALL HIGH SCHOOL HOME football games 2. methods for activating the local EMS system in the absence of an ambulance 3. role and responsibilities of team physicians, athletic trainers, and coaches in an emergency 4. procedures for notifying parents/guardians and/or family members of injured student/staff 5. procedures for notifying appropriate school administrative personnel b. Basic Emergency Equipment - All SFDRCISD Athletic Training Rooms shall be equipped with the following emergency equipment: 1. a telephone 2. a cellular telephone or two-way radios for on the field emergency communications 3. basic first aid supplies such as gauze, bandages, triangular bandages, rubber gloves, etc. 9

10 4. splints (air splints, vacuum splints, or board splints) 5. CPR Valve masks 6. other emergency equipment as determined by the school s athletic trainer. c. Transporting the Ill or Injured Athlete - Ill or injured athletes shall be transported in one of the following ways should they need medical care beyond that which can be provided by the Athletic Trainers or their student trainers at the High School facility: 1. by ambulance, along with an official school representative, for a traumatically injured or seriously ill athlete if the legal guardian of the student-athlete can not be reached. The school official will remain with the student-athlete until the legal guardian arrives and assumes responsibility. 2. by the student athlete s parent and/or designated guardian (for non-life threatening injuries/illnesses). The parent will be given the choice of having an ambulance called or taking the student-athlete themselves. A school representative is not required to go with the student-athlete. 3. by the athletic trainer in a school vehicle (when a parent and/or designated guardian is not available and the illness/injury is non-life threatening). 4. by a designated member of the coaching staff or other school staff member in a school vehicle (when a parent and/or designated guardian is not available and the illness/injury is non-life threatening). 5. by another parent and/or adult designee (non-school personnel) at the request of a school administrator or the athletic director (when a parent and/or designated guardian is not available and the illness/injury is non-life threatening). - At NO TIME shall an ill or injured athlete be transported or left in the charge of another student. Section VIII Documentation and Record Keeping a. Student Athlete Records - All schools employing an athletic trainer shall maintain individual medical records for all students participating in athletics and/or that are examined in the training room. These medical records shall include the following: 1. Pre-participation physicals 2. Current insurance information (primary coverage) 3. An emergency information form 4. Injury records (either hand written or from computer data base) 5. Copies of physician referral notes, physician reports, lab reports, x-ray reports, etc. 6. Copies of prescriptions for rehabilitation, medications, etc (when applicable) 7. Copies of all insurance claims submitted to the school s athletic insurance policy carrier. - In the event that a student is seriously injured or dies while participating in a practice or game, the athletic trainer shall contact his/her Principal and the Athletic Director as soon as possible to inform them of the situation. In addition, the athletic trainer should, with the assistance of the Principal, Athletic Director, and/or coaching staff, secure all equipment worn or used by the student athlete at the time of the injury or death. This equipment, along with any game or practice video tapes or photographs, should be placed in a box or bag and safely secured in the school s main office or athletic office. 10

11 b. Training Room Records - All athletic trainers employed by the SFDRCISD shall also maintain the following records in their training room: 1. Injury reports for all of the injuries that were evaluated on that day. 2. A daily treatment log for the training room (including a record of any and all OTC medications that may have been distributed) 3. Records indicating routine maintenance checks of modality equipment 4. An annual inventory of equipment and supplies 5. Copies of invoices and/or purchase order requests for equipment and/or supplies. 6. Parent notification of injury forms - sent home with student-athletes when the athletic trainer needs to communicate with the parents of an athlete about an injury. 7. A phone log of all calls made to or received from parents regarding their child is advised but not mandatory. c. Regular Reporting - Each Athletic Trainer shall submit regular reports, including information on daily visits to the athletic training facility by student athletes, treatment totals, injury summaries, etc., on a regular basis as determined by the school district s Director of Athletics. - These reports shall be submitted to the Director of Athletics or his/her designee and will be available for review by school district administrative personnel, the Board of Education, and the general public. Section IX Weather and Lightning Guidelines Note the following guidelines are based upon the University Interscholastic League Lightning Protocol. a. Severe Weather and Lightning Guidelines 1. Establish a chain of command that identifies who is to make the call to remove individuals from the field. 2. Name a designated weather watcher (A person who actively looks for the signs of threatening weather and notifies the chain of command if severe weather becomes dangerous). 3. Have a means of monitoring local weather forecasts and warnings. 4. Designate a safe shelter for each venue. See examples below. 5. Use the Flash-to-Bang count to determine when to go to safety. By the time the flash-to-bang count approaches thirty seconds all individuals should be already inside a safe structure. See method of determining Flash-to-Bang count below. 6. Once activities have been suspended, wait at least thirty minutes following the last sound of thunder or lightning flash prior to resuming an activity or returning outdoors. 7. Avoid being the highest point in an open field, in contact with, or proximity to the highest point, as well as being on the open water. Do not take shelter under or near trees, flagpoles, or light poles. 8. Assume that lightning safe position (crouched on the ground weight on the balls of the feet, feet together, head lowered, and ears covered) for individuals who feel their hair stand on end, skin tingle, or hear "crackling" noises. Do not lie flat on the ground. 11

12 - Athletic Trainers are responsible for determining the presence of inclement weather. The Athletic Trainer will communicate daily regarding procedures for safe practice and competition environments for student-athletes. This includes all environmental conditions heat, humidity, rain, and lightning. As inclement weather conditions arise, review protocol. Check the weather report daily before any practice or event. Weather conditions may be ascertained by contacting, viewing, or listening to any of the following sources: NOAA Weather Radio; local television or radio stations; computer weather bulletins, including local radar via the internet. Establish methods to communicate to all team members and coaches in the event of hazardous weather. Ensure all players, coaches, and team personnel understand what a warning indicates, and what to do. In the event of lightning in the area, it is important to determine the flash-to-bang time. If the time is less than 18 seconds, cease all activity and take cover immediately in the nearest safe site. If the time is less than 30 seconds, cease activity immediately and take cover in the most secure site available. Note each 5 seconds between seeing a lightning flash and hearing thunder represents approximately one (1) mile of distance from yourself and the lightning. For example, a flash-to-bang count of 15 seconds would represent a distance of 3 miles. Reminder the magnitude of the rainfall is not indicative of the severity of the storm. Attention should be paid to the threat of lightning, not the amount of rainfall associated with the storm. Classifications of Shelters in Lightning Storms Safe Shelter = buildings which people occupy; office buildings; clubhouses; classrooms; gymnasiums. Emergency Shelter (if safe shelter is not available) = enclosed car with metal roof; dense cluster of similar height trees/bushes; depressed areas. Shelters that are NOT safe = convertible car; golf cart; storage sheds; picnic shelters; portable toilets; single tall objects (ie, a tree); umbrellas; open fields; bodies of water; hills. If members of the coaching staff fail to heed your warnings concerning severe weather in the area and continue to practice in dangerous situations, insure your own personal safety and document the coach s failure to respond to your warnings about dangerous weather conditions in writing. This documentation should be forwarded to your Athletic Director and/or Principal. b. Severe Heat Guidelines - All athletic trainers should be familiar with the dangers of extremely hot and humid weather conditions and should exercise common sense when overseeing the healthcare of athletes participating in practices or contests in extremely hot conditions. All SFDRCISD Athletic Trainers should have available to them a Sling Psychrometer which may be used to determine air temperature and relative humidity. All SFDRCISD Athletic Trainers should refer to the chart below (or Appendix C) when making recommendations to coaches and/or athletes about the likelihood of heat related illnesses when there is extreme heat and humidity. Temp (F) Humidity Procedure < 70% Monitor unacclimated and obese athletes closely > 70% 10 min. water breaks every mins. Monitor all athletes for signs and symptoms of heat illness < 70% 10 min. water breaks every mins. Monitor all athletes for signs and symptoms of heat illness > 70% Suspend activities or practice in t-shirts/shorts ONLY with breaks. *Adapted from Modern Principals of Athletic Training 6th Edition - All recommendations to members of the coaching staff, Athletic Director, or other school personnel should be documented appropriately and kept on file in the athletic training room by the Head Athletic Trainer. 12

13 - Athletes exhibiting the signs and symptoms of heat related illness should be immediately removed from participation and placed in a cool environment and their condition appropriately documented on an injury report. c. Severe Cold Guidelines - Athletic Trainers should monitor cold weather conditions using local weather forecasts and other available weather information resources. In extremely cold circumstances, Athletic Trainers should work in cooperation with the school s Athletic Director and/or coaching staff in determining whether or not outdoor practices and/or contests are appropriate. 13

14 Appendix A ATHLETIC TRAINER REVISED 03/27/03 ATHLETIC TRAINER Summative Appraisal Form Name School Location Position Date of Review Evaluation Appraisal Period: From to Directions The following statements describe the employee who achieves success. Based on cumulative performance information, the evaluator estimates the employee s effectiveness in meeting each criterion. Rate each criterion using the scale below that most closely describes the employee s attainment of that criterion. For each domain, a comment area is provided for general statements and/or recommendations. Rating Scale 5 Clearly Outstanding: Performance is consistently far superior to what is normally expected. 4 Exceeds Expectations: Performance demonstrates increased proficiency and is consistently above expectations. 3 Meets Expectations: Performance meets expectations and presents no significant problems. 2 Below Expectations: Performance is consistently below expectations and significant problems exist. 1 Unsatisfactory: Performance is consistently unacceptable. 0 Not Applicable JOB PERFORMANCE STATEMENTS Illness/Injury Prevention and Treatment 1. Plans and implements a comprehensive athletic injury and illness prevention program for student athletes. 2. Attends practice sessions and athletic contests as assigned by athletic director. 3. Establishes and maintains effective communication with students, parents, medical and paramedical personnel, coaches, and other staff. 4. Provides physical conditioning training to student athletes. 5. Fits injured athletes with specialized equipment and oversees its use. 6. Prepares athletes for games and practices by conducting evaluations and using tape, wraps, splints, braces, and other protective devices as needed. 7. Responds to emergencies and makes quick, independent judgments about how to deal with injuries. 8. Identifies acute injuries and provides first-aid triage, including assessing injuries and deciding whether an athlete should seek further medical attention and should discontinue participation in the athletic event. 9. Establishes specific procedures to be carried out by a coach or student trainer in the event of a medical emergency. 10. Detects and resolves environmental risks to athletes. COMMENTS: Rehabilitation/Reconditioning 11. Plans and puts in place a comprehensive rehabilitation and reconditioning program for injuries and illnesses sustained by student athletes. 12. Determines therapeutic goals and objectives for individual athletes. 13. Applies therapeutic modalities and instructs athletes on proper use of exercise equipment. 14. Evaluates and records rehabilitation progress of athletes. Develops criteria for progression and return to practice and competition. 15. Follows professional, ethical, and legal parameters regarding use of drugs and therapeutic agents for treatment and rehabilitation of injured athletes. COMMENTS: 14

15 Administration 16. Coordinates scheduling of athletic physical examinations and screening. 17. Selects, trains, and supervises student assistants. 18. Compiles, maintains, and files all physical and computerized reports, records, and other documents including medical, accident, and treatment records as required. 19. Maintains an inventory of training supplies and equipment. Requisitions additional supplies as needed. COMMENTS: Other 20. Performs other duties assigned by supervisor. 21. Maintains confidentiality of information. COMMENTS: Supervisory Responsibilities 22. Supervises the work of student assistants. COMMENTS: What strengths does possess? What are some improvements can make to ensure a higher degree of success for students on this campus/department? Summative Conference Comments: Recommendation of Evaluator: I have read and received a copy of this evaluation. I have reviewed this instrument. Renewal and/or Extension of Assignment Non-renewal of Assignment Termination of Assignment Non-extension of Assignment Administrator s Signature Date Employee s Signature Date 15

16 Appendix B San Felipe Del Rio CISD Team Physician Standing Orders Form Bradley S Dixon, ATC, LAT Athletic Trainer s Name (Type or Print) R. Alan Davis, LAT Athletic Trainer s Name (Type or Print) Rudy Rocamontes, LAT Athletic Trainer s Name (Type or Print) Del Rio High School School (Type or Print) Del Rio Middle School School (Type or Print) Del Rio High School School (Type or Print) I, Antonio Cadena, Jr., MD, (Type or Print Physician s Name) as Team Physician/Consulting Physician for the above-listed schools, I hereby authorize the athletic trainer(s) named above to act in my behalf during my absence. Such authority shall include the following: Carrying out the practice of care, prevention, and physical rehabilitation of athletic injuries, and in doing so, may use physical modalities, including, but not limited to heat, light, sound, cold, electricity, or mechanical devices related to rehabilitation and treatment. In addition, I authorize the following: Physician s Signature Date Athletic Trainer s Signature Date Athletic Trainer s Signature Date Athletic Trainer s Signature Date 16

17 Appendix C The Heat Index Environmental Temperature Fº 70º 75º 80º 85º 90 95º 100º 105º 110º 115º 120º Relative Humidity Apparent Temperature Fº 0% 64º 69º 73º 78º 83º 87º 91º 95º 99º 103º 107º 10% 65º 70º 75º 80º 85º 90º 95º 100º 105º 111º 116º 20% 66º 72º 77º 82º 87º 93º 99º 105º 112º 120º 130º 30% 67º 73º 78º 84º 90º 96º 104º 113º 123º 135º 148º 40% 68º 74º 79º 86º 93º 101º 110º 123º 137º 151º 50% 69º 75º 81º 88º 96º 107º 120º 135º 150º 60% 70º 76º 82º 90º 100º 114º 132º 149º 70% 70º 77º 85º 93º 106º 124º 144º 80% 71º 78º 86º 97º 113º 136º 90% 71º 79º 88º 102º 122º 100% 72º 80º 91º 108º Apparent Temperature Heat-stress risk with physical activity and/or prolonged exposure. 90º-104º - Heat cramps or Heat Exhaustion possible 105º-130º - Heat cramps or Heat Exhaustion likely. - Heat Stroke possible. 130º and up - Heat Stroke very likely. Caution: This chart provides guidelines for assessing the potential severity of heat stress. Individual reactions to heat will vary. Heat illnesses can occur at lower temperature than indicated on this chart. Exposure to full sunshine can increase values up to 15º F. *Source: Princeton University Outdoor Action 17

18 Appendix D Revised San Felipe Del Rio CISD Sports Medicine Emergency Action Plan Introduction Emergency situations may arise at anytime during athletic events. Expedient action must be taken in order to provide the best possible care to the sport participant of emergency and/or life threatening conditions. The development and implementation of an emergency plan will help ensure that the best care will be provided. Athletic organizations have a duty to develop an emergency plan that may be implemented immediately when necessary and to provide appropriate standards of emergency care to all sports participants. As athletic injuries may occur at any time and during any activity, the sports medicine team must be prepared. This preparation involves formulation of an emergency plan, proper coverage of events, maintenance of appropriate emergency equipment and supplies, utilization of appropriate emergency medical personnel, and continuing education in the area of emergency medicine and planning. Hopefully, through careful pre-participation physical screenings, adequate medical coverage, safe practice and training techniques and other safety avenues, some potential emergencies may be averted. However, accidents and injuries are inherent with sports participation, and proper preparation on the part of the sports medicine team should enable each emergency situation to be managed appropriately. Components of the Emergency Plan These are the basic components of this plan: 1. emergency personnel 2. emergency communication 3. emergency equipment 4. roles of first responder 5. venue directions with map Emergency Plan Personnel With athletic association practice and competition, the first responder to an emergency situation is typically a member of the sports medicine staff, most commonly a licensed/certified athletic trainer. A team physician may not always be present at every organized practice or competition. The type and degree of sports medicine coverage for an athletic event may vary widely, based on such factors as the sport or activity, the setting, and the type of training or competition. The first responder in some instances may be a coach, an athletic training student or other institutional personnel. Certification in cardiopulmonary resuscitation (CPR), first aid, prevention of disease transmission, and emergency plan review is required for all athletics personnel associated with practices, competitions, skills instruction, and strength and conditioning. The development of an emergency plan cannot be complete without the formation of an emergency team. The emergency team may consist of a number of healthcare providers including physicians, emergency medical technicians, certified athletic trainers; student athletic trainers; coaches; managers; and, possibly, bystanders. Roles of these individuals within the emergency team may vary depending on various factors such as the number of members of the team, the athletic venue itself, or the preference of the head athletic trainer. There are five basic roles within the emergency team. The first and most important role is establishing safety of the scene and immediate care of the athlete. Acute care in an emergency situation should be provided by the most qualified individual on the scene. Individuals with lower credentials should yield to those with more appropriate training. The second role, EMS activation, may be necessary 18

19 in situations where emergency transportation is not already present at the sporting event. This should be done as soon as the situation is deemed an emergency or a life-threatening event. Time is the most critical factor under emergency conditions. Activating the EMS system may be done by anyone on the team. However, the person chosen for this duty should be someone who is calm under pressure and who communicates well over the telephone. This person should also be familiar with the location and address of the sporting event. The third role, equipment retrieval may be done by anyone on the emergency team who is familiar with the types and location of the specific equipment needed. Student athletic trainers, managers, and coaches are good choices for this role. The fourth role of the emergency team is that of directing EMS to the scene. One member of the team should be responsible for meeting emergency medical personnel as they arrive at the site of the emergency. Depending on ease of access, this person should have keys to any locked gates or doors that may slow the arrival of medical personnel. A student athletic trainer, manager, or coach may be appropriate for this role. Roles within the Emergency Team 1. Establish scene safety 2. Immediate care of the athlete 3. Activation of the Emergency Medical System 4. Emergency equipment retrieval 5. Direction of EMS to scene Activating the EMS System Making the Call: 911, (if from school district phone) notify campus police at telephone numbers for local police, fire department, and ambulance service Providing Information: name, address, telephone number of caller nature of emergency, whether medical or non-medical * number of athletes condition of athlete(s) first aid treatment initiated by first responder specific directions as needed to locate the emergency scene ("come to south entrance of coliseum") other information as requested by dispatcher * if non-medical, refer to the specific checklist of the emergency action plan When forming the emergency team, it is important to adapt the team to each situation or sport. It may also be advantageous to have more than one individual assigned to each role. This allows the emergency team to function even though certain members may not always be present. Emergency Communication Communication is the key to quick emergency response. Athletic trainers and emergency medical personnel must work together to provide the best emergency response capability. Communication prior to the event is a good way to establish boundaries and to build rapport between both groups of professionals. If emergency medical transportation is not available on site during a particular sporting event then direct communication with the emergency medical system at the time of injury or illness is necessary. Access to a working telephone or other telecommunications device, whether fixed or mobile, should be assured. The communications system should be checked prior to each practice or competition to ensure proper working order. A back-up communication plan should be in effect should there be failure of the primary communication system. The most common method of communication is a public telephone. However, a cellular phone is preferred if available. At any athletic venue, whether home or away, it is 19

20 important to know the location of a workable telephone. Pre-arranged access to the phone should be established if it is not easily accessible. Emergency Equipment All necessary emergency equipment should be at the site and quickly accessible. Personnel should be familiar with the function and operation of each type of emergency equipment. Equipment should be in good operating condition, and personnel must be trained in advance to use it properly. Emergency equipment should be checked on a regular basis and use rehearsed by emergency personnel. The emergency equipment available should be appropriate for the level of training for the emergency medical providers. Creating an equipment inspection log book for continued inspection is strongly recommended. It is recommended that a few members of the emergency team be trained and responsible for the care of the equipment. It is important to know the proper way to care for and store the equipment as well. Equipment should be stored in a clean and environmentally controlled area. It should be readily available when emergency situations arise. Medical Emergency Transportation Emphasis is placed at having an ambulance on site at high risk sporting events. EMS response time is additionally factored in when determining on site ambulance coverage. The athletic department coordinates on-site ambulances for competition in football. Ambulances may be coordinated on-site for other special events/sports, such as major tournaments or championship events. Consideration is given to the capabilities of transportation service available (i.e., Basic Life Support or Advanced Life Support) and the equipment and level of trained personnel on board the ambulance. In the event that an ambulance is on site, there should be a designated location with rapid access to the site and a cleared route for entering/exiting the venue. In the event of an emergency, the 911 system (8-911 on campus) will still be utilized for activating emergency transport. In the medical emergency evaluation, the primary survey assists the emergency care provider in identifying emergencies requiring critical intervention and in determining transport decisions. In an emergency situation, the athlete should be transported by ambulance, where the necessary staff and equipment is available to deliver appropriate care. Emergency care providers should refrain from transporting unstable athletes in inappropriate vehicles. Care must be taken to ensure that the activity areas are supervised should the emergency care provider leave the site in transporting the athlete. Any emergency situations where there is impairment in level of consciousness (LOC), airway, breathing, or circulation (ABC) or there is neurovascular compromise should be considered a load and go situation and emphasis placed on rapid evaluation, treatment and transportation. Conclusion The importance of being properly prepared when athletic emergencies arise cannot be stressed enough. An athlete s survival may hinge on how well trained and prepared athletic healthcare providers are. It is prudent to invest athletic department ownership" in the emergency plan by involving the athletic administration and sport coaches as well as sports medicine personnel. The emergency plan should be reviewed at least once a year with all athletic personnel, along with CPR and first aid refresher training. Through development and implementation of the emergency plan, the athletic department helps ensure that the athlete will have the best care provided when an emergency situation does arise. Emergency Communication Procedures I. Home games, competitions, and practices: Emergency procedures are to be initiated at any time when the athletic training student(s) on duty feels that a situation with an athlete is out of his scope of ability. 20