Follow Up – Why ATs are needed

20 Sep

On August 31, 2011, I wrote this blog entry highlighting an unfortunate situation in Nokesville, VA.  In the entry I wrote:

The sad realization is this, that if a experienced athletic trainer was managing this football player’s concussion I firmly believe this young man would be alive today.  If the parents were instructed about cocoon therapy properly, then this young man may be a freshman in college today.  But, only 42% of this countries high schools provide an AT for their athletes!  We need to change this or there will be more sad stories, more grieving parents, more schools who will lose a bright student and a vibrant member of their community.

My blog entry was missing some major information – there was an athletic trainer present at the game.  Several AT who know the inside story not revealed in the original article highlighted in my post, informed me of this important fact.  I inadvertently threw a fellow AT under the bus, an action for which I deeply regret.  It was not my intention to do so.  The article never stated that the school provided the services of a full time AT – a fact that was conveniently overlooked in my opinion.

So, how does an AT involved in the situation change things?  What mistakes were made that should be corrected so that another football player doesn’t suffer the same fate post concussion?

Here are some facts:

  • There was an AT present who immediately recognized a concussion and referred the concussed athlete to the ER for further medical care.
  • The ER correctly diagnosed the athlete with a concussion and seemingly gave incomplete information to the parents by not emphasizing “no activity and complete rest”.
  • The athlete was driving a car, watching game film, watching TV and playing video games while still suffering symptoms.

Lee Bowman of ABC News in Tampa today wrote an article that raises the problem that I have with the circumstances in VA:

The thinking on brain trauma clearly is changing, not only in football but all youth sports. Increasingly, ankle-biter leagues are hiring athletic trainers, high school policies mandate medical clearance before a head-injured player can return to the field, and professional leagues are adopting tougher standards for helmets and the care of the heads inside them.

Still, it’s not entirely clear how comprehensive the new policies are, or just which athletes most need protection.

The level of response has been uneven. According to the advocacy group Sportsconcussions.org., 28 states and the District of Columbia have adopted laws to protect youth athletes from concussions in the past several years, and 10 more have legislation pending, most requiring medical evaluation and clearance by a medical professional before returning to play. A dozen have nothing on the books.

Some experts worry that regulations do little good if athletic trainers or other qualified medical specialists aren’t near the sidelines. Only about a third of high schools around the country have full coverage by certified athletic trainers. (See Scripps Howard News Service’s report on athletic trainers at http://scrippsnews.com/projects/athletic-trainers/most-high-schools-sports-teams-lack-full-time-athletic-trainers .)

Many of the laws address only scholastic sports, leaving the safety of younger and older athletes to their respective leagues or associations. In some states, legislatures have deliberately left setting treatment and return-to-play standards to leagues or high school associations.

Notice that the writer clearly touts that access to athletic trainers on the sidelines is the gold standard for concussion management, and many other medical organizations and state legislators agree.  But does the general public have the same view of our medical qualifications?  I would answer the question with some of the public does, but many do not!

The profession of athletic training clearly has a long ways to go in educating the general public about our qualifications and expertise, not just in concussion management but also under the umbrella of Sports Medicine.

Put it this way, it doesn’t matter if every 10 year old football player has immediate access to an AT at every practice and game IF the parent’s don’t value the ATs medical opinion.

What can we do about it?

  • Stay informed and educated
  • Hold yourself to the highest of professional standards
  • Present yourself with confidence and expertise to every athlete and parent that you speak to
  • Promote the profession of athletic training to the general public when given the opportunity

 

5 Responses to “Follow Up – Why ATs are needed”

  1. Emily September 20, 2011 at 9:55 am #

    I am currently in the process of jumping through hoops to get people associated with one of my schools to understand my qualifications for dealing with concussions. I am a full-time athletic trainer but I split time at two schools that are about 30 minutes apart. Visiting both in one day and covering games is simply impossible. I try my hardest to ensure that all athletes are receiving the best care but when I am not able to excuse a concussed athlete from participating in PE (they have no school nurse so he must see a physician) my hands automatically become tied to when the physician sees fit for the athlete to return to play. I almost feel useless when I encounter situations such as this. I’m trying to help the athletes and save the parents a trip (and copay or more) to a doctor, but to no avail.

  2. Paul LaDuke, ATC September 20, 2011 at 12:01 pm #

    Emily, thanks so much for sharing your frustrations with your situation. I am sure you are not alone and this is a problem throughout the country.

    Fellow ATs, this is further reason to get involved in actively promoting the profession of athletic training! This is especially true at your local level. Do everything you can to raise the standard of excellence and professionalism with everyone you meet on a daily basis. Be proactive!

  3. Michael Hopper September 20, 2011 at 12:56 pm #

    Emily,

    At my school, every kid that I decide has suffered a concussion gets referred to a physician. It is our company’s stance that doing so is in the best interests of the student-athlete. Then when an athlete receivers clearance from the physician, we begin our RTP protocol that includes progressive exercise. This has been our stance for a couple of years, but this year is when I am starting to see it actually come into play correctly.

    We do have a school nurse and I communicate with her regularly. She gets my weekly injury reports and additionally she is notified every time a student-athlete suffers a concussion. I email her along with the sport coach, the principal, and the athletic director. She is then responsible for notifying a kid’s teachers.

    One thing I have made a major emphasis this year is the progressive exercise protocol. Last spring, I had a girl miss 9 days with a concussion and then just return to games the day after being cleared by the physician. She hadn’t done anything for 9 days and then right back in. This year many more of the physicians that see my student-athletes are sending back notes that say, “cleared to begin return to play protocol.”

    Illinois just passed concussion legislation this summer. I jumped on this. At first the school personnel did not seem too excited about it and it seemed to me they were resistant to me making it the issue that it is. Now that we have gotten into the season and I have held my line, they are much more appreciative of what I have been able to accomplish.

    Keep working!

  4. Brad September 20, 2011 at 10:06 pm #

    Funny, I just added a blog to my site that describes a recent situation in youth league football where nobody had any respect for an AT. To tell the truth, they almost reacted with even more hostility because of the AT. It was truly sad and disturbing.

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