Other Environmental Factors & Record Keeping

1. Other Environmental Factors & Record Keeping Sports Injury Management Spring 2011

2. Haveyou heard this?????? We have just a few more minutes left in the game. We’ll get it in. Awe, it’s alright. That storm is miles away, and it’s not even raining here. We’re safe. We can get in a few more plays before it gets here. Practice is almost over. WHAT’S WRONG WITH THIS PICTURE?!?!

3. “Friday’s delay came after the top of the first and lasted longer than two hours before the decision to suspend play was made around 9:20 pm. Weather radar projections showed plenty of activity in the area until well past midnight and a Clemson spokesman reported that there were more than 455 lightning strikes recorded in the area between 7:03 and 8:39 pm.”

4. NORTH CAROLINA IS IN THE TOP TEN! (in lightning related deaths.)

5. Did you know……………………. • 27% of all strikes occur in open fields and recreational areas. • 84% are Male victims. • Most active months are June – 21%, July – 30%, and August – 22%. • Time of day ----- 2 pm – 6 pm. • Top five states for Lightning Injuries -> Florida, Michigan, Pennsylvania, North Carolina, and New York.

6. WHAT CAN BE DONE????? It’s SIMPLE. If you see it….FLEE IT! If you hear it…CLEAR IT! Education is the key! Guidelines are available from: NATA, NCHSAA, NCATA All have suggested guidelines for inclement weather, including lightning events.

7. Lightning Rods?!!? How many of us wear these? How many officials wear these? How many fans wear these? Why is this a lightning rod?

8. Available Technology • There are many scanners available. • NCHSAA recommends the “Thunderbolt” • Local television stations, EMS, etc. • Referee has the final word on the field Available from most sports medicine Supply stores. Cost: $ 400 - $500

9. Other Hazards • Tornados, Water spouts If your stadium is close to a body of water, you must have a plan to evacuate in the event of a water spout. • This evacuation must include athletes, coaches, officials, AND FANS!!!!! • Local Law Enforcement and EMS will be extremely helpful here. Make friends and play nice with them!!!!!

10. Athletic Training Record Keeping AKA – Being Anal and CYA (Covering Your A- -)

11. Pre-season Information • NCHSAA requires a meeting with parents of athletes once a year. Athletic Department Expectations Coaches Expectations NCHSAA Sportsmanship Pledge Parent Agreement Documentation Medical and Emergency Contact Information

12. Medical Information • Medical History Form- medical information on the athlete up to this point in time: previous broken bones?, asthma?, does he/she overheat easily?, does she suffer from extreme menstrual cramps?, etc. Having this information on file solves lots of issues later on. Example: a female athlete says she can’t practice or she missed practice because of cramps, BUT she is able to play on game day. If this is not stated on the medical history form, (a) she didn’t want to practice that day, (b) there may be a new medical condition that needs further investigation. • Helmet Warning- on the back of every helmet worn in the state of NC, there is a sticker that says (basically): you can get hurt playing football and that this helmet will not protect from all injuries. This is just a CYA piece of information. Parents sometimes assume that the equipment their children wear will protect them from everything. It won’t. OBVIOUSLY, this is just for football players.

13. Medical Information - continued • EMERGENCY TREATMENT FORM !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! • General Demographic Information: Name, Address, Social Security Number, Date of Birth, Family Physician • Contact Information: where parents / legal custodians can be reached at different times of the day – work number, home number, cell number • Emergency Contact Information: who does parent / legal custodian trust to take care of athlete in the event they cannot be reached? • Any allergy information: food allergies?, drug allergies? • Authorization for treating facility to render treatment: in the event the parents / legal custodians cannot be reached • Insurance Information: Company name and Policy number; a copy of the insurance card copied on the back saves lots of time!!!

14. Medical Information > Medical Information Form – con’t. HIPAA – Health Information Patient Accountability Act Boils down to confidentiality issues…. High Schools are covered under FERPA: Family Educational Rights and Privacy Act Be specific about whom you may or may not discuss an athlete’s injury. Have parents agree on those entities by writing their initials in the blank spaces – so not accept a check mark or an “X”. Also included in this section is a statement which allows (with parent permission) the treating facility to release information about their evaluation / diagnosis / and treatment. It was extremely helpful in completing accident reports and insurance claims later on. Make sure parent / legal custodian’s signatures are on the form!!

15. What Worked for Me….. Have a folder for each athlete that plays a sport during the year. You can keep it for their HS athletic career, and it will be the place to store all of the information listed thusfar. Use COLORED PAPER for different forms. When you are talking with parents, you can refer to the “blue sheet” or the “yellow sheet”. In the folder, I kept any injury reports (we’ll talk about that later), any and all notes from all treating physicians and parents, whether or not it pertained to an injury. At the end of the school year, I add their athletic physical form (for reference: I keep physical forms from the time they begin doing physicals at the middle school level. That’s a topic for another day!) At the end of a student’s high school athletic career, their folder was removed from the active ones and stored (3-7 years depending on your county’s policy) until the time that the contents could be shredded.

16. Daily Record Keeping FALL: daily weigh-in / weigh-out sheet, environmental information, any treatment rendered (protective or acute), injury information WINTER: same as fall, adding Wrestling information – hydration testing, body fat measurements, daily / weekly reporting of weights SPRING: same as fall, beginning of coordination of athletic physicals with area physicians for the coming school year

17. FALL FOOTBALL:although all fall sports are important, and you will be “on call” for them, you are required by NC Constitution, G.S. 115C-12(12), Article IX, Sec. 5 to be in attendance at all football practices and games unless excused by the superintendent due to an emergency. The LEA may require you to attend games and practices of other sports. (Eff. July 1986, Amended Eff. September 1, 2002) Weigh-in / Weigh-out sheets: The easiest way for me was an Excel spreadsheet – players’ names and numbers typed in, with columns for weigh-in and weigh-out. I also included a column called “You must weigh this to practice today!” that was placed before the weigh-in column. I believe this is the single MOST IMPORTANT sheet for daily activities. I kept all daily weight sheets in a notebook for reference.

18. Sample Weight Chart • Make one up that will suit your needs. It doesn’t have to be something fancy… just useful! These are actual weights from practice on 9/4/07.

19. Weight Chart for Wednesday No problem on Timaine’s weight, did not lose more than 3 pounds. Darnel lost 5 pounds…he must be back within 3 lbs. of what he STARTED at YESTERDAY. Josh loses 5 – 7 lbs daily. He does a good job of re-hydrating. However, his performance has decreased due to constant weight loss. He is seeing a physician to make sure everything is OK.

20. COMPARISON

21. Environmental Issues & Daily Treatments I combined these two things on one form. I kept these daily forms with the weight charts in the notebook. Things to be aware of: The computer is your friend! Check local TV stations weather website for weather updates and a radar image. You will learn “where your weather comes from”. You will be able to assist your coaches determine if environmental issues of the day may modify or even cancel that day’s practice. Check with your local EMS personnel to determine if there are any weather advisories you should be aware of. (Example: In NENC, we have had wildfires to the north and to the south of us. The smoke in the air would have been a danger to athletes trying to practice in the outdoors. Obtain a digital psychrometer / heat index instrument. They are priceless!!

23. Technology Available Old, reliable sling psychrometer Newer, digital psychrometer Combo unit heat index / psychrometer

24. WINTER WRESTLING: Because of the nature of the sport, you will spend a great deal of time (mostly at the beginning of the season) with wrestling. HYDRATION TESTING: determining how well-hydrated an athlete is prior to the wrestling season (information later) Hydration testing must be successfully passed before body fat measurement can be performed. BODY FAT MEASUREMENT: determines a “safe weight” at which a wrestler may compete Daily weigh-in / weigh out is extremely important in wrestling. Knowing the rules about weight loss in this sport is essential to keeping a wrestler healthy during his/ her competitive season. Weekly weigh-ins are reported to the state via the NWCA weight management website. Communication with parents is also a key to a healthy wrestler.

25. SPRING Environmental issues become important again during the spring season. Also, daily weigh-in / out should be done on all athletes. The spring is especially busy (at least it was for me) because of the coordination of athletic physicals for the coming school year. (This process actually begins at the beginning of the new semester.)

26. Injury Reporting BE AS SPECIFIC AS YOU CAN !!!!!!! HISTORY: What happened? Did athlete hear any unusual sound (pop)? Did athlete feel anything unusual? OBSERVATION: What do you see? Obvious swelling, discoloration, etc. PALPATION: start away from the injured area and work toward it TESTS: vary with injury What worked for me….. I always had a small notebook and pen / pencil in my pocket. Write down any and all pertinent information so that when the “immediate” has passed, you have record of what you said and did in regards to the injury.

28. Injury Reporting – con’t. Your school system may have a specific form on which you have to report any injuries. You may also have to report injury specifics to an insurance company. You may have to report information on how an injury occurred to a physician and work with physical therapists in helping an athlete get back into his/her sport safely. Knowing the specifics helps greatly! Become familiar with the form(s) that your treating facilities (doctors’ offices, hospitals and/or clinics) use. It will make your job somewhat easier. It is advantageous to know the physicians you work with. It is GREAT if you have one team physician, but not everybody does. Developing a collegial relationship makes a great deal of sense!

29. NCHSAA Forms The NCHSAA website has forms that you will have to download and use in specific situations. They are found by going to NCHSAA and clicking on the word FORMS in the blue toolbar, then click on NON-SPECIFIC Forms. Prescribed Appliance Form - this form is to be completed by the athlete’s physician if he/she is allowed to participate in sports with a cast / hard brace. Certain specifications must be met, and the form is given to the officials for their records. The official has the last word as to whether or not the athlete will participate. 8 Quarter Permission - This form has to be completed on Friday mornings if a JV player is to be allowed to play on Friday night with the varsity. It must be signed by a physician or Licensed Athletic Trainer! A first responder or EMT is not eligible to verify these players. Concussion Return to Play Form – will be discussed in detail next week For communicable disease release forms, go to the HOME website, click on “Select a Sport”, “Wrestling”, then scroll down to Physician Release. Please read this one carefully!

30. Some General Information Be confident but not cocky. “Play nice” with your coaching staff. When they trust you, they will trust your decisions. “Play nice “ with your EMS personnel. At some point in the season, you will need their assistance. Having a good relationship with them will help to avoid power struggles in an emergency situation. Parents do not always understand “medical-ese.” They may look to you for explanations of a doctor’s diagnosis and planned treatment, especially about follow-up appointments, etc. Do not allow an athlete, who has been out of practice due to injury to return without a clearance note / documentation from his/her physician. Make sure parents understand that they are responsible for that last piece of information.