Lifesaving Medications Use By Athletic Trainers

The athletic trainer's (AT) emergency management skill set requires competency in the delivery of basic lifesaving medications. Some lifesaving medications have been a part of athletic training practice for decades, but that list has grown as ATs' practice setting has expanded - increasing the types of em ergent conditions that the AT may have to treat. The 2020 CAATE curricular standards require athletic training students be trained to administer the following: supplemental oxygen, nitroglycerine, low dose aspirin, bronchodilators, epinephrine using automated injection device, glucagon, and naloxone. Clinically, the conditions treated by these medications can be categorized as follows: cardiac, respiratory, hypoglycemia, or anaphylaxis. All ATs should know the indications, contraindications, administration methods, and the details of patient monitoring for each medication. Generally, these medications are safe, have clear indications for use, and few contraindications. While ATs are trained to administer these medications, they must consider state laws and local policies.

Efficacy of Prophylactic Knee Bracing in Sports

Anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries are common knee injuries, which can result from contact and noncontact during sports, recreation, or work-related activities. Prophylactic knee braces (PKBs) have been designed to protect the knee and decrease risk of recurrence of these injuries. Despite their success, PKBs have not been proven to be consistently effective and cost of the device must be evaluated to optimize its use in sports, particularly American football. Biomechanical studies have suggested that increased hip and knee flexion angles may reduce frontal plane loading with bracing which can protect the knee joint. This is essential with knee loading and rotational moments because they are associated with jumping, landing, and pivoting movements. The clinical efficacy of wearing PKBs can have an impact on athletic performance with respect to speed, power, motion, and agility, and these limitations are evident in athletes who are unaccustomed to wearing a PKB. Despite these concerns, use of PKBs increases in patients who have sustained an MCL injury or recovering from an ACL reconstruction surgery. As the evidence continues to evolve in sports medicine, there is limited definitive data to determine their beneficial or detrimental effects on overall injury risk of athletes, therefore leading those recommendations and decisions for their usage in the hands of the athletic trainers and team physicians' experience to determine the specific brace design, brand, fit, and situations for use.

Trends in College Student-Athlete Mental Health in the National College Health Assessment (NCHA), 2011–2019

ABSTRACT Context: Recently the athletic training community has paid increased attention to college student-athlete mental health, treatment-seeking, and impacts on athletic and academic performance. Ongoing efforts to better-educate and equip athletic trainers to help student-athletes in this regard should result in improved mental health-related outcomes. Objective: Examine changes in student-athlete mental health over the past decade compared to non-athlete students. Design: Cross-sectional study. Setting: United States colleges and universities. Patients or Other Participants: Varsity athletes (n=54,479) and non-athlete students (n=448,301) who completed the National College Health Assessment (NCHA) between 2011 and 2019. Main Outcome Measures: Survey responses (self-report) to questions in five mental health-related domains: symptoms, diagnoses, treatment-seeking, institutional information distribution, and academic impacts. Results: Student-athletes consistently reported significantly lower symptom and diagnose rates than non-athletes, except for attempted suicide, substance abuse, and eating disorders. Diagnoses increased over time in both groups, but remained lower in athletes. Treatment-seeking and openness to future treatment increased over time in both groups, but remained lower in athletes. Student-athletes received more information on stress reduction, substance abuse, eating disorders, and handling distress/violence than non-athletes. Both groups received information more frequently over time. Athletes reported lower academic impacts, especially for depression and anxiety, but impacts grew over time in both groups. Impacts of injuries and extracurricular activities on academic performance were higher in athletes than in non-athletes. Conclusions: Athletes reported overall lower levels of symptoms, diagnoses, and academic impacts than non-athletes. While non-athlete rates climbed over the past decade, athletes' rates broadly remained flat or climbed less rapidly. Increasingly positive attitudes toward treatment are encouraging, but the deficit relative to non-athletes remains. Ongoing efforts of athletic trainers to educate athletes and guide them to mental health resources are needed in order to continue (or, better yet, accelerate) the observed positive trends in information dissemination and treatment-seeking.

Effectiveness of an Assistive Instrument for Physical Therapists with Visual Impairment to Conduct the Muscle Tightness Test

Disability sports have been globally promoted to achieve an inclusive society. However, the current opportunities for people with disabilities are few in terms of participating in supporting positions, such as athletic trainers. In Japan, many people with visual impairment (VI) work as physical therapists; thus, they can become active as medical staff in the sports field. An example of a medical assessment is the muscle tightness test (MTT); however, conducting it is expected to be difficult for people with VI. To improve this difficulty, the current study developed an assistive instrument (AsI) and examined its effectiveness. We recruited 22 physical therapists with VI. The measurement for MTT targeted the hamstrings, iliopsoas, gastrocnemius, and quadriceps. The participants performed the MTT using a universal goniometer (UG) and the AsI and filled up a questionnaire. AsI was compared against UG based on three aspects, namely, ease, accuracy, and measurement time. In terms of ease, significant differences were observed in 9 out of 12 questionnaire items. The mean (SD) score for “Comprehensive ease of the MTT” improved from 2.8 (1.0) to 3.9 (0.8). For accuracy, the AsI yielded a decrease in the total error of the measurement. Lastly, the measurement time for AsI was longer than that for the UG. Therefore, the AsI was effective in terms of ease and accuracy, whereas measurement time remained as an issue.

Promoting Interprofessional Communication through Situation, Background, Assessment, and Recommendation (SBAR): An Educational Technique

Context The Board of Certification Standards of Professional Practice and the 2020 Curricular Content Standards indicate athletic trainers should establish working relationships with collaborating medical professionals and be able to communicate effectively. In addition, increased emphasis on interprofessional collaboration (IPC) in practice is apparent throughout health care professions and their educational programs. However, integrating both interprofessional communication and IPC within 1 learning opportunity can be difficult. Objective To share an educational approach aimed to enhance athletic training students' abilities and confidence in delivering patient information to physician assistant students via the situation, background, assessment, and recommendation (SBAR) technique. Background As part of the health care team, athletic trainers need to communicate with various providers while making clinically based decisions. Anecdotally, learners in their final year of health care education are not confident in their ability to make recommendations to other health care professionals. The SBAR communication strategy from the evidence-based framework TeamSTEPPS has become widely adopted in health care disciplines and may help to enhance confidence in communication. Description This learning activity enables athletic training students to use a patient case scenario to develop an SBAR for delivery via phone to a physician assistant studies student. This article describes the content, delivery methods, outcomes to date, and connection to the 2020 Curricular Content Standards. Clinical Advantage(s) This clinically relevant activity provides a low-stakes, real-life opportunity for students to practice communication skills, including the following: condensing the evaluation process, clinical decision-making skills, and the ability to make recommendations for a plan of care. Active participation in the communication process enhances reasoning skills needed for collaborative clinical decision making and the transfer of care, when applicable. Conclusion(s) Developing and implementing an interprofessional SBAR communication experience with 2 health care disciplines is an innovative strategy that bridges the gap between clinical education and actual patient care experiences while addressing curricular content needs.

When Direct Pressure Is Not Enough: An Educational Technique for Teaching Wound Packing in Athletic Training Education

Context Uncontrolled hemorrhage is a major cause of preventable death. Wound care and managing external hemorrhage are important skills for athletic trainers. Objective Describe a laboratory activity used to allow students to practice managing uncontrolled external hemorrhage and wound packing. Background The prevalence of active shooter and other mass casualty events has grown, and a trend to move military-based emergency skills into civilian casualty care has emerged. Athletic trainers are uniquely positioned to respond to catastrophic events at the time of injury. Controlling hemorrhage and rapidly applying a tourniquet or administering wound packing have a great effect in preventing death due to severe hemorrhage. Description An educational technique using a pork shoulder was implemented to provide students with experience in wound packing. Clinical Advantage(s) Students describe this activity as a beneficial way to gain experience on an important skill not often seen in the clinical education setting. Conclusion(s) Faculty may consider implementing wound packing using a pork shoulder as a laboratory activity when teaching wound care and external hemorrhage management.

Teaching Dermatology Using a Cognitive Learning Theory Approach: An Educational Technique

Context Athletic trainers must develop the knowledge and skills to recognize signs and symptoms of dermatologic conditions in the physically active population. Objective To present an overview of an educational technique aimed at promoting the development of skills related to dermatological care that meets clinical practice needs and accreditation requirements for athletic training programs at all levels. Background Curricular content standards in athletic training education require learners to obtain the skills necessary to perform an evaluation, formulate a diagnosis, and establish a plan of care relevant to the integumentary system, including dermatological conditions. Cognitive Learning Theory uses specific sequencing of content and learning sessions to promote student engagement in the learning process. Description Within an evaluation course for nonorthopaedic conditions, a 3–class session learning module was developed to target instruction, application, and assessment of dermatological conditions. This article describes the development, overview of content, delivery methods, outcomes to date, and connection to the instructional standards in athletic training. Clinical Advantage(s) Integrating evaluation of dermatological conditions into athletic training curricula enhances clinical decision-making skills and direct application of these skills to clinical practice. Conclusion(s) Athletic trainers should be able to effectively identify, manage, and potentially refer patients with dermatological conditions. Educating future athletic trainers to be able to prevent the spread of infection, decrease disease transmission, and enhance their ability to recognize and manage dermatological conditions is vital to their development toward independent clinical practice.

Integrating Safe Space Ally Training Into the Athletic Training Curriculum

Context It has become increasingly important that athletic trainers (ATs) understand and promote diversity, inclusion, and cultural competency. One technique athletic training educators can use to promote cultural competency for those in the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community is by attending a safe space ally training (SST) program to integrate the concepts of SST programing into their curriculum. Objective To provide athletic training educators with techniques to integrate inclusion and cultural competence regarding the LGBTQIA+ community into the athletic training curriculum using SST content. Our goal is that athletic training educators will train future ATs as well as embrace individual professional development. Background The National Athletic Trainers' Association (NATA) LGBTQ+ Advisory Committee (AC) has created an SST workshop for athletic trainers. Educators can promote cultural competency throughout the curriculum using evidence-based training programs such as the NATA LGBTQ+ AC SST. Description The emphasis of SST is to improve cultural competence regarding sexual minorities to improve inclusivity in all athletic training settings. It is critical that athletic training education programs prepare graduates to be competent, compassionate, patient-centered and professional ATs who are ready to function as health care professionals for all patients. Clinical Advantage(s) A goal of cultural competency is to create an inclusive environment within all athletic training settings, whether it be in a classroom, a clinic, or a nontraditional work setting. Health disparities and health care inequities must be appreciated by every AT to deliver compassionate and competent care for all in marginalized populations. Educators can make a difference in the future of athletic training by increasing the cultural competency of their students. Conclusion(s) Patient-centered care, knowledge of the care of those in diverse and minority populations, and ethical behavior can be enhanced through SST programs.