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#AT4ALLSecondary SchoolSudden Cardiac Death

Athletic trainer hailed as hero for saving North Las Vegas student’s life

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Article reposted from Las Vegas Review-Journal
Author: Art Marroquin

Chely Arias is already considered a hero just two months into her first job as a high school athletic trainer.

The North Las Vegas Fire Department credited Arias with saving a 17-year-old high school senior who collapsed Oct. 24 while warming up for a flag-football practice at Cheyenne High School.

“Her life was literally in my hands, and that’s a unique feeling to have,” Arias said shortly after a brief recognition ceremony held Wednesday in the school library. “Once you experience something like that, it changes your life.”

Arias couldn’t find a pulse when she aided Kennedi Jones just after 1:30 p.m. that day. The teen had stopped breathing and was unresponsive, prompting Arias to start CPR.

A flag football coach called 911 while a student retrieved one of the school’s three portable defibrillators from the gym.

Arias placed the automated external defibrillator pads on Jones’ chest, hoping an electrical shock would revive her. After three attempts, Jones finally had a pulse.

“It was devastating to walk up and see what was taking place at the time,” said Kimberly Jones, who arrived to watch Arias work on her daughter before paramedics arrived.

“As a mom, you never want to come to a scene and see things happen at that magnitude,” Kimberly Jones said. “She didn’t stop, she stayed focused and she was well-trained for this occasion.”

Jones was taken to University Medical Center, where she spent nearly two weeks in recovery. Like most teens, she just wanted to eat, walk around and go home. The teen said she didn’t have any previous medical problems and was enjoying her second year as a middle linebacker for the school’s intramural flag football team.

“I’m thankful because I could’ve died,” Jones quietly said. “She knew what she was doing. She saved my life.”

While presenting Arias with an accommodation plaque, North Las Vegas Fire Chief Joseph Calhoun said the athletic trainer’s effort demonstrated the need for more people to learn CPR and how to operate AED devices.

“Your actions and your quick thinking did an incredible thing,” Calhoun said. “It saved a young woman’s life for her to be able to grow up and become an adult and live a normal and happy life.”

Contact Art Marroquin at amarroquin@reviewjournal.com or 702-383-0336. Follow @AMarroquin_LV on Twitter.

 

#AT4ALLCollege and University

Huskies to wear sport safety helmet stickers during Apple Cup

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Article reposted from The Seattle Times
Author: 

Nationwide, 37 percent of high schools in the United States have at least one full-time athletic trainer to monitor sports programs, according to a 2015 study by the National Athletic Trainers’ Association.

“If you think about that, that’s really low,” said Rob Scheidegger, the University of Washington head football trainer.

During Saturday’s Apple Cup, the Huskies will wear stickers on the back of their gold helmets to raise awareness for safety in youth and high-school football — and athletic trainers’ roles in promoting and maintaining safe standards. It’s part of the Washington State Athletic Trainers’ Association’s safety in football campaign.

“We’re hoping parents of kids who are participating in those programs see those stickers and ask what it’s all about,” Scheidegger said. “We talk so much about how dangerous football is, but there so much good from football too. The safety (questions have) sort of put our sport at risk a little bit. There’s a lot of people who look at football and aren’t going to let their kid play. But, really, football is as safe as it’s ever been … and athletic trainers are a key part of that.

“So we want people asking questions about the sports programs they’re letting their kids participate in: Do we have an athletic trainer? And if we don’t, why not? Do we have an emergency-action plan? And if we don’t, why not? That’s what we’re hoping for, to raise awareness about those things.”

The UW employs four certified athletic trainers just for the football team. There are 11 other trainers for the Huskies’ other sports teams, a fairly standard number for major-college athletic departments.

“Our student-athletes here are super lucky,” Scheidegger said. “We have such a great administration. Jen Cohen and her staff put such an emphasis on student-athlete health and safety and put a big invested heavily as far as equipment.”

It’s a different story at youth levels.

Washington state, Scheidegger said, is “pretty progress” when it comes to having athletic trainers in high schools, but many of those trainers are employed part-time — meaning some are only in attendance at football or basketball games. In reality, he said, 60 to 70 percent of injuries occur during practices, and there aren’t always trainers there to assist.

“Yeah, it’s great to have someone there in your program who can create an emergency-action plan, who can educate student-athletes and talk to coaches,” he said. “But, really, the gold standard should be having full-time athletic trainers.”

#AT4ALLSecondary School

California’s crisis with athletic trainers: High school athletes are at risk

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Article reposted from The Orange County Register
Author: 

Javier Venegas, a 21-year-old distance runner for Golden West College, suddenly collapsed on the track one afternoon in late January.

He wasn’t breathing. He didn’t have a pulse.

Fortunately, Pat Frohn, a certified athletic trainer for Golden West, plus a Long Beach State athletic-training student, Tori Mulitauaopele, were in the Athletic Training Room and were called out to the track. They began CPR. It took two shocks from the automated external defibrillator (AED) to return Javier’s heartbeat.

From left, Pat Frohnn and Tori Mulitauaopele recount how they used CPR to save a life on the track at Golden West College in Huntington Beach. (Photo by Drew A. Kelley, Contributing Photographer)
From left, Pat Frohnn and Tori Mulitauaopele recount how they used CPR to save a life on the track at Golden West College in Huntington Beach. (Photo by Drew A. Kelley, Contributing Photographer)

The EMTs arrived and Venegas was rushed to the emergency room, where he was put into a medically induced coma. He is now recovered from what was determined to be a heart arrhythmia.

“If I wasn’t here, if there was no athletic trainer on staff, if this was any high school in the area?” Frohn said, “Javier would be dead.”

California has more than 800,000 high-schoolers playing sports, yet the state does not require schools to have athletic trainers at practices or games—and very few do. Just 25 percent of public high schools employ a full-time athletic trainer, according to CIF data from 2016-17 (athletic directors from 1,406 schools self-reported—an 88.6 percent rate).

Even more troubling? California is the only state that does not regulate the profession of athletic training. That means that anyone can call themselves an athletic trainer, regardless of whether they are certified; regardless of whether they possess the educational qualifications, clinical experience or medical knowledge to practice.

This puts student-athletes at enormous risk. Among those working as athletic trainers in California high schools, 16.2 percent are not certified, according to CIF data.

“It’s a level of fraud,” said Brian Gallagher, director of sports medicine/certified athletic trainer at Harvard Westlake.

The CATA has been working on this issue for more than three decades. California Assemblymember Matt Dababneh (D-Woodland Hills) has introduced Assembly Bill 1510, which would provide for the licensure and regulation of athletic trainers and establish the Athletic Trainer Licensing Committee within the California Board of Occupational Therapy. It would bar a person from practicing as an athletic trainer or using the title unless the person is licensed by the committee.

The bill is scheduled to be heard next at the California State Assembly and Senate at the beginning of 2018.

We’ve reached a tipping point. Or something worse: “It’s a crisis,” said Trenton Cornelius, coordinator for L.A. Unified School District’s Interscholastic Athletics Department.

***

Michael Boafo, a Redlands High football player, suffered a hit in a 2015 game against A.B. Miller High in Fontana.

Heather Harvey, a certified athletic trainer for Miller at the game, said Redlands’ athletic trainer called her over to help him with calling EMS for Boafo. She sprinted over and felt stunned, alleging that neither the athletic trainer nor other staff were monitoring Boafo’s vitals or checking his pulse as he laid face up on the sideline, unconscious.

“Is he breathing?” Harvey asked. She said she was assured that Boafo was “fine” and was simply experiencing “flu-like symptoms.”

Harvey took over care by assessing his vitals and level of consciousness while activating EMS. It seemed apparent to her and her team physician that this was more than Boafo simply being sick. While on the sidelines, Harvey said it was mentioned that Boafo had suffered a concussion earlier that season. Harvey was able to effectively monitor Boafo until paramedics arrived.

Later that night, Boafo ultimately underwent a five-hour brain surgery to address a bleed in his brain (the surgery was successful and he was able to make a full recovery). Harvey said Redlands’ athletic trainer did not know proper protocol.

The athletic trainer, still at Redlands, is not certified, according to the online registry of Board of Certification Certified Athletic Trainers.

“That was mismanaged,” Harvey said. “I hate seeing it and unfortunately, I see things like that on a regular basis at this point. Not necessarily the catastrophic injuries, but just knowing the people on the sideline might not be appropriate medical personnel.”

How many parents assume the athletic trainers in charge of their child’s safety are qualified to oversee his or her care?

Some athletic directors might not even be aware if their athletic trainer is certified or not, according to Mike Chisar, chair of the CATA Governmental Affairs Committee. “There’s nothing that mandates (certification) as part of the hiring criteria, the minimum qualifications, then (athletic directors) wouldn’t necessarily be looking for that,” Chisar said.

Sometimes well-meaning parents and volunteers assume the role, as do coaches, who are CPR and First Aid certified and must take a sport-specific concussion course and sudden cardiac arrest training. But these are not healthcare providers.

Imagine if Celtics coach Brad Stevens was tasked with tending to Gordon Hayward’s gruesome ankle injury on NBA opening day.

“You can’t cut someone’s hair in our state if you don’t have a professional license and qualifications,” Dababneh said. “We are much more stringent on someone that cuts your hair then someone that can make a decision about your kid’s health in an athletic competition, whether or not he can go back in the game, whether he needs medical treatment.”

Opposition for the bill mainly comes from the California Physical Therapy Association.

Gov. Jerry Brown vetoed bills in 2014 and 2015 that would have required athletic trainers to be certified, reasoning the bills would require athletic trainers to attend college, which would “impose unnecessary burdens on athletic trainers without sufficient evidence that they are really needed.”

***

To understand why athletic trainers are needed, you have to understand who they are and what they do.

Athletic trainers are healthcare providers who focus on the prevention, treatment and rehabilitation of injuries and illnesses. They are not gym trainers or physical therapists or chiropractors.

“Most of us hold Masters degrees and have spent countless hours in clinical settings honing our craft,” said Kirsten Farrell, certified athletic trainer at Venice High School and 2018 California Teacher of the Year.

The CIF, which supports AB1510, is working to educate principals, superintendents and athletic directors on the importance of having athletic trainers. “We’ve got to make it a priority for our schools,” said Roger Blake, CIF’s Executive Director. “They need to see the human value in this.”

Injuries, concussions, heat stroke, cardiac arrest, can happen at any second and immediate response is critical.

Sierra Canyon faced Buena High in a junior-varsity football game on Aug. 31. Buena did not have an athletic trainer when one of its players went down with a hit. Fortunately Eric Dick, Sierra Canyon’s certified athletic trainer, was on site.

Dick asked the player if he had a headache or felt dizzy or nauseous. The player smiled but wasn’t responding. Dick told the player and his father to not wait, and walked them to their car. Dick asked the player to read the word “SCAN” on the stereo. He couldn’t formulate the words, mumbling and struggling. Eventually he got the words out, but it took far too long. Dick said they should go to the hospital immediately.

“The continual follow up over that time period, was only about five minutes. In those five minutes, he took such a big change in his behavior,” said Dick, who mentioned the importance of having an athletic trainer to make decisions about when it is safe for an athlete to return to play, as those decisions have long-lasting health consequences.

Dick works at a private school — but what about public schools?

LAUSD is a large district of 150 schools and more than 52,000 athletes and comprises the L.A. City Section. Yet only 13 percent of schools of schools that reported in this Section have athletic trainers.

Some are funded by non-profits, such as the West Coast Sports Medicine Foundation or Team Heal Foundation. Alex Merriman, Dorsey High’s certified athletic trainer, is one of them.

She oversees the Dons’ 23 teams on her own, though she has student athletic-training aides to help out. She works 60 hours on what she calls a “good” week and 70-75 hours on a “bad” week (one that involves more injuries and treatment). As devoted as she is, she cannot make every single game, especially with two to three sports going on during one season.

“You have to be really passionate about what you do in this field,” Merriman said. “There are plenty of days where I want to quit and give up and find another job somewhere else, but I remember all the kids that we care for here. What would they be doing if I wasn’t here?”

CIF data indicates that both public and private suffer from a shortage of athletic trainers. However, some of the lower socioeconomic sections (Oakland, L.A. City, Northern) report only 9 to 13 percent of schools having a certified athletic trainer. More affluent sections (San Diego, Southern, San Francisco) report having the largest percentage of schools having an athletic trainer at 60 to 77 percent.

What will it take for students to be protected?

“I don’t want this to become a reactionary story where, God forbid, another student is injured or hurt badly or their health is compromised,” Dababneh said. “Then everybody says: ‘Well why didn’t we do this already?’”

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CIF data from 2016-17 (athletic directors from 1,406 schools self-reported — an 88.6 percent rate)

#AT4ALLEmerging Settings

Terre Haute City firefighters get athletic trainer services

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Article reposted from Tribune Star
Author: Lisa Trigg

Pushing, pulling, dragging and carrying equipment are part of the regular physical stress firefighters place on their bodies as they do their job to keep their communities safe.

But seldom do firefighters have evidence-based plans to take care of their own bodies, other than wearing heavy protective equipment on the job.

That situation has changed for firefighters with the Terre Haute Fire Department due to a partnership with Indiana State University’s College of Health and Human Services and its Department of Applied Medicine and Rehabilitation.

Associate professor Kenneth Games is researching the area of tactical athlete health and safety to help firefighters and others in public safety and military service reduce and prevent injuries.

“It’s about the overall health and well-being of the person, not just the job they do,” Games said this week while talking about the Neuromechanics, Interventions, and Continuing Education Research Laboratory, which opened Sept. 11 at ISU.

The NICER lab is where THFD firefighters are already going, voluntarily, to work on physical issues they have, or to avoid future issues.

The lab operates as a clinic four hours each day. It also serves as a classroom for the athletic training program at ISU.

The program is offered free to city firefighters. It has received a grant from the Center for Community Engagement at ISU, and Games said he plans to apply for other federal funds to expand the program to other public servant groups.

“There is tremendous physical and mental toll taken on public servants, but they often don’t take the time to stay fit,” Games said.

Many firefighters start their careers in good physical condition and have been high school or college athletes, he said, so they might be used to running or lifting weights. The tactical athlete approach is different and includes flexibility and other functional movements that firefighters do on the job.

Games said much of the research done by the program has examined the relationship between firefighter personal protective equipment and musculoskeletal injury.

While personal protective equipment has greatly reduced exposure to occupational hazards in firefighting such as smoke and flames, it has had the unintended consequence of increasing musculoskeletal injuries due to the increased weight loads now placed on firefighters.

Games directs the Tactical Athlete Research and Education Center at ISU, which is a collaboration between researchers and public or private agencies such as the Rural Health Innovation Collaborative.

While some fire departments in larger metropolitan areas may hire athletic trainers to work with firefighters and police on physical fitness, Games said, smaller departments such as Terre Haute’s usually do not have the funding to invest in such programs.

“Our long-term vision is to make ISU and the city a national model for this type of program,” Games said.

For more information on TAREC, go online to www.indstate.edu and search for Tactical Athlete.

Lisa Trigg can be reached at 812-231-4254 or at lisa.trigg@tribstar.com. Follow her on Twitter at TribStarLisa.

#AT4ALLSecondary School

20 years on, full-time athletic trainers help make Northwest Florida ‘envy of the state’

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Article reposted from Pensacola News Journal
Author: Eric J. Wallace

You’ve seen them on your high school sports sidelines, and they’ve probably had a helping hand in taking care of your favorite young athletes.

For 20 years, certified athletic trainers from Baptist Health Care, and now the Andrews Institute, have provided on-the-spot medical care for high school athletes in Northwest Florida, be it managing hydration or emergency triage for on-field injuries.

The services have come at no cost to student-athletes and parents while the savings to institutions, which include 23 high schools and four small colleges across Escambia, Santa Rosa, Okaloosa and Walton Counties, often reach well beyond a school’s budget.

“It’s invaluable. We’re kind of the envy of the state because of the situation we’re in,” Escambia County athletic director Roger Mayo said. “That’s been a crucial situation.”

While it may be easy to take such services for granted — particularly when a generation of the area’s athletes have had the services since the program’s inception in 1997 — the situation in Northwest Florida is far from the norm.

According to a 2015 study published by the Korey Stringer Institute at the University of Connecticut — which studied 14,951 schools from all 50 states — 70 percent of public secondary schools in the United States had access to athletic-training services, with only 37 percent reporting full-time athletic training services.

That total is doubled from the 35 percent of schools that reported any access to athletic-training services in 1994.

But later studies from the Korey Stringer Institute indicated that budget concerns have limited the expansion of athletic-training services, despite a growing preference for them from school athletic directors.

It’s little surprise considering that the annual mean wage for athletic trainers in 2016 was $47,880, according to the U.S. Bureau of Labor Statistics. Those wages alone, when multiplied across 27 schools across Northwest Florida, would creep into the millions.

Former FHSAA Executive Director Roger Dearing estimated in 2013 that it would cost nearly $30 million to have athletic trainers at every high school in Florida.

“No school district could afford that,” Mayo said. “You would have to start eliminating coaching supplements to be able to do that, but then you’re talking about a trainer having to have a curriculum to teach. Most athletic trainers don’t have teaching certificates.”

The costs alone have inspired some schools districts to find shortcuts for their athletic programs.

Be it first-aid trained coaching staffs or community volunteers from local clinics and hospitals, athletic directors have often chosen athletic trainers as a corner to cut when feeling bound by the budgeting decisions of superintendents and school boards.

Those corners may be cut in the name of financial necessity, but the cost can ultimately come on the shoulders of the student-athlete.

“I always like to point out that we’re a nationally certified profession,” said Kathleen McGraw, sports medicine coordinator at the Andrews Institute. “Most states require you to be licensed in the state that you’re going to practice in.”

“Our athletic trainers, as a profession, are on-site and out in the field wherever your field may be. It may be a court, it may be a field, it may be a dance studio or a backyard at your house. We’re at a bunch of different places and interacting with people in their environment.”

As awareness of the magnitude of sports injuries like concussions continues to grow, so too have the responsibilities of those entrusted with an athlete’s care.

Aspects of recovery that often weren’t addressed in a student-athletes’ day-to-day life – such as campus mobility and classroom accessibility – have become the domain of trainers.

“There are things that likely in the past got lost in the shuffle,” said Michael Milligan, M.D., team physician with Tate High School. “With us trying to educate with those things, anything that we can do to help our schools commit resources on behalf of student-athletes for health and safety is very important.”

Athletic trainers such as Crystal Evans – who has served as the Pace High School athletic trainer for 10 years – have become community regulars in the meantime.

Be it a lineman whose hand was stepped on or an ankle that plain went the wrong way, Evans stands on alert for each home athletic event at Pace High, leaning and supporting the Patriots with each dramatic turn of events.

Evans isn’t from Pace, nor was she even raised in the Pensacola area. Nonetheless she’s become a steadying presence for the area’s athletes, through injury, dehydration and all.

“I still live in Pensacola,” she said, “but sometimes it feels like (Pace) is home.”

#AT4ALLCollege and University

An Ode to the Athletic Trainer

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Article reposted from Seminoles.com
Author: Bryce Kelley

There once was a trainer

Who stayed up all night

To sit in a waiting room

Shaking with fright

For her athlete had called just hours before

Complaining of chest pains, head pains, nose pains and more.

 

After hours had passed

And every test was done,

The athlete walked to the trainer with his sorry head hung

For he knew the trainer was about to be told

That the athlete had nothing more than a common head cold.

 

By now the sun had rose

To reveal a new day

And with it a training room

Where the trainer must stay

Until the last of her hundred-odd athletes had gone

No longer complaining of legs they can’t walk on.

 

And the trainer went home

To eat her first meal

And wait for tomorrow’s inevitable spiel

About how this calf hurts and how this knee pops,

How this hip aches and how this leg stops.

 

But patience is key along strong coffee

So the trainer goes to bed

Dreaming of a vacation – or three.

An Ode to the Athletic Trainer

If you’re hurting, you go to the trainers. If you’re sick, you go to the trainers. If you’re like me and need someone to complain to about your statistics class and how there’s no earthly reason you’ll need to know how to reverse code variables, you go to the trainers (they may not listen though, they’re good at tuning me out at this point). Athletic trainers are the lifeblood of college athletics and they don’t get the credit they deserve. So this week, by the power vested in me, I now pronounce The Rundown, lowly as it may be, a dedication to Florida State Athletic Trainers.

By this point in my college running career, a list of my injuries probably looks more like the never-ending receipt you get from CVS after buying a Coke. Or maybe the opening credits to a Star Wars movie. And I wouldn’t be here today, able to still call myself a runner, if it weren’t for the trainers that helped keep the jigsaw puzzle that is my body in one piece. It’s not just me either.

In my time here, I’ve seen miracles be performed on the training table. I’ve seen athletes who spend more time in the training room than at home achieve their dreams that had, at one point, seemed so hopeless. I’ve seen the trainers, like in an episode of Scooby-Doo, solve the mystery of an injury and unmask the culprit – which let’s be honest, was probably just not enough stretching.

I think on every ACC title, hell every national title that FSU has ever earned, there should be, in fine print, a note that reads: “This wouldn’t have been possible without our athletic trainers.”

They really are the glue that holds this team together, or more thematically spoken, the athletic tape that holds this team together. They become our coaches, our parents, and our motivators. They drive us to our appointments and endure the countless hours spent in waiting rooms as doctors try to fit us in (Tallahassee Orthopedic Center, I love you guys, but if you’re reading this, please play something other than HGTV in your waiting rooms. I can’t watch another couple not pick the house that they CLEARLY should pick). But most importantly, our athletic trainers deal with us at our lowest lows so they can help us get to our highest highs.

Being an athletic trainer can be a thankless job. So thank you. Thanks Gwen, Armand, Kyra, and Danielle. Thanks to our past trainers, Natalie, Symone, and Kathleen. Thanks to all the student trainers. So raise your glass of PowerAde. Here’s to you athletic trainers. Ok, I’m done. I’m making myself feel like a pine tree with all this sap.

On another note, the Noles will be in the destination hotspot of South Bend, Indiana to run really fast on Notre Dame’s golf course this Friday.

Bryce Kelley, a graduate student in Integrated Marketing Communications, is a fifth-year Seminole from Hope Valley, R.I. A two-time All-ACC Academic selection in cross country with his undergraduate degree in Creative Writing, Kelley will be providing a weekly inside look at the FSU men’s team throughout the season.

#AT4ALL

How California puts high school athletes at great risk

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Article reposted from San Francisco Chronicle
Author: Al Saracevic

As the sun sets and the Friday night lights go on at football fields across California this week, thousands of high school players will prepare to clash.

In the stands, proud parents will look down on the field nervously, outwardly willing their sons to succeed while inwardly praying for their safety.

Missing from the equation, in many of those games, will be certified athletic trainers to watch over the proceedings, ready to address anything from common injuries to life-threatening situations. That’s because California is the only state that does not require its high school athletic trainers to be certified in any way. The state doesn’t even require schools to have trainers at games. So many do not.

It’s a shocking revelation, at a time when injury awareness and concern is at an all-time high — especially in football. We’re worried about the long-term effect of concussions, but we’re not even staffing high school football games with trained professionals? It’s an absurd situation that could be easily rectified.

According to a recent study published in the Orthopedic Journal of Sports Medicine and conducted by the University of Connecticut’s Korey Stringer Institute, a nonprofit dedicated to minimizing preventable death on the playing field, California ranks second to last in the nation — ahead of only Colorado — when it comes to implementing policies that help prevent the leading causes of sudden death in high school athletes. That dismal result is directly tied to the state’s lack of a coherent policy on trainers.

“California is the only state in the nation that does not regulate athletic trainers,” said Samantha Scarneo, director of sports safety for the Stringer Institute, named for a Minnesota Vikings lineman who died from heatstroke in 2001. “There’s been a lot of push to get licensure (legislation), but the governor keeps blocking it.”

Indeed, Gov. Jerry Brown vetoed bills in 2014 and 2015 that would have required athletic trainers to be educated and licensed. By explanation, he wrote that the bills would have required anyone using the title “athletic trainer” to go to college, and that would “impose unnecessary burdens on athletic trainers without sufficient evidence that they are really needed.”


Brown might face the issue again next year. There is a bill making its way through the Assembly — AB1510, sponsored by Assemblyman Matthew Dababneh, D-Encino (Los Angeles County) — that would require licenses for athletic trainers. If passed, it would be on the governor’s desk before next fall.

“I felt the need to take action in order for our state to properly protect our student athletes,” said Dababneh, in a statement to The Chronicle. “Athletic trainers are the expert on the sidelines, and the first people able to identify potential injuries. Parents trust these individuals to protect the health of their children but without proper education and training, signs of heatstroke or a concussion can be easily missed. By licensing athletic trainers, AB1510 will effectively protect the athletes by ensuring only qualified individuals can work as an athletic trainer.”

The bill faces opposition from the California Physical Therapy Association, which has held for years that there is no need for a layer of certification for athletic trainers. In a letter to Dababneh last spring, which addressed six concerns, the professional group said, “AB 1510 is highly flawed and addresses no pressing issues facing the State of California and its citizens. Instead this legislation seeks to benefit a single category of individuals.”

Digging a bit deeper, the physical therapists seem most concerned about the scope of the bill, fearing it would give athletic trainers too much leeway to practice medicine.

The bill “absolutely oversteps its bounds and would allow athletic trainers to practice in a way that they’re not trained,” said Chris Reed, a physical therapist and chair of the government affairs committee for the CPTA. “It would be great if we had a bill that would require a trainer on every sideline. This bill doesn’t do that.”

The athletic trainers counter by saying physical therapists are trying to protect their job territory. The argument between the two professional organizations has been going on for years, leading certification efforts down a political rabbit hole the Assembly will wrestle with again in the next session.

In the meantime, sports are being played and California remains the only state without a rational certification process.

“I’m very much for certification,” said Scott Heinrichson, 45, an accredited athletic trainer at St. Francis High School in Mountain View. “We’re dealing with kids on a daily basis. As a parent, you’d definitely want someone in there who is qualified to do that job, not just someone who just says they are qualified.”


We’ve all heard the horror stories. Just this season, a high school football player in Santa Rosa suffered a severe head injury that required brain surgery. During training camp over the summer, a young player in the Bronx collapsed and died, apparently from heat exhaustion. From 1982 to 2015, 735 high school athletes died during and after participating in sports, according to the University of North Carolina’s National Center for Catastrophic Sport Injury Research. According to the Stringer Institute, the leading causes of this most tragic result are sudden cardiac arrest, traumatic head injuries, heatstroke and complications related to sickle-cell trait.

Any of those four medical conditions requires quick-thinking action from a trained professional. But too many California high school athletes are not getting that kind of treatment.

“Athletic trainers need to be licensed in California. The fact is that we deal with a variety of medical conditions on a daily basis, and yet there’s no regulation, there’s no mandate on qualifications,” said Mike Chisar, chair of the California Athletic Trainers Association’s governmental affairs committee. “We wouldn’t go to a physician that hasn’t gone to medical school. To see an athletic trainer to manage your concussion, when that trainer isn’t actually an athletic trainer, doesn’t make sense.”

In other states, athletic trainers need to be college educated, receiving training and degrees similar to other health care professionals, such as physical therapists, occupational therapists or physicians’ assistants.

“There are accredited programs,” said Chisar, an accredited trainer himself. “Every state utilizes the same accredited program. There is one national exam that validates whether you have the skills necessary to function as an athletic trainer. Every state uses it.”

Except California. And that’s why many high school athletes compete with no trained medical staff on hand.

“I’d say it’s about half,” said Heinrichson, when estimating how many Bay Area schools have qualified trainers. “If an emergency happens, are they prepared? You have concussions, and cardiac emergencies. Do you have someone who’s trained to work with that? You also need someone who’s qualified to make return-to-play decisions. Are they making the right decisions, in the best interest of the athlete?”

Of those schools that do have trainers, many aren’t qualified. According to a fact sheet attached to AB1510, “Fifteen universities in California, including seven CSUs, have nationally accredited athletic training education programs. Despite this fact, anyone can still act as an athletic trainer; approximately 30 percent of individuals calling themselves athletic trainers in high schools are not qualified.”


It’s not a pretty picture, but there are steps schools can take while waiting for possible legislative relief.

The Stringer Institute strongly recommends that every school have an emergency action plan, or EAP in trainer parlance, that answers some basic questions. Who should be calling 911? Who goes and gets the athletic director? Who directs (emergency personnel) to the field? What are the directions to the field? Is there a gate that needs to be unlocked?

“It’s a low-cost effort,” said the Stringer Institute’s Scarneo. “There are templates out there that schools can use. Mandating that schools should have a medically specific EAP for sports-related injuries is one area that California could score points, but more importantly save lives. That’s more important than licensure, in my opinion.”

Whether Sacramento listens to this advice, we’ll see. Brown’s office said it does not comment on pending legislation. Perhaps those nervous parents, sweating it out under the Friday night lights, can ask the governor and the Assembly to stop listening to the lobbyists on both sides of the legislative fight and do the right thing by the kids.

“Our message to parents is that if your school can afford to have a football team, they can afford to have an athletic trainer,” said Scarneo. “If they can’t afford an athletic trainer, they can’t afford to have athletics.”

Al Saracevic is sports editor of The San Francisco Chronicle. Email: asaracevic@sfchronicle.comTwitter: @alsaracevic

Tell us your stories

Has your son or daughter been injured while playing high school sports? Did you feel the medical care was sufficient, or not? Share your stories with The Chronicle, which plans to pursue the subject of high school athletic trainers in greater depth. Email Al Saracevic at asaracevic@sfchronicle.com.

 

#AT4ALLSecondary School

Colorado Physician: Athletic Trainers a Must in Schools

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Article reposted from The Pueblo Chieftan
Author: Jon Pompia

A local physician who has long volunteered his services at area high school sporting contests believes certified athletic trainers should be mandatory at Pueblo City Schools’ (D60) four high schools.

Rocky Khosla, a medical doctor with expertise in sports medicine, said D60 should follow the lead of Pueblo County School District 70 and make full-time certified trainers a staffing requirement.

At present, there is one certified trainer and one first-aid responder (non-certified but with training experience) at each of D60’s four high schools.

But the trainer positions are part-time or extra-time, meaning that an educator may fill that role as an additional duty, as an example.

“But all major/physical contact sports have a trainer at all events,” said Rick Macias, D60 athletic director. “In addition to this, many doctors volunteer their time to cover all football games at Dutch Clark Stadium, with American Medical Response present at all athletic contests played at the stadium.”

Dalton Sprouse, D60 communications director, said East, Central and South high schools “are in the process of hiring a certified trainer, but the job pool is limited.

“At this time, however, funding four full-time positions to serve solely as a certified trainer is not a feasible option for us.”

In District 70, the starting salary of a certified trainer is similar to that of a first-year teacher, with job duties to include training, evaluation and injury prevention.

Khosla said D60’s “patchwork quilt” approach to athletic training ultimately falls short, potentially endangering students injured in action.

“Some are certified, some are not. Some are EMTs, some are not,” Khosla said of D60’s trainer corps. “And they are well-intended, don’t get me wrong. But the truth is that certified athletic trainers have to go through a really rigorous curriculum, so you know you have a standard of what to expect.”

There is no Colorado High School Activities Association requirement that certified trainers be on-site during athletic contests or practices, Khosla said. In fact, the National Athletic Trainers’ Association reports that “no state has legislation that requires every high school to have an athletic trainer,” despite several instances in which athletes have been fatally injured during games and practice sessions.

Khosla said several organizations he supports, including the American Medical Society for Sports Medicine and the NATA, have long pushed for a full-time trainer requirement.

“The majority of high schools do not have certified athletic trainers,” Khosla said. “And I think CHSAA did not want to make that requirement because of the financial drain on schools. But why can’t CHSAA say, ‘If you have enough kids to have a Class 3A or higher team, you should have the finances to hire a certified athletic trainer.'”

And while Khosla praised the presence of AMR at D60 contests, he added, “Those people are well-trained for emergencies and the big catastrophic events, but not necessarily for bumps, lumps and concussions, as examples.”

 

#AT4ALL

Protecting student-athletes from heat, head injuries

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Article reposted from My AJC
Author: Michael Ollove

Another high school football player, this one a 14-year-old in New York, collapsed on the field and died last week, possibly the result of high heat and humidity.

The death of Dominick Bess of apparent cardiac arrest came at a time when thousands of high school athletes have returned to practice fields. It again raises the question of whether states are doing enough to ensure that student-athletes are safe as they collide into one another, run wind sprints, or dig in against hard-throwing pitchers.

Nearly 8 million kids participated in high school sports last year, the most in U.S. history. The shocking deaths of young student-athletes have prompted some states to weigh major changes.

The California Legislature is considering a bill that would bring athletic trainers under state regulation. Others, including Texas and Florida, are strengthening policies on training during high heat and humidity and on the use of defibrillators during sporting events and practices. They are also moving to require schools to devise emergency plans for managing catastrophic sports injuries. And in response to growing concerns about concussions, the state of Texas recently embarked on the largest study ever of brain injuries to young athletes.

But overall, a just released study of state laws and policies on secondary school sports found that all states could do more to keep high school athletes safe. And some have a long way to go.

The study has prompted a strong pushback, including from the national organization that represents state high school athletic associations. But it also has encouraged some athletic trainers and sports medicine physicians who hope poor rankings will impel their states to make improvements and avoid exposing student-athletes to needless risk.


“I was embarrassed we were last,” said Chris Mathewson, head athletic trainer at Ponderosa High School in Parker, Colo., speaking of his state’s showing in the study’s ranking of state safety efforts. “My hope is it will kick people in the pants and get people to do something about it.”

The rankings were devised by the Korey Stringer Institute (KSI), also known as Stringer, which is a part of the University of Connecticut and provides research, education and advocacy on safety measures for athletes, soldiers and laborers engaging in strenuous physical activity. It was named for a Minnesota Vikings offensive lineman who died of heat stroke during a preseason practice in 2001. His death sparked changes in NFL training practices and influenced reforms at the college and high school levels as well.

The rankings are based on whether states have adopted more than three dozen policies or laws derived from recommendations published in 2013 by a task force that included representatives from KSI, the National Athletic Trainers’ Association and the American College of Sports Medicine. The recommendations cover such areas as prevention of heat stroke, cardiac arrest and head trauma, as well as qualifications of school athletic trainers and educating coaches in safe practices.

Some state athletic associations, including Colorado’s, and the National Federation of State High School Associations, known as NFHS, which represents the associations that govern high school extra-curricular activities, have objected to the methodology of those rankings. They say it relies too much on information found on the websites of state athletic associations while failing to note efforts those groups have undertaken to reduce risks to high school athletes.

“By ‘grading,’ state high school associations based on a limited number of criteria, KSI has chosen to shine a light on certain areas, but it has left others in the dark,” said Bob Gardner, NFHS executive director. He pointed to steps his group and its members have taken related to safe exertion in heat and humidity, use of defibrillators and tracking head injuries, which Stringer didn’t take into account.

In Colorado, Rhonda Blanford-Green, commissioner of the state’s High School Activities Association, said officials are “comfortable and confident that our (policies) meet or exceed standards for student safety.”

She complained that Stringer’s methodology is too rigid. For example, she noted that Stringer penalized states that did not require that all football coaches receive safety training taught by USA Football, the governing body for amateur football. But, she said, Colorado coaches are trained in other programs that she described as more comprehensive.

She also noted that her association was penalized because it made policy recommendations to its high school members, rather than making them requirements, as Stringer prefers.

The scholastic association in California, which finished just ahead of Colorado, also objected to the survey. Its executive director, Roger Blake, suggested that funding was a chief barrier to progress.

California Interscholastic Federation “member schools will need more funding, more AEDs (automated external defibrillators), more athletic trainers and more research to help support our efforts to minimizing risk,” Blake said. “With the assistance of everyone who cares about young athletes, including KSI, we can continue to progress.”

Between 1982 and 2015, 735 high school students died as a result of their participation in school sports, according to the National Center for Catastrophic Sport Injury Research at the University of North Carolina. The vast majority of those deaths were related to football, and three-quarters of the overall deaths were attributed to cardiac arrest, respiratory failure or other ailments associated with physical exertion. The rest were linked to trauma, such as head injuries.

More of those deaths occurred in the 15 years prior to the year 2000 rather than the 15 years after — likely a reflection of the fact that most of the policies and laws pertaining to safety in high school sports were put in place after 2000, particularly in the last nine years.

In 2014-15, the last year for which there are statistics, 22 high school athletes died, 14 of them football players.

Some of the reforms carry the names of student-athletes who died while participating in school sports. That was true in North Carolina after the 2008 death of Matthew Gfeller, a 15-year-old sophomore linebacker who died in the fourth quarter of his first varsity game in Winston-Salem after colliding helmet-to-helmet with another player.

Now a foundation and a brain injury research institute at the University of North Carolina are named after Matthew. His name and that of another North Carolina high school football player, Jaquan Waller, who died the same year as a result of on-field head injuries, are attached to a 2011 North Carolina law that specifies concussion education for coaches and concussion protocols to be followed in high school athletics.

“Was the information out there in ’08?” said Matthew’s father Robert, who created the foundation. “No, but it’s out there now, big time.”

Despite the progress, the Stringer rankings demonstrate the distance many athletic trainers and doctors believe states still need to go to protect student-athletes.

For instance, although North Carolina finished No. 1 in the Stringer rankings, it has adopted only 79 percent of the laws or policies used in the rankings. In particular, Stringer found the state hadn’t done enough to make certain that defibrillators — and people trained to use them — were present at sporting events.

Many athletic trainers, such as Jason Bennett, president of the California Athletic Trainers’ Association, say the rankings should create urgency in his state and others. “This is life and death,” Bennett said. “The sad thing is that in many of these cases, the deaths were 100 percent preventable.”

California fared particularly poorly because it is the only state that does not regulate athletic trainers.

“Sometimes it’s the school’s janitor or maybe a friend of the coach,” said Democratic California Assembly member Matt Dababneh, who introduced a bill that would create state licensure for athletic trainers. “These are people who are making decisions about whether a kid who has just been hit in the head can safely go back into a game. And they have no qualifications to make that decision.”

The bill would not require all schools to employ an athletic trainer, although that’s exactly what many athletic trainers and sports medicine doctors say would best ensure the safety of student-athletes.

“The No. 1 thing we can do to make high school and youth sports safer is to have athletic trainers at any sporting event,” said Michael Seth Smith, co-medical director of a sports medicine program at the University of Florida focused on sports medicine for adolescents and high school students.

A survey from Stringer and others published this year found that fewer than 40 percent of public secondary schools in the U.S. had a full-time athletic trainer.

Mathewson, the athletic trainer in Colorado, said he has little sympathy for smaller schools who say they can’t afford athletic trainers. “If you can afford to put a football team on the field, you should be able to afford an athletic trainer.”

In a number of places, including in Florida and North Carolina, hospitals subsidize athletic trainers working in public schools, some in the expectation that after a year or two, the school district will pick up the costs.

Aside from the salary of an athletic trainer, schools could adopt most of the best practices at an initial cost of $5,000 and an outlay of less than $2,500 a year thereafter, according to Springer CEO Doug Casa.

#AT4ALL

SDSU’s Steve Fisher: How California can keep athletes safe

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Article reposted from San Diego Union Tribune
Author: Steve Fisher

It’s every parent’s nightmare: You’re watching your son play basketball and all of a sudden he collapses. You don’t know what’s happening, how to help or even if he is going to be all right.

In my tenures as head basketball coach at San Diego State University and University of Michigan, all of the players under my charge were my sons. I still remember vividly watching Dwayne Polee II running down the court and suddenly collapsing in a 2014 SDSU game against UC Riverside. Polee may have been in a world of hurt if it weren’t for our certified athletic trainer at the time, Tom Abdenour, who was formerly the head athletic trainer for the Golden State Warriors.

I credit Abdenour with helping save Polee’s life by implementing crucial emergency procedures to restart his heart.

But, every day, Californians are putting their athletes at risk because there are not enough athletic trainers and the ones we have are unregulated.

In fact, according to a recent study by the University of Connecticut’s Korey Stringer Institute, we are ranked second to last in the nation for implementing policies that are intended to keep the state’s more than 785,000 high school athletes safe every year and help prevent sudden death and catastrophic injury.

One critical reason for this appalling rating is that California is the only state that does not regulate athletic trainers — professionals charged with the prevention, treatment and rehabilitation of injuries and illnesses sustained by athletes and other individuals of all ages. Athletic trainers are the medical experts on the sidelines and a player’s first line of defense when an injury occurs.

I was lucky that the schools I worked at had certified athletic trainers to protect our talented athletes, but many athletes are not so fortunate.

Every state except ours requires that anyone who is hired as an athletic trainer has the required education and certification to provide lifesaving care. In California, anyone can be hired to act as an athletic trainer and provide treatment to athletes.

“Unqualified individuals are falsely representing themselves as athletic trainers to California athletes and their family members,” said Dr. Cindy Chang, a UC San Francisco clinical professor and past president of the American Medical Society for Sports Medicine. “We’re aware of serious mistakes that have resulted from this lack of licensure.”

Last school year, the California Interscholastic Federation (CIF), surveyed 1,406 high schools across the state and found that more than 45 percent of high schools did not have an athletic trainer. Of those that did, more than 15 percent had an athletic trainer who was not certified.

That means more than 60 percent of our kids who play high school sports are at risk of not having a qualified athletic trainer to protect them in cases of cardiac arrest, concussions and heat illness, among other issues.

Even if your school has a certified athletic trainer on its staff, when athletes play at other schools, there’s no guarantee these institutions do.

To keep our athletes safe, Assemblyman Matt Dababneh, D-Woodland Hills, has introduced Assembly Bill 1510, which would require individuals to be certified by the Board of Certification before they can call themselves “athletic trainers” — notably, at no cost to taxpayers.

This bill has tremendous support, including from the American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, CIF, NCAA, National Federation of State High School Associations and nearly 40 other organizations.

I credit San Diego State’s athletic trainers as members of the core team that make the Aztecs’ success possible. Multiple severe ankle problems, dislocated fingers and other injuries are common in basketball. It’s imperative that teams have a certified athletic trainer on-site to address them.

I’ve seen athletic trainers rehabilitate incoming athletes who were injured and may have had their careers halted before they even began, such as Tim Shelton and Chase Tapley, who both played on SDSU’s 2010-11 basketball team, with a school record 34-3 season and SDSU’s first Sweet 16.

Concerned athletes, parents and community members can keep our players safe by learning more at the California Athletic Trainers’ Association’s website at ca-at.org and supporting AB 1510. Parents should also ask their children’s schools if they have a certified athletic trainer on staff, and verify athletic training credentials at www.bocatc.org/public-protection.

As Dababneh said, “No parent should wonder if their child will be safe on the field or court.”

Fisher was the head basketball coach for San Diego State University from 1999-2017 and is also known for coaching as the University of Michigan, where his team won the 1989 NCAA championship and where he later coached the Fab Five. He currently holds a part-time role with SDSU’s athletic department.