EDUCATIONAL OBJECTIVES
The learner should, at the completion of the chapter, be able to perform the following:
Simply stated, athletic training is the prevention, recognition, evaluation, treatment, rehabilitation, and health care administration of athletic injuries. However, implementation of the athletic training concept by a school system is not a simple action, for the program does not begin and end with the person designated as the athletic trainer. In fact, the program involves an entire team of people, including not only the NATABOC certified athletic trainer, student athletic trainers and team physician, but also parents, coaches, the equipment manager, school administration and maintenance personnel.
The National Athletic Trainers’ Association Board of Certification (NATABOC) certified athletic trainer is a highly educated and skilled professional specializing in health care of the physically active. In cooperation with physicians and other allied health personnel, the certified athletic trainer functions as an integral member of the health care team in sports medicine clinics, industrial settings, professional sports programs, educational institutions, and other athletic health care settings.
NATIONAL ATHLETIC TRAINERS’ ASSOCIATION
The Athletic Training Profession
The National Athletic Trainers' Association (NATA) started in 1950 and has evolved into a highly respected organization with a membership of over 24,000 members. The mission of the NATA is to enhance the quality of health care for the physically active and advance the profession of athletic training through education and research in the prevention, evaluation, management, and rehabilitation of injuries.
In 1990, the American Medical Association recognized athletic training as an allied health profession. This endorsement is providing monumental benefits for the advancement of athletic training as a profession and for the professional development of the student athletic trainer. The National Athletic Trainers’ Association is the primary professional assocation of athletic trainers in the United States. Since the early 1960s, the NATA has assumed the leadership in establishing high standards for the education and certification of athletic trainers. For more information on professional preparation or careers in athletic training you should contact:
ESTABLISHING AN ATHLETIC TRAINING/SPORTS MEDICINE
PROGRAM
Checklist for Safety in Sports
To establish an effective athletic training program, school administrators should see that their school has the following:
The athletic training program starts with the individual appointed to supervise the care and prevention of athletic injuries, an NATABOC certified athletic trainer. Before establishing an athletic training room and ordering supplies, the certified athletic trainer should perform a most important function: finding a team physician. The team physician will provide direct supervision of the athletic trainer.
Team Physician
The team physician promotes the success of the athletic training program. And, since athletic success is dependent on the health of the players, each team's success could be directly related to the amount of time the physician can devote to the athletic training program. The team physician is the "cornerstone" of the medical team, which should include the athletic trainer, coaches, student athletic trainers, parents, and athletes. School administrators, the school nurse, and even game officials share some of the athletic training program's responsibilities.
Duties and responsibilities of each member of the team are interrelated. A school should have a qualified team physician on the sidelines at football games or other contact sports. The team physician should be immediately available when emergency situations arise. Other team physician duties should include supervising pre-participation physicals and medical histories, clearing of players for return to activity after injury, working with the athletic trainer and student athletic trainers in further developing the athletic training program, and being on call for emergencies.
NATABOC Certified Athletic Trainer
The NATABOC certified athletic trainer is a highly educated and skilled professional specializing in health care of the physically active. This allied health professional has fulfilled the requirements for national certification, and in some cases, met state licensure requirements. The certification examination administered by NATABOC consists of a written test, practical examination, and written simulation questions. The certification examination covers a variety of topics within the current five practice domains of athletic training:
The ATC is vital to every athletic program. Without an NATABOC Certified Athletic Trainer, the responsibilities for the care and prevention of athletic injuries must be assumed by the coaching staff. Research studies have shown that injury rates will increase without a certified athletic trainer on site at practices and games. The certified athletic trainer serves as the liaison between team physician, coach, parent, and athlete. Communications regarding the health of the players must be channeled through the athletic trainer in order to have an efficient program. The athletic trainer, especially at the high school level, should maintain contact with parents regarding their son or daughter's injury status and ability to return to active competition. Additionally, it may be necessary to notify the appropriate school officials (school nurse, physical education instructor, or principal) of limitations caused by an injury.
During the non-competitive seasons, the athletic trainer should work with the coaches on programs to improve the conditioning level of the team, devising specific conditioning programs for certain athletes, assisting athletes recovering from injuries, and monitoring athletes who need to increase their lean body weight or decrease their body fat. Additionally, the athletic trainer will assist the coaching staff and the equipment manager on the purchasing and reconditioning of protective equipment.
Under the team physician's direction, the athletic trainer will evaluate and provide first aid care, give basic treatments (ice/heat), design and implement rehabilitation programs based on physician's protocol, and apply protective/supportive techniques that will allow the athlete to regain a physically active lifestyle. Additional duties could include inventory/purchasing of supplies, completing medical/accident record forms, and providing treatment.
Other Allied Health/ Sports Medicine Personnel
The athlete has the responsibility for keeping in good physical condition, practicing the techniques taught by the coaches, playing by the rules, and following the instructions of the coaches and athletic trainer.
Parents
The parents can assist in keeping their son or daughter healthy if they are kept updated about the injury or illness. The parents should be provided with information on nutrition and with recommended home treatments for injuries. When an athlete is injured, the athletic trainer should immediately make the parents aware of the extent of the injury or illness.
Officials
Game officials are responsible for enforcing fair rules, monitoring playing conditions, and cooperating with the athletic trainer and physicians when injuries occur and environmental hazards exist.
Coaches
Coaches have numerous athletic training related responsibilities. They must plan practices that include conditioning and training of the athlete, and teach techniques and rules of their sport. These practices must be of reasonable duration, taking skill level, fatigue, and environmental conditions into consideration. Coaches are often responsible for selecting, fitting, and maintaining protective equipment. Additionally, supervision of practice and game facilities must be reviewed by the coaching staff. Coaches must update their education by attending clinics that review rule changes, skill development, first aid/C.P.R. and selected topics in athletic health care. Most importantly, the coach must place the athlete's welfare foremost. The coach must work closely with the team physician and athletic trainer in determining what is best for the athlete. Note: If the school does not have an athletic trainer, additional duties and responsibilities would then be assumed by the coach. See the NATABOC Certified Athletic Trainer section for a review of those duties and responsibilities.
Student Athletic Trainers - Roles and Responsibilities
The duties of the student athletic trainer can be defined by their interest, experience in allied health care, and desire to gain knowledge in this profession. Once a student athletic trainer has obtained basic certification in first aid and CPR, a supervising certified athletic trainer can assist them in developing skills in immediate care of injuries, preventive techniques, and basic treatment protocols. Advancement of responsibilities depend upon the student's ability to master introductory skills in athletic training.
Every student athletic trainer should start by maintaining a clean athletic training room/facility. Because various wounds are treated in the athletic training room, proper hygiene in this facility is critical. One reason is because of the possibility of cross contamination between bodily fluids and the various surfaces in the facility. Other duties assigned to a student athletic trainer can be inventory control, keeping track of supplies and equipment, and informing the head athletic trainer when inventories are low. The student athletic trainer should have a checklist of supplies to have on the field or court for games, practices, or road trips. Packing of kits and other preparation activities are good duties for the student athletic trainer. Additional duties might include preparing an electrolyte drink and taking it or water to the field; making sure there is enough ice, both for treatments and for water coolers; and making sure each athlete has weighed in before and after every practice and documenting weights on the weight charts. Other than the weight charts, the certified athletic trainer or coach might give other record-keeping duties to a capable student athletic trainer. For example, daily treatments to athletes need to be recorded in a daily log and also in the athlete's medical file. As a student athletic trainer shows more initiative and competence, he or she may even become involved in taping, wrapping, changing dressings, giving minor treatments, and first aid procedures. Besides the practical experience gained from working under the supervision of a certified athletic trainer or athletic coach, the student athletic trainer can also benefit from attending workshops and reading pertinent texts and publications.
ATHLETIC TRAINING FACILITY AND MANAGEMENT
Establishing an athletic training room is very important. Athletic training facilities at high schools vary from almost non-existent to those as modern and spacious as professional/college athletic training rooms. While everyone prefers good working conditions, facilities at some schools will always be less than ideal because of space or budget limitations. However, a resourceful athletic trainer will find ways to develop a program regardless of the limited facilities.
Typical athletic training rooms include the following areas: administrative office, prevention (taping), hydrotherapy, rehabilitation, treatment (electrical therapy), physician's examination office, and storage room. A review of typical daily tasks for each area is listed.
Administrative Office
1. Review and file appropriate record documentation
(accident/injury report, daily treatment forms, physical examination, insurance
reports, etc.)
2. File all medical records in orderly fashion
3. Keep office in well-organized state
4. Keep phone accessible for business calls
Prevention (Taping) Area
1. Restock taping areas with selected supplies
2. Roll-up the clean wraps
3. Wipe off taping tables with appropriate cleanser
4. Clean surgical trays weekly and refill with
disinfectant solutions
5. Prepare heel and lace pads
Hyrdotherapy Area
1. Clean sink, mirror, stool, and whirlpool
2. Clean all coolers and place upside down
3. Check supply of paper towels
4. Drain, disinfect and fill the whirlpools (Hot:
100-110 degrees, Cold: 55 degrees)
5. Fill ice cups and rotate those in the freezer
6. Fill ice immersion buckets
7. Make ice bags in the morning and before treatment
and empty ice bags at end of day
Rehabilitation Area
1. Make sure all equipment is in its proper place
2. Check paper supply in isokinetic machine (if
available)
3. Clean and disinfect equipment
Treatment (Electrical Therapy) Area
1. Make sure all modalities are working properly
and turned off when not in use
2. Clean treatment tables and electrical modality
machines
3. Fold and put away clean towels and take dirty
towels to laundry
4. Check to see that the hydrocollator has sufficient
water
5. Check the paraffin bath
6. Refill ultrasound gel
Physician's Examination Office
1. Update supplies in medical kits
2. Prepare equipment for physican use
Storage Area
1. Review inventory and rotate stock
2. Notify staff athletic trainers of limited supplies
*Additionally, other daily tasks include maintenance of a clean facility, medical record documentation and filing, reviewing supplies and equipment for facility and medical kits, and reviewing new skills and knowledge in the care and prevention of athletic injuries.
Daily Duties
1. Keep athletic training facility clean
2. Complete all record forms
3. Restock medical kit supplies
4. With disinfectant spray, wipe these items: tables,
hydrocollator, therapeutic modalities, rehabilitation equipment, ice machine
and freezer, whirlpools
5. Confirm newly acquired skills and review emergency
procedures with staff
Supplies and Equipment - Athletic Training
Facility
| Adhesive white tape (1", 1 1/2", 2") | Alcohol, rubbing |
| Antiseptic spray | Athletic training kits |
| Adhesive Bandages | Blankets |
| Broom and dustpan/trash can | Cervical collar |
| Clock | Crutches |
| Cups | Disinfectant spray |
| Elastic tape (1", 2", 3") | Elastic wraps (2", 4", 6") |
| Elastic wrap (double length 6") | Eye wash |
| Face mask cutters | Gauze pads (3x3, 3x4) sterile and non-sterile |
| Hydrocollator (covers) | Hydrogen peroxide |
| Ice bags | Ice machine |
| Pen light | Refrigerator |
| Latex gloves | Scale |
| Scissors | Soap |
| Spine board | Splints |
| Tables (treatment, taping, examining) | Tape cutters |
| Thermometer | Towels |
| Waste containers | Water coolers |
| Whirlpool |
In additon to the these items, the athletic training room must have those items that are mandated by the Occupational Safety and Health Administration (OSHA), which are addressed in Chapter 4. These items basically deal with bodily fluids and bloodborne pathogens.
Supplies for athletic training kits:
| Adhesive tape (1", 1½") | Analgesics |
| Antimicrobial hand wipes | Antacids |
| Antibacterial/antiseptic cream | Band-aids (regular, large, knuckle, fingertip) |
| Bandage scissors and/or tape cutters | Biohazard bags |
| Butterfly bandages or Steri-strips | Contact lens kit |
| Cotton tip applicators | Elastic wraps (2", 4", 6") |
| Eyewash, sterile solution | Foot powder |
| Heel cups | Hydrogen peroxide |
| Ibuprofen | Instant cold pack |
| Latex gloves | Mirror with plastic holder |
| Moleskin | Mouth shield or protector |
| Paper bag | Pencil and paper |
| Plastic bags for ice | Povidine swab sticks or wipes |
| Roller gauze | Sterile gauze pads (3x3 inch) |
| Saline solution/eye wash | Scissors (bandage, heavy duty) |
| Skin lubricant or petroleum jelly | Sun lotion |
| Tape adherent | Thermometer |
| Tongue depressors | Triangular bandage or sling |
| Underwrap |
Emergency information (athlete’s home phone #, medical release forms, money/coins)
Athletic Training Room Rules
Once an athletic training room has been established, drafting of rules is very important. First, outline services that will be offered, specific times you will be open, and conduct expected in athletic training facility. Remember, this is a medical facility and it should not be used as a gathering place. To prevent misuse, athletic training room rules should be posted and enforced. Among the common rules are:
In order to ensure proper treatment of the athlete, careful records should be kept on all athletes. All athletes are required to complete a physical examination and have this medical form on file prior to participation in sporting activities. The team physician may want to keep the original physical examination form at their office or in the school nurse's office. However, the athletic trainer should have a copy of this medical form and notations that are significant for the proper care of each athlete. The physical examination form should include past and present condition of the athlete.
Another form that is important in caring for athletic injuries is an accident-injury report form. This form should include these items: athlete's name, sport, date and time of accident/injury, place of injury, mechanism of injury, evaluation of injury, first aid and treatment provided, rehabilitation recommendations, and medical referral to physican. An accident-injury report form is very important, particularly when the injury involves athletic insurance coverage and reporting. Insurance companies require accurate information regarding the reporting of injuries. Check the insurance requirements at your school when designing your school's injury form.
The daily treatment form is another important document to be kept when treating injuries. There should be a place on this form for the athlete's name, date and time, treatment provided, protective technique, and rehabilitation procedure utilized. This form should be reviewed often when assessing the progress or lack of progress of an injury. It can tell you which treatment or taping procedure was successful in dealing with that particular injury.
THE FUNDAMENTALS OF ATHLETIC TRAINING
Every athlete is entitled to adequate conditioning, injury prevention measures, proper treatment of injuries, and complete rehabilitation. Programs for conditioning, injury prevention, therapeutic modalities and therapeutic rehabilitation are best designed and supervised by highly educated and trained certified athletic trainers, who have extensive knowledge in first aid, anatomy, physiology, and kinesiology.
Having a team physician who is well qualified in sports medicine is important. Their assistance in reducing the risk of injury is vital. In the absence of a physician, the responsibility to give first aid treatment falls on the athletic trainer or coach. The student athletic trainer should be well qualified and provide assistance when needed. Individuals interested in becoming an athletic trainer should possess these characteristics: professional skills, knowledge required of athletic training, enjoyment of athletics, interests in each athlete's well-being, good fitness and personal health, common sense, and a willingness to complete assigned tasks. Avenues of employment for certified athletic trainers include employment in educational institutions (secondary and higher education), professional sports associations, sports medicine clinics, hospitals and corporate settings.
The certified athletic trainer is a professional who is well educated to carry out the tasks mentioned in the previous sections. A thorough knowledge of anatomy, physiology, physiology of exercise, psychology, first aid, cardiopulmonary resuscitation, nutrition, pharmacology, therapeutic modalities, rehabilitation protocols which include the physical readiness of the returning an injured athlete to activity, and specialized courses in sports medicine are required to carry out these duties.
The NATA is the administrative organization that dedicates its endeavors to the advancement, encouragement, and improvement of the athletic training profession. An athletic trainer who follows the educational procedures set forth by the NATABOC is then eligible to take an examination which, if successfully passed, entitles the athletic trainer to be a Certified Athletic Trainer (ATC).
Athletic Training Education
Presently, over eighty educational institutions offer athletic training education programs that have met accreditation standards, set forth by the Commission on Accreditation for Allied Health Education Program (CAAHEP) of the American Medical Association. Most of these programs are offered at the undergraduate level. An accredited entry-level education program includes formal instruction in all areas documented in the NATA Competencies: athletic injury prevention and evaluation, first aid and emergency care, therapeutic modalities and exercise, athletic training program administration, human anatomy and physiology, exercise physiology, kinesiology/biomechanics, nutrition, psychology, personal and community health, and instructional methods. The education program prepares future athletic trainers for employment in athletic health care settings. Through a blend of classroom instruction and clinical experience, the program teaches the prevention, management, and rehabilitation of athletes' injuries and illnesses.
Educational Programs: Curriculum and Internship
Currently, student athletic trainers have the option to pursue one of two educational routes toward National Athletic Trainers’ Association Board of Certification (NATABOC) certification. CAAHEP accredited athletic training education programs provide a study in athletic training education which is approved by the NATA Board of Directors. Successful completion of a CAAHEP Accredited Athletic Training Education Program requires completion of formal academic courses, completion of psychomotor skills, and documentation of a minimal of 800 hours of athletic training experience under the supervision of a NATABOC Certified Athletic Trainer. Internship programs are designed to provide a practical education/work experience concept approach to gaining the knowledge and skills needed to fulfill the requirements for internship candidacy. Internship programs require the completion of 1500 hours of athletic training experience under the supervision of a NATABOC Certified Athletic Trainer.
Student athletic trainers, regardless of whether they complete a curriculum or internship program, must take one formal course in each of the following areas: human anatomy, human physiology, exercise physiology, kinesiology/biomechanics, personal health, basic athletic training, and advanced athletic training. To become a certified athletic trainer, individuals must:
The Board of Directors of the National Athletic Trainers Association (NATA) has mandated that, beginning January 1, 2004, candidates sitting for the NATABOC Examination must have graduated from either a CAAHEP accredited undergraduate or graduate ATEP. Candidates for certification via the internship route will not be able to begin a program any later than November of the year 2001 and be eligible to sit for the NATABOC certification examination.Complete either a CAAHEP accredited program or internship program Show proof of graduation from an accredited college or university Show proof of current certification in First Aid and CPR Show proof that at least 25% of their athletic training experience hours were attained in actual practice or game coverage of contact/collision sports Obtain the endorsement of a NATABOC Certified Athletic Trainer Successfully pass the NATABOC Certification Examination
NATA COMPETENCIES
The competencies enumerated in the document, "Competencies in Athletic Training," written and distrubuted by the National Athletic Trainers’ Association Professional Education Committee (NATAPEC), have been identified as those necessary for effective functioning as an entry-level Certified Athletic Trainer (ATC). Results of role delineation studies conducted by the National Athletic Trainers’ Association Board of Certification (NATABOC) in 1982 and 1990 served as the primary source for development of these competencies by the National Athletic Trainers’ Association, Inc. Copies of the most recent Role Delineation Study may be obtained by contacting the NATABOC through the NATA office (800-TRY-NATA).
The Competencies in Athletic Training serve as a guide to development of educational programs and learning experiences leading to NATA certification as an athletic trainer and is intended to assist administrators, instructional personnel, and students in identifying knowledge and skills to be mastered. The competencies included in the document are categorized according to the five major "domains" which comprise the role of the Certified Athletic Trainer:
SUMMARY
This chapter has presented the fundamental concepts of the profession of athletic training and its relationship to the sports medicine team. The necessity for qualified allied health professionals, appropriate supplies, and proper documentation of health care records provides a sound basis for the care and treatment of the active population. Additional information can be obtained by accessing the references and continuing the educational process of acquiring knowledge.
REFERENCES
Arnheim, D. & Prentice, W. (1997). Principles of Athletic Training (9th ed.). St. Louis: McGraw-Hill.
Committee on Allied Health Education and Accreditation (1992). Essentials and Guidelines for an Accredited Education Program for AthleticTrainers. Chicago: American Medical Association.
Kibler, W. (1990) The Sports Participation Fitness Examination. Champaign, IL: Human Kinetics.
Mueller, F. and Ryan. A. (1991). Prevention of Athletic Injuries: The Role of the Sports Medicine Team. Philadelphia: F.A. Davis.
National Athletic Trainers Association Board of Certification, Inc. (1993). Study Guide for the NATABOC Entry Level Athletic Trainer Certification Examination. Philadelphia: F.A. Davis.
Rankin, J. M. and Ingersoll, C. (1995). Athletic Training Management: Concepts and Applications. St. Louis: Mosby.
Ray, R. (1994). Management Strategies in Athletic
Training. Champaign, IL: Human Kinetics.
Chapter 1 - Review Questions
Completion:
1. The student athletic trainer duties are limited,
however, important duties could include: _____________, ________________, and
_____________
2. Just as a coach, the student athletic trainer should maintain___ certification.
3. The __________ plays a vital role as a member of the sports medicine team.
4. Student athletic trainers can benefit by attending ______ and _______.
5. A ________ form should be kept to record all treatments given or preventive/supportive techniques applied by the athletic training staff.
6. A _________________ is someone who has successfully passed the national certification examination set forth by the NATABOC.
7. In the year 2004, candidates sitting for the NATABOC Examination must have graduated from either a ______ accredited undergraduate or graduate ATEP.
Short Answer:
1. List three important aspects of establishing
an athletic training facility:
2. Coaches play a very important part in the sports medicine program. List two things a coach should know related to the care of an athlete.
3. Name all seven areas of an athletic training facility.
4. List five employment situations where a certified athletic trainer can work.
5. List at least five medical personnel who should be included on the sports medicine team.
6. List all requirements for becoming a NATABOC Certified Athletic Trainer.
7. Items recommended by O.S.H.A. are used for what purpose?
8. What is the duty of the NATA?
9. What role do parents play as a member of the sports medicine team?
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