BATTLE MOUNTAIN �HIGH SCHOOL �SPORTS MEDICINE

Brooke Rey MSAT, LAT, ATC

Vail Health – Howard Head Sports Medicine

The Steadman Clinic

Athletic Trainer (ATC)

• “Athletic trainers (ATs) are highly qualified, multi-skilled health care professionals who collaborate with physicians to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of a physician as prescribed by state licensure statutes.”*
• I have been a certified athletic trainer for 15 years. I am also a Sports Physiology teacher, a CPR instructor and the head athletic trainer for the PLL Cannons, a men's professional lacrosse team.

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*National Athletic Trainers Association

www.nata.org

Objectives

1. Sports Medicine Team
2. Emergency Action Plan
3. Sports Medicine
4. ATR Procedures
5. Concussion Protocol

The BMHS Sports Medicine Team

• Athletic Trainers
• Vail Health & The Steadman Clinic
• Brooke Rey, MSAT, LAT, ATC
• Fellowship ATC’s
• Medical Doctors/Orthopedics
• Dr. Matthew Provencher : ECSD Medical Director
• Resident MD’s
• Physical Therapists
• Howard Head Sports Medicine
• Abigail (Abby) Bohn, PT, DPT
• Sports Psychologist and Performance Optimization Psychologists
• EMS – as needed for EAP, emergencies, severe injuries
• Parent – collect and submit medical documents, support injury process
• Athlete – taking care of self, responsible for carrying out medical instructions
• Administration – EAP, assuring student athlete safety is a priority
• Coach – EAP, refers to AT when needed, adheres to limitations, understand importance of injury prevention
• Any other allied healthcare professional that meets athletes need

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http://thesteadmanclinic.com

Emergency Action Plan

• EAP in its entirety is in the Athletic Training Room and is posted at each athletic venue.
• Lists:
• Chain of command
• Emergency contact personnel and information
• Proper emergency procedures for each venue and maps
• Concussion, lightning, CPR, anaphylaxis, equipment removal, air quality, heat illness, mental health, COVID-19 Protocols

Coach’s Role In an Emergency*

• Take charge of the situation and stay calm
• Calm the athlete
• Determine if situation is life-threatening
• Contact EMS of appropriate medical personnel
• Provide first aid or appropriate medical care (CPR/AED)
• Organize team members/inform team physician, director of sports medicine, ATC, and parent/legal guardian of athlete

*In absence of ATC

Communication

• Injury reports will be sent to coaches upon coach request with student athletes' injuries and participation status. *(As best able, please ask if you need an update.)
• ATS is an EMR for student athletes sign-ins
• HIPAA/FERPA
• Feel free to email/text/call with any questions or concerns
• brey@thesteadmanclinic.com

– (970) 306-9863

Sports Medicine

• Athletic Training Room Coverage
• 3-6pm Monday-Friday (hahahahaha)
• Will NOT be covering weekend practices
• There are always exceptions (lots), as discussed with coaches
• Will cover all home games and matches as able
• Higher injury risk/contact sports are priority
• Weekend home game coverage
• Holidays- regular hours coverage TBD
• I will need practice schedules 2 weeks in advance
• Practice and game schedule changes (update calendar)
• need 48 hours notice, or athletes may not have medical coverage

Sports Medicine

• Binder/Medical Kit-Coaches have
• Practice Schedule  ASAP
• Game Coverage
• Concussions & ImPACT Testing
• Concussion RTP
• COVID-19 Procedures
• COVID RTP

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Sports Medicine

• Athletic Training Room expectations

– Acute and chronic injury evaluation, treatment and rehabilitation, as well as wound care and preventative care

• Hydration
• Nutrition
• Air Quality
• Allergies (medications, epi-pens, inhalers)
• Equipment
• Team Medical Kits & Black Binders
• Covid-19 & Concussion management and Return to Play
• ImPACT : neurocognitive pre-season assessment
• Recommended but not required, complete at parent request
• Freshman, Juniors, recent concussion, new to school

Coverage Priority

1. HOME GAMES vs. AWAY GAMES – home games receive first priority
2. COLLISION vs. CONTACT GAMES
3. COLLISION vs. CONTACT PRACTICES
4. VARSITY vs. SUB-VARSITY
5. NON-CONTACT GAMES
6. DEFINITIONS:
1. Collision Sport – football , ice hockey, wrestling and boys lacrosse
2. Contact Sport – soccer, basketball and baseball
3. Non-contact Sport – cross-country, volleyball, swimming, tennis, golf and track. Track and volleyball would rank higher in coverage priority.

VII.

VIII.

TOURNAMENT COVERAGE

I. The AT will cover all home tournaments as able based on other event coverage.

COVERAGE SCHEDULE

1. All home events are attempted to be covered. If there are multiple contact or collision events locally, every effort will be made to find additional coverage.
2. The AT will travel to all collision events if no other collision or contact events are home and the athletic training room will then be closed.
3. The AT schedule is posted in the athletic training room and is subject to change.
9. CHANGE IN SCHEDULE
1. The AD and Head Coach should notify the AT of any schedule changes as soon as possible.
2. Please notify the AT of make up date and time of weather related schedule changes as soon as possible.
1. Failure to notify the AT of schedule changes may result in no coverage for an event due to prior coverage commitments.
10. SPORTS MEDICINE STUDENTS
• Sports medicine students will assist in athletic training room, practice and game coverage under direct supervision of head AT.
• Sports medicine students may travel to away events, if room allows on team bus and approved by coach and head AT

Coverage Reality

• Burnout: a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed, emotionally drained, and unable to meet constant demands.

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End of Fall 2022

Patience

Please remember that I am the sole athletic trainer at BMHS and your student athlete is not the only one. I work my hardest to treat all student athletes efficiently and to the best of my ability, but this may often mean they need to wait their turn. If you are not satisfied with their care, please feel free to seek treatment elsewhere and respectfully share documentation from any other providers with me. I frequently collaborate with allied healthcare providers locally to ensure the best possible outcome for your student athletes health.

Concussions

2018-2019 Data

2022-2023

2022-2023

Reduce Concussions

• Create safe playing environments
• Teach proper hitting and tackling techniques
• yes, some kids need to be taught how to fall well
• Properly fitted equipment
• helmets should be fitted snug with wet hair
• Encouraging rules to be followed and enforced
• Neck Strengthening
• Overall neck strength or deficits in is a significant predictor of concussion
• For every one pound increase in neck strength, odds of concussion decreased by 5 %

Concussions in Sport

• Head trauma results in more fatalities than any other sport injury

and is the cause of most football fatalities

• Fatal head injuries have been reported in soccer, wrestling, track, baseball, and many other sports
• The morbidity and mortality associated with traumatic brain injury have been labeled a silent epidemic because they have received remarkably little attention compared with other neurologic illnesses
• Traumatic brain injury is common in contact sports, with an estimated 250,000 concussions occurring every year in football alone
• Repeated concussions occurring within a short period can be fatal

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Mueller FO. Catastrophic Head Injuries in High School and Collegiate Sports.Journal of Athletic Training. 2001;36(3):312-315.

What is a Concussion

• Mild Traumatic Brain Injury (mTBI)
• “A complex pathophysiological process that affects the brain, and induced by biomechanical forces”
• In the broadest clinical sense, Sports Related Concussion(SRC) is often defined as representing the immediate and transient symptoms of traumatic brain injury (TBI)
• Any head trauma that causes an altered mental state that may or may not involve
• a loss of consciousness.
• Can occur from rapid acceleration, deceleration or a sudden twisting motion.

It is an injury to the Brain!

“A complex pathophysiological process affecting the brain”

Signs

Observed Signs by Coaches...I can witness it or see it happening

• Witnessing a hard hit to the head
• Looked “dazed” or stunned
• Act Confused
• Repeats Questions
• Answers slowly or incorrectly
• Can’t recall events
• Loss of Consciousness
• Personality Change
• Forgetfulness

Symptoms

Red Flags

• Slurred speech
• Weakness or numbness in arms/legs
• Decreased coordination or balance
• Neck pain
• Seizures
• Loss of consciousness
• Rapidly worsening headache
• Unusual behaviour changes or increased confusion
• Repeated vomiting
• Looks very drowsy/can’t be awakened
• One pupil bigger than the other

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Refer to emergency department with sudden onset of any of the following symptoms:

***The Athlete will be immediately transported to the hospital if there is:

• Prolonged loss of consciousness, seizures, vomiting; and/or
• Significant alteration or deterioration in mental status; and/or
• Other significant injuries needing emergency management such as a potential cervical injury

Why do I need to know all of this?

• Colorado SENATE BILL 11-040, January 1, 2012
• "JAKE SNAKENBERG YOUTH CONCUSSION ACT"
• “Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion shall be immediately removed from participation and shall not return to play until cleared by a licensed healthcare provider.”
• Coaches of youth sports will take an annual concussion recognition education course
• Athletic trainers are specifically named to manage the return to play after a concussion.

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The Research

• Eagle County Community Concussion Consortium
• Medical data has guided our management policies and procedures

Concussion Protocol

• Communication is KEY!
• Concussion management should involve a Multi-Disciplinary team

Family

Medical

School

Management

Every concussion is treated independently and with a multidisciplinary team approach

Coach

• Communication
• Rest is the key to Recovery
• Assess, remove from play
• Involvement with Team

Medical

• Communication
• Diagnosing
• Management
• Return to play progression/protocol
• Clearance to return to play

School

• Communication
• Return to academics progression/protocol
• Accommodate

Parents

• Communication
• Rest, reduce and assess

Accommodations Based on Symptoms

Return To Learn

*STUDENT-ATHLETE…means that academic function is highest priority.

Return to Play Protocol

Return To Play

Myths About Concussions

• Must have loss of consciousness
• Person with a concussion should be woken from sleep every few hours
• Symptoms resolve in 1 week for an initial concussion
• A concussion is usually diagnosed with imaging, such as a CT scan
• Grading scales are the best way to classify a concussion
• Concussion symptoms appear immediately after a hit to the head
• It takes a calculated amount of force for a person to get a concussion
• Special “concussion reducing” equipment prevents concussions
• Medical professionals fully understand mTBI

Questions

brey@thesteadmanclinic.com

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(970)306-9863 cell

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(970)569-5349 office

CHSAA Sports Medicine Advisory Committee Handbook 2023