In today’s secondary school athletic department, it is extremely important to have a team approach to athletic health care. It takes a team of physicians, athletic trainers, school nurses, concussion specialists, administrators and local EMT/paramedics to complete a comprehensive athletic health-care model.
This important team should be charged with the development and implementation of health and safety policies and procedures based on current state rules and regulations as well as best practices. These policies and procedures should be utilized in the course of daily operations, events and practices. The goal of this type of coordinated program is to provide an appropriate level of health care for student-athletes in all sports.
Ideally, the sports medicine team is led by either a sports medicine orthopedic surgeon or a primary care sports medicine physician. Recently, due to increased concern regarding medical liability, it has become more difficult for some schools to secure the services of a team physician. This is more often the case in rural areas where hospitals are not easily accessible, but it can occur anywhere. If a trained sports medicine physician is not available, the individual who serves as team physician should stay current on issues such as heat illness management, cardiac issues, and concussion evaluation and management.
The gold standard would be to have a full-time, on-site athletic trainer at the school. The athletic trainer’s relationship with the team physician and other local health-care providers is paramount to the success of this team approach to athletic health care.
While a full-time athletic trainer is not always available, all schools should, at minimum, have a part-time athletic trainer. The role of the athletic trainer is to coordinate services with the team physician and the rest of the athletic health-care team; and he or she should be the primary person dealing with the athletes, coaches and parents. The primary role of the athletic trainer is
to develop and manage a comprehensive athletic health-care program for the student-athletes.
The school nurse’s role is also critical. His or her duties might include, but are not limited to, maintaining current health histories; communicating health-care issues, including concussion information, with teachers; collecting and clearing athletic physical forms; and assisting with the return-to-learn protocols for concussions.
Local first responders, including EMTs, Fire and Rescue personnel, police departments and local emergency response teams, should be aware of the school’s Emergency Action Plans (EAPs). They should also be prepared to play a role at large sporting events. In addition, they should also participate in and practice those coordinated plans with the athletic trainers.
The sports medicine team should also review all of the team’s personnel and treatment policies and procedures at least yearly. This team should review and practice a coordinated EAP once or twice a year.
Athletic administrators must take an active role in supporting their athletic trainers and coaches in professional development. This includes concussion education, coaching certification and, as previously mentioned, practicing and reviewing the Emergency Action Plans, just like they practice various required fire drills, tornado drills, etc.
The athletic trainer, team physician and athletic administrator should document the review of EAPs and also their protocols for treating concussions. The EAP and concussion education plans can be shared with parents to better educate them on how the team will treat their student-athletes, what they can do when their son or daughter is injured, and when an athlete can return to his or her sport and school after suffering a concussion.
During depositions in some recent legal cases, the school’s athletic trainer, team physician and school administrators have been asked if they have documented evidence of pre-season meetings and reviews of the EAP. Be prepared for worst-case scenarios and discuss how to prevent them from happening.
This is just one example of the team approach to administer a comprehensive sports medicine-based program. Regardless of the specific program, the goal is the same – to provide the best possible care for our student-athletes, similar to what college and professional athletes receive, because these student-athletes are priceless to their parents.
Lawrence Lemak, M.D., is a recognized leader in orthopedic sports medicine with more than 30 years of experience treating athletes from the professional to the youth levels. He is the founder of Lemak Sports Medicine in Birmingham, Alabama, and is a member of the NFHS Sports Medicine Advisory Committee.
Larry Cooper, ATC, has been a certified athletic trainer for 31 years, with a majority of time at Penn Trafford High School in Harrison City, Pennsylvania. He is chair of the National Athletic Trainers Association Secondary School Athletic Trainers Committee and is an ex-officio member of the NFHS Sports Medicine Advisory Committee.
Steve McInerney, ATC, CAA, is the National Athletic Trainers Association liaison to the National Interscholastic Athletic Administrators Association and is a member of the NFHS Sports Medicine Advisory Committee.