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Scarneo-Miller SE, Hosokawa Y, Drezner JA, Hirschhorn RM, Conway DP, Elkins GA, Hopper MN, Strapp EJ. National Athletic Trainers' Association Position Statement: Emergency Action Plan Development and Implementation in Sport. J Athl Train 2024; 59:570-583. [PMID: 38918009 PMCID: PMC11220767 DOI: 10.4085/1062-6050-0521.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVE An emergency action plan (EAP) is a written document detailing the preparations and on-site emergency response of health care professionals and other stakeholders to medical emergencies in the prehospital setting. The EAP is developed to address any type of catastrophic injury response and should not be condition specific. The objective of this National Athletic Trainers' Association position statement is to provide evidence-based and consensus-based recommendations for developing and implementing an EAP for sports settings. METHODS These recommendations were developed by a multidisciplinary expert panel that performed (1) a comprehensive review of existing EAP evidence, (2) a modified Delphi process to define consensus recommendations, and (3) a strength of recommendation taxonomy determination for each recommendation. RESULTS An EAP is an essential tool designed to facilitate emergency preparedness and an efficient, coordinated emergency response during an athletic event. A comprehensive EAP should consider modes to optimize patient outcomes, the various stakeholders needed to develop the plan, the factors influencing effective implementation of the EAP, and the roles and responsibilities to ensure a structured response to a catastrophic injury. CONCLUSIONS These evidence-informed recommendations outline the necessary steps for emergency planning and provide considerations for the immediate management of patients with catastrophic injuries. Increasing knowledge and implementation of the EAP to manage patients with catastrophic injuries improves the overall response and decreases errors during an emergency.
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Scarneo-Miller SE, Adams WM, Coleman KA, Lopez RM. Exertional Heat Illness: Adoption of Policies and Influencing Contextual Factors as Reported by Athletic Administrators. Sports Health 2024; 16:58-69. [PMID: 36872595 PMCID: PMC10732114 DOI: 10.1177/19417381231155107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Little is known about the adoption by athletic administrators (AAs) of exertional heat illness (EHI) policies, and the corresponding facilitators and barriers of such policies within high school athletics. This study describes the adoption of comprehensive EHI policies by high school AAs and explores factors influencing EHI policy adoption. HYPOTHESIS We hypothesized that <50% of AAs would report adoption of an EHI policy, and that the most common facilitator would be access to an athletic trainer (AT), whereas the most common barrier would be financial limitations. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 4. METHODS A total of 466 AAs (82.4% male; age, 48 ± 9 years) completed a validated online survey to assess EHI prevention and treatment policy adoption (11 components), as well as facilitators and barriers to policy implementation. Access to athletic training services was ascertained by matching the participants' zip codes with the Athletic Training Locations and Services Project. Policy adoption, facilitators, and barriers data are presented as summary statistics (proportions, interquartile range (IQR)). A Welch t test evaluated the association between access to athletic training services and EHI policy adoption. RESULTS Of the AAs surveyed, 77.9% (n = 363) reported adopting a written EHI policy. The median of EHI policy components adopted was 5 (IQR = 1,7), with only 5.6% (n = 26) of AAs reporting adoption of all policy components. AAs who had access to an AT (P = 0.04) were more likely to adopt a greater number of EHI-related policies, compared with those without access to an AT. An AT employed at the school was the most frequently reported facilitator (36.9%). CONCLUSION Most AAs reported having written EHI policy components, and access to an AT resulted in a more comprehensive policy. CLINICAL RELEVANCE Employment of an AT within high school athletics may serve as a vital component in facilitating the adoption of comprehensive EHI policies.
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Affiliation(s)
| | - William M. Adams
- Division of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado
| | - Kelly A. Coleman
- Department of Health and Movement Sciences, Southern Connecticut State University, New Haven, Connecticut
| | - Rebecca M. Lopez
- University of South Florida, School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, Tampa, Florida
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Sooy-Mossey M, DeRusso M, Green CL, Best DL. Sudden cardiac arrest response preparedness in Durham County schools. Cardiol Young 2023; 33:1561-1568. [PMID: 36047061 DOI: 10.1017/s1047951122002815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Sudden cardiac arrest is an uncommon event with high morbidity and mortality. There are improved outcomes with early access to an automated external defibrillator and cardiopulmonary resuscitation. We assessed the availability of automated external defibrillators and emergency cardiac arrest plans in schools. A cross-sectional electronic survey was conducted to determine the status of emergency cardiac arrest plans and automated external defibrillator presence. Most schools (88%) had access to an automated external defibrillator; however, trained staff and maintenance plans were highly variable. Automated external defibrillator availability did not differ by racial/ethnic or socio-economic composition; however, there was a relationship between number of automated external defibrillators and student population (p = 0.0030). The majority of schools either did not have (28%) or did not know if they had (36%) an emergency cardiac arrest plan. Even without state legislation, automated external defibrillators were largely available in schools. However, there remains a paucity of emergency cardiac arrest plans and automated external defibrillator maintenance plans.
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Affiliation(s)
- Meredith Sooy-Mossey
- Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, 2301 Erwin Road, DUMC Box 3127, Durham, NC 27710, USA
| | - Michelle DeRusso
- Department of Pediatrics, Duke University, 2301 Erwin Road, DUMC Box 3046, Durham, NC 27710, USA
| | - Cynthia L Green
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Duke Clinical Research Institute, 200 Morris St, Durham, NC 27701, USA
| | - Debra L Best
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Duke University, 2301 Erwin Rd. DUMC Box 3675, Durham, NC 27710, USA
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Hirschhorn RM, Huggins RA, Kerr ZY, Mensch JM, Dompier TP, Rudisill C, Yeargin SW. Access to Athletic Trainers and Emergency Medical Services Activations for Sport-Related Injuries. J Athl Train 2023; 58:387-392. [PMID: 37523419 PMCID: PMC11220907 DOI: 10.4085/234.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
CONTEXT Having athletic trainers (ATs) employed at secondary schools is associated with improved preparedness for sport-related emergencies. The use of emergency medical services (EMS) in settings with different access to athletic training services remains unknown. OBJECTIVE To compare the incidence of EMS activations for patients with sport-related injuries among zip codes with various levels of access to athletic training services. DESIGN Descriptive epidemiology study. SETTING Data were obtained from the National EMS Information System and the Athletic Training Location and Services Project. PATIENTS OR OTHER PARTICIPANTS Zip codes where 911 EMS activations for sport-related injuries among individuals 13 to 18 years old occurred. MAIN OUTCOME MEASURE(S) Incidence of EMS activations, athletic training service level (no ATs employed [NONE], less than full-time employment [PARTIAL], all ATs employed full time [FULL]), and athletic training employment model (independent contractor [IC], medical or university facility [MUF], school district [SD], mixed employment models [MIX]) for each zip code. RESULTS The EMS activations were 2.8 ± 3.6 per zip code (range = 1-81, N = 4923). Among zip codes in which at least 1 AT was employed (n = 2228), 3.73% (n = 83) were IC, 38.20% (n = 851) were MUF, 27.24% (n = 607) were SD, and 30.83% (n = 687) were MIX. Compared with SD, MUF had a 10.8% lower incidence of EMS activations (incidence rate ratio [IRR] = 0.892; 95% CI = 0.817, 0.974; P = .010). The IC (IRR = 0.920; 95% CI = 0.758, 1.118; P = .403) and MIX (IRR = 0.996; 95% CI = 0.909, 1.091; P = .932) employment models were not different from the SD model. Service level was calculated for 3834 zip codes, with 19.5% (n = 746) NONE, 46.2% (n = 1771) PARTIAL, and 34.4% (n = 1317) FULL. Compared with NONE, FULL (IRR = 1.416; 95% CI = 1.308, 1.532; P < .001) and PARTIAL (IRR = 1.368; 95% CI = 1.268, 1.476; P < .001) had higher incidences of EMS activations. CONCLUSIONS Local access to athletic training services was associated with an increased use of EMS for sport-related injuries among secondary school-aged individuals, possibly indicating improved identification and triage of sport-related emergencies in the area. The difference in EMS use among employment models may reflect different policies and procedures for sport-related emergencies.
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Affiliation(s)
| | | | - Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - James M. Mensch
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | | | - Caroline Rudisill
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Susan W. Yeargin
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
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Hedberg R, Messamore W, Poppe T, Tarakemeh A, Baker J, Burkholder R, Salazar L, Vopat BG, Darche JP. Emergency Action Planning in Kasas High Schools. Kans J Med 2022; 15:360-364. [PMID: 36320339 PMCID: PMC9612905 DOI: 10.17161/kjm.vol15.18217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Current evidence showed a variable rate of emergency action plan (EAP) implementation and a low rate of compliance to EAP guidelines in United States secondary schools. Compliance to EAP recommendations in Kansas high schools is not known. The purpose of this study was to identify the emergency preparedness of high school athletics in the state of Kansas and identify prevailing characteristics of schools that correlate with decreased compliance of an EAP. Methods Athletic directors for high schools in the state of Kansas were asked to participate in a web-based questionnaire that was emailed to each athletic director. The questionnaire identified demographics of the study population, EAP implementation rates, compliance to national EAP guidelines, access to certified medical personnel, and training received by athletics personnel. Descriptive statistics were then compiled and reported. Results The response rate for the survey was 96% (341/355). A total of 94.1% (320/340) of schools have an EAP, 81.4% (276/339) of schools have an automated external defibrillator (AED) at all athletic venues, and 51.8% (176/340) of schools had an athletic trainer (AT) on staff. Urban schools were significantly more likely than rural schools to have an AT on staff (OR = 11.10, 95% CI = [6.42, 19.18], p < 0.0001), have an EAP (OR = 3.69, 95% CI = [1.05, 13.02], p = 0.0303), require additional training for coaches (OR = 2.69, 95% CI = [1.42, 5.08], p = 0.0017), and have an AED on-site for some events (OR = 2.18, 95% CI = [1.24, 3.81], p = 0.0057). Conclusions Most Kansas high schools have an EAP in place and have at least one AED. Emergency planning should be improved through venue specific EAPs, access to early defibrillation, and additional training. Rural and lower division schools had less AT staffing and consequently were impacted more significantly than urban and higher division schools by these factors. These factors should be taken into account in future improvement strategies.
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Affiliation(s)
- Riley Hedberg
- Department of Orthopedic Surgery, Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - William Messamore
- Department of Orthopaedics, University of Kansas School of Medicine-Wichita, Wichita, KS,Kansas Orthopaedic Center, PA, Wichita, KS
| | - Tanner Poppe
- Department of Orthopedic Surgery, Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Armin Tarakemeh
- Department of Orthopedic Surgery, Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Jordan Baker
- Department of Orthopedic Surgery, Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | | | | | - Bryan G. Vopat
- Department of Orthopedic Surgery, Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Jean-Philippe Darche
- Department of Orthopedic Surgery, Sports Medicine, University of Kansas Medical Center, Kansas City, KS
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The Effect of a Statewide Policy on High School Emergency Action Plans. Sports (Basel) 2022; 10:sports10100161. [PMID: 36287774 PMCID: PMC9606913 DOI: 10.3390/sports10100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/07/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Institutions sponsoring athletics must be prepared for emergencies. Due to this, more governing bodies are requiring a sports-related emergency action plan (EAP). Yet, the effects of these policies are unknown. We compared adoption of EAPs and associated best practices in Oregon high schools before and after a policy requiring an EAP. Athletic directors were invited to complete a survey during the year before the policy went into effect and again the following year. We assessed whether the school had a written EAP and if they did, was the EAP venue specific, available at the venue, distributed to personnel, and annually reviewed and rehearsed. Pre/post-policy proportions were analyzed using Fisher exact tests for all schools and then schools that completed both surveys. There was a significant increase of schools that reported having an EAP after the policy went into effect (all schools: 55% to 99% [p < 0.001] and schools responding both years: 60% to 98% [p < 0.001]). Venue specific EAPs also significantly increased but only when analyzing all responses (59% to 71% [p = 0.03]). No best practice recommendations related to EAP availability, distribution, review, or rehearsal changed after the policy. Schools met the minimum requirements of the policy, but other related best practices did not significantly improve.
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Hedberg R, Messamore W, Poppe T, Tarakemeh A, Burkholder R, Carter T, Vopat B, Darche JP. Emergency Action Planning in School-Based Athletics: A Systematic Review. Kans J Med 2021; 14:282-286. [PMID: 34868470 PMCID: PMC8641435 DOI: 10.17161/kjm.vol14.15299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction A significant number of preventable catastrophic injuries occur in secondary school athletics. Compliance to Emergency Action Plan (EAP) recommendations is not well documented. The purpose of this systematic review was to identify compliance to EAP recommendations, access to an athletic trainer (AT) and automated external defibrillator (AED), and current legislative mandates in school-based athletics. Methods Electronic databases were searched to identify articles that met criteria for inclusion. Studies in English that focused on adoption, implementation, or compliance with EAPs or other national guidelines pertaining to athlete health were eligible for inclusion. Quality and validity were examined in each article and data were grouped based on outcome measures. Results Of 12,906 studies, 21 met the criteria for inclusion and full text review. Nine studies demonstrated EAP adoption rates ranging from 55% - 100%. Five studies found that EAPs were rehearsed and reviewed annually in 18.2% - 91.6% of schools that have an EAP. At total of 9.9% of schools were compliant with all 12 National Athletic Trainers Association (NATA) EAP guidelines. A total of 2.5% - 27.5% of schools followed NATA exertional heat illness guidelines and 50% - 81% of schools had access to an athletic trainer. In addition, 61% - 94.4% of schools had an AED available at their athletic venues. Four of 51 state high school athletic association member schools were required to meet best practice standards for EAP implementation, 7 of 51 for AED access, 8 of 51 for heat acclimation, and 3 of 51 for concussion management. Conclusions There was a wide range of EAP adoption and a low rate of compliance to EAP guidelines in U.S. schools. Barriers to EAP adoption and compliance were not well documented and additional research should aim to identify impeding and facilitating factors.
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Affiliation(s)
- Riley Hedberg
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - William Messamore
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Tanner Poppe
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Armin Tarakemeh
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | | | - Trent Carter
- University of Kansas Health System, Lawrence, KS
| | - Bryan Vopat
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Jean-Philippe Darche
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
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Williams RM, Root HJ, Valovich McLeod TC. Athletic Administrators' Reporting of Emergency Preparedness Regarding Policies and Procedures in Iowa Secondary Schools. J Athl Train 2021; 56:1224-1231. [PMID: 34752627 PMCID: PMC8582625 DOI: 10.4085/1062-6050-0494.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Secondary schools that offer school-sponsored athletic events should follow best-practice guidelines to provide policies that promote student health and safety. OBJECTIVE To assess emergency preparedness from the perspective of athletic administrators (AAs) in Iowa secondary schools. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS Ninety-eight AAs from Iowa completed the survey (age = 45.33 ± 10.22 years, years as an AA = 9.37 ± 8.14, years in current role = 7.72 ± 7.09). MAIN OUTCOME MEASURES(S) The 6-section survey contained with questions about access to athletic trainers (ATs), emergency action plans (EAPs), cardiopulmonary resuscitation (CPR), automated external defibrillators (AEDs), concussions, heat illness, and other general policies. Descriptive statistics (percentages and frequencies) were reported. Relative risk was calculated to compare schools with and those without access to ATs (P < .05). RESULTS Most respondents (76.5%, n = 75/98) reported their school had access to a licensed AT. The majority had a written EAP (83.3%, n = 70/84), but fewer than half (39.2%, n = 31/79) reviewed it annually and fewer than 10% (n = 6/85) reported practicing it each year. All respondents (100%, N = 78/78) stated they had an AED on campus. All respondents (N = 77/77) indicated that they were familiar with the Iowa High School Athletic Association's (IHSAA's) concussion policy and had a concussion guideline in place. Many respondents (95.9%, n = 71/74) described being familiar with the IHSAA's heat illness policy, but more than half (62.1%, n = 41/66) noted they did not have a heat illness policy in place at their school. CONCLUSIONS Most respondents indicated their school had access to ATs, followed the state-mandated concussion guidelines, and had an AED. Although participants reported having written EAPs in place, levels of annual EAP review and practice were low. These results suggest that schools would benefit from educational opportunities to improve safety policies.
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Affiliation(s)
| | - Hayley J. Root
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix
| | - Tamara C. Valovich McLeod
- Athletic Training Programs and School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa
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Scarneo-Miller SE, Lopez RM, Miller KC, Adams WM, Kerr ZY, Casa DJ. High Schools' Adoption of Evidence-Based Practices for the Management of Exertional Heat Stroke. J Athl Train 2021; 56:1142-1153. [PMID: 34662417 PMCID: PMC8530428 DOI: 10.4085/1062-6050-361-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Exertional heat stroke (EHS) deaths can be prevented by adhering to best practices. OBJECTIVE To investigate high schools' adoption of policies and procedures for recognizing and treating patients with EHS and the factors influencing the adoption of a comprehensive policy. DESIGN Cross-sectional study. SETTING Online questionnaire. PATIENTS OR OTHER PARTICIPANTS Athletic trainers (ATs) practicing in the high school (HS) setting. MAIN OUTCOME MEASURE(S) Using the National Athletic Trainers' Association position statement on exertional heat illness, we developed an online questionnaire and distributed it to ATs to ascertain their schools' current written policies for using rectal temperature and cold-water immersion. The precaution adoption process model allowed for responses to be presented across the various health behavior stages (unaware if have the policy, unaware of the need for the policy, unengaged, undecided, decided not to act, decided to act, acting, and maintaining). Additional questions addressed perceptions of facilitators and barriers. Data are presented as proportions. RESULTS A total of 531 ATs completed the questionnaire. Overall, 16.9% (n = 62) reported adoption of all components for the proper recognition and treatment of EHS. The component with the highest adoption level was "cool first, transport second"; 74.1% (n = 110) of ATs described acting on or maintaining the policy. The most variability in the precaution adoption process model responses was for a rectal temperature policy; 28.7% (n = 103) of ATs stated they decided not to act and 20.1% (n = 72) stated they maintained the policy. The most frequently cited facilitator of and barrier to obtaining rectal temperature were a mandate from the state HS athletics association (n = 274, 51.5%) and resistance to or apprehension of parents or legal guardians (n = 311, 58.5%), respectively. CONCLUSIONS Athletic trainers in the HS setting appeared to be struggling to adopt a comprehensive EHS strategy, with rectal temperature continuing as the biggest challenge. Tailored strategies based on health behavior, facilitators, and barriers may aid in changing this paradigm.
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Affiliation(s)
| | | | | | - William M. Adams
- Department of Kinesiology, University of North Carolina at Greensboro
| | | | - Douglas J. Casa
- Department of Kinesiology, University of Connecticut, Storrs
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Murata Y, Scarneo-Miller SE, McMahon LJ, Casa DJ. Adoption of Emergency Action Plans in Secondary Schools: A Study of School Nurses' Knowledge and Behavior. THE JOURNAL OF SCHOOL HEALTH 2020; 90:694-702. [PMID: 32779227 DOI: 10.1111/josh.12930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 12/16/2019] [Accepted: 01/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The adoption of an emergency action plan for athletics (AEAP) minimizes the consequences of injuries. School nurses may play an important role in the adoption of an AEAP. The purpose of our study was to describe school nurse's knowledge and perceptions related to AEAP adoption. METHODS An online survey, following the Precaution-Adoption Process Model, examining respondents' readiness to act, was distributed to 1228 school nurses to evaluate their knowledge and perception of an AEAP, with N = 131 (10.6%) responding. RESULTS Sixty-one school nurses were unaware of AEAP adoption at their school. A lack of athletic training services at the school was associated with not adopting an AEAP. The most frequently reported barrier to adopting an AEAP related to finances. When nurses reported perceiving more barriers to adopting an AEAP, their schools were less likely to adopt one. CONCLUSIONS A large number of nurses were unaware if their school adopted an AEAP. There is a need to improve nurses' knowledge and perceptions to promote AEAP development.
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Affiliation(s)
- Yuki Murata
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Samantha E Scarneo-Miller
- Division of Athletic Training, School of Medicine, West Virginia University, 1 Medical Center Drive, 8501A Health Sciences Center South, Morgantown, WV 26506-9225
| | - Liza J McMahon
- Department of Health Sciences and Nursing, University of Hartford, 200 Bloomfield Avenue, West Hartford, CT 06117
| | - Douglas J Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, 2095 Hillside Road U-1110, Storrs, CT 06269-1110
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Beidler E, Welch Bacon CE, Hattrup N, Powers C, Saitz L, McLeod TV. Going Beyond the State Law: Investigating High School Sport-Related Concussion Protocols. J Athl Train 2020; 57:466508. [PMID: 34129675 PMCID: PMC8775288 DOI: 10.4085/1062-6050-0505.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT State laws provide general guidelines for sport-related concussion (SRC) management, but do not comprehensively address the multiple layers of management for this complex injury. While high schools are encouraged to develop a SRC protocol that includes both state law tenets and additional management practices, the execution of this warrants examination. OBJECTIVE To investigate state law compliance and practice components included in high school SRC protocols, and determine whether the degree of sports medicine coverage influenced protocol quality. DESIGN Qualitative document analysis. SETTING High school athletics. PARTICIPANTS In total, 184 Pennsylvania high schools [24.3% of schools statewide; full-time athletic trainer=149, part-time athletic trainer=13, missing=21] voluntarily provided copies of their protocol from the 2018-2019 academic year. MAIN OUTCOME MEASURES Four athletic trainers conducted document analyses using a 67-item component analysis guide. Frequencies were computed for included protocol components related to the state law, preparticipation and prevention, recognition and assessment, and management. The difference in the total number of included components (max 60) by sports medicine coverage was assessed using a Mann-Whitney U test. RESULTS There was heterogeneity in components included in the submitted protocols. Only 23.4% included all mandatory state law tenets. Immediate removal from play was noted in 67.4% of protocols, while only 1.6% contained prevention strategies. Return-to-play was addressed more frequently than return-to-learn (74.5% versus 32.6%). The sample had a mean of 15.5±9.7 total components per protocol. Schools with full-time sports medicine coverage had significantly more protocol components than those with part-time athletic trainers (15 [8.5-22.5] versus 6 [3-10.5] median components; U = 377.5, p < .001) Conclusions: School-level written SRC protocols were often missing components of the state law and additional best practice recommendations. Full-time sports medicine coverage in high schools is recommended to increase SRC protocol and healthcare quality.
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Affiliation(s)
| | - Cailee E Welch Bacon
- A.T. Still University, Athletic Training Programs, School of Osteopathic Medicine in Arizona, 5850 E Still Circle, Mesa, AZ 85206, United States,
| | - Nicholas Hattrup
- Boston University, Athletic Training Services, 285 Babcock Street, Boston, Massachusetts 02215, United States,
| | - Cassidy Powers
- Duquesne University, Department of Athletic Training, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, United States,
| | - Lilly Saitz
- Mount Holyoke College, Department of Environmental Studies, 50 College Street, South Hadley, Massachusetts 01075, United States,
| | - Tamara Valovich McLeod
- A.T. Still University, Athletic Training Programs, School of Osteopathic Medicine in Arizona, 5850 E Still Circle, Mesa, Arizona 85206, United States,
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Post EG, Roos KG, Rivas S, Kasamatsu TM, Bennett J. Access to Athletic Trainer Services in California Secondary Schools. J Athl Train 2019; 54:1229-1236. [PMID: 31714144 DOI: 10.4085/1062-6050-268-19] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT California is currently the only state that does not regulate who can and cannot call themselves athletic trainers (ATs). Therefore, previous national or state-specific investigations may not have provided an accurate representation of AT availability at the secondary school level in California. Similarly, it is unknown whether the factors that influence AT availability in California, such as socioeconomic status, are similar to or different from those identified in previous studies. OBJECTIVE To describe the availability of ATs certified by the Board of Certification in California secondary schools and to examine potential factors influencing access to AT services in California secondary schools. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS Representatives of 1270 California high schools. MAIN OUTCOME MEASURE(S) Officials from member schools completed the 2017-2018 California Interscholastic Federation Participation Census. Respondents provided information regarding school type, student and student-athlete enrollment, whether the school had ATs on staff, and whether the ATs were certified by the Board of Certification. The socioeconomic status of public and charter schools was determined using the percentage of students eligible for free or reduced-price lunch. RESULTS More than half (54.6%) of schools reported that they either did not employ ATs (47.6%) or employed unqualified health personnel (UHP) in the role of AT (7.0%). Nearly 30% of student-athletes in California participated in athletics at a school that did not employ ATs (n = 191 626, 28.9%) and 8% of student-athletes participated at a school that employed UHP in the role of AT (n = 54 361, 8.2%). Schools that reported employing ATs had a lower proportion of students eligible for free or reduced-price lunch than schools that did not employ ATs and schools that employed UHP (both P values < .001). CONCLUSIONS With ongoing legislative efforts to obtain regulation of ATs in California, secondary school administrators are encouraged to hire ATs with the proper certification to enhance the patient care provided to student-athletes and improve health outcomes.
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Affiliation(s)
- Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, CA
| | - Karen G Roos
- Department of Kinesiology, California State University, Long Beach
| | | | | | - Jason Bennett
- Department of Kinesiology, California State University, Fullerton
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