Introduction
• INSERT PRESENTER(S) NAMES
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Who are athletic trainers?
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Who are Athletic Trainers?
• Athletic trainers (ATs) are highly qualified, multi-skilled health
care professionals who collaborate with physicians to provide:
o
o
o
o
o
Preventative services
Emergency care
Clinical diagnosis
Therapeutic intervention
Rehabilitation of injuries and medical conditions
• AT Education
All athletic trainers must graduate from an accredited baccalaureate program.
o Athletic training is a medical based education model, like physical therapy and
nursing.
o Many ATs have a master’s degree or higher.
o
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Athletic Trainers are trained in:
Prevention, evaluation and rehabilitation of
orthopedic injuries such as sprains and tears.
Emergency care, including CPR and AED use.
Recognition and treatment or management of
concussion, cardiac arrest, heat stroke and
cervical spine injury.
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Meeting topics
• Promote physical activity and youth
sports safety by providing education
and the latest information about:
o Concussion awareness
o Heat related illnesses and
dehydration
o Cardiac arrest and proper response
o Prevention of pediatric overuse
injuries
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Objectives
1. Identify at least 2-3 signs and symptoms of different youth
sports safety issues, including who is at risk.
2. Apply 3 strategies immediately that help keep kids safe and
having fun while they play the sports they love.
3. Access at least 1 resource to turn to for reliable sports safety
information.
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Youth sports safety myth busters
True or False
1.
Helmets prevent concussions.
2.
If your child didn’t lose consciousness, he/she
doesn’t have a concussion.
3.
Heat-related illnesses like heat cramps, heat
exhaustion or exertional heatstroke are not
preventable.
4.
Most Americans will act to help a victim in
cardiac arrest.
5.
Youth athletes are likely to tell an adult (parent
and/or coach) about pain or possible injury.
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Centers for Disease Control and Prevention
Concussions
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What is a concussion?
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Who is at risk?
• Young children and teens are more likely to get a
•
concussion.1
Between 2001 and 2012, approximately 70% of all
sports-related concussions seen in the emergency
department have been reported among kids and
teens ages 0-19.2
o
Significant increases in emergency room visits for
sports-related concussions have been seen in both
males and females regardless of age. Reasons for
the reported increases are not known but may be
associated with increased awareness.
• Concussions can happen in any sport or
•
recreational activity.
Sports in which contact with another athlete is
common have an increased risk.
1U.S.
Conswww.cpsc.gov/cgibin/NEISSQuery/home.aspxumer Product Safety Commission. National Electronic Injury Surveillance System (NEISS) Estimates Query Builder. Available at https://. Accessed June 24, 2014
V., Haileyesus, T., Cheng, T., Bell, J. Haarbauer-Krupa, J. Lionbarger, M. et al, (2015). Trends in sports –and recreation- related traumatic brain injuries treated in US emergency departments: the national electronic injury
surveillance system – all injury program 2011-2012. J Head Trauma Rehabil: 30(3), 185-197.
2 Coronado,
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Concussion signs & symptoms
Signs Observed by Parents
Symptoms Reported by Athletes
Appears dazed or stunned
Headache or “pressure” in head
Is confused about assignment or position
Nausea or vomiting
Forgets an instruction
Balance problems or dizziness
Is unsure of game, score, or opponent
Double or blurry vision
Moves clumsily
Sensitivity to light
Answers questions slowly
Sensitivity to noise
Loses consciousness (even briefly)
Felling sluggish, hazy, foggy, or groggy
Shows mood, behavior, or personality changes
Concentration or memory problems
Confusion
Just “not feeling right” or “feeling down”
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What should you do if you suspect a
concussion?
• Remove the athlete from play. When in doubt, sit them out!
• Keep an athlete with a possible concussion out of play for the
remainder of the day of the injury and until cleared by a health care
provider.
• Watch your athlete for signs and symptoms that may show up or get
worse once the athlete is at home or returns to school.
• Let the brain rest until cleared by a health care provider to prevent
serious injury from secondary impact syndrome.
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When can an athlete who experienced a
concussion return to the classroom?
• For most students, only short-term changes or support services are needed
as they recover from a concussion.
• A variety of formal support services may be
available to help students who are experiencing
a longer or more difficult recovery. Support
services may include:
o Response to Intervention Protocol (RTI)
o 504 Plan
o Individualized Education Plan (IEP)
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When can the athlete return to play?
Returning to activity should follow a step-wise progression after an athlete
has been cleared by a health care provider.
Baseline
Step 1
Step 2
Step 3
Step 4
Step 5
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• No symptoms
• Light aerobic activity
• Moderate activity
• Heavy, non-contact activity
• Practice and full contact
• Competition
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How to help keep athletes safe
• Talk with athletes about the importance of reporting a concussion and
following return to play guidelines.
o
Coming back too early can be dangerous, lead to a longer recovery and a delay
in return to play.
• Create a culture of safety, including proper
equipment fit.
• Keep up-to-date on concussion
information.
o
Review state, league or organizational
concussion guidelines.
o
Go to CDC for HEADS UP Concussion
information www.cdc.gov/HEADSUP.
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Heat Illnesses & Dehydration
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Who is at risk?
All youth athletes are at risk.
Some factors that may increase risk include:
Intrinsic Factors – Unique to the individual
Extrinsic Factors – Outside athlete’s control
Lower fitness level
Intense or prolonged exercise without enough
breaks
Lack of sleep
High temperature and/or high humidity
Illness
Equipment and/or heavy clothing
Taking certain medications (antihistamines,
diuretics, antihypertensives), supplements,
and/or stimulants
Direct sun exposure
Overweight or obese
Not enough fluids or breaks
Not used to the heat
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Heat-related illnesses signs & symptoms
Heat Syncope
• Fainting or lightheadedness episode
Heat Cramps
• Involuntary muscle contraction, large electrolyte loss,
sweating, fatigue
Heat
Exhaustion
• Inability to continue to exercise in the heat, weakness, headaches, heavy
sweating, clammy skin, dizziness or fainting, rapid pulse, heat cramps, fast
and shallow breathing, nausea, vomiting
Exertional
Heat Stroke
• Rectal temperature above 105 degrees
• Central nervous system dysfunction
• Confusion, disorientation, combative behavior, unconsciousness, collapse, weakness
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What should you do if you suspect a
heat-related illness?
Heat Syncope
• Move to cool or shaded area, sit or lie the athlete down as soon as they
begin to feel symptoms, elevate legs to promote blood returning to
heart, rehydrate with water or sports beverage. Monitor vital signs.
Heat Cramps
• Remove from play, consume salty foods/beverages, light stretching (if
tolerable)
Heat
Exhaustion
• Remove from play to cool or shaded area, rehydrate, douse with cold
water or rotate cold, wet ice towels over the body, elevate legs to
promote blood return, monitor closely
Exertional
Heat Stroke
• MEDICAL EMERGENCY – call 911
• Cold water immersion
• COOL FIRST, TRANSPORT SECOND
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What is dehydration?
• Dehydration occurs when a person does
not replace body fluids lost from
sweating.
• Dehydration causes a person to become
hotter and have a higher heart rate,
putting them at greater risk for heat
illnesses.
• Minimizing dehydration to less than 23% of a person's body weight will help
to optimize health and performance
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Dehydration signs & symptoms
Signs and Symptoms of Dehydration
Thirst
Heart palpitations
Dry mouth
Lightheadedness
(especially when standing)
Being irritable or cranky
Weakness
Headache
Decreased urine output
Dizziness
Dark urine color
Nausea and vomiting
Exercise session weight loss > 2%
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How can hydration be monitored?
• Body Weight changes– Pre-practice to post-practice
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Most weight lost during activity is because of water loss.
o
For every pound of body weight lost, an athlete should drink 16 ounces of
fluid. That is about one bottle of drink per pound weight lost.
• Urine color check
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Check before and after practice.
o
Urine that is light or like lemonade indicates proper hydration. Urine color
that is dark like apple juice would indicate dehydration.
o
Encourage your athlete to maintain a urine color that looks like “lemonade.”
o
Note: Supplements or medications can alter urine color.
It’s best to try to rehydrate within 2 hours post exercise.
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Role of sports drinks
• Sports drinks are sometimes used to replace electrolytes and
provide energy for athletes who:
o Are doing intense activities that last 60 minutes or more.
o Practice more than once a day, particularly in hot, humid
conditions.
o Sweat a lot, particularly athletes wearing a lot of equipment.
• In short-session practices, there is no added benefit of drinking
sports drinks when compared to plain water.
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How to prevent heat-related illnesses
and dehydration
 Heat acclimatization
 Proper hydration before, during and after activity
 Take regular breaks throughout exercise sessions
 Make practice adjustments to account for the weather
conditions
 Dress for the heat
 Have your athlete observe the color of their urine
 Your athlete should never be denied, limited or
discouraged from drinking water
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Cardiac Arrest
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Cardiac Arrest
• Cardiac arrest occurs when the heart unexpectedly stops beating.
o
It’s triggered by an electrical malfunction in the heart that causes an irregular
heartbeat (arrhythmia) and prevents the heart from pumping blood to the brain,
lungs and vital organs.
• Death occurs within minutes if the victim does not receive treatment.
• It is not a heart attack.
o
A heart attack is caused by one or more blockages in the heart’s blood vessels,
preventing proper flow, and heart muscle dies.
• A person has the best chance of survival if CPR (cardiopulmonary resuscitation) and
an AED (automated external defibrillator) are used immediately.
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Who is at risk?
• Cardiac arrest can impact anyone at any age or any time.
o
There is no evidence that cardiac arrest is more common in athletes than in the
general population of young people (ages 12-25).
• ROC unpublished data from November 2015 suggest that 7,037 children under age of
18 experience EMS-assessed Out of Hospital Cardiac Arrest each year in the United
States.1
• The incidence of cardiac arrest in athletes is unknown.
• According to one study, sudden cardiac arrest in student-athletes is largely a
survivable event (>85%) if the event is witnessed, the school has an established
emergency action plan and the victim receives prompt cardiopulmonary resuscitation
and early defibrillation from an automated external defibrillator (AED).2
1American
2Drezner,
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Heart Association 2015 Statistical Update
Jonathan A., et al. "Outcomes from sudden cardiac arrest in US high schools: a 2-year prospective from the National Registry for AED Use in Sports."
British journal of sports medicine (2013): bjsports-2013. Retrieved from https://www.nata.org/sites/default/files/outcomessuddencardiacarrest.pdf
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Cardiac arrest signs & symptoms
Many young cardiac arrest persons have no
symptoms until the cardiac arrest.
Signs and Symptoms of Cardiac Arrest
Unresponsive
Not breathing or only gasping
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What should I do if I suspect cardiac
arrest?
• Call 911, give CPR and use an
AED if one is available.
• Survival depends on
immediately getting CPR from
someone nearby and if needed,
a shock from an AED.
CPR, along with defibrillation from an AED, can double or triple a
cardiac arrest victim’s chance of survival.
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Child CPR
• Child CPR Video
• Child CPR
• CPR with Breaths technique should only be performed on
children who have not gone through puberty.
o Determine if CPR with breaths should be given:
1. Tap child and shout “Are you okay? Are you okay?”
2. Get help – “Hey you, call 911 and get the AED now!”
3. Check child’s breathing. If not breathing or only gasping, then start CPR.
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Child CPR
1. Position child next to you.
2. Place heel of hand in center of chest.
3. Push hard and fast in the center of the chest at a rate of 100-120
compressions per minute.
• Push down about two inches deep, let chest rise completely back up
• Give 30 compressions – count out loud
• Keep arms straight and stay directly over the chest as you push
Continued on next slide
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Child CPR Continued
4. Give 2 breaths.
•
•
•
•
•
•
Put one hand on the forehead and the fingers of your other hand on the bony part of the chin.
Tilt the head back and lift the chin.
While holding the airway open, pinch the nose closed with your thumb and forefinger.
Take a normal breath. Cover the child’s mouth with your mouth.
Give 2 breaths: Blow for 1 second for each. Watch for the chest to begin to rise as you give each breath.
Try not to interrupt compressions for more than 10 seconds.
5. Repeat cycles of 30 compressions and 2 breaths for five
cycles or until help arrives.
6. If no one else as done so yet, pause to call 911 and get the
AED (if available).
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Hands-only CPR
• Hands-Only CPR – Heckling Fan Video
• Hands-Only CPR is CPR without breaths.
It is recommended for use by people
who see a teen or adult suddenly
collapse. It consists of two easy steps:
1. Call 911 or send someone to do it.
2. Push hard and fast in the center of
the chest to the rate of 100-120
compressions per minute or to the
beat of the disco song “Stayin’
Alive” until help arrives.
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Automated External Defibrillator
Automated External Defibrillator (AED) is most
effective when used within the first 3-5 minutes.
• Call 911 first.
• Start CPR. If an AED is available have someone bring
you an AED.
1.
2.
Turn AED on.
Place pads on bare chest at the locations shown on
the pads.
o
3.
If no options for child (key, switch or pads) use
adults pads.
Follow prompts from the AED that you see and
hear.
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How to prepare for cardiac arrest?
• Get CPR trained and ensure coaches and staff are trained. Visit www.cpr.heart.org to find
a CPR training course near you. The best way to prepare for a cardiac arrest is to learn CPR and
share this lifesaving skill with family and friends.
• Support education programs for effective bystander CPR and appropriate AED use.
Also support public access to defibrillation (or PAD) programs. PAD programs help place AEDs
throughout communities. AEDs benefit survival most when they’re placed where cardiac arrest is
likely to occur, such as areas where lots of people gather.
• Ensure emergency plans are in place at your school or youth league. Check out
www.heart.org/cerp for free tools to build a Certified Emergency Response Protocol.
• Ensure athletes complete a physical examination before they participate in a
sport. Speak to your child’s physician if you are concerned about your child’s health.
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CPR Practice
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Prevention of Pediatric Overuse Injuries
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Types of pediatric injuries
Acute
Overuse
Cause
Result of a single,
traumatic event
Result of micro-trauma to tendons,
bones and joints
Examples
Sprain, shoulder
dislocation, wrist
fracture
Tennis elbow, runner’s knee, shin
splints, swimmers shoulder, youth
pitching elbow, jumpers knee
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Who is at risk?
Overuse or repetitive trauma injuries
account for approximately half of all youth
(ages 6-18) sport related injuries and it is
thought more than half of all reported
overuse injuries may be preventable.
-NATA Position Statement: Prevention of Pediatric Overuse Injuries (2011)
Potential Causes or Risk
Factors:
Training errors
Improper technique
Excessive sport training
Inadequate rest
Muscle weakness and imbalance
Early specialization
Equipment failure
Poorer fitness levels
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Overuse injuries signs & symptoms
Signs and Symptoms
Decreased performance
Gradual onset of pain
Pain presenting as an ache
No history of direct injury
Fatigue, stiffness or aching during or after training or competition
Point of tenderness
Visible swelling
Missed training sessions as a result of pain
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What can be done to treat overuse
injuries?
• Early identification and proper treatment are
keys to a successful recovery.
• To diagnose an overuse injury, it is best to do a
thorough history and physical examination with
a sport medicine specialist with specific interest
in and knowledge of your athlete’s sport or
activity.
• Additional tests, such as X-rays and MRIs may be
needed.
• The sports medicine specialist will make a
recommendation based on their evaluation.
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Ways to reduce risk for overuse injuries
Preparation
 Complete a Pre-participation Physical Examination.
 Proper preparation – at least 2 months in advance of
season.
 Check equipment - conduct routine checks to look for
damage, wear and proper fit.
Training and Conditioning
 Proper instruction and training techniques.
 Proper skill and training progression is followed -- Not
too much too fast!
 Engage in proper warm-up and cool down activities.
 Preseason and in-season training programs.
 Increase training gradually – 10% rule.
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Ways to reduce risk for overuse injuries
continued
Participation
 Participate in multiple sports and recreational
activities to enhance general fitness and aid in
motor development.
 Recognize and limit repetitive sports activity.
 Prevent over-training. Some data suggests a
general guideline of no more than 16-20 hours per
week of vigorous physical activity by youth athletes.
Education
 Educate youth athletes, coaches, and parents on signs and symptoms of overuse
injuries. Encourage athletes to notify an adult when symptoms occur.
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Keeping Sports Fun and Safe Year-Round
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Keeping Youth Sports Fun
• According to research one of the main reasons kids drop
out of sports is because it’s no longer fun.1
• According to a recent study, here are the top 5 things kids
enjoy about sports:2
1. Being a good sport
2. Trying hard
3. Positive coaching
4. Learning and improving
5. Game time support
1Sabo,
D., & Veliz, P. (2008). Go Out and Play: Youth Sports in America. Women’s Sports Foundation. Retrieved on June 14,
2016 from https://www.womenssportsfoundation.org/home/research/articles-and-reports/mental-and-physical-health/~/media/PDFs/WSF%20Research%20Reports/Go%20
Out%20and%20Play_FULL%20REPORT.pdf.
2 Visek, A. J., Achrati, S. M., Manning, H., McDonnell, K., Harris, B. S., & DiPietro, L. (2015). The fun integration theory: towards sustaining children and adolescents sport participation. Journal of physical activity & health, 12(3), 424.
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What can you do to keep sports fun?
 Show good sportsmanship.
 Provide positive feedback.
 Focus on individual improvement.
 Keep the game in perspective. Don’t
define success by the outcome.
 Play at the appropriate age and skill
level.
 Explore different types of sports.
 Set goals with your child.
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Youth Sports Program Safety Checklist
 Emergency action plan posted at venue
• Contains phone numbers, location for EMS directions, basic steps to follow for an emergency
 Accessible and functioning AED within 1-2 minutes of venue
 Accessible water source for cold water immersion & hydration
that includes supplies to provide water
 Policy on practice and game cancelation or modification for
extreme weather
• Based on WBGT preferred, if don’t have then should use a local reputable heat index source
 Coaches certified in first aid, CPR and AED use
 Policy for medical professional presence at practices or games
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Take the pledge at heart.org/BackToSports
I pledge to help keep youth sport participation safe and fun for all by:
 Striving to be knowledgeable of the rules and fundamentals of the game
 Increasing awareness for sport-related issues and proper responses
 Learning CPR and becoming aware of where the closest AED is located
 Promoting proper hydration and nutrition
 Ensuring proper equipment fit by checking equipment every week
 Checking coaches’ backgrounds on sport-specific knowledge and sport-safety training
 Modeling sportsmanship to all players, coaches, and officials
 Displaying unconditional support regardless of the outcome of the game
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Let’s keep sports fun and safe for all kids!
Back to Sports Survey
Please complete the following survey
www.BacktoSportsSurvey.com
Your feedback will provide us with a better
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Let’s see what you have learned!
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Resources
National Football League
nflevolution.com
American Heart Association
heart.org
Centers for Disease Control
cdc.gov/HEADSUP
Korey Stinger Institute
ksi.uconn.edu
National Athletic Trainers' Association
nata.org/public
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