Legal/Modalities Unit SM 2

Legal Vocabulary Chp. 3 Liability Negligence   Liability Negligence Standard of reasonable care Duty of Care Tort Nonfeasance/Ommission Malfeasance/Commission Misfeasance Statute of limitation Assumption of Risk Good Samaritan Law Managed Care Medical Insurance HMO PPO  Legal Vocabulary Chp. 3   CAATE BOC NATA

Modalities Vocab Thermotherapy: application of heat to treat traumatic injury   Ischemia: inadequate blood supply to a part of the body Cryotherapy: application of cold for first aid of a trauma Cryokinetics: combines cryotherapy and exercise Conduction: heat is transferred from a warmer object to a cooler one   Convection: heating indirectly through another medium such as air or liquid Radiation: heat transferred through space Conversion: heating through other forms of energy

History of Athletic Training Sports Med 2

On Your Own Silently read the paragraph “what is sports medicine” on pg. 3, and “roles and responsibilities of the AT” on pg. 7-9 Define the following on your paper using your book focus box 1-2: Training: Athletic training: Trainer: Certified Athletic trainer:

5th Century Hippocrates Greatest athletic trainer: Herodicus of Megara ( He encouraged patients to walk 20 miles from Athens to Megara) Father of Sports Medicine recommended strict diet, constant physical activity and regular training to maintain health Tutored Hippocrates Hippocrates Father of western medicine Helped athletes in reaching optimum performance

776 BC First Olympics: first professional athletes

1916 After WWI athletic trainers play more of a role, they started to work at the college level 1917 Dr. S. E. Bilik: Physician who wrote first major text on athletic training and care of athletic injuries: The Trainer’s Bible

1920’s / 1932 Cramer Family Produced a liniment to treat ankle sprains Realized the potential market between athletes and coach To enhance communication and exchange ideas with the coaches, published the First Aider in 1932 played an important role in the education of S.A.T’s

1938-1944 Tried to form NATA (National Athletic Trainers Association) Failed because of WW2.

1950 Athletic trainers got organized 101 AT’s met in Kansas City and officially formed the NATA The purpose: to establish professional standards for the Athletic Trainer (domains)

First AT’s to Work Olympics 1952 Finland

1970’s 1970: 1972: 1976: Had to get certified Title IX established: "No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance” 1976: Title IX played a big role in the growth of the Athletic Trainer. More athletes = more jobs

Current 2019 Entry level Masters degree required 2016 last class accepted into the 3 year undergraduate program

Athletic Training Domains Sports Med 2

Five Performance Domains of the Athletic Trainer Prevention of Athletic Injury Recognition, Evaluation, and immediate care of injuries Rehabilitation and Reconditioning Health care administration Professional Development and Responsibility

Prevention of Athletic Injuries Make the competitive environment as safe as possible to reduce the likelihood of injury Includes the following 1. pre-participation physical exams 2. ensuring appropriate training and condition of the athlete 3. monitoring environmental conditions to ensure safe participation 4. protective equipment 5. education, parents coaches athletes

Recognition, Evaluation, & Immediate Care of Injuries A. Evaluation of athletic injuries 1. obtaining a brief history 2. observation 3. palpation 4. ROM check 5. Muscle strength check 6. Functional joint stability tests 7. Brief neurological exam **the MD is ultimately responsible for providing an accurate diagnosis of an injury! B. First aid and Emergency care 1. BLS CPR/first aid certification 2. Emergency care procedures established with community C. Referral to appropriate medical personnel

Rehabilitation & Reconditioning Designing rehabilitation programs B. Supervision rehab programs

Health Care Administration A. Record keeping: physicals, injury reports, TX records, rehab programs B. Ordering equipment and supplies C. Supervising assistants D. Establishing policies for operation of and AT program

Professional Development & Responsibility A. Continuing education 50 CEUs/2 years B. Professional journal C. Educating SAT’s, general public.

Legal Considerations Sports Med 2

Liability legally responsible for the harm one causes another A.T. will act according to the standard of care, compared to another with similar educational background and training. Key word, reasonable care

Reducing the Risk of Litigation! Preparation for the activity Conduct of the activity Injury Management Records Management

Malpractice The dreaded threat. “conduct associated with adverse outcome of patient.”

Medical Malpractice & Health Care Video https://www.youtube.com/watch?v=sK- E_d1MGtU

Negligence Read pg. 32-33 Fill in your notes on what 4 things need to be established to be found negligent

How to Protect Yourself Assumption of Risk Build healthy relationships Liability insurance Continuing Education Follow Dr. orders and recommendations Document!! Confidentiality Adequate Supervision Emergency Action Plan

Potential Hazards Failure to provide competent personnel Failure to provide instruction Failure to provide proper equipment Failure to warn Failure to supervise Improper treatment

Modalities Read pg. 193-194 Copy down focus box 11-2

Modalities are Fun! Sports Med 2

Modality: a physical technique or substance administered to produce a therapeutic or pain free affect. Legal concerns Understand use of specific modalities Accurate evaluation of injury Avoid “shotgun” approach Adhere to the law

Cryotherapy most common forms are; ice massages, cold immersion, and ice packs. Physiological effects of cryotherapy: Muscle spasm pain reception blood flow up to 10-15 minutes metabolic rate joint stiffness

Therapeutic effects of cryotherapy: pain or prevent swelling inflammation Minimized secondary tissue damage.

Skin response to cryotherapy: Stage 1 Cold Sensation 0 – 3 min Stage 2 Mild burning, aching 2-7 min Stage 3 Anesthesia 5-12 min

4. Adverse Conditions to Cryotherapy hypothermia frostbite cold allergies Raynauds phenomenon

Contraindications for Cryotherapy lack of normal temperature sensibility cold hypersensitivity Raynaud’s disease Coronary artery disease

Methods p 445… http://youtu.be/9hQsymsi5xU http://youtu.be/ucFQbSbKNJY Ice massage Ice Immersion, CWP Ice Pack Equipment Towel, ice cup Ice bucket or whirlpool, temp @50-60 degrees Chemical packs, bags, crushed ice Indications Use for small area, tendons, muscle belly, shins Preferred for all around cooling Numbness, follow up movement patterns Application Rub in overlapping circles. 5-10 min, or until numb Immersion in water until numb. Can use w/cryokinetics Wrap on injured body part, elevate. 15-20 min Considerations Comfort of athlete, ie area exposed Frostbite, allow ample time to reheat Do not put chemical ice packs directly on skin  

Cryokinetics Numb the part to pain free Ice until numb Work toward regaining ROM 3-7 min. Ice until numb Exercise 3-7 min. Ice 3-5 min Repeat 5 times

Thermotherapy is Hot

Thermotherapy: application of heat to treat traumatic injuries Thermotherapy: application of heat to treat traumatic injuries. Heat energy increases activity by conduction, convection, and radiation. Modes are moist, dry, superficial and deep.

Physiological Effects of thermotherapy: muscle spasm pain perception blood flow metabolic rate collagen elasticity joint stiffness   Therapeutic effects of thermotherapy pain soft tissue extensibility

Adverse Conditions to thermotherapy burns open wounds Contraindications of thermotherapy loss of sensations immediately after injury impaired circulation directly to eyes during acute inflammation

Methods Moist Heat Pack Warm Whirlpool Equipment Hydrocullator packs, 160 degrees. Retain heat for about 20-30min. Terry cloth or towel 98-110 degressF. Heat 10 -20 min Indication Warms and relax, reduction for spasm. Superficial only convection, reduce swelling, spasms, and pain. Applications Remove pack from water, cover, treat Fill tank, put extremity in and heat Considerations Never! Let athlete sit or lay on heat pack…burns Light headedness, electrical outlets, cleanliness

Ice vs heat Copy down focus box 11-3 p. 194 from your book