Athletic Training Office Manual of Operation

Administrative Issues:

Mission Statement:
To provide the athletic community of Cameron University the highest possible level of health care resources will permit.

Expectations of Athletic Trainer:
The Athletic Trainer is expected to:

• Present a professional image
•  Represent the university and the athletic department positively
•  Interact with recievers of athletic training services with equity and respect
•  Promote complete communication regarding athletic training services
•  Respond to all requests for athletic training service with appropriate urgency and priority
•  Actively engage in health education at every opportunity
•  Exemplify and demand the pursuit of excellence

Expectations of Student Athletic Trainers:
 

•  conduct themselves in a professional manner at all times
•  communicate with proper medical terminology when appropriate
•  dress appropriately according to practice/game situations
•  arrive in a timely manner with reguard to obligated duties
•  treat all student athletes with equity and appropriate urgency
•  maintain confidentiality with all business pertaining to this office
•  utilize time spent in this office as part of the learning experience
•  place highest prioroity on duties of service to the University

Expectations of those who seek service from the Athletic Training Office:

Coaches:

We encourage the coaches of Cameron University to be involved in cooperation and communication with the Athletic Training Office (ATO).  The following expectations will be held: 

• Inform the ATO daily of team schedule and need of services.
• Communicate directly with the Athletic Trainer (AT) when concerned with the disposition of a student-athlete.
• Work in cooperation with the athletic training staff in meeting the health care needs of each student-athlete.
• Be an active participant in the education of student athletic trainers (SATs).
• Make your expectations clear to your team members and to the athletic training staff regarding interaction with the ATO.
• Exercise appropriate leadership in injury situations when the AT is absent.  SATs are students, not licensed professionals; therefore it remains the responsibility of the head coach to provide appropriate health care in the absence of the AT.

Student/Athletes:
We demand that student-athletes who seek services in the athletic training office become students of their personal health and athletic potential.  We will take advantage of every opportunity to educate student-athletes regarding total health and well-being as well as promote their cognitive involvement in their rehabilitation and recovery.  To this end, the following code of conduct will be adhered to while visiting the ATO: 

• Student-Athletes will be expected to conduct themselves as ladies and gentlemen at all times.
• Student-Athletes will refrain from inappropriate language.
• Student-Athletes will be clothed properly at all times.  Shirt and short required for all personnel at all times.
• Student-Athletes will be expected to arrive at the office with sufficient time to complete rehabilitation, leaving ample time to prepare for team activities.  “Being in the training room” is not an acceptable excuse for being late to team activities.
• Student-Athletes will not be permitted access to any of the athletic training facilities without express permission of  the athletic training staff.  This is to include: therapeutic modalities, shower facilities, restroom facilities, supplies, telephone, computer and athletic training office.

Office Operations:

Normal Operating Status of the Athletic Training Office:
The Athletic Training Office (ATO) at Cameron University is located in Room 118 of the Cameron Gymnasium.  The primary function of this office is to serve the athletic training needs of Cameron University student-athletes.  The normal hours of operation of the ATO will be as stated below:

M - F 0730-0830, 1230-1700

Appointments:
Coaches and/or student-athletes may request service of the ATO as an extension of the posted normal hours of operation.  Appointments for service must be made 24 hours in advance.  The respective head coaches will be informed of athletes who fail to meet appointments. The athletic director will be informed of teams that fail to meet appointments.

Day Of Competition:
The ATO will be available 1 hour prior to scheduled events.  Arrangements to adjust game day schedule may be made at the request of the head coach or visiting team coach.

Student Athletic Trainer (SAT) Administrative Duties:
Opening/Closing - The assigned SAT will open the ATO at 0730 or as scheduled.  Duties include general cleaning of tables, modalities, refrigerator, taping stations, shelves, storage area, laundry, whirlpool, floor and locker area.  The SAT assigned to open the office will prepare ice/water coolers for the daily activities.  The opening SAT will be available to assist Athletic Trainer (AT) in daily evaluations and treatments as needed.  Closing SAT will repeat cleaning duties described above and make sure that all gymnasium outside doors are locked if SAT will be the last person out of the building or inform coaching staff or AT that office duties are concluded for the day.

Provision of Services:

On-Campus Medical Services:
The ATO is committed to providing the highest level of medical service to the student-athletes of Cameron University. The provision and extent of on-campus services are governed by law, rule, and the availability of resources. The ATO is accessible to all student-athletes during normal and appointed hours of operation. Service resources are distributed at the direction of the AT.  Those in need of service from the ATO are directed to inquire of the AT as to resource and service availability and limitation.  When requested services are beyond the scope of available resources the AT will direct the student-athlete as to the appropriate source of service.

Procuring Medical Services From Off-Campus Providers:
The Athletic Training Office, specifically the Athletic Trainer, is the only Athletic Department representative authorized to secure medical services from outside sources in cases other than emergency. Emergency status exists when an athlete is in significant pain, life or limb is threatened, or illness symptoms are extreme.

Preparticipation Medical Examination:
Every athlete is required to receive a preparticipation medical examination upon their initiation of association with the athletic department. This medical examination will typically be attended by department team physicians. It will be permissible for an incoming athlete to provide documentation of current medical examination in place of department sponsored examination. Documentation from outside source providers will be evaluated by the AT and medical clearance status will be determined. The department designated physician will be the final authority as to the medical clearance of student-athletes.

Health Insurance:
All student-athletes at Cameron University are required to have and maintain a primary personal health insurance policy.  The athletic department holds an athletic insurance policy that stands as secondary coverage to the individual athlete’s personal primary coverage. When medical expenses are incurred due to university sponsored sport related injury, the athlete’s personal insurance will be filed. The outstanding balance will be filed with the department policy. It is the responsibility of the student-athlete to pursue the resolution of all expenses incurred. Only sport related injury that has been evaluated by the AT and managed according to ATO recommendations will be eligible for coverage under department insurance.

Assumption of Risk:
Participation in department sponsored activities is voluntary. Therefore, participation by the student-athlete is indication of expression of assumption of risk.

Equitable Access to Athletic Training Services:
It is the practice of the CU-ATO to operate under the standard of treating student-athletes equitably. The ATO does not practice or condone discrimination on the basis of race, creed, national origin, gender, age, handicap, disease entity, social status, or financial status. Any noted deviation from this practice should be brought to the immediate attention of the AT or AD.

Distribution of Resources:
Distribution of ATO resources is the responsibility of the AT. Distribution of resources is based on accepted medical criteria.
 

Blood-Borne Pathogens:
It is the practice of the ATO to instruct and encourage the use of  “universal precautions” in the treatment of wounded student-athletes. These precautions are in place to assist in the assurance of the health of both the student-athlete and the ATO staff member.

Emergency care:
Reasonable attention to all possible preventive measures will not eliminate sports injuries. Making every reasonable effort to minimize the incident and severity of injuries relating to the sponsored sporting activities of the department is paramount. The ATO maintains high priority in this regard. The following will address this area of need:

1. The person responsible for medical care of the student-athletes of Cameron University is the AT. In the absence of the AT from the immediate venue the head coach assumes this primary responsibility.

2. The plan for medical access is as follows:

 a. ATO staff in attendance will have mobile radio communication access to the university’s Public Safety Office. Dispatch of EMS to the venue will take place through the Public Safety Office. Secondary communications will rely on access to the nearest telephone. The AT or coach will make decisions regarding the urgency of need for care. At no time is an attending SAT to be required to act as the primary responsible party in regard to SA care.

 b. The designated medical facility for urgent care is Comanche County Memorial Hospital. Any athlete in need of immediate physician attention will be transported to the CCMH emergency room.

 c. The coach is responsible for obtaining emergency information on their team members and having that information immediately available at all practice or competitive situations. This information will be distributed to the coaching staff from the ATO. Included in this information will be: name, permanent address, contact person, phone numbers of contact person, known medical conditions, insurance information, statement of release of records to the ATO and/or it’s representative.

 d. All department personnel associated with practices and/or competitions will be required to maintain current certification in cardiopulmonary resuscitation techniques. Instruction in basic first-aid procedures and disease transmission prevention will be made available through the ATO. 
  
Evaluative Protocol:

On Field Evaluations -  The responsibility for on-field evaluation of athletic injury lies with the AT whenever present at the site of activity.  If the AT is not immediately present at the site of the activity the Head Coach assumes said responsibility.  The SAT, when present, is charged with the responsibility of assisting the Head Coach as requested and reporting findings of the evaluation and details of the incident to the AT.

When present the AT will be the sole responsible party for determining the disposition of the student-athlete and instructing the student-athlete and the Head Coach as to the appropriate course of action.  The Head Coach assumes responsibility for determining appropriate course of action in the absence of the AT.  The SAT will assist the Head Coach when requested in determining the appropriate course of action.  However, the SAT will never be charged with the responsibility for determining the appropriate course of action unless the incident is in the absence of the AT and the Head Coach.

The protocol for on-field evaluations is as follows:

 H - History:  The evaluator will gather all information regarding the specific nature of the injury.  This  information will include, but is not limited to,: time, place, mechanism of injury.

 O - Observation:  The evaluator will note the following: presence of swelling, discoloration, bleeding,   deformity.  In addition the evaluator will make note of the student-athlete’s report of the injury in regard to:  primary complaint, loss of function, what was felt and heard at the time of injury.

 P - Physical Assessment:  The evaluator will determine the student-athlete’s physical capacity for  performance by conducting the appropriate physical performance tests.

Upon conclusion of the on-field evaluation the AT make recommendations for physician referral. An emergent medical need is defined as including threat to life or limb and severe pain or illness.

Clinical Evaluations -  Clinical evaluations will be the sole responsibility of the AT.  A clinical evaluation is required of all injuries and illnesses.  The purpose of the clinical evaluation is to determine a detailed evaluation of the injury/illness.  This evaluation will be conducted by the AT at the earliest opportunity following report of the injury.  The protocol for the clinical evaluation will be as follows:

S - Subjective:  The evaluator will determine the subjective information available from the injured student-athlete.  The historical interview will determine the subjective impressions of the injured relative to  time, place, mechanism, and primary complaint.  The student-athlete’s characterization of the pain of the  injury will be noted.

 O - Objective:  Objective findings include the evaluator’s visual inspection, palpation, and assessment of  active, passive, and resistive motion.  Need for special testing is also determined at this stage.  The objective  note should include but is not limited to: deformity, swelling, point tenderness, limitations of active motion  and pain during passive, active, and resistive motion, joint stability and apprehension.

 A - Assessment:  The evaluator’s professional judgment with regard to the nature of the injury.  Although  the precise nature of the injury will not always be known initially, information pertaining to suspicions of site  and anatomical structure will be included.  If the clinical evaluation is conducted in the acute phase of the  injury the severity may be included but is not essential.

 P - Plan:  The evaluator should include recommendations for course of treatment during first aid  applications.  The plan may include referral for physician evaluation, and/or application of splint, wrap or  crutches, and/or request for reevaluation the following day.  Evaluation of sub-acute and chronic injuries  may include evaluator’s plan for treatment and therapeutic exercise when appropriate.

Restriction of student-athletes from physical activity:
At times during the course of evaluation, rehabilitation, and recovery from injury/illness it may become necessary to restrict a student-athlete from specific physical activities. This responsibility lies primarily with the AT and TP. At no time should a SAT have responsibility for or initiate the restriction of a student-athlete. All rehabilitation of student-athletes will take place under the direct instruction of the AT.  A student-athlete may be restricted from physical activities by the AT.  A student-athlete, SAT, coach, or physician is not permitted to release a student-athlete to physical activity once restricted by the AT.  The team physician (TP) may restrict a student-athlete from physical activities.  Once restricted by the TP only the TP may release that student-athlete for physical activity.  The coach may restrict a student-athlete from physical activities for medical concerns.  Once restricted the student-athlete may only be released back to physical activity by the AT or TP.