Gunn High SchoolGunn High School

Sports MedicineSports Medicine

Sports MedicineSports Medicine StaffStaff

Christina Romero: Head Athletic TrainerChristina Romero: Head Athletic Trainer

Sports Medicine Phone Number (650) 354-8295Sports Medicine Phone Number (650) 354-8295

Volunteer StaffVolunteer Staff

Jo Silken, ATCJo Silken, ATC

Pat Wager, PTPat Wager, PT

Gunn HS Athletic Training StudentsGunn HS Athletic Training Students

(First Aid only - with ARC First Aid Card and (First Aid only - with ARC First Aid Card and

CPR/AED Certification)CPR/AED Certification)

Head Team PhysicianHead Team Physician

Frank Chen, MD - Orthopedic Surgeon

Beth Ogilvie, PA, ATC

Palo Alto Medical Foundation

Physicals can be arranged in Dr Chen’s Office

Call PAMF and mention the athlete is from Gunn HS

Phone Number: (650) 853 - 2943

$20 fee gets donated back to Gunn HS Athletics

Athlete must use Apryse Physical Forms !!!!!

MD’s office submits form by electronic fax

Sports Medicine HoursSports Medicine Hours

• Hours

– Fall

• Monday -Thursday 3 - 7 PM

• Fridays: Closed (Sports Medicine Staff will be with football on Fridays)

– Winter

• Monday – Friday 3 -7 PM

– Spring

• Monday – Friday 3 -7 PM

Sports Medicine Sports Medicine

Policies and ProceduresPolicies and Procedures

• Please ask your athletes to stay out of the sports medicine clinic if they

are not being treated

• Athletes should not be getting treated during practice unless a coach

sends them in, during practice time

• Athletes should check in with coaches before coming for treatment

• We would appreciate your cooperation, in asking your athletes to

adhere to the Sports Medicine Policies and Procedures

Sports Medicine Sports Medicine

RulesRules• NO Foul language

• NO Food, candy and gum

• Smart devices are to be turned off or used with head phones

• No using the Sports Medicine Clinic as a hallway, in and out of the building

• All personal belongings should be left in the locker room, the team room or in the hall, outside the sports medicine facility

• Cleats may not be worn in the Sports Medicine Facility

• Do not ask the Sports Medicine Staff to open the locker rooms

Sports MedicineSports Medicine StaffStaff

• The goal of the Sports Medicine Staff is to provide

health care for the prevention and care of athletic

injuries/illnesses.

– Athletic Injury Assessment

– Differential diagnosis

– First Aid and Emergency Care

– Rehabilitation of athletic injuries

– Taping, Wrapping and Padding

– Nutrition and hydration

– Referral to other health care providers

Emergency Care at Another SchoolEmergency Care at Another School

•Ask if there will be an Athletic Trainer available

while you are on campus

•If there is no Athletic Trainer, ask who should be

notified in case of emergency for EMS activation

•When hosting competition at Gunn HS, notify the

visiting coach of the availability of our Athletic

Trainer, during the competition.

Qualification for Provision of Medial CareQualification for Provision of Medial Care

•Coaches should only provide first aid care for skills they have

been trained to provide

•(ie American Red Cross First Aid and/or CPR and AED use)

Reporting of Injuries to Reporting of Injuries to Sports Medicine StaffSports Medicine Staff

• It is the responsibility of the injured athlete and/or the parent or

legal guardian, to report all injuries/illnesses to the Sports Medicine

Staff.

• In the case of serious injury and/or illness, where the athlete is

physically unable to perform this task, and/or the parent or legal

guardian is not available, it is the responsibility of the coach to

notify the Sports Medicine Staff of any injury or illness to an athlete

on their team.

Parental Notification of InjuryParental Notification of Injury

• The Sports Medicine Staff will notify a parent or legal guardian of moderate to severe injuries

• In the absence of the Sports Medicine Staff, the coach should assume this duty

• Do not try to tell the parent the details of the injury (ie. Severity of Injury, Structures Injured or the need for certain types of treatments or surgeries)

• Parents may ask questions that you may not have the knowledge to answer and/or you may not know what is wrong with the athlete

• It is better to leave the diagnosis and other information to the Health Care Providers

Referring Injured Athletes to Gunn HS Referring Injured Athletes to Gunn HS Sports MedicineSports Medicine

• When an athlete is injured, he/she should be referred to

the Sports Medicine Staff for an Injury Assessment.

• Please do not tell injured athletes to request specific

treatments

• The Sports Medicine Staff will evaluate the injury and

determine what treatments are appropriate.

Confidentiality (FERPA)Confidentiality (FERPA)

• Information regarding an athlete’s injury or illness should not be released by a

coach, to anyone other then the athlete’s parents or legal guardian/s, the

Sports Medicine Staff and/or Gunn HS administrators directly involved with the

care of the athlete.

• All information to anyone other than those listed above will only be done by

Gunn HS Administration (usually the Athletic Director, with permission of the

parents or legal guardian)

• Team mates may be informed that an athlete was injured and that everything

is being done to provide the injured or ill athlete with the best possible care,

without disclosing information about the particular injury.

• Discussion about a particular athlete’s injury or rehabilitation should be done in

private, where others are not privy to the conversation.

Medical Clearance for Injury or IllnessMedical Clearance for Injury or Illness•All new injuries/illnesses should be evaluated by

Sports Medicine Staff, prior to return to activity,

treatment and/or taping

•Moderate to severe injuries will be referred to a

medical doctor (MD or DO) for further evaluation.

•Athletes sustaining a serious injury or illness or

having surgery must be cleared by a note in writing

by a medical doctor (MD/DO) for unrestricted return

to full participation.

•Medical clearance forms are available through the

sports medicine office.

•The Gunn HS Sports Medicine Staff may clear an

athlete to return to activity with the treating physician’s

permission.

Universal Medical Universal Medical PrecautionsPrecautions

• Protect yourself at all times from blood or other bodily fluids when providing first aid for an athlete

• Wash your hands before and after providing first aid

• Always wear Nitrile or latex exam gloves

• Protective glasses, masks and or gowns should be worn as needed

• Properly dispose of contaminated gloves, bandages or clothing in the Red Biohazard Bag in your

Medical Bag or Biohazard Container, as available

• Athletes that are bleeding should be immediately removed from practice or competition to have

bleeding controlled and appropriately covered

Minor InjuriesMinor Injuries• Refer athlete to sports medicine staff if available, for evaluation and treatment

• If the sports medicine staff is not available follow the RICE principle for first aid

– R: Rest the injured area (stop participation if unable to perform skills without compensating for injury (ie. limping or changing mechanics of skills)

– I: Ice the injured body part for 20 minutes every hour

– (Tell the athlete to continue using ice for 24 to 48 hours after a new injury, or until swelling has ceased)

– C: Compress the injured body part with an elastic wrap, if available, to control swelling

– E: Elevate the injured body part, as much as possible

– Warning: Do not massage new injuries, except for muscle cramps

– The athlete should be instructed to report to the Sports Medicine Staff for further evaluation on return to school if injury occurs on a road trip

Serious InjuriesSerious Injuries

• Refer to sports medicine staff if available, for evaluation and treatment

• If the sports medicine staff is not available

• Notify a parent or legal guardian (discuss transportation options to hospital)

• Activate EMS by calling 911

• If in doubt or if you strongly disagree with parent, activate EMS

• Keep the athlete still and try to reassure them that everything is being done to provide appropriate care

• Apply ice to injured area

• Splint as appropriate

• Keep the athlete warm to prevent shock

• Do not give fluids, food or medication in case the athlete needs surgery

• Notify the Sports Medicine Staff as soon as possible

IllnessIllness

• When should athletes stay home?

– Fever

– Sore throat

– Lower Respiratory Infection (Lungs)

– GI Illness (ie vomiting, diarrhea)

• Prevention

– Don’t share water bottles or towels

– Frequent hand washing or use of hand disinfectant

Injuries During CompetitionInjuries During Competition• The sports medicine staff will assess and treat injuries as

quickly as possible during competition and determine if it is safe

for an athlete to continue participation without causing further

harm. Our goal is to safely return them to play and not keep

them on the bench or sideline unnecessarily.

• Your cooperation will be appreciated

WhatWhat’’ss

wrong?wrong?

Athletic Athletic

Injury Injury

AssessmentAssessment

• Injury/Illness examination

– Past Medical History

– Present history of injury/illness

– Palpation of injured structures

– Special Tests

• Ligamentous Laxity Tests

• Range of Motion Assessment

• Strength Assessment

• Neurovascular Assessment

• Functional Tests

• Sport Specific Test

• Other test as needed

– Differential Diagnosis

– Plan for treatment/intervention

RehabilitationRehabilitation• The Sports Medicine Staff is available to provide limited rehabilitation of

athletic injuries, as time allows

• Long term treatment may require referral to a physical therapy clinic

• Athletes may supplement outside physical therapy programs, in the Gunn Sports Medicine Clinic, with a written prescription from the treating physician

• In season athletes have priority

• Please feel free to talk to the sports medicine staff about any concerns you may have about an athlete’s treatment. This should be done in private, not in front of other athletes, to protect the athlete’s privacy (ie FERPA)

• Modalities are available for treatment of athletic injuries

• Application of some modalities may require a prescription from an MD/DO

• Modalities include

– Ice

– Hot Packs

– Electric Stimulation

– Infrared Light Therapy

– Ultrasound

– Paraffin Heat Therapy

ModalitiesModalities

TapingTaping

• In season athletes with Gunn HS tape and supplies

• Out of season athletes must supply their own tape

• Advise your athletes that tape should be removed

immediately after practice or games to prevent skin infections

• KT tape may be left on for up to 5 days

Playing with a CastPlaying with a Cast• Some sports allow participation with a cast

• A note in writing must be presented to the Sports Medicine

Staff, from the treating physician, giving permission for an

athlete to participate with a cast.

• The Sports Medicine staff must receive the MD’s/DO’s note

prior to the day of participation

• The cast must be adequately padded to protect

other athletes from injury, caused by impact with the cast

Sports MedicineSports MedicineEquipmentEquipment

• All equipment is on loan• Athletes may never keep any durable medical equipment

• Crutches• Braces

• Athletes must pay for or replace lost or damaged

equipment• The Sports Medicine Staff can assist athletes in finding a

vendor, if they wish to purchase their own equipment

Automated External Defibrillator (AED)Automated External Defibrillator (AED)• All coaches should be CPR and AED Certified

• Location of AEDs in Athletic Facilities• Sports Medicine Office (in Athletic Trainers Desk drawer)

• Pool (In coaches office)

• Titan Gym (on wall in hallway between Basketball court and aerobics room)

• Bow Gym (on wall where banners are hung)

• Football Field (on Restroom Building)

• Call Sports Medicine Staff Immediately, if AED is needed

• If the Sports Medicine Staff is not available• Send an Assistant Coach or athlete to get the AED

• Send an Assistant Coach or athlete to call 911 and tell them to come back to you after completing the call (handout instructions for information to be given to EMS)

• If you are by yourself, activate EMS, get and apply AED, initiate CPR as indicated

HELP!HELP!

MRSAMRSA

– Staphylococcus Aureus bacteria that is resistant to antibiotics

– Looks like a “Zit” but is very painful

– Can progress to a large open skin lesion within hours

– May need IV antibiotics with hospitalization or even surgery to

stop the spread of the infection or to safe the life of the athlete

– Can progress to becoming systemic and life and limb

threatening.

– Red or tender skin around wound

– Swollen, painful and/or oozing boils

– Does not get better with typical antibiotic treatments

– Other serious symptoms• Fever

• Difficulty breathing

• Chills

– If you have an athlete with a skin lesion, refer them to the Sports Medicine Staff for evaluation and referral to a physician as appropriate

Signs and SymptomsSigns and Symptoms

• Instruct your athletes• Not to share

– Razors– Towels– Other personal items

• Clean/Wash gear and practice clothes and uniform after each use

• Spray gear with alcohol or other hospital level disinfectant (Lysol or others)

MRSA PreventionMRSA Prevention

– Athlete’s with skin lesions should be evaluated by the Sports Medicine Staff or a MD/DO, before participation

– Athletes with skin lesions should not participate until deemed non contagious by the treating physician (MD/DO)

– All skin lesions should be adequately covered to prevent transmission to other athletes or other infection/s to the athlete with the lesion

• Band-Aids and athletic tape do not stop transmission of pathogens, as sweat can pass through these products

• Skin lesions need to be covered with Bioclussive bandages designed for that function

• The Sports medicine Staff can provide appropriate covering of skin lesions, as allowed within the rules of each sport

– Skin Lesion Clearance Forms may be obtained from the Sports medicine Staff

Skin LesionsSkin Lesions

ConcussionConcussion• Mild Traumatic Brain Injury

– Proper Medical term

• May cause permanent disability or death– Mental

– Physical

• Only need to have one symptom to be diagnosed with a concussion

• You don’t have to have Loss of Consciousness to have a concussion

Physicians Trained in Athletic Physicians Trained in Athletic Concussion Assessment Concussion Assessment

• Refer to Emergency Room, not the family physician, in case medical

imaging or emergency care is needed

• International Concussion Consensus Statement recommends that a

concussed athlete be assessed by a physician (MD/DO), trained in

athletic concussion assessment, like a Neurologist, Physiatrist

(Physical Medicine and Rehabilitation Specialist), Sports Medicine

specialist and not the Family Physician

• The Gunn HS Sports Medicine Staff can assist concussed athletes in

obtaining a referral to a physician with this training

MTBI AssessmentMTBI Assessment

• Many different tests (No one test best)• Must look at total picture

– Impact Test (Computer Neurocognitive Test)• Establishes baseline for comparison after injury

– Cranial Nerve Tests– Balance Tests– Memory, Reasoning and Concentration Tests– Physical Exertional Tests– Graded Symptoms Chart

MTBIMTBI• CIF Rules require a minimum of no participation for 7 days, for athletes

diagnosed with a concussion (MTBI)

• MD/DO must clear the athlete to start a medically supervised graduated

progressive exercise program when symptom free

• The graduated exercise program usually takes several days to

complete, if there are no return of symptoms

• Athlete must provide a written note from their treating MD/DO, that they

have successfully completed the Progressive Exercise Program with no

return of symptoms

Second Impact Syndrome

• Athlete suffers a second concussion before the brain has had enough

time to heal from the initial concussion.

• Rapid swelling of the brain occurs

• Athlete may collapse and die within 15 seconds of the second

concussion

• Please, educate your athletes to inform the coaching staff and/or the

Sports Medicine Staff if they get hit in the head and just don’t feel right

• Team mates should let you know if they notice another player that is not

behaving normally (ie. loss of balance, doesn’t know what the play is,

dizziness or other problems)

Lightning Safety• 30-30 Rule is a combination of the:

– 30 second flash-to-bang count to suspend play

– 30 minute delay to resume activity after the last lightning flash

– When Lightning is present

– Go inside the nearest permanent building

– If no buildings are available, get inside a vehicle with a metal roof, but do not touch

any metal surfaces

– If no vehicles are available

• Crouch down immediately in the lowest possible spot, with feet on the ground

• Cover your ears with your hands and close your eyes

– Do not lie down

– Do not go under trees

– Avoid metal objects like wires, fences, benches

MedicationMedication•Coaches are not to dispense medication to athletes at any time!

•Exceptions:

– Athlete needs assistance in administering medication already prescribed by personal physician

• Asthma inhaler

• Insulin injection

• Epi-pen Administration

•Athletes are not to share medication with other athletes

•Refer athletes to Sports Medicine Staff for counseling on appropriate use of mediation

•Notify Sports medicine Staff if you are concerned about drug abuse whether legal or illegal substances are being used

HydrationHydration• Water should be available at all practices and games

• Athletes should be given adequate water breaks through out practices and games

• Water coolers are available through the Sports Medicine Office• Water coolers should be emptied immediately after practices or games have ended

• Water coolers should be left open to prevent formation of mold and/or mildew

• Please return the water coolers to Sports Medicine when practice or games are over

• If Sports medicine is closed, please return water coolers the following day

• Please do not leave water coolers in the gym or out on the fields after games or practices

• Athletes are responsible for providing their own water bottles

• Cups may be provided at some competition, as budgets allow

Game Day CoverageGame Day Coverage• The Sports Medicine Staff will do their best to provide

on site coverage for high risk sports

• Ice and drinking water will be provided for all home competitions

• Please notify the Sports Medicine Staff immediately, of any schedule changes. If we don’t know there’s a game, we can’t provide services

Medical BagsMedical Bags

• Each team will be issued a fully stocked medical bag• You should have the medical bag present at all practices and

competitions whether at Gunn HS or at other schools• Do not expect other schools to provide supplies for your teams• Familiarize yourself where various supplies are in your medical bag,

so you can find them quickly in case of emergency• (ie. CPR Mask, Exam Gloves)• Athletes should not help themselves to supplies from the medical

bag, but should be dispensed by the coach or athletic trainer present

Medical BagsMedical Bags

• Medical Bags that are lost or damaged must be replaced by

the coach that the bag was issued to

• Return the medical bag to Sports Medicine for restocking as

needed

• Return the medical bag to the Sports Medicine Staff as soon

as your season is over

• Gunn HS Medical Bags may not be used for out of season

activities