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