Athletic Injury Management Plan

Athletic Injury Management Plan
Delavan-Darien High School 150 Cummings Street Delavan, Wisconsin 53115
Date: 3/27/18 Prepared by: Ryan Romeo ATC/L, MS, ITAT
Delavan-Darien High School Athletic Injury Management Plan 3/27/18
1. Overview
1.1. Athletic Injuries are common in those individuals that choose to participate in sports or athletics.  These injuries can occur in practice or games, and have the potential for effects to last days, weeks, months, or years after the initial injury.  To ensure these potential injuries are identified and treated in the best way as proven by evidence-based research, Delavan-Darien High School has established the following policy to enhance the athletic experience of these athletes.
1.2. The following components will be outlined as part of a comprehensive athletic injury management plan:
1.2.1. Athletic Injury Overview (section 2)
1.2.2. Coaches responsibilities (section 3)
1.2.3. Pre-participation physical evaluations (section 4)
1.2.4. Athlete/Parent responsibilities (section 5)
1.2.5. Return to Play Protocol for Athletic Injuries (section 6)
1.2.6. Lightning protocol (section 7)
2.  Athletic injury Overview
2.1. Athletic injuries include but are not limited to sprains, strains, fractures, abrasions, lacerations, and other injuries sustained during the course of an athletic event or season.  Note: Concussions are a serious injury that can be sustained during the course of athletic participation, however, as Delavan-Darien High School has a separate concussion management policy, concussion management strategies can be found in the concussion management plan/policy.  Athletic injuries have the potential of negatively effecting an individual over the course of one’s lifetime if not properly diagnosed and treated.
2.1.1. Athletes and their parents/legal guardian give Delavan-Darien High School and any of their contracted agents permission to evaluate, treat, or otherwise seek medical treatment when an athletic injury occurs.
2.2. Licensed Athletic Trainer.  Delavan-Darien High School has obtained the services of a Licensed Athletic Trainer (LAT).  Athletic trainers (ATs) are highly qualified, multi-skilled health care professionals who collaborate with physicians to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of a physician as prescribed by state licensure statutes. The NATA Code of Ethics states the principles of ethical behavior that should be followed in the practice of athletic training (National Athletic Trainers’ Association, 2018).  
2.2.1. The LAT is not employed by the school or school district, thus the main directive of the LAT is to ensure that athletes are competing in a manner where the health and safety of the athlete is the primary concern.
2.2.2. The LAT provides onsite medical coverage to practices and games as outlined in 
the specific contract signed between the school and the health care organization.
2.3. Emergencies.  There will be instances where the LAT, coach, or other school staff is not equipped to treat different injuries, and activation of Emergency Medical Services (EMS) needs to occur.  It is up to the discretion of the individual in charge of the situation as to whether EMS should be activated.  Emergency Action Plans (EAPs) have been developed to help facilitate the treatment of the injured athlete, and limit the opportunities for situations to be mishandled.
3. Coaches Responsibilities
3.1. As the coach or coaching staff spends the most time with their team or athletes, it is necessary for the coach to understand their role in the athletic injury management plan.
3.1.1.  Coaches should structure their practices in a way that the health and safety of their athletes’ is a primary concern, and the chance of an athlete sustaining an injury is as minimal as possible.   
3.2. The most important responsibility of the coach of an injured athlete is to notify the proper individuals when an injury occurs to their athletes.
3.2.1. Coaches must report injuries to the Licensed Athletic Trainer immediately if an injury occurs.  If the injury occurs outside of regular medical coverage hours, the coach can notify the LAT via phone call, text, or email.
3.2.2. Coaches must notify the athlete’s parent of the injury.  Parents of the injured athlete should be notified as soon as possible to determine the desired treatment plan for the athlete.
3.2.3. If no parents are available or are unreachable, Emergency Medical Services (EMS) should be activated.  This is done to ensure the athlete receives quality health care, and the individual is properly treated.
3.3. Emergency action plans (EAPs).  Coaches are required to obtain the appropriate EAPs for the facilities they or their team uses on a regular basis.  This might entail the coach having multiple EAPs at their disposal over the course of a season.  EAPs are available through the Athletic Director’s office.
3.4. Emergency contact numbers.  Coaches are required to have contact information for each the athletes on the team.  This information should include, but is not limited to: parent contact information, athlete insurance information, allergies, and medications.
3.5. CPR/First aid.  Paid Coaches are required to maintain CPR/First aid certification as part of their employment with the school district.  This is in accordance with the WIAA policy requiring CPR/First Aid certification.  Coaches are also responsible for having first aid/medical kits for each practice and game.  Supplies can be re-stocked by the Licensed Athletic Trainer upon request.
4. Pre-Participation Physical Evaluations (PPEs) / Alternate Year Cards (AYCs)
4.1.  PPEs- A pre-participation physical fitness form attesting to current physical fitness to participate in sports as determined by a licensed physician, Physician’s Assistant (PA) or Advanced Practice Nurse Prescriber (APNP) no less than every other school year with April 1 the earliest date of examination (chiropractors are not accepted). School policy determines when an athlete may return to competition following an injury, except where rule book or WIAA tournament policies apply.  Physical examination taken April 1 and thereafter is valid for the 
following two school years; physical examination taken before April 1 is valid only for remainder of that school year and following school year. (WIAA, 2016)
4.2. AYCs-In the year when an examination is not required, an Alternate Year Athletic Permit Card must be signed by a parent or guardian and be on file. (WIAA, 2016) 
5. Athlete/Parent Responsibilities
5.1. The athlete is a major contributor to their health care and treatment, thus this role comes with great responsibility.  The athlete must report injuries sustained to proper personnel to ensure they receive the care they need.  The athlete should report injuries to the coach, Licensed Athletic Trainer, Parent, Athletic Department, School Nurse, or other school or health care personnel.
5.1.1. The athlete also has the responsibility to participate in athletics or sports in a safe manner.  This includes but is not limited to wearing proper equipment, supervised participation, participation in safe environments, and fair play.  
5.2. The parent has the right and responsibility to have their child cared for as they feel appropriate.  Medical intervention and treatment for an injured athlete is based on the best evidence-based practices and research.  Parents have a right to ask questions and seek medical advice as they see fit.
5.2.1. Parents choosing to seek advanced medical treatment for their athlete from a physician must understand that written medical clearance is required for the athlete to return to athletic participation.  If it is discovered that an athlete/parent has sought out advanced medical treatment, and no written clearance has been provided to the Licensed Athletic Trainer, the athlete will be disqualified from further participation until written clearance is provided. 
5.2.2.  Athletes and parents/legal guardians must provide proof of health care insurance or sign a waiver stating that they understand that injuries can occur as a result of athletic participation, and understand that they are physically and financially responsible for any costs associated with such injuries.  They also must acknowledge that the school, school district, personnel, or contracted agents are not financially responsible for any injuries that might occur as a result of athletic participation.
6. Return to Play Protocol for Athletic Injuries
6.1. Return to Play is an important step of any athletic injury, and should not be taken lightly by anyone involved with the health and safety of the athlete.
6.1.1. The decision to return an athlete to participate/play in their sport should be made in conjunction with the parents/legal guardian, the athletic trainer, the medical provider, the athlete themselves, and if necessary, the school athletic director; all who are responsible for the safety and medical well-being of the athlete. This should all be done in accordance with respective school policies already in place. The final/ultimate decision must be left to the school itself after input from the above parties (WIAA, 2016, p. 3).
6.1.2.  The athlete, parent/legal guardian, head coach, Licensed Athletic Trainer, medical provider, and athletic administration must be in agreement that the athlete’s injury has progressed through the rehabilitation process well enough that athletic participation is deemed safe in order to return to play.  If one stakeholder feels that the health and safety of the athlete is at risk, the athlete will be disqualified from return to play until it is deemed the athlete has reached a level that their health and safety is not compromised by returning to sport.  
6.1.3. Written medical clearance is required for any athletic injury prior to return to participation.  Concussions are viewed as an athletic injury, however, specific policies and 
procedures regarding return to play from a traumatic brain injury or head injury are detailed in the Delavan-Darien High School’s Concussion Management Policy.
7. Lightning Protocol
7.1. The purpose of these guidelines is to provide a default policy to those responsible for making decisions concerning the suspension and restarting of contests based on the presence of lightning. The preferred sources from which to request such a policy for your facility would include your state high school association and the nearest office of the National Weather Service. 
Proactive Planning
1. Assign staff to monitor local weather conditions before and during events.
2. Develop an evacuation plan, including identification of appropriate nearby shelters.
3. Develop criteria for suspension and resumption of play:
a. When thunder is heard, or a cloud-to-ground lightning bolt is seen, the thunderstorm is close enough to strike your location with lightning. Suspend play and take shelter immediately.
b. Thirty-minute rule. Once play has been suspended, wait at least 30 minutes after the last thunder is heard or flash of lightning is witnessed prior to resuming play.
c. Any subsequent thunder or lightning after the beginning of the 30-minute count, reset the clock and another 30-minute count should begin. 
4. Hold periodic reviews for appropriate personnel. 
Guidelines for Lightning Safety Education and prevention are the keys to lightning safety. Practice and competitions should be immediately suspended as soon as lightning is seen or thunder is heard. All athletes and spectators should seek shelter during severe weather. Play should not resume for at least 30 minutes after the last lightning strike or thunderclap.  (WIAA, 2016, p. 41).
7.2. Coaches and other personnel should know where the safe place to seek shelter is at their practice or game venue.
7.3. Fans and spectators are expected to leave the area as well, and seek shelter when a weather delay occurs.