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SHAC Meeting Audio December 13, 2023

Added Dec 14, 2023 •

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okay I wanted to thank everybody for coming today we have Cody walls are laughing that's Ledic Turner who's here today it's going to go over some things with y'all I gave you the agenda I gave you about to take about five minutes and go over the minutes and let me know if there's anything that you need would like changed or added if you let me know we'll go from there and if everybody signed in okay if everybody's ready if your if I don't want to take a bath time if you're done if you're good then we'll move on y'all just let me know you're very good okay alright so we're going to go ahead and get started this is Cody qualities were lost in that played trainer and I'll let you tell her thank you Nurse gives asked me if I could it sounds various questions have come up at different times as far as to what an athletic trainer is what I do because unfortunately most of the time as a trainer we spend most of our job doing stuff behind the scenes I said my name is Cody Wallace I'm a nationally certified as an athletic trainer state-licensed I'm also an EMT I have a retired athletic training license in Arkansas close enough to the practice covers there I'm also teacher certified ec312  aha BLS instructor stop the bleed instructor I've had other EMS credentials that I've let retire because I do lead them to practice based on the 2021 National athletic trainers Association salary survey the NATA represents almost 60,000 athletic trainers Nationwide I'm one for athletic trainers with my combination of active credentials not very many or teacher certified nationally state license and also an EMT alright so probably going to have some adjustments throughout the the presentation here in there this is a presentation I used to use when I was on a Public Relations Committee for swata which is our regional division of the National Association that's Texas and Arkansas it's up here I have some questions and what happens if what happens if your running back takes a helmet hit in the game gets knocked unconscious who's there that can tell the difference between if they have a spinal injury or concussion or neither if a member of the marching band practicing in the the beginning part of the Season all the sudden collapses becomes unconscious for no apparent reason no traumatic reason and they have a temperature of 105 degrees who's there to deal with that take care of that aperture cheerleader the pyramid in practice or in a game on the sidelines collapses and one of them suffers a broken leg again who's the one that's delegated or designated and trained to hand member of the members multiple members of the basketball team get contagious staph infections who knows how to assess that diagnosed that referred out to necessary individuals and then also lead the cleanup and making sure that everything's disinfected appropriately for so it doesn't continue to spread faculty or staff member or parent at assembly or game play basketball football softball they all the sudden they fall out in the stands or in the the seats I having a heart attack typically during out of academic our times you're not go have the bulk of your Healthcare staff available all right athletic trainers are kind of unique in that in that we work hours outside of the traditional academic day so what happens if your dish wants to minimize risking of catastrophic injuries and lawsuits they want to decrease student time Los out of class increase test performance with in-house medical treatment and rehab and Kamiah cost-effective medical care for their students on site so when you have an athletic or an athlete that gets hurt during their athletic. Or during an after-school practice the day before earlier in the week and they're sitting in class and they're in pain are they really going to be able to focus on what the teachers talking about what they're trying to teach what if they're trying to take a test that day their ankle is just throbbing away they the headache their shoulder hurts they're not going to be at their top performance in the academic world either in Texas has an athletic trainer I have a lot more. Healthcare is state-by-state some states have more restrictive practice acts for athletic trainer Texas has one of the more open practice acts where I can have a lot of autonomy delegated to me by my oversea a position in Texas I'm able to dispense over the counter medications under my positions oversight so I can give based off of standing orders Tylenol or Ibuprofen other over the counter medicines to help them with aches and pains related to sports injury and illness so go back that top bullet though now that can be a big one and I I've been following a case of legal case that's on going back in 2019 in Georgia 10 year old female basketball player was participating and conditioning offseason conditioning exercises that were being leading oversaw by two coaches those coaches failed to follow their safety relations for the Georgia version of you IL they did not communicate with the athletic trainer that was on staff that particular school only had one athletic trainer covering multiple entities locations they did not communicate with them that they were what their plans for practice was that day this young lady went in to exertional heat stroke the coaches then did not follow what they have been trained to do in their first play training they do call 911 but they did not remove her from the heat move her to the Shaded area they didn't attempt any form of cooling by the time I m s or she'd gone into cardiac arrest and they had no started CPR EMS was able to transport her to the hospital where she died in the ER the school district has since settled with the parents in a wrongful death lawsuit to the amount of 10 million dollars for that amount they could have hired five athletic Trainers for 30 years that above average salary those coaches and this is where the this cases is particularly of Interest one that's one of the highest to date settlements for wrongful death that a school district has had to pay out at 2 coaches have second degree murder as well as other things and trials are pending so I'll Pawn what happened you depending what happens on the outcome of this could have major implications as far as setting case law for what may or may not be liable on the school's part and on the Schools Employees for so now flick trainer is someone who cares about taking care of your kids where medical professionals we have a least a bachelor's degree for nationally certified you have the national certification mean you've taken and passed the test that shows that you have a minimal knowledge to practice as an athletic trainer your National certification like most do not actually give you the ability to practice athletic training in a state you still have to apply for your state license and be cleared and then we are required to to complete 50 continuing education hours every two years to make sure that we maintain our credentials and that were up to date on all of our education paramedics have slightly more CEUs that they have to get but compared bachelor's degree in higher athletic trainers you have the most ceu requirements sober are you for students athletic trainers provide injury assessment Rehabilitation at the school this leads to improved attendance because your kids are having to be checked out of school to go go to rehab and stuff like that because athletic trainer can provide that on site as long as the the kids do with their supposed to and come in when they're supposed to this will yield better grades and increase funding because they're not missing their attendance cut off where we get our funding for the day Outlet trainers make medically bass return-to-play decisions whereas you know I love coaches there are some great coaches not there I'm a product of great coaches I played High School sports did powerlifting in college as well and so I've known some of the very best coaches but there's always those bad apples all right and fortunately I look at it as it is a societal issue that we put so much focus on coach's jobs being tied for the winter lost, and so you do when you look at it from that respected you can kind of understand they want their best players on the field because that's how they feed their families that's how they put a roof over their kids head so it's a job for them athletic trainers we're not our job isn't typically tied to the win-loss call alright the head coach gets fired because we go and 10 for two or three seasons in a row that late trainers usually going to be you still there all right unless they choose to go on their Studies have supported the athletic trainers come to the same diagnosis as Physicians 92% of the time and just to kind of $2 home in a little bit we do that with all the fancy gadgets and gizmos we don't have x-rays and lab and all that kind of stuff at our immediate disposal we have to do it all the old-fashioned way. They're trying to provide easy access to the same experts that professional athletes in 2019 there was a study that examined 132 cases of exercise-related cardiac arrest over 2 years and survival with an athletic trainer present is nearly two full greater there's been a recent this past year a high-profile case if you follow the NFL Damar Hamlin had a cardiac arrest of yet is there Monday Night Football the athletic trainers responded implemented their emergency action plan perform CPR on him on the field got him revived and then turned him over to EMS for transport to the hospital EMS did a great job keeping him breathing and pulse and got in there where they could continue to take care of him in the hospital Tuesday would be released and now he's back to playing overall survival of sudden cardiac arrest in youth athletes in studies has been found to be about 48% trainers on-site increase that rate of survival of to 83% double in resuscitation rate when an appellate trainer is there an athletic trainer and AD increases the survival rate to 89% with those numbers tell us is that we have a lot of Youth athletes that are unnecessarily passing away from Cardiac Arrest because they are not being given the emergency resources to increase their rate of survival value for parents so and we talked about or I talked about how the value for the student not being not missing class and stuff like that when we start looking at value parents their student-athlete is getting assessed by specialized Healthcare professional at no charge them because the school district's already paying that salary so they're not having to pay a co-pay and stuff like that on field in it immediately and professionally EMS are great at what they do I'm also an EMT I know exactly what they're training is what they're capable of what their scope of practice is and they are great at what they do but with ankle sprain on the sideline that could or could not be a fracture that they don't have the evaluation tools to try to differentiate that so they're going to do what they're trying to do and that's going to be didn't take it to the ER all right students can stay at school for rehabilitation this reduces their parents missed time from work because they're not having to take off work to drive to the school to pick up go to the appointment he said that the appointment take them back to school depending on what time of the day the appointment is there is continuity of care athletic trainers or one of the only Health Care professions that work with an injury from onset a full recovery and return to play where we deal with that patient on nearly a daily basis whereas you go to your orthopedic surgeon they see and once they go in and see the doctor it requires follow up the doctor may see him a couple of weeks or month or two later depending on the type of injury and what protocol is being utilized that but training will work with that athlete if the school has one on site everyday athletic trainers provide an injury and illness prevention education we do this for coaches we do this for the athletes we do this for parents we do this for the community at Large there's Tom's where throughout the year especially during the month of March which is National athletic training month when I'll send out information District Wyatt our District employees on different ways to help them prevent injury and get active all this reduced Healthcare cost and co-pays paid out for the parent most conditions can be treated by the athletic trainer under the direction of 18 position we do have a team physician. tacos Gristmill Sacco's he's based out of San Antonio I saw him out and partnered with him so 1 is easier travel on our kids the next closest would be into Rockwall and on in the Dallas where you're doing with a lot more travel or a lot more traffic and congestion harder to get appointments made because the Sulphur Springs tacos tacos used to be a he was one of the team service for the San Antonio Spurs so he had recently moved here from San Antonio I'm sorry thanks for so he is a very highly trained orthopedic surgeon that is also board-certified of sports medicine he oversees my protocols for what I'm able to do for the app have an athletic trainer on site means that treatment and evaluation will start before you have to wait in without having to wait on EMS to arrive but I had to wait on the paramedic in the EMTs to get there take a look at it and if it's a orthopedic based injury that's outside of obvious, that's going to be outside of the scope of EMS training it increases the attendance for the district you don't have as many kids sitting at home because they don't know it you know how bad their injury is a lot of this all the time were kids come in as I owe my ankle or my wrist so swollen it's swollen but it ain't let me show you a bad song and in that comes down to the education portion of it teach him half this is what significant swelling is you have a pain but is that is it significant alright continued value for parents and students athletic trainers the only Health Care Providers there specifically at least another strenuously active populations athletic trainers are on school grounds school-sponsored athletic events providing immediate Quality Healthcare Services and studious Sharon Pizza find that there is somebody trained specifically to deal with their type of injuries not all injuries can be prevented athletic events athletic participation comes with an inherent risk of injury athletic trainers can quickly assess the injury stabilize the patient and provide life and limb to the measures if needed certified athletic trainers also educate students and Healthcare are healthy lifestyle proper nutrition exercise machines advise on how to prevent illness and injury during physical activity most young athletes they don't understand that if you want to be competitive it's a lifestyle it's not something that you just do for 60 to 90 minutes a day but it. And every once in awhile at a game if you want to be competitive you have to hydrate properly every day you have to get the proper amount of sleep every day you have to eat right everyday you have to stretch in your downtime not just part of warm-up you have to warm up appropriately before activity to reduce the risk of injury so ask yourself secondary schools house middle schools reduce liability by preventing injuries as supporting risk management reduce absenteeism help competitive Athletics increase public relations faculty in service provider training for teachers and faculty of like this past in service I had a session where I spoke about paying Euro sites and how you in the word pain can increase an individual's pain added Health Care Services some states allow workers comp cases to be treated by athletic trainers I've seen in Rusev staff members for the school district as well as the students so just a little diagram here at Electra about schools with Health Care coverage risk abatement safety of students PR with parents and community and cost-savings a school that employs an athletic trainer and proves its risk management reduce has missed class time and provides on-site treatments rather than the students have to go off-site to get treatments parents have eased concerns over their children's health and well-being while they're participating in school extra curricular activities insurance and they save on insurance premiums and co-pays they don't miss productivity time at work trying to handle their athletes Healthcare all in all this benefits the community a large as well by improving safety of the child increased cost savings the community can focus extra money on improving schools and it and putting more money back into extracurricular programs the AMA has an official statement that High School administrators athletic directors coaches should work with local Physicians Medical societies and Specialty Sissy as well as government officials and Community groups to undertake appropriate measures to ensure funding to provide these Services of some of certified athletic trainers to all high school athletes now I would go as far as to say secondary athletes because that would be middle school and high school yo Aunt to talk about as far as covering everything yo middle school athletes get hurt as well but they're on a separate campus and most cases and they don't get hurt as often to this same extent that the high school athletes typically do they do have some true emergencies on occasion but most of the time they're more of a moderate to minor nature sprains and strains you do get the occasional fracture but when they're that age their bones tend to bend a little more before they break but it is hard yo talkin about our in here Quinlan we have our middle school and a high school on opposite sides of the town and I'm the only athletic trainer and so my office is based at the high school so sometimes it's difficult for me to make it over to the Middle School to get over there to check on things but athletic trainers are the only Health Care Professionals who provide all of these in one location on side of me Emergency Care injury tree with and Rihanna set to return to play field coverage at practices and games before during and after school weekends holidays and Summers ongoing injury prevention taping bracing abrasive adjusting braces safety gear fitting injury tracking and trending Services you know this is keeping up a hay this year we had more hamstring strains in this search for and then working with the coaches to adjust their offseason routine to help to strengthen those muscles and increase flexibility to reduce those injuries and future populations school health demonstration School District Public Health representative some of the services that are uniquely provided a lot of the things I do can overlap with the school nurses and what they do and vice a versa but things that are would be specific to an athletic trainer you're not going to come in as a physical therapist to come out to do on-site physical therapy for your athletes unless you're I honestly I can't think of anyone Allan doesn't even have a physical therapist that comes out to work with their athletes at 5 a.m. so but your athletic trainers will plan coordinate all the preprufe dissipation physicals every year they perform concussion Baseline assessments when available they help to adjust conditioning programs with the coaches they help to advise on strengthening programs proprioception training nutritional Services they helped provide ongoing Health screenings for the Pacific Athletic populations equipped build safety every time we have a home game I walk our court I walk our field looking for things that could be dangerous objects you'd be amazed at the things that you pick up off of an outdoor field pencils 9 inch steaks broken pieces of wood all kinds of stuff that I picked up off the fields that could be penetrating for an athlete that falls or slides across from we help with emergency action planning and evacuation plans are we help to maintain asthma action plans for the offside athletic participation participation was at Potenza then put that in there MRSA and other infectious disease prevention I like one of the first things I did when I got here was purchased a couple of a you're so that we can macaroons that help keep staph infections and other infections down station again having an equipped athletic training room with certified license athletic trainer I've got to see how many 12 3 active ACL rehabs going right now two rotator cuff reconstruction surgeries rehabs going right now to ankle rehab post-surgery rehabs going in this is all just at the high school and then multiple concussion return-to-play protocol is in progress at the moment about that High School parents athletes return our patients athletes return to play faster and stronger you can't harp on the improved attendance enough and prudent in attendance helps raise their test yours and also helps raise our funding athletic trainers monitor progress under the direction of physician this on all the money is saved in health insurance cost because they're not having to go out to a PT clinic for a basic ankle rehab the average ankle sprain will require 22 patient contact services from onset to recovery so that's 22 at the doctor's visit that's Rehabilitation that's follow up for clearance with an athletic trainer on-site you drastically cut those numbers down from that student missing class I'd like trainers frequently provide teacher in-service that you know I do all the coaches and make sure that they're up to date on their concussion training every year helped make sure that their CPR and AED training is current every year and then beyond that to any teachers I help the nurse training for other teachers whenever I'm available I know last year and the year before we did all the fine fine arts staff and got them certified athletic trainers do typically or can typically teach a limited load as far as classroom instruction goes I teach three classes Sports Medicine 12 those classes are geared towards Health Sciences students that are interested in pursuing a healthcare career whether it be as an athletic trainer physical therapist nurse EMT we we definitely look at the entire gamut of all Healthcare professions that fall under the sports medicine umbrella right now we're in the middle of doing CPR first aid in Ada here pretty soon my classes my sports medicine one class will all brand-new be certified in CPR AED and first date so this is one of the best cost analysis that I've been able to come up with and find a good detail that's been documented Glenbrook South High School in Glenview Illinois trainer that athletic trainer was able to provide student-athletes with 3172 treatments when you compared that to those same treatment provided it's a physical therapy clinic other men it valued came back at about $475,000 and that was in 1992 alright so that number with inflation has just gone up astronomically 2008 added an additional athletic trainer on the staff and with two athletic trainer over 11,000 treatments that was in medical services that they did on site 6 they had three athletic trainers they provided almost 14,000 treatments to the tune of nearly three million dollars in medical service athletic trainers help reduce general liability for the school district United Educators general liability insurance review 31 student injuries or deaths that occurred in connection with that athletic practices at students and their families most commonly cited one of the following grounds for liability when they sued the school's failure to adequately supervise practice or other Student Activities proper instruction and warned of dangers failure to offer reasonably safe facilities or equipment failure to provide adequate emergency response all of these grounds there is Central State essential duties the trainers we help provide supervision especially with the sports that have fewer coaches and we can be in one place while there's somewhere else you know we try out here we don't allow what gives to be in the locker room without a coach present so if you have half your team on the court and half of them in the locker room and the coach has to be in the locker room will that leaves our kids to the ability in the gym or out on the field and that's a lot of times where I come into play and help supervise them until the whole team's in one spot where the coaches can watch him again failure to give proper instructions and warn of danger I work with the coaches as far as their in-service to make sure that we're all up to speed on proper safe practices for various Sports whether be tackling practice is in football weather for the proper mechanics and basketball you know come at the proper way to come to a jump stop versus teaching especially our young female athletes when they're coming to jump stop there too much higher increase risk for an ACL rupture so teaching them how to do that to reduce the amount of strain on that ligament so that they don't blow their knee out in the middle of the high school game or practice failure to offer reasonably stay facilities or equipment as I mentioned earlier board games and most time before practices I'm walking our facilities checking things making sure everything is a safe order and then our equipment those that were safety equipment I help the coaches with evaluating our equipment every year to make sure that it's in safe and working order and if they are to provide adequate emergency response here and Hunt County RMS service does not have enough Staffing to provide us with a dedicated ambulance for our football games at Best we get an on-call amias meaning of an ambulance that is on actively on shift and could be called away for now. any point in time A lot of times we rely on First Responders from our local volunteer fire department to fill that void well they're not able to transport that patient all their able to do is come out in it was some immediate emergency first day so in the event that you don't have an athletic trainer present you have you you have people who are not transfer pacifically and how to handle injuries in the sports population you know we're talkin about say football how to remove equipment there specific practices and protocols that are standards practice to how to remove that stuff and most of our local EMS and it's not just here it's other where everywhere else are not specifically trained to do that unless they their company makes it upon bring somebody in trainer to teach them how to remove equipment and then if you don't practice it you're not going to be very good at it athletic trainers are First Responders these are some quotes that are from other school administrators across the State of Trance First Responders to sports injuries they are the catalysts of information coaches and athletes kind of elaborate on that has athletic trainer I am the the the go-between for everybody was at athletic injury and when I know I'm talkin about Athletics and athletes y'all need to understand that athletes in today's term also encompasses our marching band our dance and drill teams are cheerleaders and I'm responsible for all of them if one of them gets hurt I deal with the athlete I'll talk with the parents if it requires a referral to a physician they have the ability to go to any physician of their choice I will make my recommendation specific to what they have going on and what their situation is but they when they go to the doctor most doctors don't take a lot of time or their staff take a lot of time to break things down in the lane so I can take the medical terminology when they come back with that note like this is what they said is wrong with little Johnny but I don't understand what they were talking about can you explain it to me a lot of times that I come in and I break it down and make it more easily understandable for them and then I'm also the one that communicates with the coaches hey this you read this report and you don't know what you're looking at is going to sound like Little Johnny's out for the next all right but this is what's going on other quotes health and safety a School's first responsibility is to keep students safe and athletic trainers and essential part of the athletic program supporting individual students who are who have incurred an injury an advising coaches about practices that support minimizing or reducing the injuries and then my favorite one it only takes one time. if something happen without an athletic trainer nearby to make it pay for itself there's no we talked about it in different presentations at different there's as far as like the 80s association annual meeting the the national or the state coaches association's you'll hear people a lot of times while we don't have an athletic trainer cuz we can't afford and my general response to that will if you can't afford an athletic training you can't afford Athletics because one catastrophic injury is going to cost you more than what an athletic trainer for 20 years this is a generalized slide that was provided more from the national anthem Association when I was reading it I was not I was thinking about not putting it in there cuz I don't want anybody to think that this is necessarily specific here or geared specifically here but this is based off of National survey so the need for athletic trainers The increased number of student-athletes over the years has exploded number of athletes to be evaluated and tripped and treated has risen substantially while the constant but is expected to begin declining because in about 2 years ago we went from an entry-level bachelor's degree minimum to an entry-level master's degree and more programs closed rather than transitioning to the master's degree so we have fewer programs putting athletic trainers out and more and more schools opening and School athletic programs expanding needing more athletic trainers and what we're currently able to produce the demand for services during peak times exceed the capacity of of an athletic trainer of a single the trainer at end of school Mini Sports have evolved to increase physical demands on athletes and resulting in an increase in both frequency and severity of injuries there is no Gap in Sport Seasons I can speak of both as an athletic trainer and as a parent my daughter is a junior here at Quinlan forward and does for sports and she never gets any time off until the summer and even Menchie's summer workouts and camps so there is significant overlap and Sport Seasons additional work hours can become unmanageable at times multiple events without coverage you know just a point out last night we had basketball games at the high school in two soccer games at the stadium I was at soccer cuz that's the sport that has the highest risk of catastrophic injury but you can make the argument basket and the more people there are more teams they're so they're from a odd standpoint there will be an increased chance of something happening especially in the crowd more more extracurricular events on off-campus sites again more of a generalized Nationwide situation has schools expand rather than building on campus. time to look for open land and they're building stadiums and Arenas off campus and that means that their trainer has to try to cover more than one location at once try to cover concurrent campus athletic trainers can't be in two places at one time fussy my general day here starts between 6 and 6:30 in the morning Monday through Thursdays all practices are games are done for the day Fridays since we don't have academic class anymore is a little easier day but Friday's is a game-day so I'm pretty much here every Friday even if it's on the road because I have to come in and take brace evaluate get water ready and get a first aid kit ready to go and send my team's off you know especially when I have them going in multiple directions during football season I'm here every Saturday as well and during soccer season out here most Saturdays cuz our soccer program plays on Wednesday night and Saturday mornings once we get into District yeah what are you doing football season can be up to 20 hour days during Friday's get here get get through walkthrough my second first year here we went to Godley and that was a 21-hour day by the time I got done with the day got their got through the game got back did insurance form for injuries that occurred that not spoke with the parents. 2 minute all my medical notes cleaned up all my water equipment and got everything ready and then I was back here at 9 a.m. Saturday morning for treatment Athleta Runners must have a minimum of a bachelor's degree so with this new transition to the entry-level master's degree is kind of created an interesting dynamic Texas was the first say two credential athletic trainers and because of that we were the first state to have a our own license your exam and we still maintain that and now that the national powers that be have decided to go to a man read texts is like that we're going to do our own thing so we can you can still become licensed in Texas with a master National certification but we still offer a pathway in in the state of Texas only apprenticeship with a bachelor's degree that allows you to go through 3000 clinical hours under the side of a licensed athletic trainer and then you have to challenge the exam which is both written and practical so after you get done passing the written exam you then have to go into a room with three licensed athletic trainers they're going to throw a bunch of stuff that you guys do you know what you're talking about certification not on the national level required I said earlier requires 50 hours continued education every two years part of that we requirements we have to go through two hours of concussion training every year plus the state of Texas has added on that we have to have a trafficking minimum of a one-hour trafficking every two years lassinger athletic trainers Weatherby State Certified state-licensed only are nationally certified for educated in these do prevention clinical evaluation and diagnosis Immediate Care treatment Rehabilitation reconditioning organizational Administration obviously just handling the paper work side of things and then professional to help now I was told that some individuals were curious about our return to play policies and procedures so Natasha's law is the state law here in Texas over concussions it was signed into law by Governor Perry and 2011 y'all can read that right on for you basically what it comes down to is every school district that participates in the sports has to have a returned to play over Russian oversight team that develops a return-to-play protocol for athletes to follow in the event that they have a concussion or suspected concussion if a school district has an but trainer the athletic trainer must be a member of the concussion oversight team has to have a position that is trained in updated concussion knowledge that is current one of the reasons it is a protocol rather than a policy is because in medicine and Healthcare things evolved sometimes rapidly they might not change her years in what sudden there's some major changes over the course of a couple of months to a year and when that occurs you need to be able to keep up with the pace of the way things are changing and having to wait to go take opossums. okay we got to rewrite the policy now we got to take it to the school board and get it re approved having it as a protocol allows you that flexibility for the medical providers that are trained in managing these to make adjustments on the why is necessary based on scientific evidence so cousins are very complex issue to discuss I can I can spend half a day giving y'all a conference over concussions alone there were often referred to as an invisible injury there is no CT scan MRI x-ray or lab test that will show a concussion not yet anyways we diagnosed concussions in the medical field strictly based off of signs and symptoms signs or what you can see all right symptoms or what a report it to you the return-to-play protocol all right that I got I had to myself on last slide so it's basically it's a pot is not a policy but a protocol all right here's a condensed version of our return-to-play protocol for Quinlan ISD once an athlete has been suspected of concussion and I've evaluated them then they are sent on to be evaluated by a physician once they bring me a physician's note that says they are cleared to begin to return to play they then have to be symptoms free without medication for 24 hours or more then we go through a 5-day process all right first days Lied Activity aerobic activities a lot riding a stationary bike pretend to 15 minutes day two is going to be bodyweight exercises as sport-specific conditioning without any contact day 3 they can start to do some limited contact drills and resistance Training Day for the Arno day threes non-contact drills with resistance training day for is limited contact with control drills meaning they're not going. Ramage that day they get through play 52 have a full unrestricted practice and once they clear that then they are eligible to return to full play they have to have a full practice under their belt before they can play in a game anytime in this process they start to develop symptoms there's 22 identified symptoms related to concussion any time they start to have any of those symptoms during this process they get shut down until they are symptom-free for 24 hours again and then once they've achieved that they start back at the last step that they successfully completed without symptoms some districts will start them over from the very beginning doctor Sacco's agrees with me that that might be a little excessive we start them over from the last thing that they could do without symptoms and then after 24 hours we try to advance them to the next step again if they continue to not be able to progress to the next step after about three attempts or depending on how severe their symptoms become then they will be referred back to a physician for a follow-up evaluation Hopper vanced treatment in that situation it doesn't occur very often but in the event that it does they may be withheld for a longer time. or they may be referred to a neuropsychologist for a specific concussion return treatment athletic trainer has athletic trainer I continue monitor the environmental conditions for all of our outdoor activities so I turn into like a junior weatherman and then I have to, I have to find a way to communicate with all of our outdoor Act Amanda baseball softball High School coaches Middle School coaches soccer any of them all right usually send it out as a text message hey one of our main environmental concerns lightning we talked about lightning general rule of thumb you can hear thunder you need to clear the outdoor space if you can see lightning you need to clear the outdoor space Thunder drawers going doors these are all little Memory aids that we use an athletic training kind of thing because if you can hear thunder or see lightning you're close enough to be struck a perfect example of that any of y'all. newest Porsche probably heard about it if you're not over here in Forney 90 we have the bolt from the blue phenomenon there was a young man going after football practice he was jogging across the field it was blue skies sunshine perfect football day but over here in about the Wylie area there was a major storm going on and the bolt that struck this young man in the middle of his practice field art about 22 Mi so you can definitely still get strut when you can't even see the storm that's why five weather apps that I'm constantly modest monitoring and have alerts so that we can try to make sure we don't wind up in the news for the wrong reasons lightning within 15 to 20 miles I usually start heads up high doors lightning within 10 to 12 miles we will start our safety procedures that's when I call him and say hey get off the field you're not allowed outside anymore until I tell you otherwise once find me this within 6 Mi you are in imminent danger and by that time everybody should be off the field if they're not they're in trouble lightning you don't get to go back out onto the field until lightning has not been detective for 30 minutes within 15 miles at that point I'll give an all-clear our environmental heat treatment alright heat illness is one of the leading causes animal death heatstroke can be survived 100% if proper measures you're taking we came very very close to not have any situation here this football season we hosted Mount Vernon and on Thursday night they had a student-athlete go down on their sideline in full heat stroke luckily we had an immersion tub ready to go I've never you and 15 years as an athletic trainer I've never used an immersion tub in a game situation is more common to be used practices marathons but as far as a football game I've never had to use one until this year but yes we did young man and I am not trying to over blow things but I am convinced based on what I saw there with him cuz we did not have an ambulance on site we were high wait on the ambulance to respond from Greenville if an athletic trainer I'm not saying me but if it athletic trainer had not been there to manage that situation I don't think that no man would have survived because EMS is not trained in emerge they're not taught how to immerse the body and cool it get the core temperature down below 102 we as of this year glow thermometer measuring device that allows us to follow these activity guidelines prior to this we were having to go strictly off of humidity and that by itself is not this device Pace wind speed direct light humidity and several other factors into consideration and it produce is numbers to the side and we follow this range now for all outdoor activities some of it will be sport-specific so like once we get to a the orange division football can go in limited equipment if we hit the red practice is still on but it's in no equipment at all and it's limited to an hour and of that our they have to have a 20 total of 20 minutes the rest breaks so if you break that down that 45-minute rest breaks or 54 minute rest breaks so that's a pretty frequent break over an hour long practice we hit that magic 92 now all outdoor activities are cancelled or delayed until that temperature gauge comes down now we don't have to deal with cold weather injuries very often here in Texas but on occasion especially with soccer softball and baseball and sometimes track we do have to deal with cold weather environmental injuries Trainor again I'm constantly about the weather in environmental factors weather is how humidity is what kind of wind speed we have all of this goes into making determinations it's for our youth athletes to participate all right when when are when windshield gets to 30 degrees Fahrenheit or below then we start to him take some precautions we start to put built-in breaks into Pratt outdoor practices and activities for specifically for rewarming 15 and Below we're going to increase the number of rewarming activity timeouts what we have and limit exposure as much as we can by increasing protective clothing and then once we get zero I am terminating that act until 8 qisd we have a combined 15 Sports for the high school and middle school for high school School 15 Sports approximately 48 teams this changes on a year-to-year basis based on how many kids want to come out for different sports I have cheer grouped in with performing arts groups because they pure don't fall under that athletic directors supervision which is somewhat different than some of the other districts have been out between the three performing groups that we have that are not we have approximately 7 teams are divisions so when you look at blue bells blue babes High School varsity cheer JV cheer 8th grade cheer 7th grade cheer and marching band of course again that's always contingent on how many students come out for different stuff different year based on numbers that I had from last year when we were still doing covid testing there's a proximately 600 average of approximately 650 students per campus we have a proximately 600 extracurricular students between marching band Athletics drill and cheer so each sport we have typically has three coaches for a major team sport with a four band directors to cover all of band for high school middle school thrill coaches Rock drill blue as blue bells for cheer coaches for TMS nfhs cheer five nursing staff if I remember correctly are for nurses and miss Robin and then each campus typically has three admin a principal into assistant principals anybody have any questions and you specific questions that I may not have gotten to her answer already just curious on top of all that you do what kind of hours do you spend follow the parents of your injuries and stuff so depending on the injury if it is I had to if I was calling a parent on every single injury I'd spend all day on the phone so if it's a minor injury especially with my high school students I do rely on them to communicate with their parents my phone is always available who is the parents won't call for clarification if it is a significant injury they get an immediate phone call from me sometimes that causes me to have to get somebody to watch my class for me while I'm dealing with I help the parents coordinate with doctor's appointments especially with Doctor melts tacos our team doctor cuz if a parent calls up there to make an appointment date they just kind of go in the gym if I call up there and talk to dr. Mel tacos or his Sports Medicine coordinator I can lot of times and most cases get a same-day appointment go ahead and get them in Insurance wise I'm the gatekeeper for the stools accident policy so if it happens in athletics your band so if something happens in a place or band and they're wanting to utilize this accident insurance policy that come schedule a meeting with me sit down with me it's a one-page form so it doesn't take a lot of time to fill it out but the scheduling when I have time to sit with them and we sit down we fill out the photocopy ball and then I give them multiple copies that way if they have to go to an independent Imaging Center for x-rays or something along those lines then they have extra here recently we've been having some issues I think that there's some new staff at a chess are the health health risk safety insurance company that we work with and they've been sending out some blank forms to parents saying hey we need you to complete this form and send back in touch with been notified that you went for the services but we didn't get a form and so I don't know if that's a breakdown from some of the doctors offices are the clinics not sending the form to the insurance company when they bill for services or if it's at 3 staff at the insurance company but whatever reason isn't accepting the form is being sent in as of right now I'm juggling a couple of cases where I'm redoing insurance forms and calling the insurance company when I'm sending it to you directly myself do you have it that is a district-by-district basis more and more schools are going to increased athletic trainers area rival Sunnyvale has to Caddo has to community has three green will have to those are districts that are in are a competitive coffee but then again we have other districts that are in our conference like Wills Point they only have one just like us Kaufman has to translate who else they have they have exploded in growth they're actually up to 3 that I have to that full-time and one that teaches only but helps out on occasion when you start getting into the more rural areas you're going to see if you were at let it trainers my previous position at a public school is at Texas to Bryan Texas quite a bit bigger here and I was 4 years there and my first two years I was the only athletic trainer and they are significantly bigger than we are there nearly a 6A School then they got me a second appellate trainer from as athletic training for my last two years there now they have I think they're up to 30 but again there quite a bit Allen ISD has a furlong time they only had their one of the biggest school districts in the state have for a long time they only had three athletic trainers they have increase that number one of the assistants there is a friend but they also have a whole separate budget for Contracting independent athletic trainers to help with coverage like and it's been a long time ago but my brother had to close to his injury in football and had a brain surgery have a good time that there was not any athletic trainers and Community I just hired ones that week and they're the ones that called CareSpot urgent care of it so at the end and I hear now that Community has three it's crazy to look at how much they've grown so I think it's just like everything that comes down to budgets your needs all that good stuff you know I do think trainers have more than I like back in the day they didn't have concussion protocols and those two that started after the fact that so good things have come out of it but as far as the number of trainers a lot of it she's faced School the school budget District my daughter was in with him this morning the coaches coaches so are we don't we have four coaches on staff that cover for sport and are three sports for coaches that cover 3 Sports the rest of our coaches only cover to sports and then as the athletic trainer I'm responsible for All Sports Plus ban drill and cheer because the UIL requires physicals for All Sports band drill and cheer and I'm the one that holds all that paperwork and goes through it and reviews of all those Medical making sure that they're cleared and then communicating with the band director the head coaches free sport hey you have kids missing paperwork or you have to get all your kids are good to go here's your travel paperwork you mentioned how many hours in a day you work but how many hours a week does that for a while to be my average week a light week is 60 hours my average week is about 70 and then do the reason why there's a dip in the program I'm on a an administrative out when I hired on once you get experience as an athletic trainer and especially working in the public school system and you you learn you know that was one of the first things I negotiated when I hired on here was for an increased number of days on my country I have an administrative contract a 12-month contract but when you take all the different schedules for sports and everything else practice is games tournaments and you lay it out it takes about 265 to 270 days to cover everything which far exceeds any of this District contract well I got in that one slide and I have a 17 year old daughter she just turned 17 Monday and I have a 4 year old son and love spending time with them and everything but I love kids helping kids in sports I got an athletic training like most athletic trainers I was a high school athlete we did not have athletic trainer to school I went to I dislocated my shoulder playing football three times and my football coaches put my shoulder back in on the sideline 3 times and I kept playing and now I have permanent nerve damage in my left arm and so when I when I was actually had an English teacher that had us do a a project where we had to research a career we thought we would be interested in and write a research paper I knew that I was interested in healthcare and I love sports so I just at random start researching sports medicine and then I came up with all the different jobs that fall under the sports medicine umbrella and start read about athletic training is like I think that's what I want to do so I found a college that offered athletic training went to college got my degree and has I started going through it and learning my upper extremity evaluations in help make my shoulder better it really lit a passion in me to want to help other not by being a school that didn't have an athletic trainer do you have any more questions I appreciate it very much and all that and I know the last time that we took what we met we were talking about the the permission slip form for the opt-in letter it did go out to the campuses we have 94% as of today yesterday no 298 kids are parents at all again Butler Jason and I talked about this morning Globe Life and so how did you get the note do I get paper coconut. I just got my phone and it was on like a way to check his grades on Skyward I was like and then follow up on the fentanyl training we met with principles about what Mr tolls I reminded him that that's important include that then also to the video we showed him here he showed the principles are looking at a time when we can show that two kiddos like maybe a second. Or something like that just see that in addition to that you already have already, do you have some teacher like cuz my thing is if we show it in a second. Class I want to have teacher prepare to be able to answer appropriately what you know I'll say it what is appropriate say what's not like a teaching point that's a very thorough if they go up teachers go to that look at that and I will get with you and when we decide to show make sure we get that to all teachers and their hand so we are working on getting out of this preferred into account services yeah yeah no longer working with Alexa we also to an effect that we come up with Proper Storage disposal of the Narcan if we have to give it and so we can update we did an addendum to that work with me and we got it all worked up so we do have that updated as well all the time Kelly Crowe with Drew's 27 chain but she had indicated that she could do that if not if it is available over-the-counter now so we may have you know cuz I think ever campus nurse DC Cannon Butler and myself only have a to do Supply in those expire in February Ikea high school I think has the most I have some in my in my go bag there's one in each ad he has to we made a list let me know where everything's at so if people are still is available but you know if you need if you get to thinking about it how do you fit to death in Target. It's hard so I mean we're doing the best of in the event you know where the officers are always there but they're down an officer this week you know if armor teen that they would be able to step check with especially if it's another life person I might have doesn't have medical offices that makes that teacher that they fill don't think of anything else I was awake play December schedule on the same day as the Christmas parade we were going to move that probably the February but will have a second one in the spring too and don't tell the counselor's the police are still doing the training for a senior and not seen your doctor mad and I can do what we've done and if you go rotational have two girls and one morning and have the girls in the afternoon or 2 afternoon all right I'm a cruciate y'all for coming please get some more that you guys are over there please if you have any questions or I don't think we'll have time for that so maybe we'll do a meeting afterwards kind of go over how it went and then if there's another topic that y'all want to hear about talk about email it to me so that we can make it so that we can plan it out but I think you all very much if you have any questions feel free to straight

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SHAC Meeting Audio December 13, 2023

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