Management of acute sports injuries and medical conditions by South Dakota high school head coaches: assessment via case scenarios.

BACKGROUND: When medical coverage does not exist at games and practices, coaches are often responsible for the management of acute conditions. The question that arises is whether they make proper medical decisions concerning the health and safety of their athletes. The purpose of this study was to assess high school head coaches' decision-making skills related to acute medical condition management through the use of case scenarios. METHODS: A cover letter/web link to the web-based survey was e-mailed to all 2008-2009 school year South Dakota high school head athletic coaches. RESULTS: Head coaches were found to be responsible for the immediate care of injured athletes at practice (87.2 percent) and home competitions (72.3 percent). Less than 75.0 percent of coaches reported feeling "prepared" or "somewhat prepared" to handle 11 of the 16 types of acute athletic injuries and medical conditions presented, with less than 75.0 percent of coaches giving "appropriate" or "overly cautious" responses to eight of the 17 cases. Little to no relationship was found between perceived level of preparedness for treating various conditions and appropriateness of responses. A significant difference was found in appropriateness of decisions based on level of athlete (68.9 percent starters, 79.3 percent non-starters) and event situation (66.5 percent important events, 76.6 percent non-important events). CONCLUSIONS: In South Dakota, high school coaches are most often responsible for the initial management of acute injuries; yet, a large percentage of coaches did not feel "prepared" to manage various conditions and/or gave "inappropriate" responses to multiple cases. Furthermore, the level of athlete and the event situation may influence coaches' decisions. Further education may include the proper management of head and neck injuries, multiple concussions, dislocations, heat emergencies, eye injuries and internal organ injuries. Health care workers can be an integral part of training coaches in the care of acute conditions, as well as providing practice and event coverage.

Assessing the need for knowledge on injury management among high school athletic coaches in South Dakota.

BACKGROUND: A lack of health coverage at athletic competitions and practices poses concern over the knowledge coaches have in providing adequate health care to high school (HS) athletes. Therefore, the purpose of this study was to determine the need for education of coaches in the prevention, assessment and management of sports-related injuries in South Dakota (SD). METHODS: Survey link e-mailed to 1,050 HS athletic head coaches in SD; 247 (23.5 percent) completed the prospective, web-based survey. RESULTS: Of the respondents, 74.91 percent reported HS enrollments less than 300, with 79.36 percent in rural/frontier counties and 28.74 percent in medically underserved areas. Coaches from 14 sports responded. The majority indicated they were responsible for the immediate medical care of athletes at practices (89.07 percent) and competitions (74.90 percent); and 79.76 percent of coaches agreed or strongly agreed they needed more injury management education. Results also indicated less than 50.00 percent had current certifications in CPR/BLS (46.65 percent) and first aid (47.4 percent). CONCLUSIONS: Due to the demand placed on head coaches to be the initial caregivers for injured athletes, there is a need for increased education of SD coaches related to the management of acute sports injuries. Additionally, policy changes may be indicated to address the lack of medical personnel available during HS athletic competitions and practices.

Building interdisciplinary teamwork among allied health students through live clinical case simulations.

A limited, yet growing, body of research suggests that health care students educated in interdisciplinary teamwork may become more collaborative professionals in the workplace, which, in turn, may foster more productive and satisfied health care professionals. Researchers also have identified lower mortality and morbidity rates, fewer hospitalizations, decreased costs, and improved function by patients among significant health benefits of interdisciplinary teamwork, especially when it is applied to underserved and geriatric populations. Such positive outcomes have prompted medical schools and accreditation boards of many allied health professions to add interdisciplinary education into their training requirements. Meeting these requirements has challenged universities, where there are multiple allied health programs and limited time, faculty, and financial resources to coordinate interdisciplinary education. The challenges have been magnified by insufficient research on the most effective methods to educate university students about interdisciplinary teamwork. This article presents the background, evolution, and key building blocks of one such method: a simulation-based workshop designed at our university over 7 years to educate its allied health students about various health professions through shared learning, interaction, and collaboration.

Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume.

BACKGROUND AND PURPOSE: The volume of all limbs can be determined by water displacement methods or calculations derived from girth measurements. The purpose of this study was to determine the concurrent validity of calculated volume and water displacement volume measurements. SUBJECTS: Both upper extremities of 14 women with lymphedema were measured. METHODS: Volumetric measurements were taken with a volumeter, and circumferential measurements were taken with a tape measure. Calculated volume was determined by summing segment volumes derived from the truncated cone formula. Pearson product moment correlations, paired t tests, and linear regression tests were used to assess relative association and absolute differences between calculated and actual volumes. RESULTS: The correlation coefficient for calculated volume versus upper extremity minus fingers (UE-F) water displacement volume was.99. Paired t tests showed differences between calculated volume and UE-F water displacement volume (t=-3.88, mean difference=-95.62 mL), and the linear regression slope was 0.83 with an intercept of 255.28 mL. DISCUSSION AND CONCLUSION: Calculated volume measurements were highly associated with measurements based on water displacement; therefore, clinicians should feel confident in using either calculated volume or water displacement volume. The differences, however, indicated that the measures were not interchangeable. Thus, clinicians should not mix or substitute measurement methods with a single patient or in a single study.