David Silverstein has been an Athletic Trainer for 12 years and has yet to need his CPR skills. That all changed in an instant as his actions helped "Z" survive long enough for the EMS to arrive and take over.

David, you just recently saved a life.  Tell us the story.

* SCA leading cause of death in exercising athletes typically caused by underlying structural or electrical conditions. * 75% of deaths occur in football, basketball and soccer. Male and African Americans are at highest risk. Survival declines 10% each minute waiting for defibrillation. * Early defibrillator increases survival chances by 80%* Eyes rolled back, brief seizure-like activity and agonal breathing was distracting and those were all the signs pointed out in the video.   * Differentiated from EHS or sickle cell in that SCA is sudden without signs of struggling or exhaustion* Any athlete who has collapsed and is unresponsive should be assumed to be in SCA until proven otherwise or another cause of the collapse clearly is identified.

What is your prior experience using CPR?

None other than teaching and getting certified.

I first took the class when I was in undergrad.

Tell us some more of your Athletic Trainer Story.

Graduated from MSU during the internship era. GA @ CCF

Got out of Athletic Training and came back to it after 5 years. Served mostly in high school settings but working at a DC office now while doing a lot of PRN coverage.

How did you process the situation afterward?

Didn’t want to be there

Replayed events in my head to see if I performed up to par

What are you going to change because of this event?

EAPs

1E. Every school or organization that sponsors athletics should develop an EAP specifically for managing serious

and/or potentially life-threatening sport-related injuries (athletic EAP)

2E. The athletic EAP should be developed and coordinated with local EMS, school public safety officials, on-site

medical personnel or school medical staff, and school administrators

3E. Every school should distribute the athletic EAP to all athletic staff members

4E. The athletic EAP should be specific to each venue (including maps, directions, etc)

5E. On-site emergency equipment that may be needed in an emergency situation should be listed

6E. The athletic EAP should identify personnel and their responsibilities to carry out the plan of action with a

designated chain of command

7E. Appropriate contact information for EMS

8E. The athletic EAP should specify documentation actions that need to be taken after an emergency 

9E. The athletic EAP should be reviewed and rehearsed annually by all parties involved

10E. Health care professionals who will provide medical coverage during games, practices, or other events should be included

Call to action:

Drill EAPs more often

TUFSS

AT Cares

More consistent hours at Shaw

Resources from David Silverstein:

for an AT to Practice within the Law requires a depth of understanding. Luckily there are people like Joseph Hacker and Tammi Gaw to help us out.

Tammi is a Lawyer and Athletic Trainer and Joseph is Practice Manager for University of Kentucky Surgery and Sports Medicine.

What are the biggest compliance issues ATs face?

Privacy is the largest

Athlete information because betting is allowed in certain states

Electronic medical records

The US is behind on Data Privacy rules

* Make sure it is a reputable company* Does it really protect patient privacy* Is it secure all the way up the chain?* Is schools wifi secure enough?* Is your personal phone secure enough for you to enter data.* What if you are 3 years removed from an institution and you get sued, can you keep that information?  Can you access it?

Engage your risk management in all the decisions made regarding records management.

Request a seat at the table!!!!

How are you allowed to communicate?

Not knowing what is in the state practice act or understanding the language.

We need an easy guide to help the practitioner know “yes or no.”

We are unclear on who is a Licensed Health Provider, how much more unsure are we which we should be following.

Looking at the Texas practice act let’s discuss this as I understand it and as you understand it. (layman vs. Lawyer)

Texas Practice Act

110.12. Scope of Practice. (New Section adopted effective October 1, 2016, 41 TexReg 4435)

(a) A licensed athletic trainer prevents, recognizes, assesses, manages, treats, disposes of, and reconditions athletic injuries and illnesses under the direction of a physician licensed in this state or another qualified, licensed health professional who is authorized to refer for health care services within the scope of the person's license. 

(b) The activities listed in subsection (c)(1)-(7) may be performed in any setting authorized by a licensed physician and may include, but not be limited to, an educational institution, professional or amateur athletic organization, an athletic facility, or a health care facility.

(c) Services provided by a licensed athletic trainer may include, but are not limited to:

(1) planning and implementing a comprehensive athletic injury and illness prevention program;

(2) conducting an initial assessment of an athlete's injury or illness and formulating an impression of the injury or illness in order to provide emergency or continued care and referral to a physician for definitive diagnosis and treatment, if appropriate;

(3) administering first aid and emergency care for acute athletic injuries and illnesses;

(4) coordinating, planning, and implementing a comprehensive rehabilitation program for athletic injuries;

(5) coordinating, planning, and supervising all administrative components of an athletic training or sports medicine program;

(6) providing health care information and counseling athletes; and

(7) conducting research and providing instruction on subject matter related to athletic training or sports medicine.

Deaf Athletes speak a different language, they are not disabled. They maybe Hard of Hearing but not any less capable. We have to learn how to provide healthcare for them the same as the hearing athletes.

Jennifer Warren learned signed language as a kid to communicate with one of her teammates and has continued learning and using the skills through her career.

Josh Woodall and John Ciecko have first hand experience working with deaf and hard-of-hearing athletes and share some ways we can provide more equitable care.

Jennifer, what is the best tip you have for working with hard of hearing or deaf athletes?

I would suggest that the hearing community speak naturally to those who are deaf or hard of hearing.  Many can read lips, but when we accentuate our words, it distorts our mouths, which can make it more difficult to read lips.  

Second tip, most people who are deaf and hard of hearing appreciate any sign language you may know.  Spelling out words or signing slowly is welcomed and appreciated. 

John: Communicate eye to eye, never tell the interpreter “tell them this…”, people of various abilities should never be excluded from sports.

Only 30% of the English language can be read on lips, and that’s with perfect lighting and a couple of strong cups of coffee. Helmets, low hats, or any kind of obstruction to see someone's face and mouth hinders this ability to catch what’s being said on the lips. This is why it’s so important for Athletic trainers to learn the basics of ASL.

Josh, give us an example of how you have used this or other tips from Jennifer?

The first week in Bryan ISD I had an athlete with a broken radius/ulna so had to learn real quick how to communicate with an interpreter.

Jennifer, what should we know about working with deaf and hard of hearing athletes?

Not all disabilities are cognitive disabilities.  In fact, the deaf community does not see hearing loss as a disability.  The deaf and hard of hearing community prefer to be seen as a community that uses a different mode of communication, rather than a group with a disability. 

American Sign Language is considered a foreign language, which is simply a different mode of communication.  The need to use sign language is comparable to the need to use Spanish when a student’s primary language is Spanish.  This means that deaf or hard of hearing students are very capable or able to participate in athletics and other extracurricular activities.

Also, the words ‘deaf or hard of hearing’ can seem like a harsh way to describe a people group, but it is actually what is accepted and preferred by the deaf community.

And, Deaf and hard of hearing students may not hear the starter’s gun or whistles blowing.  Adjustments may need to be made to allow for access to the audible elements of the sport.

Discuss some of the hearing devices and how we can protect those for participation.

Most students self-care for their devices by the time they make it to the secondary sports level.  But, AT’s (Athletic Trainer/Assistive Technology) may find it helpful to know how to support these athletes:

FM systems - wireless assistive hearing devices that enhance the use of hearing aids.  The coach or AT may wear a mic that is bluetoothed to the student’s hearing aid or cochlear implant.

Mike and Kathy exemplify the "AT in the Capitalist Economy." Share in the discussion and consider if being an AT business owner is right for you.

Mike, what does “Capitalist Economy AT” mean to you?

What can an AT do and what is the value of our skillset?

Will people pay you for your services?

We are bridging the gap and speaking directly to the public.

Live the American dream

This is all about advocacy for me.

17 years ago I started my business D&D Sports medicine.

I am worth being paid for the services I am providing.

Part of our COPA committee is developing resources for the capitalist AT.

Kathy as a business owner where do you see us going?

We have become so diverse.

Pandemic has caused a lot of ATs to try running their own business.

Helping with reimbursement even though “cash is King”

Reimbursement opens the doors wider.

When the poop hit the fan and sports stopped the earth shook.

I made the decision 7 years ago to go out on my own.

I try to look at my business as telling the athletes how they can get better.

How can we do this to positively impact the profession?

This entrepreneur road is a great way to keep good ATS here.

Kathy - I have been a mentor each time I switched jobs out of a sense of duty.

I constantly get questions about how they can follow my path.

“First guy through the fence always gets a little bloody...I was that first guy” - Mike Stella

Knowing your “why” is crucial.

When I am faced with making a business decision I go back to my core values and see if it fits.

State practice ascites were written 20-30 years ago and when ATs were only in sports settings.

We need to update them to include a lot of the new settings.

READ your state practice act and have a good understanding of it.

Standing Orders: keep or trash them and why?

Kathy - What we are seeing is a result of a profession that has always worked under the supervision of a physician.

In the medical community, there are a lot of providers working under a physician.

Mike - Having the medical team in place is important.

Working under a physician puts the thumb on us and creates an automatic glass ceiling.

I was told, “You can not start a business because you can not hire my boss.”

The doctors I worked with decided they wanted a piece of the pie.

Now we have to jump through hoops that a massage therapist does not with one year of training.

“If we want a different solution or answer then we have to ask different questions.”

Access to insurance billing, does it hurt or help, and why?

CMS recognition helps as a sign of credibility

Do you lose some patients who want to bill insurance?

As it stands right now ATs are an expense item on the budget where as PT and Chiro generate revenue

AT Moms have a lot to deal with. Being mom at home and "mom" at work, breastfeeding in a football locker room at halftime...I mean come on.

Cari Wood, Valerie Moody, and Kelly Salter join share some of their stories to encourage and lift you up as an AT Mom.

Val, what is your family makeup?

University of Montana Director of our program

AT Journey Colorado, Nebraska, Colorado, Florida back to Nebraska

Met husband in high school but actually met when she was back in Nebraska

Cari?

22 year old and 19 year old

Married 23 years

Kelly?

Born and raised in Michigan

Husband was a coach at her first job

23 years this summer

21 and 20 year old sons

Tell some stories of raising kids as an AT mom?

Kelly - we now sleep with a phone on for our kids...but it can not be me as I get messages from former kids at all hours.

I was able to provide AT care to my kids in little league.

As the only AT at my school, I have to care for my kids.  It takes practice and objectivity.

Cari - former athlete called her after a varsity football game and they had been having fun.

I love they feel safe to call me

A friend fell off the golf cart and broke her 5th metatarsal but Cari made her play through it.

It is hard to evaluate your own kid.

My son was a wrestler but my contract did not cover the road trips.  So I had to sit in the stands and sit and watch, but I can never really turn that off.

Val - when my kids are playing I have the other AT doing the evaluation.  It gives me a layer of separation.

“Will there ever be a game where I am just mom, not the AT?”

What are some of the best moments?

Cari - raising the kids in the high school and having them be included with the teams.  Allowing the high school kids to guide and instruct them.

Realizing I had to lay down the law with the boys trying to date my daughter.

Kelly - getting to see role models and how the teams can be like family.

Now my boys are returning the mentor favors.

Keeping my kids involved in what I do and allowing them to be pediatric patients and part of my regular routine

How do you handle the dating scene?

It was great for me but tough for the kids.  I always knew everything.

It is a double-edged sword.  There was much more benefit than difficulty.

Being relationship-driven has always been important to me so it caused some issues as I wanted to be friends with others.

Am I an imposter?

Val - It is easy for us to fall into that trap with social media.

I try to surround myself with good role models that I can reach out to.

I intentionally connected with another faculty member who is in a similar situation.

Cari - I missed a lot of competitions because I had to work, my husband did a lot of the nighttime routines.

Kelly - It is hard to be vulnerable,

As a single mom AT you have to make a lot of sacrifices. Dr. Erin Hassler has gathered a few friends to share their stories.

Dr. Hassler, start us off with your story of getting into AT.

Went to school in Atlanta and always playing some sort of sport.

When I got to college I put the two together.

The 1996 Atlanta Olympics

Currently a teacher

Own SportzFactory

Own a non-profit

Work with Olympic Track and field

Teach adjunct online

Paula -

20 years out of college and 28 years in AT world

I started as an aide at 13 years old

I hated PE and tried to find my way out of it.

As a cheerleader, I jumped down the stairs and had to visit 

First 5 years I was at a private school and then after school stuff

After that I became the sports performance coordinator.

I loved being part of the team and celebrating and getting better.

It was neat as a high school student to understand the psychological pressures

Chakaia -

Athlete with a lot injuries

My high school AT taught me a lot 

Tennessee state for undergrad

Fell in love, got engaged, had a baby, we split and went our separate ways

I knew it was time for me to complete my schooling.

Te Shondra -

Born and raised in Florida and I was into sports.

A close family friend was the AT and she became my ride to and from school.

I was active but always found a way to help in with AT.

Went to school in South Carolina

Was married for about 7 years and moved back to Florida.

About year 7 or 8 we were pregnant and about that time he bailed

I did not make the adjustment until my daughter was at an age where she needed more hands-on for competitive practices.

When did the kid(s) come into the picture?

Tell me about your Tribe:

Co-workers that all started at the same time and were in similar situations.

These are the emergency contacts for my daughter

Now I have my “mommy squad” that I have met through my daughter.

Being willing to pick up and drop off your friend’s kids and it is reciprocal.

You need someone to celebrate and sorrow with.

Dr. Hassler - I do not call myself a single mom

I do not label myself as a single mom so that it does not look like I am missing a piece.

“You do not need to try to make up for someone else”

K - I am a thinker and a planner.  I will manage my emotions, but sometimes that is at the end or the process.

I have to let someone else help me

Advice for K

Let your story show your passion and desire

Build your network now

Reach out to everyone you know.

Know the presence the ATs have in the area.

Founder of the Brookbush Institute, Dr. Brent Brookbush joins Tanya Watson to discuss some tips for maximizing online learning. AS we are hot on the heels of NATA going virtual again, we hope to help make lemonade.

Dr. Brent Brookbush, you were recently on the movement underground with Mike Stella.  What was your big takeaway from that podcast?

We make statements that I feel are for social media.  We do not live that out in our lives, but we do it for the clicks.

Manual Therapy is supported in research.  Period

All of our courses are Evidence-Based courses

Joints mobs and manipulations have the most research of any treatment in our profession.

How do I find a research-based course?

If it does not have a bibliography then it is not worth studying.

Is there evidence other than this guru’s opinion?

Is there original research?

Look for original sources as the citation

Accreditation is important but an end all be all

Brookbush Institute has lots of courses, almost all online now.  How can we as ATs maximize our online learning? 

There is no current research saying in-person education is better than online.

Would you benefit more if you could review the material and practice on a colleague and then go to the course or course first?

Take it on your own

Repeat it as much as you want

Practice until you are comfortable

Practice on related injuries but not the exact (i.e. shoulder injuries get a spinal manipulation)

Add in an in-person workshop for mastery.

What is Brookbush Institute including in their courses to help retain learning?

The online workshops were incredibly successful because now people had access.

We were only getting into 20-30 cities

“I hate the education system as it is” - Brent Brookbush

What will make this possible for my working colleagues?

We have to make courses short and give credit as they go.

Needs to be on mobile and desktop.

Multimedia - we are adding audio voice over so you can listen while driving or running

We want you to have more access during random downtime.

We do not want to penalize people for taking a long time to finish a course.

Educators tend to kick customer service out the window.

Make it possible to take education easily.

I want to take an IASTM course. What can I do to help me master the manual skills while learning online?

Find a mentor or find/form a local group and “therapize” each other

Watch the podcast on Facebook

Contact Us:

Brent - www.brookbushinstitute.com

Tanya @tewatc on

Women in Athletic Training acknowledges women and men are not the same; however, that does not mean one is less than the other. Come celebrate with this awesome group as they are growing healthy relationships to grow our profession.

What’s new with WAT? 

* Since the last time we were on the SMB a ton has happened - specifically in the area of intentionality and forward direction. * We launched our re-brand of WAT 2.0 on 1/1/2020 and that for us signified a HUGE shift both in who we were and where we were going. We started the process in September of 2019 and used the last 4 months of 2019 really collaborating and digging deep into who we (the revitalized WAT board) wanted to be and where we wanted to take WAT. * That leads us to the creation of a formal mission, vision, and our credo that WAT is more than AVERAGE (insert visuals here) standing for authenticity, virtue, empowerment, respect, advocacy, growth, and elevATion. * We moved what was a place for all women AT to just come and ‘be’ to a true resource. A safe space for the women in this profession to empower one another. * It was through this re-launch that we saw a huge shift in the way our membership interacted with the group - in a hugely positive way. We also were sure to come into the process using the evidence-based models and surveys out then 7800 members. This year when we started 2021 we did the same thing to evaluate our model. * We are super proud that we just hit 9000 members, have 9 board members, we were the 1st group to offer a virtual interview of the then-candidates for NATA presidency, have hosted multiple call-in sessions for professional development around covid, interviews with NATA LGBTQ, EDAC, and more.  

What are y’all working on now?

* At the end of each year, we put out a survey for our members to complete for the Women in AT board to review and re-assess the needs of what our members are wanting from us. We all completed passion roadmaps which is a resource that we utilize from Passion Planner (Megan loves Passion Planner) that allows us to each individually brainstorm the goals that we foresee for WAT over a time period of 3 months, 1 year, 3 years, and a lifetime. * We work together to review the survey answers to plan and create a quarterly outline for Women in AT to help us take small steps to reaching our larger goals for WAT while also catering to the needs that our members requested of us. * This past year the survey revealed that the top two needs that the members would like for us to provide are networking opportunities and educational content. This is something we are working hard to provide for our members. * This month as NATM’s theme is AT’s are Healthcare, we want to shed more light on the emerging settings of athletic training. This month will include some roundtable discussions from multiple settings, some social opportunities, and an interview with a professor who teaches negotiation tactics. We are all very passionate about athletic training and the future for WAT, and are excited to see how it all evolves. 

What are two key issues y’all are working to improve for women in athletic training?

Showing up for each other in an authentic, empowering way. For too long women in this profession (and in general) are forced into competitive environments that pit one against another. We aim to change that. We should be building each other up, and working together as athletic training professionals. Empowering each other forward. Not holding each other back.  

What is the vision for the next 5-10 years?

To infinity and beyond :-) no but in all seriousness, we have big dreams and no intention of slowing down.

What are you doing to provide quality COVID Care and Prevention?

Paul Calloway of MiotechGroup joins us to discuss some of the options available to prevent the spread of COVID and other communicable diseases.

What is new in COVID care?

NanoBio - the average person touches their face

BZK kills 99.9% + the negatively charged bacteria

Nasal Swab basically creates a line of defense

Microsure surface protectant

Let’s talk about washing hands

8HD 

Up to 200 applications

Spray rub and let your hands dry

BZK has antiseptic properties

Surface disinfectant

Microsure surface protectant

Protective barriers

MS Sports & Healthcare - basically a bag that goes between the.

PPE

The materials used for masks is the same used for underwrap

There are no alot of places the produce vinyl gloves.

Some of the hospital systems are using 2 years’ worth of gloves in 90 days.

Purell has a food service-rated disinfectant.  Look for the foodservice disinfectant products for things that are dealing with food.

What do you think?

What are you doing for COVID care and prevention? Tweet Us: @MrJeremyJackson @JohnCiecko @Paul_Calloway @MioTechGroup

Watch COVID Care with MioTech on Facebook

Contact Us:

Paul Calloway

John Ciecko

Jeremy Jackson

Sports Medicine Broadcast and COVID Care partners

Allan Parsells is an Amazon AT or as they call him IPS. Injury Prevention Specialists are positions at Amazon that are only held by Athletic Trainers.

What is it like working for Amazon?

There are about 150 ATs across Amazon

BOC certified is a job requirement

Been with Amazon for 4 months

The industrial setting is a complete 180 from the traditional setting.

I had to step out of my comfort zone.

I had to learn OSHA stuff and learn what I was able to do and what they wanted me to do.

From day one the IPS network at amazon has been extremely helpful.  From onboarding to answering questions.

There is a six-month learning curve.

How did you get the job?

Amazon is the most customer centered company in the world.

Allan’s customers are the associates that fulfill orders.

Our “athletes” are our associates and getting them back into work.

You are dealing with professionals that can not afford to go home or “sit out”

They need to earn income.

What is good about being an Amazon AT?

Favorite thing: interactions with associates that make a difference.

* Collaborating with co-workers

* Great Benefits Package* Stability* Opportunity for advancement* Life Balance

Calling in sick - there is no sub, you just do not go to work.

Switching to the morning shift - may require moving to a different building.

Leadership roles - there are managerial roles in IPS, safety manager role, ergonomics role.

What is not so good?

There are a lot of people that have to approve things before changes can be made

Everything that happens in safety affects operations.

Amazon is hell-bent on safety.

In the Facebook Insights, it says women 2-10 years into the profession are the target audience.  What specific advice would you give them?

What am I going to do now and what am I going to do when I have a family.

Amazon provides a great opportunity for you if you are starting a family.  Maternity/paternity leave.

It is not a “boy's club”. Everyone has equal opportunity here.

If you love to help people you can help people here at Amazon too.

Amazon is thriving during the pandemic, does that impact you as an AT?

There are salary employees and hourly employees. At this point, I do not know what that looks like.

PhysicalTherapy.com is a great way to earn CEUs as an AT and be a better clinician.  What are the skills you are improving on as an AT right now?

If you stop learning you are getting behind.

OSHA requirements are the biggest learning right now

Contact Us

Allan - [email protected]