KINE 2495 - Topics 1-3

Historical Perspectives of Sports Medicine

1) Early greek and roman civilization: coaches, therapists and doctors

2) 1920's: Cramers invented liniment for muscle spasms

3) 1930's: NATA is created (stopped because of WWII)

4) Post WWII: AT's for intercollegiate athletes

5) 1950's: NATA is re-established

6) 1960's: CATA is created in Canada

What is sports Medicine

Broad field of medical practices related to Physical Activity and sport.

Relates to performance engagement and injury care and management

Who is part of the primary care team?

- Athlete
- Coach
- Team Doctor
- Athletic Therapist

What is the role of the Athletic Therapist?

- Preventing, managing and rehabilitating injuries.
- Immediate emergency care in the field
- Clinical evaluation and SUSPECT diagnosis
- Organizational and professional health care and well-being

Athletic Therapists are the only professional that can see the athlete through the full continuum of health

True!

Professional Responsibilities of an AT

- Educator
- Counselor
- Continuing education
- Researcher (incorporating Evidence Informed Practice)

Difference between evidence based and evidence informed practice?

- Evidence based: the findings are based on the literature. (Empirical Data)

- Evidence informed: the literature is complemented by the knowledge and experiences from the researcher to inform the findings.

What is PICO

- Patient
- Intervention
- Comparison
- Outfome

Research Steps for ATs

1) Deep clinical question: PICO
2) Search Literature
3) Appraise evidence
4) Apply evidence
5) Access outcomes

Primary Care Team responsibilities:

1) ATHLETE: Well performance and injury prevention

2) COACH: Figure out how to help the team achieve the goals: teach skills and strategies, injury prevention, team leader, admin.

3) TEAM DOCTOR: Supervise health care of the team. Determine mental and physical fitness. Make official diagnosis, administer medicine, and support and coordinate for further testing (scan, MRI...)

CATA

CANADIAN ATHLETIC THERAPISTs ASSOCIATION:

- it's a stablished membership and a standard scope of practice.

- offers careers opportunities in professional and amateur sports, in clinic, insurance companies...

NATA:

NATIONAL ATHLETIC TRAINERS ASSOCIATION:

- Enhance the quality of health care providers by certifying athletic trainers.
- Has more than 55.000 members
- Members can challenge multiple certification exams to practice outside of Canada

CAESEM

CANADIAN ASSOCIATION OF SPORTS AND EXERCISE MEDICINE:

- Association for doctors and physicians that specialize in sports

- Membership is necessary to work in most major games and sports organizations

Sport Physiotherapy Canada

Necessary to work as a physiotherapist in Canada

Medical Team at Major Games:

CORE STAFF:
- CMO (chief medical officer) - member of CASEM
- CT (chief therapists) - member of CATA or sports physio
- Health care team: sports medical physician, certified AT's, physiotherapy, massage therapists, chiropractors, psychologists.

TEAM STAFF: traveling specifically with a team.

EAP

Emergency Action Plan:

Details and outlines the plan in case of emergency.

Outlines the professionals' responsibilities:
- AT: Immediate Care (First responders)
- One person in charge of calling EMS
- Person to control everything happening around the emergency.

Litigation

Process of taking legal action

Act of Malfeasance

When a practitioner acts beyond their scope of practice (Negligence)

Liability

State of being legally responsible for the harm one causes to another person.

AT as a first responder should have a liability (malpractice) insurance

Scope of practice

Duties and Responsibilities you are allowed to perform

Minimum Standard Care

Minimum reasonable care that is owed to an athlete to keep them safe.

ATs need to follow a set of standards and guidelines within our professional boundaries so that we can keep ourselves patients safe and are not negligent in any way.

Negligence

- going beyond scope of practice (malpractice)

- Fail to use ordinary or reasonable care

- Failure to perform legal duties

Tort Law

- Legal Wrongs committed to a person.

Tort can emanate from:

1) NONfeasance: Non acting: Fail to perform legal duty of care (fail to refer)

2) MALfeasance: perform action beyond scope of practice.

3) MISfeasance: commits a mistake: performs an act incorrectly that they have the legal right to do.

What is gross negligence?

When a therapists has a total disregard for the safety of others

vicarious negligence

Employer gets sued for the actions of the employees

Proving negligence we must show that:

1) Duty of care was owed to the athlete
2) A breach of the standard care was committed
3) An injury resulted
4) The injury was direct result of the breach of standard care

All four must be present

Defense against negligence

1) proper standard of care was taken (No breach of duty)
2) Injury was unavoidable (accident or act of god)
3) injured individual was involved in contributing negligence
4) Athlete was aware of the assumption of risk

We must prove at least one

Assumption of risk

- Athlete is aware of risks but decides to continue participating
- Express in form of waiver which can stand in court except for: fraud, misrepresentation or duress

Other defenses against Negligence

1) Sovereign Immunity: Government cannot be held accountable for negligence

2) Statue of limitation: Timeline to be sued for negligence

3) Contributory Negligence: smaller percentages of negligence (owner, injured individual...)

4) Good Samaritan Law: Protects legal liability from a person that provides care if something goes wrong

informed consent

Injury party has been informed of needing treatment, and advantages and disadvantages of each case.

Battery (Criminal Law)

1. Intentional harmful or offensive touching
2. with no consent from the victim

Product of Liability

Products with inherited defects are subject to liability suits