Athletic Trainers and Sports Medicine

Communicable Disease and Skin Infection Procedures

The risk for blood-borne infectious diseases, such as HIV and Hepatitis B, remain low in sports.  However, proper precautions are needed to minimize the potential risk of spreading these diseases. In addition to these diseases that can be spread through transmission of bodily fluids only, skin infections that occur due to skin contact with competitors and equipment deserve close oversight, especially considering the emergence of the potentially more serious infection with methicillin-Resistant Staphylococcus aureus (MRSA). (See position statement on this on NFHS web site and in the third edition of the NFHS Sports Medicine Handbook).

Universal Hygiene Protocol for All Sports

  • Shower immediately after all competition and practice 

  • Wash all workout clothing after practice 

  • Wash personal gear, such as knee pads, periodically 

  • Don’t share towels or personal hygiene products with others 

  • Refrain from (full body) cosmetic shaving 

Infectious Skin Diseases

Means of reducing the potential exposure to these agents include: 

Notify guardian, athletic trainer and coach of any lesion before competition or practice. Athlete must have a health-care provider evaluate lesion before returning to competition. 

If an outbreak occurs on a team, especially in a contact sport, consider evaluating other team members for potential spread of the infectious agent. 

Follow NFHS or state/local guidelines on “time until return to competition.” Allowance of participation with a covered lesion can occur if in accordance with NFHS, state or local guidelines and is no longer considered contagious. 

Blood-Borne Infectious Diseases

Means of reducing the potential exposure to these agents include: 

  • An athlete who is bleeding, has an open wound, has any amount of blood on his/her uniform, or has blood on his/her person, shall be directed to leave the activity until the bleeding is stopped, the wound is covered, the uniform and/or body is appropriately cleaned, and/or the uniform is changed before returning to competition. 

  • Certified Athletic trainers or caregivers need to wear gloves and take other precautions to prevent blood-splash from contaminated skin or mucous membranes with soap and water. 

  • Immediately wash contaminated skin or mucous membranes with soap and water. 

  • Clean all contaminated surfaces and equipment with disinfectant before returning to competition. Be sure to use gloves with cleaning. 

  • Any blood exposure or bites to the skin that break the surface must be reported and evaluated by a medical provider immediately. 

Game Coverage Policy

The following is the order in which games will be covered throughout the season, if you have any questions on this please contact us for more information:

  • Although it is not feasible to cover all athletic events at your school it is the responsibility of the athletic trainer to ensure that events are covered to the best of their abilities.  In addition, there are sports every sport season that take priority for game coverage, which is mandated by the district athletic department. Below is a priority breakdown of games and practices coverage:

  • District mandated sports (take priority over all other events)

    • Fall →  1. Football  2. Men’s soccer

    • Winter →  Men and Women’s Basketball, Wrestling

    • Spring →  1. Men’s Lacrosse  2. Women’s Soccer 3.  Track

  • Order of priority for all other events

    • Home varsity games, high contact sports taking priority

    • Home JV games, high contact sports taking priority

    • Home “C” level games, high contact sports taking priority

    • Practices  

When an athletic trainer is present at the facilities the following protocol will be followed:

Injury situation with ATC present

  • As soon as an injury occurs, the athletic trainer will be notified, either by phone or by sending a student to the athletic training room.

  • Once the athletic trainer has evaluated the injury, he/she will determine (based on the Standards of Care) if the injury is serious enough to activate the EMS or refer the athlete to a physician.

  • If it is determined that the EMS should be activated, the athletic trainer will do so him/herself or delegate a coach or bystander to use their cell phone or the nearest phone available, according to the emergency plan for the specific sport.  Each coach will have a copy of the emergency plan, as well as the athletic trainer and athletic director. A map designating ambulance entrance sites will also accompany each emergency plan.

    • The athletic trainer/administrator/head coach will contact the athlete’s parents to inform them of the injury and to which hospital the athlete will be transported, if applicable.

    • A responsible adult other than the athletic trainer will accompany the athlete to the hospital.

    • The athletic trainer/administrator/head coach will update the parents on the situation as many times as necessary.

    • The athletic trainer will call the athlete and his/her parents within 24 hours to inquire about the outcome at the hospital or request that the parents call him/her.

    • The athletic trainer will contact the appropriate coaches and athletic director to update them on the athlete’s status as soon as updates are available.

  • If the athletic trainer determines that the injury is not serious enough to activate the EMS, the previously established Standards of Care will be followed.

  • All aspects of the injury situation will be documented on the appropriate forms by the athletic trainer.

​If an athletic trainer is not present and an injury occurs please follow the protocol below:

​Injury Situations without ATC present

  • As soon as an injury occurs, the attending coach will determine if the EMS needs to be activated.  If the coach is in any doubt about the seriousness of the injury, he/she should activate the EMS and let them decide if transport is necessary.

  • Coaches will follow their specific emergency plan formulated with the sports medicine staff at the beginning of the season.

  • The coach will contact the athlete’s parents and inform them of the injury and to which hospital the athlete will be transported, if applicable. In addition, the coach will make the athletic trainer and athletic director aware of the injury as soon as reasonably possible (at the time of injury or immediately following game or practice).  

  • If the injury is determined not to be serious enough to activate the EMS, the attending coach will hold the athlete out of practice/competition until the athletic trainer or other qualified healthcare professional has evaluated the athlete.

  • Regardless if EMS is contacted the coach will notify the Athletic Trainer within 24 hours of the injury occurring.

  • The athletic trainer will follow-up and evaluate the injury upon return to the school or event.

  • All aspects of the injury situation will be documented on the appropriately by the athletic trainer.

Severe Weather Protocols

Severe Weather can not only cause field conditions to be unplayable, but can also prompt environmental and other health hazards.

The following policy has been adopted by the DPS sports medicine staff.

  • For lightning the national regulation of ten miles has been adopted. Anything lightning less than ten miles from the event can be considered hazardous and should be treated accordingly.

  • If severe weather conditions (lightning, heavy rain, hail, wind, sleet, snow, temperature, humidity, etc.) occur during practice or competition times, the athletic trainer will coordinate with the head coach and officials to determine the safety of the conditions. Inclement weather restrictions will be followed based on NATA recommendations and CHSAA policy.

  • If the athletic trainer determines the conditions to be unsafe, the athletic trainer will notify the officials and head coaches of all teams to postpone their practice or competition and to come indoors immediately.

  • The athletic trainer will determine the length of the delay based on NATA (30-30) standards and inform the head coaches when it is safe to return to practice or competition..

  • The athletic trainer’s determination to postpone practices or competitions due to severe weather will be based on the NATA Position Statements, CHSAA policy,  information obtained from WeatherBug™, and reasonable judgement.

  • The CHSAA recommends that lightning be monitored by a lightning meter or lightning device such as an appropriate weather app on a smartphone.  

  • The NATA position statement regarding severe weather supports the use of WeatherBug™ as superior to a standard lightning meter.  

  • Based on the recommendations, DPSSM utilizes Weatherbug™ to monitor severe weather and makes practice and game delay determinations based on this information.

Concussion Protocol

DPS Sports Medicine has adopted the Zurich Consensus Statement on Concussion in Sports Medicine return to play guidelines and the NATA position statement for Head injuries outlined as follows:

  • Head injury: The DPS Sports Medicine Staff has adopted the guidelines set forth by the NATA, Colorado Department of Education and in accordance with Colorado Senate Bill 11-040 for managing sport related head injury and sport concussion

    • When managing head injury in presence of helmet combined with shoulder pads, the helmet will not be removed; the face mask and cheek pads will be removed in the event that rescue breathing becomes necessary.

  • Evaluation

    • The SCAT 3 will be utilized for all evaluations and documentations.

    • In the event of a head injury the athletic trainer will contact the athlete’s parents/guardians to inform them of the situation and will send the athlete home with home instructions.

  • Return to Play

    • The Zurich Consensus Statement on Concussion in Sports Medicine Graduated Return to Play.

If an athlete is suspected to have a concussion he or she will be immediately removed from the game, and evaluated by the attending athletic trainer. They will then be removed from the game, and be  taken through a SCAT3 or SCAT 5 evaluation. 

If they are diagnosed with a concussion, the athlete will be removed from play and disqualified from competition until completion of the Zurich return to play protocol.

​Zurich Concussion Return to Play Protocol

After an athlete is symptom free for 24 hours they may begin the following return to play protocol with their athletic trainer, their athletic trainer will assess their ability and readiness to begin this protocol:

Graduated return to play protocol table

Rehabilitation stage

Functional exercise at each stage of rehabilitation

Objective of each stage

1. No activity

Complete physical and cognitive rest

Recovery

2. Light aerobic exercise

Walking, swimming or stationary cycling keeping intensity <70% maximum predicted heart rate

No resistance training

Increase heart rate

3. Sport-specific exercise

Skating drills in ice hockey, running drills in soccer. No head impact activities

Add movement

4. Non-contact training drills

Progressing to more complex training drills, eg passing drills in football and ice hockey

May start progressive resistance training

Exercise, coordination, and cognitive load

5. Full contact practice

Following medical clearance participate in normal training activities

Restore confidence and assess functional skills by coaching staff

6. Return to play

Normal game play

Athletic Trainer Contact Information by School

More information coming soon.