I'm back baby!

 This has been one tough summer; but I am finally looking forward and able to get back to blogging.  Here are some miscellaneous thoughts/tips/experiences I've had throughout, and hopefully back to some blogging normalcy.  I returned this week from another trip to the Dominican republic, my 11th trip in the past six years.  It's difficult for me to encapsulate the service learning experience concisely, but I'll give it a shot.
1.  First time bitten by a centipede.  I hope it never happens again.
2.  While writing a SOAP note on a patient, an AT student asked "how do you spell machete"? How many educators have heard that before?
3. Watching students educate injured patients on proper posture, lifting techniques, and making on the fly adjustments to improve quality of life is one of the most beautiful things I've ever seen.  I will never tire of it.
4. Don't think that just because your patient doesn't walk with a limp (antalgic gait) that they don't have significant pain and/or dysfunction in their lower extremity.  Some people make subtle adjustments without even knowing it.  Fully evaluate with a careful history, palpation, range of motion and manual muscle testing and then special tests before you complete your assessment.
5. Look your patient in the eyes directly when they are speaking to you, and LISTEN.  Sometimes listening and expressing compassion is the best care you can give someone.

That's it for now,  but look for more coming soon!

Athletic Trainers & Nurses: A Healthy Collaborative

Haven't blogged in awhile, because I haven't seen much that I considered blogworthy.  Happens I guess.  I stumbled upon this article while reviewing potential collaborations, and this will immediately become required reading in my sophomore level AT course.  In our field, we often speak of working collaboratively with other disciplines, and in fact, on clinical rotations students will often witness/participate in discussions/debates with other health care professionals addressing the student athlete.  While learning to practice interdisciplinary care is in my opinion the best option for athletes, it can admittedly be at times difficult and/or frustrating.
Some key points prior to reading the article:
1.  Understand that most everyone is coming from an angle in which they believe that their plan of care is the BEST way for the athlete to heal and return to activity in a safe and expedient way.
2.  Listen.  Listen to counterpoints; often times we tend to "zero in" on orthopedic or gen med issues as they are presented from faculty or textbooks.  As we all know, unfortunately cases do not always present this way, and we can learn much from other professionals who have experience in dealing with those issues.
3.  Share knowledge.  Don't be afraid to speak your mind in a calm and professional demeanor.  Emotion tends to force others into a defensive stance, which can alter the level of care for the athlete.
4.  More is more.  I love this adaptation to "less is more".  The more information you and your colleagues have, the more informed decisions can be made, and outcomes can be enhanced (read: improved standard of care).
I have been fortunate enough to work closely with nurses and nursing students the past several years during our coursework in the Dominican Republic, and the exchange of knowledge in both directions has made me much more informed regarding general medical conditions; including signs, symptoms and overall management.  Working side by side on real patients has incredible benefits, including my own progression as a clinician.

The article itself, published in the May 2012 edition of the National Association of School Nurses (NASN), can be found here:  http://nas.sagepub.com/content/27/3/136.full.pdf+html?ijkey=xo5hF791ez6E6&keytype=ref&siteid=spnas

I really believe this can serve as a nice informational piece when either creating or modifying the Emergency Action Plan (EAP).    Hope you enjoy!

Congratulations to the Class of 2012!

This group you see above are the 2012 graduates of the University of Southern Maine's Athletic Training Education Program.  One of my favorite times of year are watching the next group of seniors move on to
the next stages of their life.  I had the privilege yesterday of watching this group of men and women at our graduation. They were a great group, and are going on to do great things; some as Graduate Assistant Athletic Trainers at Auburn University, University of North Carolina, Thomas University, Providence College; some onto obtain their Doctorates of Physical Therapy and Physician Assistants degrees.  Either way, a heartfelt congrats to an amazing class.  Great Job Gang!

Concussion Management

Watching the exciting UEFA semi-finals, I was struck by a concussion and it's management during the game.
Check out the video here first:

It should also be noted that after a quick evaluation he was allowed back on the pitch and, eventually, several minutes later, subbed off.  Watching this left me with some questions.
1.  Does UEFA have specific rules regarding this?  For instance, if this were the NHL/NFL, etc., he would be out of the game immediately, right? Why isn't unconsciousness grounds for immediate removal from game play? Perhaps the rules are different?  Lastly, how does this align with the Zurich Protocol?
Of course, I had the benefit of TV and countless replays, while this medical staff was in a pivotal moment at a crucial match.  I would never question the decision made, as I was not present personally, but as a teacher, I have to understand to better explain why some injuries are managed differently from our position statements to the clinical world.  

Looking further into this, I found an interesting blog which seems to be neat resource for all things concussion.  You can check it out at http://theconcussionblog.com/

Spring Motivation

Each spring I get fired up, sign up for a few 10k's, maybe a sprint tri, and try to get going again.  I guess it's my way of breaking out of winter hibernation in Maine.  Last night I came across this video which was both emotional and inspiring.  Amazing stuff. 

Check out a Runners World Article on Ben here:


His personal blog/website: Ben Does Life            Hope you enjoy as much as I did!

History of Ironman...from a medical perspective.

I teach an online course each summer called The History of Athletic Training,  The premise behind it is that in order to better appreciate the present, we need to examine the past. It's easy to look at today and complain where we are at, but if you look a bit closer, and  further back, even a few decades, you can see we've come quite far in a number of areas.  In addition, it's nearing the start of triathlon season (yes!).  With those thoughts in mind, I devoured this article posted online a few weeks ago.

Check it out:  http://triathlon.competitor.com/2012/03/training/from-the-inside-triathlon-archives-iron-docs_49285

Some prevailing thoughts at the time (keep in mind this was the 80's):
1.   Glycogen runs out
2.   Electrolyte levels didn't change
Boy, has that changed over the years!

Triathletes have always fascinated me; the sacrifice of training in three separate disciplines certainly requires diligence and a level of self experimentation that is intriguing.  At any rate, if you are interested in working at one of these events, this article is a must read. 

Automated Internal Defibrillator in Action

After a discussion in class the other day regarding cardiac issues in sport, a student had asked if I had seen the following video.

One, I'm glad he is OK, and back on the pitch.  Two, I can't believe I didn't see this before (thanks Devon), but it is a tremendous testament to modern technology and athletics. In the AT world we often talk about managing cardiac events with an automated external defibrillator (AED) and CPR, but seldom how best to manage this situation.  It's a good reminder that appropriate emergency transport and testing should be completed prior to return to competition (which likely goes without saying, but there it is anyway).  It is highly likely future ATC's will be seeing more of these as both testing and technology advance.