Newsletter Articles

Getting Ahead of Head Injuries in Sports and Recreation

May 12, 2011

Katharine M. Nohr, Esq.
Nohr Sports Risk Management, LLC

On March 18, 2009, headlines all over the world announced that actress Natasha Richardson died from a head injury she sustained from a fall on a Quebec ski slope. An autopsy revealed that she sustained an epidural hematoma, causing bleeding between the skull and the brain’s covering. Such bleeding from a skull fracture may quickly produce a blood clot which puts pressure on the brain, forcing the brain downward. This impacts the brain stem that controls vital functions, including breathing. Logically, if all of that is happening it should be obvious and immediate medical attention would be sought. That is not the case. It is common for people that suffer head injuries to feel fine initially as it takes some time before symptoms emerge. Dr. Keith Siller of New York University Langone Medical Center, when interviewed in relation to this tragedy explained that, “This is a very treatable condition if you’re aware of what the problem is and the patient is quickly transferred to a hospital.”

The news coverage about Natasha Richardson, generally reported that she was a beginning skier who declined to wear a helmet for her ski lesson. She felt fine after her fall and turned an ambulance away at approximately 1:00pm. She later developed a headache and medics returned at approximately 3:00pm. As her condition deteriorated, she was driven from a local hospital to a Montreal hospital, not arriving until approximately 7:00pm. There were no medivac helicopters or airplanes available.

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Risky Business: Abandoning Risk Management Practices in a Poor Economy

May 12, 2011

Katharine M. Nohr, Esq.
Nohr Sports Risk Management, LLC

The newspaper headlines report daily on failing business, lost jobs, stock market plunges and government bailouts. It looks like this recession is here to stay for awhile at least, and so schools and recreational facilities are faced with decreased revenues and increased costs. Budgets are being prepared for 2009 and beyond with plans to slash unnecessary expenses and programs. Before an organization cuts its risk management budget and decreases insurance coverage in order to save on premiums, it is important to consider that declining economic conditions lead to increased incidences of insurance fraud. Accordingly, lawsuits increase during a bad economy as those that are injured seek compensation, exaggerating their injuries or placing blame on others when, in a good economy, they might have accepted the blame themselves.

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Learning Outcomes: Part I

May 12, 2011

Accountability in Campus Recreation

Wallace Eddy, Ph.D.
Associate Director
Campus Recreation Services
University of Maryland (College Park)

Introduction & Overview

After reading this article, you will be able to articulate in your own words the main tenets of learning outcomes, describe the difference between indirect and direct assessment measures, and list at least two forms of assessment used to measure learning outcomes. How will I know if you have achieved these outcomes? I won’t, but after reading this article, hopefully, you will have a basic understanding of learning outcomes, a beginning point for developing learning outcomes for your department, and an understanding of the assessment issues involved in a learning outcomes program.

Why bother with learning outcomes? The notion of public accountability for what we claim to achieve in higher education is a trend that appears to have staying power. When our university was in the re-accreditation process, the area of primary focus of the accrediting body was assessment, and specifically on the assessment of learning outcomes. Of course, it is impossible to assess something that has not been explicitly stated. The university began a process whereby all departments in all colleges would develop a number of learning outcomes and assessment measures related to those outcomes resulting in assessment plans.

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Learning Outcomes in Campus Recreation: Part II

May 12, 2011

From Accountability to Enhancement

Wallace Eddy, Ph.D.
Associate Director
Campus Recreation Services
University of Maryland (College Park)

The first article on learning outcomes dealt with the “what” of learning outcomes; this second part deals with the “how.” Is there anything more daunting to creativity like a blank page, canvas, or slate? Although you may be just getting started in the process of creating learning outcomes documentation, the learning is already occurring. So you really aren’t facing a blank page. How do you identify the learning that is taking place in your department or organization? To illustrate the process, I offer a case study of sorts, using the Challenge Course Supervisor position at our university.

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Physical Activity Readiness Questionnaire: Ready or Not?

May 12, 2011

April Boulter
Fitness, Aquatics and Special Events
Loyola University Chicago

The promotion of physical activity within a comprehensive recreation program is an important component for all Campus Recreation Departments. As part of a risk management assessment, many universities are evaluating the pre-activity screening process. While nearly all universities require participants of their Personal Training program to complete a Physical Activity Readiness Questionnaire (PAR-Q) as well as a health history questionnaire, very few universities require the general population to complete the same paperwork. Although most individuals are at very low risk for an exercise-related cardiovascular event, the risk of adverse cardiac events is considerably higher during or immediately after exercise, especially in habitually sedentary individuals engaging in vigorous physical activity (American College of Sports Medicine [ACSM], 2007). Researchers have concluded that, in general, risk of heart attack is about two to six times higher during strenuous exercise than during light physical activity or rest (Balady, 1998). The risk of a cardiovascular event is highest in persons with known heart disease.

An important challenge facing campus recreation facilities is to provide a motivation toward participation in an exercise program while minimizing the potential risk of an adverse medical event during or after exercise (ACSM, 2007). In years past, some lawyers and risk managers have recommended that fitness professionals not engage in pre-screenings. The advice was based on the concept that if the information was received from clients and misinterpreted, it could create liability for the facility in the event of a later injury to the client (Herbert, 1997). The American College of Sports Medicine’s guidelines require that every facility offering exercise equipment must provide a general pre-activity risk assessment, e.g., Physical Activity Readiness Questionnaire (PAR-Q), to all new/prospective members (ACSM, 2007).

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Good Swimmers Don’t Drown

May 12, 2011

Katharine M. Nohr, Esq.
Nohr Sports Risk Management, LLC

Multiple athlete drownings in triathlons have recently puzzled the multi-sport community. In July of 2008, a 60 year old male and a 52 year old male drowned in two different triathlons on the same weekend. A 32 year old male died during the swim of the New York City Triathlon the previous weekend.

Why do well-conditioned athletes die during the swim portion of the three discipline event, rather than during the more hazardous cycling portion or when they are more fatigued on the run? As aquatics safety expert Tom Griffiths has said, “good swimmers don’t really drown—they die of other specific causes, known as ‘drowning triggers,’ that predispose them to death in the water.” The trigger that commonly causes these mysterious drowning deaths is Jervell and Lange-Nielsen syndrome and Romano-Ward syndrome, which cause their sufferers to develop a sudden abnormal heart rhythm as a response to exercise or stress. These abnormalities can occur for no known reason in people who have “long QT” syndrome (“LQTS”), which refers to an interval seen on an EKG (electrocardiogram). Not everyone who has LQTS will develop a dangerous heart rhythm. However, when this does happen, it can be fatal.

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