Providing Reasonable Accessibility to Medical Care at Events

January 17, 2012

The Ball is In Your Court:

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

Does your organization provide reasonable accessibility to medical care during recreational activities? A recent Federal Court case addressed this issue, with the Court denying the Defendant’s motion to dismiss the case and so the matter will proceed to trial unless the parties are able to enter into a settlement agreement. See: Estate of Newton v. Grandstaff, 2011 WL 2678933 (July 8, 2011).

The facts of the case are that De Shawn Newton was participating in a basketball tournament involving 128 teams at a YMCA facility in Dallas, Texas. Newton apparently played well in the first half of the game and was seated on the bench, when he suddenly went into cardiac arrest. The coach attempted CPR, but no one else came to his aid. Newton apparently had a congenital respiratory condition and heart defect. Emergency medical personnel were ultimately dispatched, but allegedly could not enter the facility and so no professional care was available for 30 minutes. The Plaintiffs alleged that Defendants failed to “hire or arrange for any medical personnel, or trainers certified in administering CPR, to provide first aid to injured players in need of medical attention; provide for any emergency medical equipment, such as a defibrillator to be available in the event of a medical emergency; and provide effective ingress and egress to the facility that would have allowed emergency medical personnel to access quickly the premises and render immediate and necessary medical aid.” Plaintiffs alleged that Newton would not have died if the proper safety measures had been taken. Defendants took the position that they had no duty owed to Newton.

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Campus Recreation in the 21st Century:

January 17, 2012

Addressing Over-Exercise and Eating Disorders

Adrian A. Shepard
Coordinator of Integrated Wellness
Winona State University

The college experience prepares young adults for meaning, purpose, and success by providing the tools necessary for living well-balanced lifestyles. Life-long learning transcends the classroom and extends well into student life and, more specifically, campus recreation. Recreation significantly impacts and influences the lives of college students via the missions set forth by campus recreation departments and woven into the fabric of university life. With an overall shift towards whole person wellness how do we address high-risk behaviors such as over-exercise and eating disorders occurring within the campus recreation setting?

Questions seeking best practices and the identification of universities with established protocols for addressing over-exercise and eating disorders in campus recreation are routinely posed through professional association listservs and at conferences. Though few, campus recreation literature specific to the subject including the role campus recreation professionals can play and suggested strategies has been published in the Recreational Spots Journal (RSJ) in 1989 and 1998.

In December 2009 an Institutional Review Board (IRB) and National Intramural-Recreational Sports Association (NIRSA) research clearinghouse approved study was administered to NIRSA members about over-exercise, anorexia, and bulimia. The NIRSA National Center (NNC) identified a sample population that included one professional from each of the NIRSA member institutions with a professional fitness and/or wellness employment position. During a two-week span 128 of 258 people responded for a 50% response rate. In 2011, the results and implications were published by RSJ in an article titled Assessing Over-Exercise, Anorexia, and Bulimia in Campus Recreation.
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Evidence-Based Risk Management: Changing the Zeitgeist

January 17, 2012

Matthew D. Griffith, M.S., RCRSP
Georgia Institute of Technology

In the past two decades, a new way of thinking has taken over the practice of medicine. The central premise is that decisions in medical care should be based on the latest and best scientific knowledge. Dr. David Sackett and colleagues define evidence-based medicine as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (1996). The movement has now grown into a storm of physicians committed to conducting, disseminating, and applying valid and reliable research to clinical care.

If you found yourself thinking “what else besides evidence would guide my doctor’s decisions?” then you are naïve about how humans generally make decisions. Although there are thousands of medical studies conducted each year, physicians don’t use much of it. In How Doctors Think, Dr. Jerome Groopman references research that show only about 15% of physician’s decisions are based on sound evidence (2008). Instead of evidence, doctors more often rely on obsolete knowledge gained in medical school, long-standing but never proven traditions, patterns gathered from experience, methods they are most skilled in applying, and information from vendors with products to sell.

Unfortunately, the same behavior holds true for risk managers in recreation and sport. In fact, it could be argued, that risk managers are far more ignorant than doctors about which prescriptions are reliable–and less willing to find out. It’s time to move the zeitgeist away from making decisions based on ideology and unsystematic experience toward those based on the best available evidence.

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Athletic Trainer Risk Management

January 17, 2012

The Ball is In Your Court

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

On August 12, 2011, a Federal Court in Alabama issued a decision in a case in which a former football player at Auburn University sued a former athletic trainer at Auburn for failing to supervise his rehabilitation properly. See Ramsey v. Gamber, Slip Copy, 2011 WL 3568911 (2011). Plaintiff Ramsey had been injured while doing weight training at the University. His athletic trainer thereafter collaborated with doctors to design a rehabilitation plan. Ramsey alleged that Gamber “improperly ordered him to perform weighted exercise before it was safe for him to do so, in violation of doctors’ instructions.” In the Court’s decision, it sympathized with the Plaintiff’s “distress over the injury that cut short his athletic career” and noted that it was “deeply regrettable that Auburn University terminated his football scholarship because of an injury he had little ability to prevent.” The Court went on to conclude that Ramsey’s case was properly dismissed as he was not able to prove that Defendant’s misconduct caused his injury.

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Emergency Action Planning

January 17, 2012

New Webinar Series on developing an effective EAP

Sean Ries, Associate Director
Campus Recreation Services
Cleveland State University

Campus Recreation departments must have an effective Emergency Action Plan (EAP) in place. The plan needs to cover all possible emergencies (e.g. medical emergency, fire, evacuation, severe weather, chemical spill etc.) and be consistent between all program and facility units within the department. Everyone in the department (full and part-time staff) needs to be well trained.

At Cleveland State University, effective and efficient emergency response is a top priority for Campus Recreation. Over the years, a comprehensive EAP has been developed, tested and refined, and consists of two key elements:

  1. Developing the EAP framework
  2. Training staff on EAP implementation

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Double Vision — The Coach as Lifeguard

December 08, 2011

Can a coach safely do double duty?

Jen Knights
Program Coordinator — Aquatics
University of Western Ontario

It sounded like a watermelon hitting the sidewalk. I knew something was wrong before I even looked up. I was on deck in a supervisory role during a diving practice. The Coach was working with his athletes and there was a Lifeguard guarding the pool as well. I remember being at the lifeguard station tidying up and hearing usual pool sounds including the sound of divers rebounding off the end of the springboards. Then — thunk. I began to move towards the diving boards and saw the Coach in the water and the Lifeguard en route. As I approached the scene for a brief moment I was fuming — wondering why the Coach in the water before the Lifeguard. But then I realized the Coach was in the water because it was his athlete he was supervising, and he knew all too well the sound of a diver in trouble.

Lifeguards use all of their senses while on duty — we observe directly with our eyes, use our hearing to listen for the unusual, employ our sense of smell when people decide to toss eucalyptus (or urinate) onto sauna rocks, and our sense of touch when moving across an uneven or slippery pool deck before entering the water to perform a rescue. Following an emergency situation or rescue it is not uncommon for a Lifeguard to vividly remember a specific sight, or smell, or sound — forever. That memory becomes embedded in your brain and gets tucked away for future reference. The diving Coach knew that sound and the Lifeguard did not, but certainly does now.

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