Sports and Infectious Diseases – Part 3 of 3

17 04 2013

Guidelines for Before, During and After Each Sports Event

The NCAA and NATA and other sports organizations carefully spell out the standards athletic organizers, including coaches, teachers and others, should follow before, during and after an 558354119_c856022b30athletic event.

Before the Event Begins

As part of the “pre-game” education program, NATA encourages trainers to:

  • Educate athletes about bloodborne pathogens.
  • Discuss the ethical and social issues related to bloodborne pathogens.
  • Review the importance of prevention programs, including standard precautions and immunizations.
  • Educate athletes about the signs and symptoms of hepatitis B [and hepatitis C] and HIV.

Make sure the athletes know the rules concerning standard precautions, including reporting all wounds immediately if and when they occur.  This is part of the coach or trainer’s critical pre-game education.

Before the opening whistle, cover all wounds, abrasions, cuts or weeping wounds that may serve as a source of bleeding or as a port of entry for bloodborne pathogens.  Remember, protection is a two-way street.  No one wants germs entering or exiting these wounds or abrasions. The “cover” or bandages should be able to withstand the demands of competition.

Wear protective equipment over high-risk areas where bruising commonly occurs, such as elbows or hands.

Make sure the necessary equipment and supplies needed to comply with standard precautions are available, including latex [or other non-permeable] gloves, biohazard containers, disinfectants, bleach solutions, antiseptics, containers for soiled equipment and uniforms and sharps containers.

During the Event

Underscore the importance of early recognition and control of any cuts or bruises that bleed.  Coaches and athletes alike should be prepared for appropriate cleaning and covering procedures and changing of blood-saturated clothes.

Require all athletes to report all wounds immediately.  Players with active bleeding should be removed from the event as soon as practical.  Return to play should be determined by appropriate staff.

All personnel involved with sports should be trained in basic first aid and infection control, including standard precautions:

  • They should use sterile latex [or other non-permeable] gloves for direct contact with blood or body fluids containing blood.
  • Gloves should be changed after treating each individual participant.  After glove removal, hands should be washed.
  • Any surface or equipment contaminated with spilled blood should be cleaned with gloves on.  The spill should be contained in as small an area as possible.  After the blood is removed, the surface should be cleaned with a disinfectant or decontaminant.
  • Proper disposal procedures should be practiced to prevent injuries caused by needles, scalpels and other sharp devices.
  • Any equipment or uniforms soiled with blood should be laundered in accordance with hygienic methods.

Any life-saving equipment should be maintained in accordance with infection control guidelines.

After the Event

When the game is over, any wounds, cuts, and abrasions should be tended to.

Coaches and athletic personnel should constantly review the level of knowledge and implementation of standard precautions policies and recommend revisions and retraining where necessary.

Appropriate policy development with legal and administrative assistance of existing OSHA (Occupational Safety and Health Administration) and other legal guidelines and conference or school rules and regulations should be considered on an as needed basis.

Medical Records and Confidentiality

While many experts feel an athlete should not have to “disclose” an infection to a coach, trainer or teacher, some athletes may decide personally to share information about a bloodborne viral infection.

The security, record-keeping and confidentiality requirements and concerns that relate to athletes’ medical records generally apply equally to those portions of athletes’ medical records.

Because social stigma is sometimes attached to individuals infected with HIV or viral hepatitis, athletic officials should pay particular care to the security, record-keeping and confidentiality requirements that govern the medical records for which they have a professional obligation to see, use, keep, interpret, record, update or otherwise handle.

An Infected Trainer, Teacher or Coach

A coach, teacher or trainer infected with a bloodborne pathogen should practice his or her profession while taking into account all professionally, medically and legally relevant issues raised by the infection.

Depending on individual circumstances, the infected coach, trainer or official must take reasonable steps to avoid potential and identifiable risks to his or her own health and the health of his or her team.

More information may be found at PKIDs’ Infectious Disease Workshop

Image courtesy of PShanks





EMRs and Privacy. Mutually Exclusive?

12 02 2010

Has your doctor been walking into the exam room with a computer or some sort of electronic gadget instead of the paper-stuffed chart that holds your medical history?

If so, she’s switched to the Electronic Medical Record (EMR), a modern-day version of that paper chart.

An EMR system has a lot of pluses going for it. It links with other electronic systems, allowing the physician to do evidence-based research on the fly, it’s easier to quickly find laboratory and diagnostic testing results that can reduce test duplication and delays in treatments, and it improves the accuracy and reliability of medical records in the patient’s chart.

Great as all this sounds, physicians can identify the drawbacks of widespread access to very personal, highly confidential health information. One study in Massachusetts found that over half of the physicians reported being somewhat or very concerned about the possibility of privacy abuses. Another study among mental health care providers found that over half of the psychiatrists, psychologists, nurses and therapists surveyed were uncomfortable recording highly confidential information in an electronic health record.

The HIPAA Privacy Rule exists to protect abuses of a patient’s confidential information by requiring safeguards within the electronic system to protect private health information and by setting limits and conditions on how the information can be used and shared.

This is the challenge of EMRs: to allow appropriate access for health care providers while ensuring that personal health information is secure and safe from the potential for abuse.

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