You can learn a lot by reading the directions

Many times you can learn a few things or refresh your memory when you read through instructions that come with various items.  In this case, after replacing a Hydrocollator pack in my unit I took a look at the included Instructions/Precautions. Here are some items that people may have forgotten or never knew.

When using a brand new pack you should soak the pack for 2 hours.

A hot pack can be heated by using a large pan on a stovetop, a microwave, or a Hydrocollator unit.

To vary the heat intensity, increase or decrease the number of toweling layers.

Storing Hot Packs

If storing out of water, place hot pack in a sealed plastic bag and store in the freezer.  Letting the pack dry out on its own results in a lumpy pack that never seems to smooth out again.  We drain our hot packs and store them in the freezer each summer.

Caution

Treatment time should not exceed 30 minutes

DO NOT apply over insensitive skin or in the presence of poor circulation

Never lay or sit on top of the hot pack (frequently abused in the ATR)


DO NOT use hot pack directly over cuts, abrasions or wounds.

Warnings

DO NOT apply pack directly to-skin;

Individuals with circulatory problems should consult with a physician before using this product.

DO NOT sit or lie on the hot pack.

DO NOT add chlorine additive to water.

DO NOT allow pack to come in contact with hydrocarbons (e.g., Comet®, Soft Scrub®, etc.).

Cleanliness

You can tell a lot about an athletic training room by the condition of their Hydroccolator unit.  Is the water cover the packs?  Is the water clear? Are the packs in good condition?  Are there enough packs in the unit?  It is advisable to check the water level frequently.  Draining and rinsing the unit and the packs frequently will help avoid that cloudy water appearance.  

Covers
 
Covers can be standard terry cloth towels or terry covers specifically for hot packs.  They should be laundered frequently.

Link to Blog Regarding the Masters as Entry Level

Great commentary on the master's degree as the minimum degree for Athletic Training.

http://atissues.wordpress.com/

The Hydrocollator

The Hydrocollator, made by Chattanooga,  is a hot pack unit. There are other manufacturers but Chattanooga has been around the longest so I will refer to all hot pack units as a hydrocollator.

The hydrocollator, that ubiquitous piece of equipment that is found in almost every athletic training room along with a whirlpool and ice machine, is a modality that is used constantly but never gets any recognition. This is a machine that will last a lifetime as I have units that are older than the students being treated by it.  You can tell a lot about an athletic training room by its hydrocollator.  This was brought to my attention recently by a student's comment.  He asked why the water in our hydrocollator was so clean and other schools were so dirty.  I got a good belly laugh out of that statement. You see I do something that I find very few facilities do.  I periodically clean my unit.  You know what I also have done?  I have read the instructions on both the unit and the packs themselves.  You can learn a lot about things by reading the directions.

So I thought this would be a great topic, "Caring for Your Hydrocollator".  Did you know that it is recommended that you change the water every two weeks in your hydrocollator?  I have seen some units that look like the water has never been changed. Sometimes these units even smell bad.  You also need to check the water level daily.  You will lose water through evaporation and high use.  If a pack  has a tear in the fabric the filler will leak out into the water and also onto the toweling.  Dispose of these pack immediately and change the water. This is what contributes to the murky water. You should always have a supply of spares on hand.  Chattanooga lists the pack's life span as one year, while many of us get see them last much longer than that.  Frequent cleaning of the toweling is also essential.

Another mistake that people make is when the unit is not used for long periods, such as over the summer.  You have two choices, leave the unit on but make sure that the water level is checked periodically so it does not evaporate. The second option is to drain the unit and shut it down for the period of time.  The most important thing to do in this case is care and storage of the hot packs themselves.  They should be put separately into plastic bags and stored in a freezer.  I have used this technique for years and it works great.  If you do not and just let the packs dry out over time they will never be the same.  If you have ever seen a pack that looks like it is full of chunks and not expanded out fully, then the pack has been allowed to dry out.  Once this happens it will never return to its normal form and thereby not retain as much hot water, making the pack cool down faster.

We also have a few rules in our athletic training room concerning the hydrocollator unit.  Athletes are never allowed to retrieve a hot pack themselves and we do not allow athletes to sit or lie on top of a hot pack.  Hydrocollator units seem to last a forever but when they do break down they are relatively easy to fix.  I have replaced a few heating coils in my day. If you would like to actually read the directions for Hydrocollators you can follow this link. So if you want people to recognize your facility for it cleanliness, take some time and clean your unit.

Cheerleading and Catastrophic Injuries

"Cheerleaders incur two-thirds of all catastrophic injuries to female athletes in high school and college. According to the National Electronic Injury Surveillance Survey, emergency room visits increased110 percent from 1990 to 2002. In 2007 alone almost 27,000 cheerleaders ended up in the ER, one in six for head or neck injuries" Those are quite the statistics and certainly cause for concern. These statistics are from the Catastrophic Sport Injury Research 28th Annual Report 2010 by Dr. Frederick O. Mueller of the National Center for Catastrophic Sport Injury Research. Too often athletic trainers look upon cheerleaders as a nuisance.  They are not considered a sport by various governing bodies so therefore they are treated differently in regards to physicals, athletic trainer access, and practice coverage. We never see them until an injury occurs which usually happens at the same time we are covering another contest. They become a distraction from our main duty and we sometime resent them for it. This does not change the fact the fact that it is a dangerous sport/activity (you decide). The federal government does not consider cheerleading a sport for purposes of Title IX. Cheerleading has evolved from the sideline cheer to a variety of gymnastics and dance routines, and sometimes all choreographed to music.

Dr. Mueller makes some recommendations in his report:

1. Cheerleaders should have medical examinations before they are allowed to participate.Included would be a complete medical history.

2. Cheerleaders should be trained by a qualified coach with training in gymnastics and partner stunting. This person should also be trained in the proper methods for spotting and other safety factors.

3. Cheerleaders should be exposed to proper conditioning programs and trained in proper spotting techniques.

4. Cheerleaders should receive proper training before attempting gymnastic and partner type stunts and should not attempt stunts they are not capable of completing. A qualification system demonstrating mastery of stunts is recommended.

5. Coaches should supervise all practice sessions in a safe facility.

6. Mini-trampolines and flips or falls off of pyramids and shoulders should be prohibited.

7. Pyramids over two high should not be performed. Two high pyramids should not be performed without mats and other safety precautions.

8. If it is not possible to have a physician or certified athletic trainer at games and practice sessions, emergency procedures must be provided. The emergency procedure should be in writing and available to all staff and athletes.

9. There should be continued research concerning safety in cheerleading.

10. Cheerleading coaches should follow the concussion policy and guidelines published by the NFHS.

11. Cheerleading coaches should have some type of safety certification.

12. The NFHS should make cheerleading a sport, which will place cheerleading under the same restrictions and safety rules as all other high school sports (physical exams, qualified coaches, safe facility, athletic trainers, practice limits, and starting and ending dates for practice and games or competitions). The NCAA should follow this same recommendation.

As Health Care providers we need to look past our own personal prejudices and accept the fact that cheerleading is dangerous and we may be called upon to deal with injuries ranging from serious to catastrophic. The best route is to be proactive in regards to yours and your schools administration of the sport. They should be treated the same as any other sport.  Physicals should be mandatory, access to the athletic training room should be no different than it is for any other athlete, they should be included on the athletic insurance policy, and practice coverage extended to them. Cheerleading coaches should be qualified and safety certified.  This they can do through the American Association of Cheerleading Coaches and Administrators  (AACCA). It is not a governing body as much as it is a business entity promoting the sport.  Even though, they do have an interest in keeping cheerleading as safe as possible. Take a look at their Safety Rules. Guidelines that any school would be smart to implement.

The best course to follow in reducing these serious injuries in Cheerleading is to have coaches that are properly trained, have safety guidelines installed, and have access to the health care that there athletes deserve.

Software you can use

You could write a book on all the different software programs out there that can be of use to the athletic trainer.  I am just going to cover a few that I use on a routine basis.

The first is PDFcreator. It is an open source program, which means it is a program that usually has been collaboratively developed and released to the public free of charge for use and personal modification.  If you do not have Adobe Acrobat, (not the reader version which is free) to turn any file into a pdf you can install PDFcreator and it will show up as another selection in your printer list.  Print the file to PDFcreator and you have your pdf file.  You can also combine different pdf files into one file.

A utility that I find indispensable is CCleaner.   CCleaner use to be called Crap Cleaner until they changed the name. A quote from the CCleaner website explains the software.

"CCleaner is our system optimization, privacy and cleaning tool. It removes unused files from your system - allowing Windows to run faster and freeing up valuable hard disk space. It also cleans traces of your online activities such as your Internet history. Additionally it contains a fully featured registry cleaner."

The files that it removes are not integral to your computers working.  More than likely it will speed up your computer.  When you surf the web a lot you will accumulate all kinds tracking cookies.  These cookies communicate back to their source bits of information.  If you have enough of them your computer slows down as the amount of communication increase. It also empties your temporary internet files.  If you surf a lot this can up to gigabytes of data.

The ability to remotely log into you computer remotely from another computer is a godsend. I have two offices at my school and thereby two computers.  I also have one at home along with a laptop. Windows has a program called remote desktop connection. It can be found under Program -- Accessories -- Remote Desktop Connection.  With this program I have the ability to log onto any of my computers as long as they are turned on and have an internet connection.  I can continue to work on a project that I started on one of my office computers or email myself a file.  You can use this program from any Windows computer as long as you know the remote IP address of the computer you want to remote on to.  You may need to get your ITech people to help you set this up. There are limitations to this program, see this microsoft link. You can find your computers IP address by simply going to the website "whatismyipaddress".

If that does not work for you then try Team Viewer. This is another remote access program that is free to use as long as it is not used for commercial use.  This program allows you to do much more.  You can transfer files back forth between computers, do voice and video over the internet, and even do a remote reboot and be able to log back on.  I do not use this for work but do use it to remote into my parents computer and while talking with them over the phone correct any issues they may be having.  Both computers must have the software installed and the remote computer must be on and connected to the internet.

The last program I will speak about is YouTube Downloader. This program allows you to download You Tube videos and many other video sites by pasting the URL into the programs download box.  It will automatically download the video into a .flv (flash video file) The program then gives you the option of converting that file into a number of different video formats.  These include MOV, WMV, AVI and MPEG-4.  You can also convert just the soundtrack to a .MP3 file. This is great if you are looking for videos for a PowerPoint.  You can also use the converter by itself to convert videos you already have to another format.

Athletic Training Room Design Resources

Most every athletic trainer has had to design an athletic training room at some point. Many of us have had to do this as class project along with a budget.  Some of us have had the opportunity to be involved in the design and construction of a new facility.  I would like to offer a couple of resources for the budding architect to consider.  The final result will look much better than the pencil and graph paper drawings.

The first resources is a website called www.floorplanner.com It is  very easy and intuitive to work with. You design your layout directly on the webpage.  Set the dimensions, wall thickness, windows and doors. It even offers small images of furniture to place in the layout.  You can make a simple table re-dimesioned to stand for a treatment table.  Install a sink, desk, and chairs.  There is even some images of exercise equipment.  You may have to get imaginative to place whirlpools, ice machines and rehab equipment.  For that you can insert a text description. A great resources for student projects or for the AT who like to visualize their ideas.  Floorplanner is free for one user and one project.  Up to five projects a year will cost you $14.95.

Another resource for the more serious user is Home Plan Pro.  With a much steeper learning curve it is free fro the first 30 days.  Beyond that it costs a one time fee of $39.00. The steeper learning curve allows you design in more detail.  You also have many more figures to choose from.  I purchased this product 15 years ago and have had free updates ever since.  I have used it to design remodels to three separate facilities.  I could make different layouts and have staff discussions on which one would work best.  One of the really nice features is the ability to create your own figures.  You can then insert that figure into the layout and it will be the correct dimensions for the room. Here is an example of a layout that I created sometime ago.

Within the drawing are a number of ready made figures such as the desks, chairs, and counters.  For specific athletic training equipment I created clip files.  Clip files are just smaller drawings placed within the larger design layout. Examples are below:

The item on the left is a taping unit.  The items on the right are three separate files.  A treatment table, a modality cart, and a split leg table.  I can mix and match these figures as I need.  They are also drawn to the dimensions of the actual items. If anyone is serious about using this program you can email me and I will send you the clip files I have already created.  This will save you a lot of work.

Feel free to go online and explore these programs.  You may find them very useful either now or in the future.