Medications and Athletic Training Part II:
Prepared by Dr. Eric Fuchs, LAT, ATC, NRAEMT, SMTC
Part II of this blog on medications and athletic training addresses the questions surrounding AT’s who work with youth sports. More specifically, for example are factors such as parental consent necessary to obtain with the handling and administration of medication. This may seem as simple as saying, athletic trainers’ working with minors will administer no medication; however, this as a policy could be problematic when faced with anaphylaxis and need for epi-pen or asthmatic in need of an inhaler should an emergency arise. And what if a minor is dropped off at camp for a day or an overnight and is taking prescription medications? Many athletic trainers and their supervisors often feel the solution is to have the youth athlete or parent provide their inhaler or epi-pen to the AT, but this practice based on many state laws may place your employees in violation of state or federal law by transporting or possessing medication not prescribed in their name. Additionally, as an administrator what if your employee forgets to give Suzie or Johnny back their inhaler or epi-pen after the practice or game and they have an allergic reaction, while eating out with their friends? This act of failing to return the medication creates a potential for liability exposure.
Best practice is to develop policies, procedures and protocols, where athletic trainers are provided the required and/or needed emergency medications through a supervising physician, if allowed by law and include training on how to administer them in compliance with the state practice act and any applicable federal laws. As always, training should be document. This helps to assure your sports medicine staff is prepared with needed medication when a medical emergency arises. For Example, a situation I can think of occurred while working at a youth event in a very large sports arena (NFL Stadium) and a patient with a known allergy to peanuts became exposed and was going into anaphylaxis. When we asked if the parents had an epi-pen, the mom said “dad was running out to the parking lot as it was left in car”; however, by having epinephrine on-site with our sports medicine staff and protocols in place with supervising physician we were able to render quality patient care in this emergency situation.
Another consideration is the need for both OTC and prescription medications requirements to have a detailed inventory and documentation of administration. These records should include, the route, dose, quantity, patient demographics, condition, lot# and any additional information in accordance with the requirements in state practice act, state pharmacy laws, and federal laws and regulations. The Board of Certification (BOC) Standard of Professional Practice 7 requires athletic trainers to document all procedures and services in accordance with federal and state law. Any discrepancies or failure to document medication inventories or administrations could create liability exposure.
Have you thought about the following: If you received notification from the FDA on a recall for a medication, could you identify all patients who were administered the recalled OTC or medication by your providers? This would be the expected standard of care in order to inform them of the recall and follow up with any concerns or adverse side effects.
In addition to these previously discussed concerns, an athletic trainer or administrator must consider what methods are being taking to assure medications staff transport are properly stored and secured. Are serial numbers being used? What about tab locking devices, which have an inventory sheet matching what was in the secured kit, quantity, lot number, etc…? This allows you to know that if the tab is broken what medications were used or are missing (risk of theft) in accordance with state and federal laws regarding medication storage.
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This two-part blog series on medications and the athletic trainer is shared to provide administrators and athletic trainers with the understanding of how to mitigate liability risk associated with medications through development of comprehensive, protocols, policy and procedure, professional development and staff training when making the decision to utilize medication, whether OTC or prescription in their clinical practice. A best practice approach would be to put together a committee or task force of stake holders, to include AT’s, Supervising physician, pharmacist, risk management &/or legal counsel to review and develop a protocol to provide for your patients’ needs, which mitigates liability if the comprehensive protocols are followed1. 1. Fuchs, E. (2020) Chapter 5: Emergency medications and administration. In Cleary, M.A. & Walsh, K. Acute and Emergency Care in Athletic Training. (pp. 105-131). Champaign, IL: Human Kinetics
2. Board of Certification (2018) BOC Standards of Professional Practice Version 3.2 Implemented January 2019. Retrieved 11/29/2020 from: https://7f6907b2.flowpaper.com/SOPP012019/#page=1
This blog was written by Dr. Eric Fuchs, LAT, ATC, NRAEMT, SMTC