ATC cheat sheet

Preparticipation examination components: personal and family medical history, cardiovascular screening (exertional syncope, chest pain, family sudden death before age 50), general physical exam, and orthopedic screening; outcome is clearance, clearance with restriction, or deferral.

Heat acclimatization requires roughly 10 to 14 days of progressive exposure; plasma volume expands and core temperature and heart rate at a fixed workload fall.

WBGT risk bands: below 18°C low, 18.3-23.2°C moderate, 23.3-28.1°C high, above 28.2°C extreme; intense activity is modified or cancelled in the high and extreme bands.

Flash-to-bang: seconds between flash and thunder divided by 5 estimates distance in miles; a count under 30 seconds means immediate shelter, and activity resumes 30 minutes after the last thunder.

Hydration targets: about 5-7 mL/kg body weight at least 4 hours before exercise, 3-5 mL/kg when urine is dark, and during exercise roughly 400-800 mL/h titrated to measured sweat rate.

Static stretching: hold at mild tension 15-30 seconds for 2-4 repetitions per muscle group; dynamic movement patterns are preferred in the immediate pre-competition warm-up.

Skin infection control in contact sports: daily disinfection of mats and equipment, immediate showering after practice, covering lesions, and excluding athletes with active herpes gladiatorum until lesions are dry.

Intrinsic risk factors include age, sex, body composition, malalignment, muscle imbalance, limited flexibility and prior injury; extrinsic factors include equipment, surface, training load, and weather.

HOPS sequence: History, Observation, Palpation, Special tests; the history portion usually yields the diagnosis more often than any single special test.

SOAP documentation: Subjective (athlete report), Objective (measured findings), Assessment (clinical impression), Plan (treatment, referral, return-to-play status).

Knee special tests: Lachman at 20-30° flexion is most sensitive for ACL; McMurray for meniscal tears; valgus and varus stress for MCL and LCL; posterior sag and posterior drawer for PCL.

Ankle and lower leg: anterior drawer stresses the ATFL, talar tilt stresses the calcaneofibular ligament, and an absent plantar response to calf squeeze (Thompson test) indicates Achilles rupture.

Shoulder tests: apprehension and relocation for anterior instability, Neer and Hawkins-Kennedy for impingement, empty can for supraspinatus, Speed test for biceps pathology.

Reflex nerve roots: biceps C5-C6, brachioradialis C5-C6, triceps C7, patellar L4, Achilles S1.

Key dermatomes: C6 thumb, C7 middle finger, C8 little finger, T4 nipple line, T10 umbilicus, L4 medial leg, L5 dorsum of foot, S1 lateral foot.

Ligament sprain grading: grade I mild with no laxity, grade II partial tear with a soft endpoint, grade III complete tear with no endpoint and gross instability.

Adult CPR: 30 compressions to 2 breaths, rate 100-120 per minute, depth 5-6 cm with full chest recoil; apply an AED as soon as it arrives and rotate compressors every 2 minutes.

Primary survey order: responsiveness, airway, breathing, circulation with severe bleeding control, disability, then environment; the secondary survey (vital signs, head-to-toe) follows only after life threats are managed.

Suspected spine injury: maintain manual in-line stabilization; remove helmet and shoulder pads only if they obstruct the airway, and log-roll the athlete as a unit onto a spine board.

Exertional heat stroke: core temperature above 40°C with central nervous system dysfunction requires immediate cold-water immersion, cooling to below 39°C within 30 minutes, and transport.

Anaphylaxis: epinephrine 0.3 mg intramuscularly in the vastus lateralis of the lateral thigh, repeated in 5-15 minutes if symptoms persist; antihistamines are adjuncts only and never delay epinephrine.

Shock management: position supine with legs elevated, maintain body warmth, give nothing by mouth, monitor vital signs, and activate emergency medical services.

Splinting rule: immobilize in the position found, cover open wounds before splinting, and reassess pulse, motor, and sensory status before and after application.

Concussion: remove from play immediately, no same-day return to activity, and monitor serially for worsening headache, vomiting, seizures, or declining consciousness that warrant transport.

Healing phases: inflammatory (day 0-6), proliferative or fibroblastic (day 3-21), and maturation or remodeling (weeks to as long as 12 months); rehabilitation goals are matched to phase.

Cryotherapy application of 15-20 minutes with a barrier; contraindications include cold hypersensitivity, Raynaud phenomenon, impaired local circulation, and application over regenerating peripheral nerve.

Therapeutic ultrasound frequency selects depth: 1 MHz for deep tissue roughly 3-5 cm, 3 MHz for superficial tissue 1-2 cm; continuous mode is thermal, 20 percent pulsed mode is nonthermal.

Ultrasound contraindications and precautions: pregnant uterus, malignancy, pacemaker, thrombophlebitis, epiphyseal plates, impaired sensation, and over eyes, ears, or the heart.

TENS relies on gate control theory: high frequency 80-120 Hz for acute pain relief, low frequency 2-10 Hz proposed to trigger endogenous opioid release.

Rehabilitation progression: control pain and edema, restore full range of motion, rebuild strength, develop endurance and power, then advance to sport-specific functional training.

Eccentric loading is used to remodel tendon in tendinopathy because it generates high force at low metabolic cost; isometric exercise is used early for pain modulation.

Return-to-play criteria: pain-free full range of motion, strength at least 90 percent of the uninvolved side, and successful completion of sport-specific functional testing.

Negligence requires four elements proved together: duty owed, breach of that duty, causation linking the breach to harm, and actual damages.

Legal scope of practice is defined by state athletic training practice acts; the BOC sets certification and continuing education standards but does not grant legal authority to practice.

Documentation must be objective, timely, and unaltered; incident reports are completed for injuries and near-misses and are separate from the medical record.

HIPAA permits release of only the minimum necessary protected health information to those with a need to know; FERPA governs education records for student-athletes.

Informed consent elements: nature of the proposed care, foreseeable risks and benefits, reasonable alternatives, and voluntary right to refuse; minors generally require parent or guardian consent under state law.

BOC continuing education: 50 continuing education units per two-year reporting cycle, distributed across defined categories including evidence-based practice and professional responsibility.

Insurance layers: general liability covers the facility or sponsoring organization, professional liability or malpractice covers the individual clinician, and secondary or excess policies pay after primary coverage.

OSHA bloodborne pathogens standard requires a written exposure control plan, offer of hepatitis B vaccination, universal precautions, and post-exposure evaluation and follow-up.