Episode Transcript
[00:00:02] Speaker A: Welcome to the @pit crew podcast. This high energy show dives deep into the world of sports emergency care. Join us as we explore cutting edge strategies, real world experiences, and expert insights to help you step up your game in emergency care. We've got the tools, tips, and stories you need to be ready when seconds matter. It's time for the @pit crew podcast. We have the green light in three, two, one.
[00:00:32] Speaker B: Welcome to the @pit crew podcast. I'm Ray Castle. Today we're thrilled to have Kelly Lohr, the head athletic trainer at USA Lacrosse, joining us. Kelly is an expert in emergency care specific to lacrosse and will share valuable insights into EAP planning and the critical protocols for helmet removal during emergencies. You don't want to miss this. Let's jump right in. Welcome to the show, Kelly.
[00:00:56] Speaker C: Thank you. I'm very excited to be here.
[00:00:57] Speaker B: I'm excited to have you here. So the audience, we. We go at least at least one year back, right?
[00:01:03] Speaker C: Way back.
[00:01:04] Speaker B: Way back.
[00:01:05] Speaker C: We'll leave it at one year at this point.
[00:01:07] Speaker B: So, you know, I'm just thrilled to have you here. Kelly one, you know, you know, our longtime friendship, we worked together when you first started as a grad assistant, lsu and continue that, and I just love that. We love the things you're doing, not just with lacrosse, but what you do in, you know, you push out with the things you do in your personal life and everything else, and it exudes out, you know, just a bundle of fun. So you ready to get started?
[00:01:37] Speaker C: Yeah, let's do it.
[00:01:38] Speaker B: It's good. So, all right, so really simple audience, we just so you know, as a recap, before we move in, each question is a lap. We have 10 laps. We're going to roll right into it. And each question, then we'll get into our final lap, which is a speed round, which will be fun. And then we get into our victory lane. So, as we mentioned in the show, and you see this as well, Kelly brings a wealth of experience in emergency emergency care. And Kelly, if you don't mind, just sharing with you, my audience, quickly, what your current role is and what you do in terms of look. USA Lacrosse.
[00:02:18] Speaker C: Yeah, absolutely. So I work for a large health care system here in Maryland called MedStar Health. One of our biggest partners is USA Lacrosse. So I came on board almost eight years ago now, and they were really officially starting the partnership. I mean, the partnership itself goes back 20, 25 years, but officially, we are on paper about eight, nine years ago.
My role started out as, you know, doing some event coverage, AP planning, working with our facility that's here in Sparks, Maryland, to get them up and running, we host close to 200 events here on the field that are very lacrosse only lacrosse. So very lacrosse specific, but planning for those events, making sure that they have appropriate medical coverage, coordinated ems, all of those things. Now my role has shifted a little bit to help cover our national team. So we have 12 national teams that are run by USA Lacrosse. Eight of them are our senior level teams and we have four development teams. Actually we're adding two more this year, a U15 team as well. So we'll be up to 14, which is kind of wild. But I hope to oversee the medical for that. Making sure all of our policies and procedures are where they need to be and then planning for our teams to go and travel when they're playing. So world championships, they could be here in the country, out of the country, international. So helping to really coordinate that and make sure they have what they need.
[00:03:36] Speaker B: So that, that perspective you're going to bring in, I think which is really critical is understanding what happens in other parts of the country in world Championships this summer. Right. The women, women national team went over overseas, you've hosted world championships here. So this, and even down to the regular this, the typical events we have. So you're audience, we got, we got a packed show here, so get after it. So, you know, you, you talk about EAPs, Kelly, and start this off, you know, where we know there's such a, the critical role it plays in sports. It's the playbook, so to speak. So what, what makes EAPS and lacrosse different from other sports? Or is it different? And why is it important that you tailor them based on each individual venue, sport level, et cetera?
[00:04:25] Speaker C: Yeah, absolutely. So the base of the EAP I don't think is too, too much different. Right. We're still following all the guidelines that are put out. We're still making sure that, you know, we know where the medical facilities are, how to get in the, in the venue where we are and what we're going to do if an emergency happens. The biggest thing with lacrosse, obviously it's an equipment laden sport. So we need to know what kind of equipment our players are wearing, where on the field they would be wearing them and the difference between men and women. So men wear full, full equipment. They have chest protector, they have helmets, women don't have that. So unless you're a goalie wearing a helmet, typically we're not seeing women in anything more than the goggles that they wear. Occasionally we'll see Someone in headgear, but it's pretty few and far between unless you're in Florida where they do require that for their high school athletes. Um, but it's really important to be able to put into your EIP how you'd go about removing that equipment, what the equipment looks like and then what you do, you know, in the event that something happens. So just being prepared with what your team could wear and then with lacrosse is like what specific injuries could come out of that. So, you know, knowing the epidemiology with lacrosse athletes and the men's and women's side, so you know, Terry Nacio is getting concussion. Like what are you going to do if those injuries happen? And then some sport specific things. So lacrosse, we look at commercial cordis as being one of them. They recently changed the chest protectors to help try to prevent some of those injuries. But you may not see that in some other sports. So understanding like what those injuries that could occur and making sure that they're in your EAP is really crucial in lacrosse planning.
[00:05:53] Speaker B: So you mentioned about helmet removal and I know that, you know, here in the south, lacrosse is not. It's in a. It's a, it's a. If just it's growing. It's not, it's not a, it's not where it is probably in the Northeast, it's not a mainstay sport, but it is growing at a pretty rapid rate. So you know, with that, you mentioned the differences like you have helmet removal and it's very. That equipment is very different than the typical football helmet or you know, if you're not familiar with hockey or some or other sport or even softball, baseball, you know, helmet removal. So what are the key considerations that for me as an athletic trainer or anyone else that doesn't. Athletes are going to be EMS need to keep in mind regarding lacrosse equipment or helmet removal during emergency.
[00:06:39] Speaker C: Yeah, so the nice thing about lacrosse helmets, I think is that there's not a huge variety of brands of helmets. There's, you know, three main manufacturers of them. They all have to be NOXY certified. So we know that at least they're coming out like that. They don't necessarily have to be recertified every year like some other sports or like go through a check in process. And a lot of times because they're expensive, we see them getting kind of handed down. So younger players are starting to get these hand me down helmets, which is great. They have a helmet, it's a cheaper price point. But we never really know what condition that they're going to be in. So we always kind of want to make sure that we're looking out for that. A lot of times I see, like, rusty screws that are on there, or they're just kind of, you know, past their prime of what they probably should be.
I've seen, you know, adult leagues where these guys are playing with helmets that maybe they played with in college or even before that. So, like the old leather helmets that lace up in the back that are not appropriate for them to be wearing, but we still see them out there wearing them. So they're all kind of still in the market. So just kind of being aware of what. What they could look like, even though they may not be the latest and greatest. The other thing with lacrosse players, because they all have to have swagger, is what they call the tilt. So their helmet is tilted slightly forward so they look quite cooler on the field, which is cool for them. But it's not great for us because it creates a really poor fitted helmet. We need to be aware of that because if we're going to remove a helmet that someone has on that's not fitted appropriately, we need to know how to do that. And a lot of times we just take the helmet off if this. If I'm able to stick my hands underneath of their helmet and I can tell that it's wobbling around, or if they're able to pull their helmet completely off without unstrapping the chin strap, I know that's a poorly fitted helmet. And I'm going to, you know, create my thinking around how am I going to remove that one versus if I have a properly fitted helmet. So a little bit different in this area because lacrosse players want to be cool. They want to have the flow, they want to have the tilt going on. But it can create some issues for us as athletic trainers when they're not fitted appropriately.
[00:08:40] Speaker B: So this kind of ties in to, you know, where you have to have the AP side, you're having ems and that collaboration with what we, you know, most. One of the most prevalent things, obviously, is a cervical spine injury because it's a contact collision sport potential, High, high potential for that. So what are some of the. In making sure that it has a smooth transition with ems. So what can I most say is athletic trainers, but also what can EMS do to effectively work with each other? Both are present for present preparing for emergencies out of lacrosse event.
[00:09:16] Speaker C: Absolutely. So we are very fortunate here. We have one EMS group that we work with. They cover all of our games that are here. And it's nice. We get to know the. The EMS providers that are there, whether it's EMT or paramedic. We work with them almost every week in the spring because we have so many games up here. But just getting to know them has really helped our relationship with them and be able to work well together. We. I know if there's, you know, know a certain person that's coming, that they already know what I'm thinking and I know what their protocols are and what they're thinking and how we're going to handle a situation, but really just being proactive with them and our other local EMS that are here, because if it's not a game, if it's a practice, we don't really know who we're getting. Right. Like, we have in Baltimore county. Here we have career fire stations and volunteer, but it's a very busy county, so we don't know who we're going to get and when we're going to get them. And I think most people are probably in that situation, so. So just going and introducing yourself to them and potentially meeting who could come up and be the person that's helping you and understanding, like, what their protocols are that they have to go through. We have a lot of EMS trainings here at MedStar Health, and we do them at least twice a year and usually more because we'll review our EAP here before the season starts at USA Lacrosse. So we're inviting the EMS to come and practice with us and go through the EAP and you know, whose role is what and how we're doing things. And I think that also goes a long way to, like, hey, come to our site. Come to see what we're doing. This is. This is what it's going to look like.
And just really try our best to get them there. It doesn't always work. I like to incentivize with snacks and taking, you know, some snacks over to them, dropping off our EAP at their station. One of the stations by us actually has a binder where they keep all of the updated ones from the schools and stuff around, which is really nice. So asking some of those questions, like, if I give you my eap, what are you doing with it? Are you just, you know, set it on the table? Are you putting the trash, or are you keeping them and kind of reviewing them so understand, like, what they would do with it and what their protocols would be when they get to you, really helps, like, alleviate some of that potential misunderstanding when we get on site.
[00:11:17] Speaker B: So that's a Great tie in. What I was going to ask next is about just the regular training and you have rehearse drills. You mentioned you did this twice a year at structured times. Are there maybe other times it may come into play, you have a medical timeout, you have some other things you go in. Is there anything specifically more than just the twice a year of things you do, you all do with EMS in terms of exercises and drills or you or even you recommend you do, that may be a good recommendation not just for lacrosse, but also for other sports as well, in your readiness for those emergencies.
[00:11:54] Speaker C: Yeah, absolutely.
[00:11:55] Speaker B: So.
[00:11:56] Speaker C: So one of the biggest things is just knowing the equipment that you're going to be working with. That's a huge part of it. And understanding like what you could encounter. Like I mentioned, sometimes we go out, if I have a youth team out there and they're all from different teams or different locations, they may all have different helmets on, they might not all be the same. So kind of like doing a scan of that, like, what does that look like? What are our kids wearing when they're out there? And making yourself aware of that. There's so much new growth of lacrosse in the country, around the world. And so I'm sure there's a lot of athletic trainers that are signing, signing up for an event, a youth tournament, without ever having actually worked lacrosse before. Right. And so if we're able to go to a dick sporting goods or a sporting goods store near us and just kind of take a look at what equipment is there and what you could potentially encounter, that can really help and go a long way. Obviously, like doing your continual education and like, things like that is really helpful. But the other thing I find is when we're able to teach other athletic trainers or even our coaches, our event staff that's there, what is going to go on. They can be a really big help in an emergency situation because we don't want them to freak out. A lot of times we see like, okay, my, my kid's laying on the ground and what do I do and, and what's going on? So if they can know what's going to be happening, it can alleviate some stress on that end as well.
[00:13:09] Speaker B: Yeah, we may have to get you, I mean, another episode, just take it, get you camera, go to the store and just walk through that. That's to be kind of neat just to kind of a. Your family shopping elsewhere over there to that and you can go. You could dance the show.
[00:13:24] Speaker C: Yes, exactly. I mean, and any, any sport. Right. Like, I haven't worked football in a while, like, so I like our trainings because I get to see what the latest and greatest is. But I know already what lacrosse is. So, you know, if you're not working it on a regular basis, just refamiliarizing yourself on like what's, what's out there and what the updates are. And a lot of times with lacrosse, like if they come out with a new helmet, it might not be drastically different than what the previous one was. A couple of years ago we had one of the Cascade helmets. They switched it and there was a piece on it, a plastic piece that went all the way back. Well, when we were talking about taking the face mask off, it made a big difference because of this one piece that was on, you know, how are we going to go about removing that? Their next one they came out with it actually broke that piece in half so that it wasn't a barrier anymore for us as athletic trainers. So it's really nice. It may be a small change that the manufacturer makes, but it can make a big difference when we're having to deal with it on a day to day basis.
[00:14:20] Speaker B: Yeah, this fits into even, you know, skill decay. I mean you just referred to that. It's like, look, you don't have this very often. You've got to prep yourself. If you do it frequently enough, if you do it enough at one time, you know, if you do ride a bike for 10 times, then you know, you kind of have an idea what it does. But you still got to go back and right, you got to get up on the bike, you gotta, you know, just like anybody, it's no different than just riding a bike.
[00:14:45] Speaker C: Exactly.
[00:14:46] Speaker B: That's a great point you made there about going back to do the continual rehearsal and when you do that periodically, if you are having a potential stale moment and you know that as much as anybody. So yeah.
[00:14:59] Speaker C: Becomes muscle memory at that point. Yeah.
[00:15:01] Speaker B: Yep. Is one of the things that. And I think part of this that hits the area. But also we talk about communication and you know, you've got to articulate communication. Like if you are familiar with. You just mentioned that just then. If you're not, you've got to find ways to communicate with yourself that you're up to breast. But also with an EMS and you're getting this team together. You have high pressure situations and obviously you cover a number of these from international competition. Any situation is the same is because you have, especially from a time sensitive nature of the severity of a potential catastrophic injury. So what strategies or tools that you all do for effective. You do or you work with your team to implement in terms of effective communication on a regular basis, not just with, like, you have practices, you have games across the different teams. You have before during an emergency.
[00:16:00] Speaker C: Yeah, I mean, communication is just so far, but even more than that is specific communication. So a few years ago at one of our EMS training sessions, and this has really stuck with me to this point, our lead instructor, Amber, you know, her, had given us some instructions leading up to this training that we needed to write down how to make a peanut butter and jelly sandwich. And it's the time we're like, oh, okay, well, this is what you do. You, you know, you take out the bread, you put on the peanut butter, you put on the jelly and. And now you have a sandwich. Right.
But as we were reviewing what everyone's thoughts were on how to make a peanut butter and jelly sandwich, some people were very specific about. About how to do it. So if you were to make a sandwich and you have no clue what you're doing, having something that's very specifically written out, okay, well, first you have to get the bread out, you have to untie the bag, you have to take the bread out of the bag. And as you're kind of going through this, what made it kind of click for me is like, you really have to be specific in an emergency situation. Like, a peanut butter and jelly is not an emergency by any means, but if you don't know how to do it and you can't explain to someone how to do it, they could get confused very, very easily. Does a peanut butter go on first or does the jelly? Right. So same thing in emergency situation. So making sure ahead of time that everybody knows what their roles are, their specific roles, what they're going to do if something happens, and specifically communicating. So instead of saying, hey, I need you to go get the aed, saying, I need you to go get my red bag that's on the right side of the sideline that has my AED in it and bring it to me here. When we're more specific about things, it eliminates questions and it can eliminate time. Time that it takes to. To that could potentially be, you know, bad in an emergency situation. So instead of having five minutes of me running around trying to find where the AED is, I just gave them specific instructions on where they can find it and what to do with it when they bring it back. So anything that can be more specifically given and if they know their role in advance and then how to do their Role in advance. That will also help to eliminate some of that time that could be crucial in an emergency situation.
[00:17:58] Speaker B: Yeah, you know, I, I see this. You, you know, I'll work. You know, you've worked number of venues. I see those as well. And this is not a, it's not being critical when I say this is that some EA venue specific aps are very long written. And yes. You know, the, the thing that. And the thing that I've done or I see something or starting to work with and I can do a lot of just using artificial intelligence like AI and stuff. I was, you know, is if you have something, write it out long like what you just referred to. It needs to be fully scripted out. This is what it is and then bring it in to find a way to make it very short, sweet, to the point.
And you know that you need bread. You need, you need a peanut butter. Peanut butter and jelly sandwich. Get the bread. Yeah, get the peanut butter. Get the jelly. Apply the peanut butter.
How much. Apply the jelly. Bring the two ends together. Eat. And it's not those. The venue specific aps need to be that succinct. But people need to know what that is on the front. Give them the full version. They need to know in advance. That's a protocol that's really written in your document. But in here, the layperson coming in, they just need to know this. Put your EAP form. So that's where the communication gets into is really making someone who is there someone who reads it, who doesn't understand it. And if they're taking longer question like, well, okay, but I like my peanut. Like, no, it's not like how you like it. This is how it has to be done.
[00:19:34] Speaker C: This is what it is.
[00:19:35] Speaker B: And I love peanut butter. Don't get me wrong. Don't get me started on that. You said that. So you need to tell Amber. She's just, you know, she's internal poster on that. So. Well, good. That's a, that's a great question. We're heading into the remainder of the show.
[00:19:50] Speaker C: Yeah, no, that's a great point. We actually recently we have a big document, I think it's over 40 pages now of what our emergency action plan is here at USA Lacrosse. We recently took one page out for the field and where all of our AEDs are, we laminated it and we put on. If there is an emergency and there's not a medical person here. You can take this off the wall. It's velcroed on the wall. You take it off and you can hold it and you can read exactly what you need to do. It's very short and can sync and succinct. And that's exactly like take these steps in an emergency in the aed, like in the boxes, we also have the full one. So if there is a specific thing that's going on and they're not sure what to do, yeah, the full document is in there. But all of the important stuff in our EAP that you really need to know is at the front. Because you're right, people get bored. It's a 45 page document. Nobody is going through and reading the whole thing. Right. So pushing that, the really important stuff up towards the front of it and then the extra stuff, you know, that kind of gets into the more nitty gritty towards the bottom so that it's still there. It's just a little bit more easy to access.
[00:20:51] Speaker B: Okay, when we. Audience, when we return in just a moment, Kelly will discuss lessons learned from the field athlete and parent education, improving EAPs and managing equipment during emergencies. Stay with us, we only have five laps to go. I'm Ray Castle and you're listening to the AT Pit Crew podcast.
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[00:22:19] Speaker B: Hey, welcome Back to the @pit crew podcast. I'm Ray Castle and We're discussing lacrosse, EAPs and equipment removal with Kelly Lohr of USA Lacrosse. As we talked about earlier in the show, those first five laps were like, wow, that was, that was a. That was packed in. And now we're going to let's talk about some of the lessons. You know, you've done this extensive amount of work and not just lacrosse, but in across different sports. But they all kind of translate in. So what are, you know, we've always learned from our experiences and best, you know, and trying to find best lessons in emergency care. Can you share a specific instance where a well executed EAP made a significant difference during lacrosse emergency?
[00:23:08] Speaker C: Yeah, I think I thought about this one a lot, actually. I think there's probably a couple that I felt very comfortable with. But the biggest one I think is in 2022, we hosted the World Across Women's World Championship here. It was at Towson University here in Maryland. We had 30 teams. It was a two week event.
I work also with World across, so I was kind of helping on both ends, you know, for the event planning. And we have a very good medical manual that we're like, okay, this is what's, this is what's going to happen. This is what we're going to do. Each team with World across is required to bring their own medical staff to the event. We prefer athletic trainers or physios, someone who can, you know, be the sideline coverage, but sometimes they bring a physical therapist or a physician, you know, someone else that might be a little bit different.
Um, and we've required that and we said, please submit the names of everyone who's going to be with you for the event. Well, what we didn't really think about ahead of time is asking will this medical person be there with you for the entire event or just on game days or just, you know, during the competition? So a lot of our teams came in early. They were doing some practices that were considered official practices, but you know, they still kind of, you know, they would scrimmage other teams and things like that. So in on our end, our staff at MedStar, we had a lot of planning going into it. We had a lot of meetings leading up to it. We reviewed the whole EAP with our staff the way because our fields were kind of spread out, we had a liaison athletic trainer that would work, you know, each field or like every two fields to make sure that the, the medical staff had what they needed if there were an emergencies, kind of help with that. So this, the first day that we had teams there, we had two international teams that were school scrimmaging. They decided they were playing next to each other for practice. They said, well, we're going to scrimmage. So our athletic trainer went over to the field crew and you know, introduced himself and said, Can I meet your medical staff? And the response was, well, they're not here yet. So we were like, oh, maybe they're just coming later. You know, he radioed up to our like main tent and said, hey, they don't have one. I'm going to stay on this field. So just so you know, and kind of shift what I'm doing. I think one of the teams, they said, oh, well, this person that's playing is a doctor. So okay, well they're not going to do much. That's great. But if you're on the field doing much, great. So he kind of shifted what he was doing, which was part of our protocol, like you're going to stay there.
We know that they don't have someone with them. Well, not 10 minutes into the game, a girl goes down with a significant knee injury. Well, thank goodness we had preplanned for what the athletic trainers were going to do because he had already shifted, he was already on that field and he was able to activate EMS and our EAP that we had in place by, you know, he radioed up to us, we were able to get our physician down there, assess really what was going on. We brought them back up to our athletic training facility and we're able to, you know, triage and kind of go from there. Fortunately, it wasn't, you know, a C spine or something that was a little bit more significant than that. Our athletic trainer was supposed to go do a medical timeout, pre, pre event medical meeting with the, the medical staff that they had realized that they didn't have it and was able to, we were able to adjust what we were doing because of that. And I think if, you know, we hadn't really planned for, for those pre event meetings, if we had just said, nope, you're just staying right here, don't move, don't do anything. Like having to be a little bit flexible. I think part of every athletic trainer's job, but really being able to like work within the constraints that we had of that EAP really made a difference. You know, this was an international athlete. The first time that they had been in the United States, they had no, nobody else with them, no parents. You know, they had just met some of their teammates for the pro maybe the first time.
And there was a little bit of a language barrier there as well. So fortunately not a big one, but enough that, you know, we kind of had to work through it. So being able to put all of these things that we had practiced together really made a huge difference. And we, you know, we Ended up spending a lot of time with that athlete. She wasn't able to continue playing, but she would come in and get treatments and things like that. And just the, you know, the difference I think that it made for this athlete having is going to be really scary, you know, having a, a major injury, but then when you're away from home and all of that. So it was great, you know, getting to know them and really seeing like what a difference that our plans had made and making sure that they had a good experience, even though it was a bad thing that happened.
[00:27:17] Speaker B: Yeah. So just real quick, you mentioned the, the complex how, just for the audience, how, how big, how many fields does that comprise of?
[00:27:25] Speaker C: So we had three competition fields. Um, they were kind of. One was across the street from two other ones and we had, let's see, one, two. Two of the fields were on the other and then one was kind of up a hill as like a practice facility. So we had about six fields that were spread out enough that it was a little bit easy to access. But also we had to plan for, plan for that access. It wasn't like we could just walk across the street.
[00:27:49] Speaker B: I think, you know, the key, I think one phrase you could because you're creating a surge event. So this, you know, this is now two events into one. But now you're having to shift and you're, you don't have that resource. So now you're putting some, you're moving here, but now, now potentially some other area or that person was already resource allocation. You now have a surge event. And if it's somewhat, you know, you had planned for it, but you hadn't planned for it. But it's your plan work. You know, you've got that set in place. So really, really important to take those in consideration what may happen. And this is, you know, that's a. Then you have additional time need for, you know, the communication barrier potentially with the athlete or the team. You're not having someone as a translator, potentially. So just little things of nuances that go into especially planning a international event or a national event at times.
[00:28:46] Speaker C: So, yeah, I mean, and honestly, it really helped us with other events. You know, since the 22 Games, we've had five or six other international events. And as we're planning it, one of the questions we ask is, hey, is your medical staff going to be here the whole time? And if they're not, we need to figure out what to do in place. So, you know, this one thing that maybe at the end of the day, you know, if, if no one had gotten hurt. Right. It probably wouldn't have been a major deal. But now we know for future ones and we're able to kind of like bridge that gap of where there could have been a really major issue.
[00:29:16] Speaker B: I joke, I say the likelihood it's not going to happen, but the, like, the reality is it's going to happen. So exactly what you like it to or not. So, you know, let's shift gears a little bit. Let's talk about that athletes and families and I think you kind of meant you kind of. You were skirting on that earlier about the, you know, and what their overall. But think about what the athlete and their safe and their athlete families are related to the comprehensive safety of an event. How do you approach or how does your team approach educating athletes and parents about injury reporting and emergency protocols in lacrosse?
[00:29:52] Speaker C: I, I really just try to take every opportunity I can to get to know my athletes, you know, outside of the sport and even their parents, you know, like, when we have our national team athletes here just chatting with their parents, you know, hey, how was the trip down? Like, just getting to know them off the field a little bit and kind of breaking down some of those barriers that, you know, a coach may have or a parent may have when it comes to reporting, you know, with our national team stuff, essentially everything is a tryout. So if you're hurt, if something's going on, right, like, we want to know about it. But a lot of times the athletes are like, I don't want to tell you about it because I don't want to stay off the field. But as we're able to kind of like develop those relationships and we start to build trust with them as a person, I really think if you build trust with them as a person, they'll trust what you're saying as an athletic trainer. So if there is something going on or like you have, you know, major or not, like, you start to build that trust with them more so off the field than you do on the field. And it's so important to stress them too. Like, just because something is hurting, it doesn't mean that you're going to get held out of things. You know, so many times our athletes are afraid to say anything because they don't want to be held out. But most of the time, if there's something going on and we, you know, even if we do hold them out or we kind of like, you know, take care of it early enough, they're gonna, it's gonna keep them playing for longer Right. Like, look at concussions. It. That's a great example of, like, if you don't report it right away, the likelihood of you being out for longer and it, you know, the symptoms staying longer gets higher and higher. But if we address it right away, it's gonna, you know, hopefully get better quicker and same thing with them. You know, I always say, like, just, just let us know it's just information at that point. Like, unless it's something significant or like, anything we can do to try to keep you playing, we're gonna do. If it's safe, we're gonna. I'm gonna let you play, but just kind of stressing that to them. Like, just because you tell me one doesn't mean I'm going to tell anyone else. It's just information. And. But if I need to, it doesn't mean that you're going to be out necessarily all the time. So just kind of like working those relationships, I think, is. I don't know, I think with any job, you could probably say that. But especially with. With athletes, you know, like, we spend so much time with them, too, as athletic trainers. It's really easy, I think, to kind of build those relationships with them, but just having them trust you and, you know, want to come to tell you things. And, and same thing with parents. I mean, this past Friday, we had our women's U20 ring ceremony, and, and one of the players, she's one of my favorites, was on our development team, and then she moved up to our women's U20 team. And I got to see her, I got to see her parents, and it was just fun to be able to, you know, connect with them and, and chat with them and enjoy. You know, you guys want a gold medal? Like, let's give you your rings and really enjoy that time. And that's something that's so unique to athletics, but it's really one of the best parts.
[00:32:32] Speaker B: Yeah, I mean, it brings home, like, for me is I do work with USTA on their Challenger tour events and, you know, athletes, just the same thing as you. They. They don't know who you are. You're coming in, you're one. You're a small ship passing by. Their big. They're in a big. They're going in one direction, you know, or think that, but you're really in the same direction. And that's what I tell them. I said, look, my goal is this. I think your goals are for me to do the best I can do and keep you on the court or on the field. My goal is to do everything I can do and if you, if you're okay with these goals here and me do it, making sure this happens, then we're. And they're like, oh yeah, definitely. I'm like, good, we're on the same page. So it's not, it's just break that.
[00:33:18] Speaker C: Being transparent. Right? Yeah.
[00:33:20] Speaker B: Some people may be more apprehensive towards that. So. And, and I get that. But you have to address. That's a great point you made there. It's just trying to work that communication. Look, we're on the same team. You may not, you may not think of it, but it is that. So let's shift back again, look to the, you know, is an evolution of EAPs. Because I think this, you know, communication with parents is. That's, you know, that's one part you have to think about. I'm not. We don't talk about. You think about what you have to do. That's the, that's the time you don't want to communicate. But you have to plan for that already is, you know, these eps evolve over time. It's based on experience. I mean you, you mentioned a little while ago with the, with the changeover and how that, that's, that, that plan that you've laid out before an event.
What advice would you give like a younger, an experienced or younger athlete trainer on continuously improving their EAPs or if it's lacrosse, I'm going to say lacrosse EAPs for this. But any EAP, I mean one is.
[00:34:23] Speaker C: You got to know the guidelines. You have to know what you're supposed to put in there. Stop looking at the old guidelines. There's brand new guidelines just came out in 2024. It's a great document. You have to know what is supposed to be in there and work within that. The, as you're thinking about, like really put some thought into the words and the writing that you're putting into your emergency action plan, it should be accurate and it should be practical to what you are doing in emergency. If it's not something that you would actually be doing, don't put it in there because you feel like you need to put it in there.
It's a legally binding document. Right? Like, so this is going to be something like if I have to go to court and the court says, well, you put it in your EAP that this was supposed to happen and you didn't do that, that becomes a very big problem. Right?
So if you put in your EAP that you are always going to do Something make sure you either always do it or don't put it in that you're always going to do it.
In February at USA Lacrosse I'm not putting out a cold water immersion tub because it's usually 10 degrees and I don't really feel like we're going to need that. So I don't put in my EAP that we will always have a cold water immersion on the sideline. But in the summertime when it's applicable, you know, I'm going to have it out there and I'm going to have you know, all the appropriate things that go with that.
[00:35:34] Speaker B: You've done risk, you've done risk mitigation and you've, you've identified what that look and you find that medium in between that you know, you can always over deliver but you can't under deliver.
[00:35:46] Speaker C: Correct. And just because you know lots of high schools, right, like I want to see what your high school is doing. Well, just because you're doing that at your high school doesn't mean you have to do it at this high school. Right. Because things may be different. Obviously the field's going to be different. Where are the keys, how you are using radios? Are you not like some of that those things like yeah, it may be idealistic but it's not practical to where you are and what you're actually doing. The other thing I think is really important is to learn from others and like what they are doing and like their experiences. What went well, what went wrong, like how those experiences could apply to you. I mean I always remember the mistakes that I made and like things that I wish I had done differently. But as long as we're able to learn from them and like make adjustments for the, for the future, that's how we're going to improve and that's how we're always going to kind of be evolving as an athletic trainer.
[00:36:33] Speaker B: Yeah. You know we did a emergency care course here this past summer working with our company, worked with LSU and our lady the Lake Hospital doing emergency care course. And I was paired up with emergency physician, emergency trained physician in on our exertional heat stroke and I was talking to him beforehand. We talked before. Well, we use, we use, they use body bags and because it's, they're contained in space like I'd be kind of toying with it. So now I don't even use tanks. We've got, you know, it's easier to move around and yeah, so now we have six or seven. I just ordered some more of the, the you Know, you can carry the body, put them on a cot, you put, you ice them down. You can do all those things very easily enough and it works great. Yeah, so we just kind of made a, a shift in that and like, okay, they're doing it, so why it makes it sense to do it in, in that, in the, in conserving. And we went, we've looked into it and it works great. So.
[00:37:33] Speaker C: Yeah, exactly is the key.
[00:37:34] Speaker B: Yeah. If you're doing the same thing you did five years ago. Well, you're doing the same thing you did five years ago, which is probably, unless it may be really good to know what you're doing. So with the, with it being said, you talked about, you mentioned equipment a little while ago and what, you know, what you bring in and communication, radio, et cetera. So obviously, you know, we know that each venue, each situation has its own uniqueness. So what are some specific challenges? You alluded to this earlier about this type of strap or plastic something. So again, I'm not familiar with lacrosse equipment. So I'm just like a first person, first grader in this. So what, so to speak. So what are those challenges that equipment poses or emergencies and you know, what are you doing, like if you address it in your EAP or do you have something separate you that you all work with as part of your medical timeout, et cetera?
[00:38:28] Speaker C: Yeah, I mean, I think most of us as athletic trainers, because lacrosse isn't everywhere, most of us are trained to work football. And a lot of times athletic trainers will, will correlate what we're doing with lacrosse to be the same as football. And it's not. Football pads or shoulder pads are big and thick. Their helmets are a little bit different. The way, you know, they're shaped are different.
And so I think a lot of times we're like, oh, okay, like we're going to do the same thing that I would do with football. Well, lacrosse shoulder pads are very thin and I think sometimes athletic trainers will get confused, like, should I take them off? Should I not take them off? Is it going to create enough of, you know, a change in the C spine going backwards like a football helmet was? And I think sometimes we just get kind of confused with that. So again, understanding the equipment that you have in practicing with it, we're. There's getting ready to be a document I help to work on with a group up here at USA Lacrosse on like specifically what to do. So similar to the football pre hospital setting document that was put out, there will be a lacrosse one coming out to kind of alleviate some of those questions and like how those things are going. But you know, when it comes to your EAP, just putting in there what the expectations are like, should you be taking the helmet off? Should you not be taking the helmet off? And with the face mask is, is probably the other biggest thing. Like with football, right, we want to get to the airway as quick as possible, so we're taking the face mask off and we may do that with lacrosse athletes as well. But it's a different way to take. It's not as easy as taking it off and it's sometimes it's almost easier just to take the whole thing off because we want to make sure that we have, you know, all of our, our breathing, our airway, like we're very easy to access and it's not, they're not hard to take off. And honestly, you can cut them most of the time like the pads, you can cut them and just take them right off. And as we're going through things and you know, making sure that we're exposing the chest in the right amount of time and all of that, but just having the expectations written into your EAP, like what you will be doing, you know, again, it's like being proactive in some of these things. It avoids the guessing game and it avoids any lag time between what you're doing. Um, it just makes, it just makes it easier in the long run because the last thing we want to be doing in emergency is like, well, I don't freezing. What do I do? How do we do it? Like I forget. So just having it written out is great.
[00:40:41] Speaker B: So the key point I got from what you just said is in your eap, you need to have a clear direction and you worked this out already through your training, all your drills. This is what we're going to do in the situation. It's not, well, I may do this, I may not do that. No, it needs to be written in. You're going to do. Either you're going to remove the helmet and the face mask or you're not. That's all there. It's not a, it's not up for. It really becomes a moot point. And if you practice that, you practice to your skill versus what your expectation. When you, when you aren't sure it worked out well. My thank goodness it worked out well. It means you're. You didn't have a well laid out plan. You've got to do what, do this and yeah. And go down that path and. But it's already laid out, you've already scripted it and if you script it exactly and the stress is a lot easier, it's a lot more efficient down the line.
[00:41:33] Speaker C: Yep, exactly. A lot of times here at USA Lacrosse now, all of our events we require some sort of medical or, you know, cpr, AD train. Usually an athletic trainer is here, but if that's the case, it's only one. If I have a youth team out here, I'm one person that's doing that. I know that if there's a C spine injury, I'm going to hold C spine until and direct the coaches around me as to what to do because they're different all the time. But I know that that's what I'm going to do because it's written in my eap. I don't put that I'm going to use a spine board and I'm going to spine board them and I'm going to do all of this because I'm not, I'm not. I'm just not going to do it. I don't have the resources. I don't have even have a spine board here because it's only me and I can't do it by myself. So having all of those expectations written out in there is just eliminates so much on the back end.
[00:42:20] Speaker B: When we come back in just a moment, Kelly will discuss future trends in lacrosse emergency care and then we'll have her for our final speed lap and then a victory lane to wrap up the show that you don't want to miss. We're refueling and putting a fresh set of tires on. We're only, we only have a couple laps to go. I'm Ray Castle and you're listening to the AT Pit Crew podcast. Hey pit crew listeners, I want to tell you about the Pit Crew Sports Emergency Care course designed to boost your confidence and skills when managing any sports emergency situation. In Sports emergency Care, seconds matter. This course is all about hands on real world training. You'll face challenging scenarios that build your teamwork, decision making and critical thinking under pressure. What really sets this course apart is the pit Crew performance report. You'll receive a nine page detailed summary that highlights your strengths and identifies key practice gaps. It's like a car inspection report, but better. It provides those crucial elements that could make all the difference when real time performance is on the line. So if you're ready to sharpen your skills and take your emergency care expertise to the next level, head over to Actionmed co Pitcrew to learn more. Now back for More laps on the AT Pit Crew podcast. Welcome back to the AT Pit Crew Podcast. I'm Ray Castle and we are now back on the track at 50 full throttle. We have one lap to go. Discussing lacrosse, EAPs and equipment removal with Kelly Lohr of USA Lacrosse.
So as we wrap this laying up, what are the future trends? You mentioned this earlier about you've got to constantly evolve and update and do the things you're doing with your eap, your emergency, your equipment, your training, et cetera. So what are some advancements or trends that you foresee or your. Your colleagues with the USA Lacrosse? And they're leading that. But in the medical side, what are some specific emergency protocols regarding equipment or overall athlete safety that you see coming down the pipeline?
[00:44:23] Speaker C: Yeah, I mean, lacrosse is one of the oldest sports in history, but in today's society, it's really such a baby sport. USA Lacrosse itself has only been around a little over 20 years as a, you know, national governing body. And so coming up with a lot of these things, you know, where other sports like football or gymnastics or track and field, we're kind of just getting started, I feel, you know, when it comes to lacrosse, emergency safety and management and all that sort of thing, especially with the 2020 Olympics coming up, lacrosse will be back in the Olympics in la. It's very exciting. We'll be with the Sixes game, so a little bit different than the field version. I think it's just going to help to open up more opportunities for more people to play lacrosse and, and to play a role into, like, what kind of research projects are we doing and what kind of changes to the game are we going to see now that more people are playing? And like, what's coming out of other these, you know, these other research opportunities that we have.
The Sixes and indoor style are even more smaller scale than the traditional game. And I think there's just so much to explore on that end and like the safety of that, I mean, indoor, indoor box across your indoor. That's a whole nother level of things you have to consider in your EAPs, like, you know, what are the access points, all that sort of thing. So as these, this sport is emerging as a new sport, really. I just think there's going to be so much more to consider and a lot to consider on the international level as well. I've seen so much growth there. There's over 90 nations now that are playing lacrosse and how they're doing it, and they're coming where they're going to and how they're doing things. It's really, it's. It's been very interesting to me working at the international level, like what the standards are in the United States and what the standards are in other countries and like how, how other places are dealing with emergencies and like what they think is important.
That it's, it's, it's interesting to see like how, how we are growing and evolving and, and matching up with what other countries are doing.
[00:46:20] Speaker B: So you just. A lot just kind of. You mentioned about growth of the sport. How many just to the audience. So understand, so I better understand this. How many like what's. Estimated numbers of athletes that are in this, in the sport or what the growth is per year across USA Lacrosse?
[00:46:41] Speaker C: That's a great question. We have about I think 500,000 members of USA Lacrosse, but there's close to 2 million people that play just in the United States alone. It's a little bit of a decrease, actually. It's interesting. We've, I've been in some meetings and we talk about the decrease since COVID of not only lacrosse, but sports in general of like these young kids who are playing and getting into the sport and how easily accessible lacrosse is. Like we, you know, with basketball you can just go pick up a ball and you go and play and you're hooping with your friends in the neighborhood, right. And so starting to see that emerge a little bit more with lacrosse and getting sticks in the. More kids hair, hands and watching it, watching it grow. I mean, I mean look at the size of our, just our national teams, right. Like when I started we had five of them and now we, we're going to have 14 this year. And so even on that scale, the growth is just immense. I mean there's a lot of little hot pockets of lacrosse around the country in the northeast, San Diego area, Denver, Dallas, Florida. We're starting to see more in Atlanta and Nashville and some of these other places that are really getting growth like crazy. Indiana and like Michigan are really starting to get these, these major programs. So the goal, we talk a lot about this here is to double participation by the 2028 Olympics. And so getting even more people to play, it's just, it's been very fun to watch.
[00:48:05] Speaker B: Wow, that's a, that's a pretty rapid growth there, to say the least.
[00:48:09] Speaker C: So it's huge.
[00:48:10] Speaker B: Yeah. So we have made 10 laps. Great. So now Kelly, we're ready. Are you ready for your final? Getting rid of this other, this 11th lap, so to speak. It's a speed wrap. We've gotten refueled. We've got five rapid fire. This is the fun part we have here. So are you ready for these five questions?
[00:48:29] Speaker C: I am ready.
[00:48:31] Speaker B: Okay, here we go. This is like we used to do. We did interviews. Remember when you interview.
[00:48:35] Speaker C: Yeah.
[00:48:35] Speaker B: You get to do the same thing. So now we're going to do the same thing. Okay. Question one. What's your favorite go to energy snack during events?
[00:48:43] Speaker C: Diet Coke.
[00:48:45] Speaker B: It's a good one. Probably a lot of it, I guess a lot. Just not being gratuitous. I have. Have a plug there, but yeah, that's. That's mine too. Yeah. Okay. Question two. Favorite band you would want to be the lead singer?
[00:48:59] Speaker C: Imagine Dragons. I love them. My kids love.
[00:49:01] Speaker B: That's good.
[00:49:02] Speaker C: I love their message. Their. Their songs are so catchy to. Is good for. Good for the soul.
[00:49:08] Speaker B: They're good. And you. I mean you have. Now you get kids, you got the. You know, you have a whole. You got Air Guitar Hero and everything else. And then. So. Okay.
[00:49:16] Speaker C: They've been playing on the. The beat Saver on the.
The Oculus. So they love it.
[00:49:21] Speaker B: Oh, yeah, yeah, that's. That's fun stuff right there. So, okay, so you're. So you were down here for several years. You came from Westchester and came in and came to LSU as a grad assistant. You're here for a while and I know you come back because, you know, husband is from Louisiana as well. So what is your favorite or funniest Mardi Gras moment?
[00:49:45] Speaker C: You know, this one is watching athletic trainer Scott Campbell.
[00:49:49] Speaker B: Oh my goodness.
[00:49:50] Speaker C: Pelted in the face with a big bag of Mardi Gras beads. That was.
[00:49:55] Speaker B: And that was. That was me, by the way.
I was riding a float. So just context. I was still. I was on a parade in New Orleans, one of the largest one in Demian. We threw. They. I knew y'all were, you know, it's you. And let's see. Heather.
[00:50:09] Speaker C: Heather.
[00:50:10] Speaker B: Scott.
[00:50:10] Speaker C: Yep. Andy and Andy. Yeah, the whole group, everybody.
[00:50:14] Speaker B: Hey, you're there. Hey, I'm looking for you. I swung back. Scott jumps, he squats down to get one and comes back up and that. And he runs right into that bag of beans I threw. Yeah. I thought I'd knocked him out.
[00:50:26] Speaker C: Oh my gosh. That. That lives rent free in my head for sure.
[00:50:30] Speaker B: I wasn't even thinking about that. I was thinking something else with family or something like that you're doing. So you gotta. You brought that. You brought that back from the grave every now so to speak. So that's. That Will not be long forgotten. And now it's in recording history now because.
[00:50:44] Speaker C: Yes, exactly.
[00:50:46] Speaker B: Oh my goodness. And hey Scott, if you're listening so.
And everyone else, so, okay, so your.
[00:50:53] Speaker C: Favorite beach vacation spot, St. John in the Virgin Islands. My husband and I went there last year for our 10 year anniversary and I'm actually going back in February for a wedding and it's hands down, it's. I don't know how we're going to top it.
[00:51:08] Speaker B: Very good. That's a, that's, that's definitely a bucket list place to go. So for that and last but not least, what is a fun fact about Kelly that we may not know?
[00:51:19] Speaker C: This one was hard for me. I always get stuck on fun facts and you know, maybe some people already know this, but I'm a big reader. Last year I read over 80 books. I think I got to 82 last year. And so this year and you know, I try to get my kids into it and all of that, but I'm up to eight books I think so far this year. And you know, I listen to books a lot too. So if you're on that side that like listening to audiobooks doesn't count, shame on you. It totally counts. But yeah, I'm just a big reader and, and just try to get into as much as I can.
[00:51:50] Speaker B: Expand the brain. Yeah, just get the brain going. And so is there a specific genre? Is it fiction, non fiction, documentaries? You know, it's all those lines.
[00:52:01] Speaker C: Yeah, I try, I try to space it out. I mean a lot of romance, a lot of thrillers, like the top, you know, the top 100, you know, times bestseller, those kind of books. But I really try this year my goal is to be, get a little bit more variety, a little more like specific and what I'm reading and kind of expand a little bit. But, but getting into like some leadership books and some stuff with my kids, even Luke and I started mom and Me book club. So we've been, I've been reading some of the books that he's reading at school and trying to like have some discussions with that. So yeah, it's just, that's what I, that's what I do if I'm not at work. Actually I'm probably reading.
[00:52:36] Speaker B: I listen, I listen to a podcast I've listened to a lot now is how I built this.
[00:52:41] Speaker C: Yeah.
[00:52:41] Speaker B: And with Guy Ross it's fantastic on leadership and you see that. I mean, you know, CEOs have done and they've their struggles and things like that. There's excellent.
[00:52:50] Speaker C: So yeah, yeah, there's some really good ones out there. I just started listening to the the 7 Minute Leadership Podcast in the mornings while I'm getting ready and it's short and sweet and you know, just anything I can get my hands on.
[00:53:01] Speaker B: Yep, that's it. Expanding the knowledge and, and growing every day like you mentioned earlier in the podcast. So. Wow, Kelly, this was fantastic. We're now in like, we've got the victory lane now. Thank you so much for again for sharing your knowledge insights on lacrosse EAPS equipment removal. Before we close, what's the one takeaway you'd like our listeners to remember from this show?
[00:53:25] Speaker C: I think the biggest thing is just prepare for things that can happen and be proactive. You know, pre communication, make sure you know your rules. Like being proactive about things and like asking for help when you need it is going to go so, so far in, in your career and your life. Just being proactive and like knowing when to communicate and what to communicate to people around you.
[00:53:47] Speaker B: Thanks so much for listening and I hope you enjoyed the show. Please make sure to click the follow button on your favorite podcast app so you never miss a lap. And don't forget, it's free. If you're interested in gaining valuable insights, courses and more from the best in emergency sports care, please sign up for the Vital connection newsletter at ActionMed co. I'm Ray Castle and you've been listening to the 18 Crew podcast. We are out of here.
[00:54:12] Speaker C: Awesome.
Yeah, that was great.
[00:54:15] Speaker B: That was good. I really enjoyed that.
[00:54:17] Speaker C: They were great questions.
[00:54:18] Speaker B: That was a good fill the cup episode right there.
[00:54:23] Speaker C: Yeah.
[00:54:23] Speaker B: So absolutely had some fun along the way. And with Scott. Oh my gosh, I'll say goodbye.
[00:54:29] Speaker C: I will. I mean, I can literally just like picture in my head the just. And you couldn't even. You couldn't even look away. He's down there and the next thing you know, the bags in his face.
[00:54:39] Speaker B: And look, I'm, you know.
[00:54:47] Speaker A: Thank you for joining us on the @Picrew podcast. We encourage you to to like, subscribe and join our community.
For more information about this podcast show, visit www. Www.actionmed.co. podcast this show is a production of Action Medicine Consultants, LLC.
The medical information provided within this program reflects the opinions of the hosts and guests and is intended for informational and educational purposes only. It should not be considered as a substitute for professional medical advice, diagnosis or treatment. Always seek the guidance of your healthcare provider with any questions you may have regarding a medical condition or treatment.
