San Antonio Fire Department athletic trainer Kilpatrick shifted from the secondary school Deena Kilpatrick, MS, LAT, ATC, provides care to setting to the public safety sector after learning more than 1,800 firefighters and civilian employees about the health care needs of firefighters. and attends department training events.

CARING FOR THOSE WHO CARE FOR OTHERS

Public safety is an emerging setting athletic trainers are finding themselves in. Two athletic trainers share what it is like to care for firefighters.

By Beth Sitzler

Ts Are Health Care” is more than have access to one. Athletic trainers Deena Previously employed in the secondary just the theme of the 2019 National Kilpatrick, MS, LAT, ATC, and Hunt Whitten, school setting, Kilpatrick became familiar Athletic Training Month. Since ATC, LAT, are prime examples as each have with the physical demands and health care Athe profession’s inception in 1950, worked tirelessly to ensure firefighters in their needs of firefighters after working closely athletic trainers have looked at the different local communities have access to athletic with a high school friend in the profession. "ways they can use their skillset to care for a trainers and health care. “I was on maternity leave, and he called me variety of patient populations. From youth “It’s humbling [to care for firefighters],” one too many times to fix something wrong athletes to astronauts, athletic trainers have said Kilpatrick, an athletic trainer with with him, and I thought, ‘What is going on a place in every setting and within every the San Antonio Fire Department. “You’re over there?’” she said, adding that she spent active population. helping the people we call on our worst day. three months researching firefighting and The number of settings in which athletic Working with this population is easy – they how athletic trainers fit into the profession. trainers can be found is constantly increasing. just want to help. As an emerging setting, it “I put together a business proposal and met Many are thinking outside the box to ensure just makes sense to have athletic trainers with the fire department [in 2014]. It took all patients who may need an athletic trainer [care for] firefighters.” almost two years to get funding.

12 | NATAnews | MARCH 2019 Through Metis Tactical, Hunt Whitten, ATC, LAT, contracts with the Ponderosa and Spring fire departments, in the area, to provide an array of injury prevention and rehabilitation services.

“I kept working at it. Once a month, I would He attended Baylor University, where he come up with a reason to contact the chief. studied athletic training. While in college, BONUS ONLINE CONTENT Spring firefighter and military veteran Jason I wanted my proposal to stay on his mind.” he would still venture home once a month Randall shares how athletic trainer Hunt Finally, in 2015, Kilpatrick was contracted for his shift at the fire department. After Whitten, ATC, LAT, helped him overcome a by the City of San Antonio and began seeing earning his degree, he moved back to debilitating back injury and remain on the patients. Two years later, SAFD Chief Charles the Houston area and began working as job in a post available on the NATA Now blog Hood pushed for the contract position to an outreach athletic trainer. In this role, at www.nata.org/blog. become a full-time employee position. he was tasked with building an athletic “It’s my belief that firefighters have to arrive training program at the high school he emotionally prepared [and] physically fit to do was assigned. a very dangerous job,” Hood said. “We go on “I loved building the athletic training 1,100 dispatches every single day, so if we’re program at the school from the ground not in our best shape and if we’re not feeling up,” he said. “I loved showing [stakehold- well, that can, in turn, be detrimental to that ers] the need that was there and how we citizen we’re going to. If we can’t take care of could change the world for [these athletes].” ourselves, how can we take care of someone Drawn to this idea of building something A firefighter himself, Whitten understands who is having their worst day?” from the ground up, Whitten decided to the demands of the profession and how athletic trainers can improve the health Wanting to ensure such a position was merge his athletic training and firefight- and wellness of those in public safety. warranted, the city issued a third-party ing passions, and created Metis Tactical study to be conducted to weigh the poten- with business partner Sean Carey, PES, tial pros and cons. The study came back CPT. Through Metis Tactical, Whitten and with a resounding “yes,” the athletic train- Carey set out to provide evidence-based them the most prepared for the occupational ing position was warranted. injury prevention solutions to emergency hazards they’ll encounter,” Whitten said. Kilpatrick went through the interview service organizations. process, and, in January 2018, became the In addition to reaching out to the Getting a Foot in the Door second athletic trainer ever hired as a full- Ponderosa Fire Department, where Whitten Even after her proposal with the city was time employee with a city fire department. is still a firefighter and the health and safety accepted, Kilpatrick had one major hurdle to Whitten’s journey to working with firefight- officer, Metis Tactical contacted the nearby overcome: lack of awareness. First, she had to ers was also long, but his started in high school. Spring Fire Department about conducing get word out to the approximately 1,800 fire- “I joined the [Ponderosa Fire Department, a pilot program. fighters and hundreds of civilian employees that in ,] at the age of 17,” he said, adding “[During the pilot,] I did a movement she existed and was available to them. Although that he received his EMT certification when assessment, identifying compensatory an email was sent out and she personally visited he was a senior in high school. “I graduated movement patterns – things that could each of the city’s 54 fire stations, word of mouth high school and thought about becoming a lead to injury – and built a program that was her greatest source of advertisement – as full-time firefighter, but decided I wanted would address that while looking at the big was her location in the fire department’s Health to see what else I could do.” picture and figuring out how we can make & Wellness Center. All photos by Renee Fernandes/NATA

nata.org | 13 Kilpatrick sees approximately 15 patients a day in the San Antonio Fire Department's athletic training facility, where she treats a range of issues, from strains and sprains to ACL reconstruction rehabilitation.

Even those who were familiar with the know your patient population, you will not Movement assessments allow athletic training profession were unsure be well-received.” Whitten to develop individualized how she could help them. Whitten said he went in knowing the numer- plans to improve movement “My only experience with an athletic ous costs associated with injury, from paying deficiencies and prevent injuries. trainer was when I played sports in high overtime to fill open positions and worker’s school, so I didn’t know what to expect when compensation to incurring increased insur- BONUS ONLINE CONTENT I started seeing her,” said firefighter James ance premiums. There also is a cost on the Visit the NATA Now blog, www.nata.org/ Perez, who sees Kilpatrick two to three times injured firefighter unable to work. blog, to read a post from the Council a week for a dislocated rib. “When you’re “They have families that are relying on on Practice Advancement on the expansion of athletic training into the a firefighter, you usually get a small injury them,” he said. “Also, they’re away from their public safety sector. that turns into something bigger. Here, you support system. Being a first responder is can [see the athletic trainer] every day and an identity, and being out of work due to injury for an extended period of time can “WHEN YOU’RE A FIREFIGHTER, YOU threaten that identity, which takes a toll on their emotional health.” USUALLY GET A SMALL INJURY THAT TURNS Understanding the challenges they faced going in, Kilpatrick and Whitten worked INTO SOMETHING BIGGER. HERE, YOU CAN to earn the trust and confidence of their [SEE THE ATHLETIC TRAINER] EVERY DAY firefighters, EMTs and administration. They have done so by proving how their skillset AND DO SOMETHING ABOUT IT." can keep first responders on the job and, - SAN ANTONIO FIREFIGHTER JAMES PEREZ if injured, get them back to duty quicker.

“I was walking by to get my annual well- do something about it before it turns into The Pay Off ness check and I saw people in here,” said something bigger.” Since starting with the San Antonio Fire Blaze Cortines, a 23-year employee of the When getting his pilot program with the Department in 2015, Kilpatrick has seen San Antonio Fire Department. “I started Spring Fire Department off the ground, an increase in the number of patients she asking around and decided to check it out. Whitten’s background in firefighting helped treats. Her first year, she treated 378 inju- It’s been great having her here. I’ve been him foster relationships with stakeholders ries. In 2018, that number jumped to 411. working with her for a month now and I’ve and gain their buy-in. By showcasing his “I see roughly 15 patients a day,” she told a lot of people about her.” athletic training skillset and firefighting said, adding that she also attends various Once word began to spread, Kilpatrick insight, he built credibility as a health department trainings, including those con- then had to explain her role as an athletic care provider capable of working with this ducted by the water rescue team. trainer. unique patient population. Sprains and strains are the most common “I had to do a lot of education [when I “To be successful in public safety, [ath- injuries she sees – they’re also the most common was first hired],” Kilpatrick said. “Often letic trainers] have to know the ins, the injuries that lead to on-the-job time loss. times, they thought my job was to yell at outs, the everyday intricacies of the life of a “Whether a firefighter or EMS, the job them as they worked out.” first responder,” Whitten said. “If you don’t is very physical, so it’s not uncommon to

14 | NATAnews | MARCH 2019 BONUS ONLINE CONTENT

Since educating the city's firefighters on how her athletic training skillset can help them, many reach out to her before their "small injuries" turn into "big issues."

BONUS ONLINE CONTENT San Antonio firefighter Timothy Worley and athletic trainer Deena Kilpatrick, MS, LAT, ATC, discuss his road to recovery after ACL reconstruction in a post to follow their prescribed routine available on the NATA Now blog at on their own. www.nata.org/blog. “After the 90 days, we went back to leadership and discussed our results, our successes and the cost of building a While incorporating athletic trainers will 12-month program that was financially help their fire departments save money by During his time working with the Spring feasible and could be rolled out to all of keeping employees on the job, more impor- and Ponderosa fire departments, a their full-time, part-time and volunteer tantly, Hood and Seifert said it shows their noticeable shift in culture has taken place, firefighters,” said Whitten, adding that the firefighters that their health and well-being with firefighters focusing more on their program rolled out in July 2018 to all 200-plus matter, and that their fire departments are health and well-being. Spring Fire Department employees. willing to invest in them. “One of the biggest challenges was “This athletic training facility and our showing how [athletic trainers] fit into the athletic trainer are the greatest assets our get hurt,” she said. “After 20 years in the daily culture and how it transitions over to fire department has,” Worley said. department, you’re going to have some aches the occupational demands. So, showing how and pains.” what we do carries over into the real world.” Finding a Place in Public Safety “Firefighters are like football players, Since establishing the partnership with The public safety sector is an emerging basketball players, baseball players, except Whitten, the Ponderosa and Spring fire setting many athletic trainers are gravi- we are expected to go from stagnant to departments have both reported a noticeable tating toward. To better serve a tactical moving at a moment’s notice – without shift in their departmental culture. athlete, such as a firefighter, Whitten said stretching or warming up,” said Timothy “We’ve had a reduction in line-of-duty it’s important to understand what they go Worley, who has been with the San Antonio injuries since [our firefighters have] been through physically and emotionally. Fire Department for 16 years. “The average prehabilitating,” said Robert Logan, Spring “Know the demands of the patient fire lasts three to four hours, and we’re Fire Department assistant . “It’s population,” he said. “If you can, go wearing 75 to 80 pounds of gear, dry, been a total culture shift in the department through volunteer firefighter training. If without the hose line.” just from the fact that they understand that you really are passionate about this, go During the pilot program with the health and wellness is imperative for them through what your patient population goes Spring Fire Department in 2018, Whitten and that they’ll do whatever they need to through. Immerse yourself in the setting. spent 90 days with a group of 15 firefight- be prepared for their shift.” Also, remain diligent on best practices ers – three from five different fire stations. “We should do everything we can to and identify where else you can use your He spent the first month working hands-on prevent injuries, and having an athletic knowledge and skillset. Look at how you with the group, conducting movement trainer is definitely a way to do that,” said can best serve your patient population.” assessments and creating individualized Spring Fire Department Fire Chief Scott To athletic trainers wanting to break plans to correct deficiencies as well as Seifert. “Our budget for 2019 is $16.3 into the public service setting, Kilpatrick’s group programs that address already- million. Out of that, $12 million is [spent] advice is simple: “Be patient. Be persistent. existing health and fitness standards. After on personnel. So, we want to ensure our It’s going to move slowly and it’s going to that first month, Whitten integrated an app personnel are healthy and well and are be a lot of work; but, in time, that work will into the process, allowing the firefighters able to do their job.” be very rewarding.”

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