Sideline Guidelines App Guides Athletic Injury Treatment

By Kurt Spindler, MD

Cleveland Clinic sports medicine physicians and a national expert panel developed a first-of-its-kind Sideline Guidelines app designed to help sports medical professionals accurately address athletic injuries on the sidelines and in the training room, as well as in the office. This app is available and free from the App Store now.

Development

The origin of this educational app was a national course in treating sideline injuries I taught in August 2014 with an expert panel of experienced team physicians. I adapted the national course from a crash course I led for the sports medicine team at Vanderbilt University in 2012 and 2013.

The national course at Cleveland Clinic drew more than 130 attendees — including physicians, athletic trainers, physical therapists and midlevel providers — who suggested an app. Cleveland Clinic’s team recognized the nationwide interest and over the past year created the Sidelines Guidelines app.

The app benefits both primary care and orthopaedic sports medicine physicians, who typically begin their respective fellowships in July and August at the height of sports team coverage. These medical professionals cover a variety of sports at many levels. A crash course and a reference guide seemed an obvious extension of their education.

Unmet emotional need

Sports injuries are quite common in high school and college sports. In the United States, there are an estimated 7.8 million high school and nearly 500,000 college athletes. More than 36,000 high schools in the U.S. employ physicians and athletic trainers — at all levels of experience and training. According to the U.S. Centers for Disease Control and Prevention (CDC), high school athletes account for an estimated 2 million injuries, 500,000 doctor visits and 30,000 hospitalizations each year.

The Sideline Guidelines app is a comprehensive resource formatted for the iPhone. The intended use is by medical professionals treating injured athletes, including sports medicine fellows, residents, physicians, athletic trainers, physical therapists and midlevel providers. The app is only available from Apple, but we hope to also convert it to the Android platform within the coming year for version 2.0.

Sideline Guidelines format

The app compiles a summary of expert medical information to provide a helpful guide and reference for medical professionals in diagnosing injuries, assessing an individual athlete’s post-injury ability, making return-to-play decisions and planning training schedules. The searchable format allows providers – on the sideline or in the training room – to quickly access key points to assist in making an informed medical decision. The app covers the most common medical emergencies, medical conditions impacting sports participants and the gamut of orthopaedic injuries.

Expert recommendations

I was fortunate to have a multidisciplinary team of nationally renowned physicians and sports medicine experts from specialties outside of orthopaedics share their knowledge in the development of the app. These experts include cardiology, neurology and neurosurgery, gastroenterology, dermatology, dentistry, emergency medicine, and ear, nose and throat practitioners. In addition, specialists from The Ohio State University, Vanderbilt University, The University of Iowa, Washington University, University of Connecticut and Allegheny Medical Center helped compile the database of clinical information used in the app development.

Practical tips

At the Sideline Guidelines course in August, we introduced the app to over 100 participants and gained insights into how the app could aid medical professions caring for sports injuries. I believe this app is a game changer for medical professionals and athletes. Never before have we had this information at our fingertips via an app to help diagnose and treat athletes.

“Medical professionals will be better equipped to assess a situation by using the app as a decision-making guide,” said Gary Calabrese, PT, Director of Sports Health and Orthopaedic Rehabilitation at Cleveland Clinic Sports Health.

The app opens up into three main sections — Emergency, Search and Tools. Under the Emergency section are sudden cardiac death, heat illness, pulmonary emergencies, environmental (lighting, etc.), and orthopaedic emergencies tabs for rapid reference. The Search section contains the main body of information that provides a comprehensive head-to-toe listing of orthopaedic and medical injuries/conditions that involve athletes. The search function also allows users to search by keyword and pulls all sections for reference.

The format for diagnosis is key history, physical examination and imaging (X-ray, MRI, CT, etc.), followed by decision on return to play that day and game-day treatment. The app includes estimated return to play and a treatment course for the remainder of the season. Finally, we include a decision point section to alert the user to controversies on treatment.

The Tools section is in its infancy and will be built out pending feedback from users in version 2.0, which will include relevant radiographs, MRI, CT and pictures for the majority of diagnoses mentioned and key references.

We hope the app serves as a practical reference and an educational tool. We look forward to your feedback to improve it in the future.

Sideline Guidelines was created by Dr. Spindler, Vice Chairman of Research at Cleveland Clinic’s Orthopaedic & Rheumatologic Institute, along with a comprehensive team of experts from Cleveland Clinic and Cleveland Clinic Sports Health. He is well-known for his work as principal investigator of the MOON project (Multicenter Orthopaedics Outcomes Network) for over 10 years, and is a nationally renowned ACL expert.