<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.32.08.05" title_num="10" subtitle_num="32" chapter_num="08" heading="Scope of Practice.">
  <paragraph num="A.">
    <text>The scope of practice of an athletic trainer in the domain of injury prevention and wellness protection includes the following:</text>
    <paragraph num="(1)">
      <text>Minimization of risk of injury of athletes through awareness and education;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Monitoring of environmental conditions to facilitate individual and group safety of athletes;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Maintenance or enhancement of physical conditioning of athletes; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Promotion of a healthy lifestyle of athletes using appropriate education and communication strategies to enhance wellness and minimize the risk of injury and illness.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The scope of practice of an athletic trainer in the domain of clinical evaluation and assessment includes the following with respect to athletes:</text>
    <paragraph num="(1)">
      <text>Obtaining athlete’s health history through observation, interview, and records review;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Examining athlete’s body to assess the type and extent of the athletic injury;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Formulating a clinical assessment; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Communicating information about the athletic injury to appropriate persons including the athlete.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The scope of practice of an athletic trainer in the domain of immediate and emergency care includes the following with respect to athletes:</text>
    <paragraph num="(1)">
      <text>Immediate and emergency procedures including:</text>
      <paragraph num="(a)">
        <text>CPR;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Applying ice;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Splinting;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Elevation;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Pressure;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Bandaging for bleeding;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Proper immobilization of spine or other body parts; and</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Dry needling; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Making appropriate referrals so that the athlete will obtain appropriate follow-up.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The scope of practice of an athletic trainer in the domain of treatment and rehabilitation includes the following activities, performed in an approved setting, with respect to athletes with athletic injuries:</text>
    <paragraph num="(1)">
      <text>Administering therapeutic and conditioning exercises as identified by the evaluation and treatment protocols of the supervising physician;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Administering therapeutic modalities as identified by the evaluation and treatment protocols of the supervising physician;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Applying braces, splints, or other assistive devices as identified by the evaluation and treatment protocols of the supervising physician;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Reassessing the status of injuries, illnesses, or conditions using appropriate techniques and documentation strategies to:</text>
      <paragraph num="(a)">
        <text>Determine appropriate treatment, rehabilitation, or reconditioning for injuries; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Evaluate readiness to return to desired level of activity with respect to injuries, illnesses, or conditions; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Administering dry needling therapy under the direction and guidance of a supervising physician who has training and experience in dry needling.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The scope of practice of an athletic trainer in the domain of organization and management includes the following activities:</text>
    <paragraph num="(1)">
      <text>Maintenance of medical records with respect to all athletes who receive emergency care, assessment, or treatment;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Planning and organization of an athletic training program; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Instructing others in prevention of and care for athletic injuries.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>The athletic trainer may accept an outside referral from a nonsupervising physician or licensed health care practitioner if:</text>
    <paragraph num="(1)">
      <text>The supervising physician specifies in the evaluation and treatment protocol that the athletic trainer may accept referrals from nonsupervising physicians or other licensed health care practitioners;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The nonsupervising physician or licensed health care practitioner has seen the athlete and has written an order for the care; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The duties are:</text>
      <paragraph num="(a)">
        <text>Within the scope of practice of an athletic trainer; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Among the duties delegated in the evaluation and treatment protocol.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>