Hernando High School Sports Medicine Policies and Procedures Manual

Transcription

1 Hernando High School Sports Medicine Policies and Procedures Manual

2 Hernando High School Sports Medicine Policies and Procedures Manual Table of Contents Responsible Personnel... 2 Hernando High School Emergency Personnel... 3 Communication: Non-Emergency Phone Numbers... 4 Emergency Equipment... 5 HHS Athletic Complex/ Football Stadium Emergency Plan HHS Athletic Complex/ Football Practice Field Emergency Plan HHS Athletic Complex/ Gymnasium Emergency Plan HHS Athletic Complex/ Baseball Field Emergency Plan HMS Athletic Complex/ Track / Tennis / Softball Emergency Plan Additional Information Inclement Weather/ Lightning Lightning Safety Tips Heat Guidelines Chain of Command Specific Guidelines Key Terms MHSAA Concussion Policy Protocol Management MRSA / Staph Policy Recognition Prevention Reference

3 Emergency Action Plan Section: Responsible Personnel The following Emergency Action Plan (EAP) has been developed to provide proper emergency management in the event of a severe injury or illness to an athlete, coach, official, or spectator at any Hernando High School athletic venue. This plan is intended to provide guidelines for management of emergencies and should be adapted to each situation. The EAP should be reviewed and rehearsed by the Hernando High School Sports Medicine staff, coaching staff, school administrators, event managers, and school safety officers. Responsible Personnel Description and Qualifications: Responsible personnel include the Sports Medicine staff, coaching staff, and event managers, all of which are recommended by the MHSAA & DCS to maintain current training in automatic external defibrillation, cardiopulmonary resuscitation, first aid, and the prevention of disease transmission. When an athletic trainer is not present, a member of the coaching staff or the event manager will assume the role of First Responder in the event of an emergency. The role of the First Responder includes the immediate care of the injured/ill student-athlete until EMS assumes control of the student-athlete. 2

4 Hernando High School Emergency Personnel Team Physician: Dr. Chip Christian (901) Athletic Trainer: Christopher Smith (901) (662) Administrative Team: Principal Duane Case (901) Asst. Principals Caleb Shepard (901) Ashely Taggart (901) Malinda White (662) Athletic Director David Lara (601) Security Team: School Resource Officer Barry Pettigrew (901)

5 Emergency Action Plan Section: Communication Emergency Communication: Responsible personnel should be familiar with the method of communication that is most readily available to them and its location at each venue in the event of an emergency. Types of emergency communication include: 1. Cell Phones 2. Landline phones within buildings 3. Non-Emergency Phone Numbers: a. Hernando Police: (662) b. Hernando Fire: (662) c. DeSoto County Sheriff: (662) d. DeSoto County Fire: (662)

6 Emergency Action Plan Section: Emergency Equipment Emergency Supply Bags: Emergency supply bags are maintained by the Sports Medicine Department and are located in the athletic training room or with the Athletic Trainer. Kits/bags include face mask removal tool(s), band-aids, gauze, tape, hydrogen peroxide, gloves, biohazard bags, non-adhesive pads, coverall, scissors, Blood Pressure cuff, alcohol, etc. Splint Bags: A Cramer Vacuum Splint Bags is kept in the athletic training room or with the Athletic Trainer. Inside the splint bag are one (1) leg splint and one (1) arm splint. Also located inside the splint bag are an Ambu Bag, Ambu Suction, and a cervical neck collar. The bag will be with the athletic trainer at all venues. Crutch Bag: A crutch bag containing a pair of medium and large crutches, walking boots, and a straight-knee immobilizer is present at all sporting activities including practices and games. The bag will be located in the Athletic Training Room or with the athletic trainer. Automated External Defibrillators: Two Automated External Defibrillators (AED s) are located at Hernando High School. One is located in the Football Field House. The other is located in the teachers lounger. A third AED will be with the athletic trainer at all athletic events. Biohazard Clean-up: The Athletic training room has an Emergency Response Pack for the absorption and disposal of small amounts of potentially harmful blood and body fluids. 5

7 Emergency Action Plan Hernando High School Football Stadium EMERGENCY PLAN: High School Athletic Complex Emergency Personnel: Certified Athletic Trainers, Team Physician (if present), Athletic Department Staff, Security and Coaches. Emergency Equipment: AED (Home Sideline), medical supply kit, splints, access to athletic training room. Emergency Communication: Emergency Personnel s Cell Phones EMERGENCY PLAN RESPONSIBILITIES 1. Certified Athletic Trainer A. Immediate care of injured or ill individual/ access situation B. Activate Emergency Medical System (EMS) 2. Athletic Department Staff/ Coach A. Instructed to CALL 911 by Certified Athletic Trainer B. When calling EMS, give the following information: i. Identify yourself (MY NAME IS. I AM A (title) at HERNANDO HIGH SCHOOL. WE HAVE AN INJURED ATHLETE ON THE FOOTBALL STADIUM FIELD AT, (805 Dilworth Lane). ii. Give campus location of injured athlete (Football Stadium Field) a) On the field - inform the ambulance service that Security Staff / Administrators will be at the Parking Lot Entrance on Dilworth Ln to meet the ambulance and direct them to the South Stadium Gate. iii. Inform them of what injury is suspected, a) What signs and symptoms are present, or current state of athlete. (WE SUSPECT THE ATHLETE HAS ) iv. Ask if any other information is needed. v. HANG UP LAST!!!!!! vi. Have individual s personal history & insurance information back to the injury site. a) Certified Athletic Trainer / Legal Guardian / Coach will accompany the athlete in the ambulance to the hospital 6

8 3. Hernando High School Security Staff / Administrators / Coaches A. Security Staff / Administrators will ensure the parking lot access from Dilworth Lane is unimpeded and will direct the ambulance to the additional security staff / administrators at the South Stadium Gate. B. Security Staff / Administrators / Coaches will direct the ambulance, once in the South Stadium Gate toward the South End Zone for access to the playing surface. C. Security Staff / Administrators / Coaches will keep the South Stadium Gate and South End Zone free of obstruction until the ambulance can exit the playing surface and stadium. 7

9 Emergency Action Plan Hernando High School Football Practice Field EMERGENCY PLAN: High School Athletic Complex Emergency Personnel: Certified Athletic Trainers, Team Physician (if present), Athletic Department Staff, Security and Coaches. Emergency Equipment: AED, medical supply kit, splints, access to athletic training room. Emergency Communication: Emergency Personnel s Cell Phones EMERGENCY PLAN RESPONSIBILITIES 1. Certified Athletic Trainer A. Immediate care of injured or ill individual/ access situation B. Activate Emergency Medical System (EMS) 2. Athletic Department Staff / Coach A. Instructed to CALL 911 by Certified Athletic Trainer B. When calling EMS, give the following information: i. Identify yourself (MY NAME IS. I AM A (title) at HERNANDO HIGH SCHOOL. WE HAVE AN INJURED ATHLETE ON THE FOOTBALL STADIUM FIELD AT, (805 Dilworth Lane). ii. Give campus location of injured athlete (Football Stadium Field) a) On the field - inform the ambulance service that Security Staff / Administrators / Coaches will be at the Practice Field Entrance on the West End of Dilworth Ln. iii. Inform them of what injury is suspected, a) What signs and symptoms are present, or current state of athlete. (WE SUSPECT THE ATHLETE HAS ) iv. Ask if any other information is needed. v. HANG UP LAST!!!!!! vi. Have individual s personal history & insurance information back to the injury site. a) Certified Athletic Trainer / Legal Guardian / Coach will accompany the athlete in the ambulance to the hospital. 8

10 3. Hernando High School Security Staff / Administrators / Coaches A. Security Staff / Administrators / Coaches will ensure the field access at the West End of Dilworth Lane is unimpeded. B. Security Staff / Administrators / Coaches will direct the ambulance down the practice field access road to the playing surface. C. Security Staff / Administrators / Coaches will keep the practice field access road unimpeded and until the ambulance can exit the premises. 9

11 Emergency Action Plan Hernando High School Gymnasium EMERGENCY PLAN: High School Athletic Complex Emergency Personnel: Certified Athletic Trainers, Team Physician (if present), Athletic Department Staff, Security and Coaches. Emergency Equipment: AED (Teachers Lounge or w/ AT), medical supply kit, splints, access to athletic training room. Emergency Communication: Emergency Personnel s Cell Phones, Gym Landline EMERGENCY PLAN RESPONSIBILITIES 1. Certified Athletic Trainer A. Immediate care of injured or ill individual/ access situation B. Activate Emergency Medical System (EMS) 2. Athletic Department Staff / Coach A. Instructed to CALL 911 by Certified Athletic Trainer B. When calling EMS, give the following information: i. Identify yourself (MY NAME IS. I AM A (title) at HERNANDO HIGH SCHOOL. WE HAVE AN INJURED ATHLETE IN THE GYMNASIUM AT, (805 Dilworth Lane). ii. Give campus location of injured athlete (Gymnasium) a) In the Gym - inform the ambulance service that Security Staff / Administrators / Coaches will be at the Athletic Complex Parking Lot Entrance on Dilworth Ln., behind the Performing Arts Center. iii. Inform them of what injury is suspected, a) What signs and symptoms are present, or current state of athlete. (WE SUSPECT THE ATHLETE HAS ) iv. Ask if any other information is needed. v. HANG UP LAST!!!!!! vi. Have individual s personal history & insurance information back to the injury site. a) Certified Athletic Trainer / Legal Guardian / Coach will accompany the athlete in the ambulance to the hospital. 10

12 3. Hernando High School Security Staff / Administrators / Coaches A. Security Staff / Administrators / Coaches will ensure the parking lot access on Dilworth Lane is unimpeded. B. Security Staff / Administrators / Coaches will direct the ambulance to Main (Southwest) Gymnasium Entrance. C. Security Staff / Administrators / Coaches will keep the gymnasium lobby and entrance unimpeded until the ambulance has exited the premise. 11

13 Emergency Action Plan Hernando High School Baseball Field EMERGENCY PLAN: High School Athletic Complex Emergency Personnel: Certified Athletic Trainers, Team Physician (if present), Athletic Department Staff, Security and Coaches. Emergency Equipment: AED (ATR or Home Dugout), medical supply kit, splints, access to athletic training room. Emergency Communication: Emergency Personnel s Cell Phones, Office Landline EMERGENCY PLAN RESPONSIBILITIES 1. Certified Athletic Trainer A. Immediate care of injured or ill individual/ access situation B. Activate Emergency Medical System (EMS) 2. Athletic Department Staff/ Coach A. Instructed to CALL 911 by Certified Athletic Trainer B. When calling EMS, give the following information: i. Identify yourself (MY NAME IS. I AM A (title) at HERNANDO HIGH SCHOOL. WE HAVE AN INJURED ATHLETE ON THE BASEBALL FIELD AT, (805 Dilworth Lane). ii. Give campus location of injured athlete (Baseball Field) a) On the field - inform the ambulance service that Security Staff / Administrators will be at the Parking Lot Entrance on Dilworth Ln to meet the ambulance and direct them to the Baseball Field Parking Lot. iii. Inform them of what injury is suspected, a) What signs and symptoms are present, or current state of athlete. (WE SUSPECT THE ATHLETE HAS ) iv. Ask if any other information is needed. v. HANG UP LAST!!!!!! vi. Have individual s personal history & insurance information back to the injury site. a) Certified Athletic Trainer / Legal Guardian / Coach will accompany the athlete in the ambulance to the hospital 12

14 3. Hernando High School Security Staff / Administrators / Coaches A. Security Staff / Administrators will ensure the parking lot access from Dilworth Lane is unimpeded and will direct the ambulance to the additional security staff / administrators at the Baseball Field Parking Lot. B. Security Staff / Administrators / Coaches will direct the ambulance, once in the Baseball Field Parking Lot toward the Baseball Field playing surface. C. Security Staff / Administrators / Coaches will keep the Baseball Field Parking Lot free of obstruction until the ambulance can exit the premises. 13

15 Emergency Action Plan Hernando High School Track / Tennis / Softball EMERGENCY PLAN: Middle School Athletic Complex Emergency Personnel: Certified Athletic Trainers, Team Physician (if present), Athletic Department Staff, Security and Coaches. Emergency Equipment: AED (Home Sideline), medical supply kit, splints. Emergency Communication: Emergency Personnel s Cell Phones EMERGENCY PLAN RESPONSIBILITIES 1. Certified Athletic Trainer A. Immediate care of injured or ill individual/ access situation B. Activate Emergency Medical System (EMS) 2. Athletic Department Staff/ Coach A. Instructed to CALL 911 by Certified Athletic Trainer B. When calling EMS, give the following information: i. Identify yourself (MY NAME IS. I AM A (title) at HERNANDO HIGH SCHOOL. WE HAVE AN INJURED ATHLETE AT THE MIDDLE SCHOOL ATHLETIC COMPLEX AT, (700 Dilworth Lane). ii. Give campus location of injured athlete (Track or Tennis or Softball) a) On the field - inform the ambulance service that Security Staff / Administrators will be at the Northeast Entrance on Dilworth Ln to meet the ambulance and direct them to the Middle School Athletic Complex. iii. Inform them of what injury is suspected, a) What signs and symptoms are present, or current state of athlete. (WE SUSPECT THE ATHLETE HAS ) iv. Ask if any other information is needed. v. HANG UP LAST!!!!!! vi. Have individual s personal history & insurance information back to the injury site. a) Certified Athletic Trainer / Legal Guardian / Coach will accompany the athlete in the ambulance to the hospital 14

16 3. Hernando High School Security Staff / Administrators A. Security Staff / Administrators / Coaches will ensure the access from Dilworth Lane is unimpeded and will direct the ambulance to the additional security staff / administrators / coaches at the Middle School Athletic Complex. B. Security Staff / Administrators / Coaches will direct the ambulance, once at the Middle School Athletic Complex to the playing surface. C. Security Staff / Administrators / Coaches will keep the access to Dilworth Lane unimpeded until the ambulance can exit the premises. Legend Red = Track Yellow = Tennis Courts Blue = Softball Field 15

17 Emergency Action Plan Section: Additional Information Hernando High School Football Field House & Weight Room: The Football Field House and Weight Room is located on the South side of campus. Access to this area can be achieved through the Baseball Field Parking Lot. Due to this proximity, any emergency situation will be responded to within the frame work of the Athletic Complex/Baseball Field EAP. Emergency Event Documentation: Emergency management of severe injury or illness must be properly documented. 1. If an HHS student-athlete is injured and an Athletic Trainer (AT) performs the assessment and treatment, the AT is responsible for completing an injury report. 2. If an AT is not present, the administrator for the sporting event will document the injury. 3. All documents will be transferred to Presagia online documentation. 4. If the injury requires doctor visitation/surgery, an injury report will be completed and made available Principal / Athletic Director / Coach upon request. 5. When a Sports Medicine staff member is not present during an incident, an Emergency Response Team member should notify Athletic Trainer immediately: a. Christopher Smith Cell: (901) or (662)

18 Inclement Weather Policy Section: Lightning Lightning is a dangerous phenomenon. Athletic teams that practice and compete while outdoors are at risk when inclement weather threatens. When lightning/thunderstorms develop in the vicinity, it can pose a significant risk to the athletes who may be participating in outdoor activities. This lightning safety policy has been developed to provide information to coaches, administrators, event managers and athletic trainers who oversee these activities. It will serve to minimize the potential risk posed by lightning in the immediate vicinity of the venue. Determination of Danger: The flash-to-bang method of lightning proximity will be used to determine when a dangerous situation develops. 1. Count the number of seconds from the time of a lightning flash is seen until the thunder is heard. 2. If the flash-to-bang is 30 seconds or less, activity should be suspended and everyone should immediately seek out the nearest shelter. (This indicates that lightning is within 6 miles of location.) Flash to bang is determined by second count divided by 5 (30 sec/5=6) 3. A Lightning Detector will be used in addition to Flash to Bang method. The Lightning Detector will only be monitored by the Athletic Trainer. 4. CoachSmart app on Smartphone will help determine number of lightning strikes in the area. Note: this app uses data from the nearest weather station and does not take into consideration recordings from the immediate venue location. Note: Lightning Detector and CoachSmart are only supplements to be used in addition to the flash-to-bang method. *The information described about is derived from NATA Position Statement on Lightning. 17

19 Suspension of Activity: 1. Suspension of practices: a. Whenever present, an Athletic Trainer (AT) will monitor the weather when it appears and electrical/thunderstorm may be imminent. The AT will notify the head coach when a dangerous situation develops which must result in immediate suspension of activity until the danger has passed. b. When an AT is not present, the supervising coach is responsible for monitoring the weather and determining when the conditions become unsafe. 2. Suspension of activity: a. An AT will meet with game officials prior to the event. He/she will explain the process of detecting dangerous lightning and will offer to notify them if imminent danger from lightning is present. b. The AT will ultimately make the final decision to suspend play or resume. 3. Evacuation of facility: a. The decision to evacuate an area will apply to participants, coaches, support staff, officials, and spectators. b. Once the decision has been made to suspend practice or competition due to lightning, the head coach should see that all athletes, coaches, support staff, and game officials are removed from the facility and into the nearest shelter as soon as possible. c. It will be the event manager s role to direct spectators of competitions to the nearest shelter. Safety Locations: HHS Stadium & Practice Field: HHS Baseball Field: HMS Athletic Complex: Field House or Gymnasium Baseball Locker Room or Field House HMS or HHS Gymnasium Resumption of Activity (30-30 rule): Activity, once suspended, should not resume until 30 minutes have passed since the last lightning strike with a flash-to-bang of less than 30 seconds. During competition, resumption of play will be determined by consultation between athletic trainers, coaches, game officials, and athletic administrators. 18

20 Inclement Weather Policy Section: Lightning Safety Tips 1. There should not be any contact with metal objects during an electrical storm. Avoid metal bleacher seats, gold clubs, aluminum bats, and fences. 2. Avoid single trees, tall objects, or standing together in a group. 3. The existence of blue skies and/or absence of rain are not protection from lightning. Lightning can strike from as far as 10 miles away. 4. Avoid using a landline telephone. 5. Avoid standing in water and open fields. 6. A person who has been struck by lightning does not carry an electrical charge. It is safe for responders to perform CPR and has been shown effective in reviving lightning strike victims. 7. If you are unable to reach a safe shelter and lightning is imminent, you should assume the safety position. Crouch down with only your feet touching the ground. Keep your feet close together. Wrap your arms around your knees and lower your head to minimize your body s surface area. Do not lie flat on the ground. 8. If you feel your hair stand on end, feel your skin tingle, or hear crackling noises, you should immediately assume the safety position. 19

21 Heat Guidelines Section: Chain of Command The following chain of command will occur: Notification of Temperature 1. Athletic Trainer (AT) will obtain weather report from National Weather service by 1:00 pm each afternoon prior to practices or events. The Athletic Director / Coach will receive the weather report prior to practices and events. 2. The predicted temperature of the day will dictate which protocol will be followed. 3. AT will check the temperature immediately before practice starts to make sure the correct protocol is implemented. 4. The AT will send a report to the Athletic Director and coaches to notify them of the day s temperatures and restrictions. 5. Weather reports are not required on days where the temperature falls between 45 degrees and 90 degrees. 6. HHS Sports Medicine will use the following weather sites to check forecast: and CoachSmart app on smartphone. a. Zip code used: HHS Sports Medicine team will use a device to measure on field temperatures. Definition of Total Exposure Time Total exposure time begins at the start of any outdoor activity related to practice including warm-ups, stretching, team practice, outdoor conditioning, outdoor meetings/ walk-throughs, and any other activities held outdoors related to the sport 20

22 Heat Guidelines Section: Specific Guidelines Specific heat conditions will determine activity restrictions during practice according to the following: Heat index under 95 F Football: shorts and shoulder pads workout: Football: full pads workout Teams will be in shorts and shoulder pads Water breaks occur every 30 minutes or sooner Each break will allow players with their helmet off Open water policy during entire practice Helmet removal encouraged while not in contact drills Water breaks every 20 minutes Each break will allow players with their helmet off Open water policy during entire practice Helmet removal encouraged while not in contact drills Baseball, Softball, and Soccer Cross Country and Track Players will be required to take a water break every 30 minutes Practice will not exceed 3 hours of total heat exposure Long distance runners need to stay where they can be seen by coaches Athletes cannot run routes where a coach cannot see the athletes running Water break will occur every 30 minutes 21

23 Heat index between 95 F-99 F Football Water breaks every 20 minutes Practice will not exceed 3 hours of total heat exposure Open water policy Baseball, Softball, and Soccer Water breaks every 20 minutes with 5 minutes of total rest time Practice will not exceed 3 hours of total heat exposure Cross Country and Track Runners have to stay within sight of the coaches Water breaks occur every 20 minutes Practice will not exceed 3 hours of total heat exposure Heat index 100 F and higher Football Shorts, pads, and helmets only Breaks will occur every 20 minutes Practice will not exceed 3 hours of total heat exposure Open water policy during entire workout Baseball, Softball, and Soccer Water break every 20 minutes with 5 minutes of total rest Practice will not exceed 3 hours of total heat exposure 22

24 Cross Country and Track Runners have to stay within sight of the coaches Water breaks occur every 20 minutes Practice will not exceed 3 hours of total heat exposure Football Heat Acclimation Guidelines: Practice time in pads may not exceed 3 hours in a single practice. If there are multiple practices in pads on a single day, only one session per day should include full contact. The total practice time in pads may not exceed 5 hours, with practices separated by at least three hours of rest in a cool environment. No student shall participate in multiple practices in pads on consecutive days. Helmets may be worn at any time. A practice would be considered a practice in pads if shoulder pads and/or football pants with or without pads are worn. If weather postpones a practice in pads, the practice may resume after conditions are deemed safe and at the remainder of the allotted practice time may be completed. 23

25 Heat Guidelines Section: Key Terms Heat Cramps Heat cramps are muscular pain and spasm due to heavy exertion and dehydration. Heat cramps usually involve abdominal muscles or legs, and it is generally thought that dehydration is the cause. Heat Exhaustion Heat exhaustion typically occurs when people exercise heavily or work in a warm, humid environment where body fluids are lost through heavy sweating. Fluid loss causes blood flow to decrease in the vital organs, resulting in a form of shock. Heat Stroke Heat stroke is life threatening. The victim s temperature-control system, which produces sweating to cool the body, stops working. The body temperature can rise so high that brain damage and death may result if the body is not cooled quickly. Any heat stroke victim must be quickly cooled and deferred for advanced medical attention. Dehydration Dehydration is when fluid loss exceeds fluid intake. Dehydration can affect an athlete s performance in less than an hour of exercise- sooner if the athlete begins the session dehydrated. Dehydration of just 1%-2% of body weight (only lbs for a 150 lb athlete) can negatively influence performance. Dehydration of greater than 3% of body weight increases an athlete s risk of heat illness. Warning signs of dehydration: Thirst Irritability Headache Weakness Dizziness Cramps 24

26 Concussion Policy Section: Mississippi Youth Concussion Law Beginning in 2014, the Mississippi State Legislature implemented House Bill No. 48, known as the Mississippi Youth Concussion Law. It is a concussion policy that all public and private schools must follow. Every individual involved in athletics must become more proactive in identifying and treating athletes who show signs of concussions. In order to address this critical issue, the NFHS has drafted the following language and made it a part of every sport rule book publication: Any player who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the game and shall not return to play until cleared by an appropriate health-care professional. Education is the key to identifying and treating student-athletes that show signs of a concussion during athletic participation. It is very important that every administrator, coach, parent, official, athlete, and health-care provider know the symptoms and steps to take when dealing with student-athletes that display signs of a possible concussion. Concussion can be a serious health issue and should be treated as such. The Acute Concussion Evaluation (ACE) plan on the CDC website ( contains specific instructions that shall be followed before an athlete can return to sports. The form must be completed and signed by a licensed medical doctor (M.D.), Osteopathic Physician (D.O.), or a Clinical Neuropsychologist with Concussion Training before an athlete that has been removed from practice or a game may return to participate. A copy of the form must be kept on file at the school by an administrator. It is strongly recommended that member schools meet with their coaching staff and review this policy prior to beginning of every sports season. This information should also be given to all parents and student-athletes. 25

27 Concussion Policy Section: Protocol 1. Dr. Chip Christian and Christopher Smith M.Ed., ATC, are the designated health care providers during all home contests. The onsite MHSAA officials will be notified of them before each contest. 2. Remove any player that shows signs, symptoms, or behaviors consistent with a concussion per NFHS rules. 3. Inform the head coach that the player is being removed for showing signs, symptoms, or behaviors consistent with a concussion. 4. The player will be examined by designated health care providers. If the designated health care provider determines that the student has not sustained a concussion, the head coach and an official during an appropriate stoppage of play. The athlete may re-enter competition pursuant to contest rules. 5. The athletic trainer is in charge of getting clearance from the athlete s chosen healthcare provider. In the event an athletic trainer is not present, this task will fall on the head coach to complete. 6. If the school s designated health care provider is not present, OR if the designated health care provider suspects that the athlete may have sustained a concussion, the only means for an athletes to return to practice or play is for the student to be evaluated and cleared by a licensed medical doctor (M.D.), Osteopathic Physician (D.O.), or a Clinical Neuropsychologist with Concussion Training. 7. If signs, symptoms, and behaviors consistent with a concussion are observed by an official, AND the designated health care provider is not available to evaluate the student athlete, written Return to Play clearance MUST be completed and signed by a licensed medical doctor (M.D.), Osteopathic Physician (D.O.), or a Clinical Neuropsychologist with concussion training, and shown to the official(s) by the head coach prior to the student-athlete returning to participate in a contest the same day. 8. Officials have no role in the diagnosis of a concussion. NFHS rules do require that the officials remove players from the contest when signs, symptoms, or behaviors consistent with a concussion are observed and the above written protocol must be followed. 26

28 Designated Health Care Providers Certified Athletic Trainer Certified Nurse Practitioner Physicians Assistant Doctor of Medicine Osteopathic Physician. 27

29 Concussion Policy Section: Management Concussion Management (Pre-Return to Play): 1. No athlete should return to play (RTP) or practice on the same day of a concussion 2. Any athlete suspected of having a concussion should be evaluated by an appropriate health-care professional that day. 3. At home guidelines shall be given to parents of a student-athlete suspected of a concussion: a. No TV b. No cell phone use c. No computer use d. No homework e. No other activities that could impair healing 4. Any athlete with a concussion should be medically cleared by an appropriate health-care professional prior to resuming participation in any practice or competition. 28

30 Concussion Management (Post-Return to Play): 5. After medical clearance, RTP should follow a step-wise protocol with provisions for delayed RTP based upon return of any signs or symptoms: a. Day 1: Low levels of physical activity: walking, light jogging, light stationary biking, and light weightlifting (low weight moderate reps, no bench, no squats). b. Day 2: Moderate levels of physical activity with body/head movement: moderate jogging, brief running, moderate stationary biking, moderate weightlifting (reduce time and/or reduced weight from typical routine). c. Day 3: Heavy non-contact physical activity: sprinting/running, high intensity biking, completing regular weightlifting routine, non-contact sport-specific drills. d. Day 4: Sports specific practice. e. Day 5: Full contact in a controlled drill or practice. f. Day 6: Return to competition. g. Movement onto the next level should only occur if the studentathlete does NOT experience any symptoms at the present level. If symptoms return, health care provider shall be notified, and the student-athlete shall return to the first level and restart the protocol once a symptom free 24 hours has occurred. 29

31 MRSA / Staph Policy Section: Recognition What is Staph/MRSA? Staphylococcus aureus, often referred to as staph, is a common type of bacteria that can live harmlessly on the skin or in the nose. Occasionally, staph can escalate into an infection. Most of these infections can be treated without antibiotics; however, some staph infections can cause serious infections, such as pneumonia, bloodstream, bone, and joint infections, and surgical wound infections. In the past, most serious staph bacterial infections were treated with a certain type of antibiotic related to penicillin. In recent years, treatment of these infections has become more difficult because staph bacteria have become resistant to various antibiotics. These resistant bacteria are called methicillinresistant staphylococcus aureus (MRSA). MRSA is one type of skin infection among several that are of concern in competitive sports. Who Gets Staph/MRSA? Staph and MRSA are becoming increasingly common in student-athletes participating in close contact sports (eg. Football, lacrosse, etc), although anyone, including coaches, staff, etc, who come into contact with colonized individuals, can contract the infection. Staph and MRSA are spread either by direct physical contact or indirect touching of contaminated objects. This includes touching, using, and/or sharing sheets, towels, clothes, equipment, dressings, personal items, bar soap, etc. which have been used by someone who has staph and/or MRSA, along with poor hygiene habits (e.g. hand washing, showering, etc.) What Does Staph/MRSA Look Like? Staph and/or MRSA usually presents as some types of skin or soft tissue infection such as pimples, abscesses, pustules, and/or boils. Some can be red, swollen, painful, and/or have pus or other drainage. The pustules may be confused with insect bites initially, and may also be associated with existing turf burns or abrasions. What to Do? Without proper referral and care, more serious infections may cause pneumonia, bloodstream, bone, and/or joint infections, and/or surgical wound infections. If you or anyone you know has what appears to be what looks like staph/mrsa, please contact the athletic trainers as soon as possible for evaluation. 30

32 MRSA / STAPH Policy Section: Prevention General Prevention of Staph and/or MRSA: 1. Education of student-athletes, students, and general population. 2. Practice good hand hygiene by washing hands frequently and in a thorough fashion with soap and warm water or using an alcohol-based hand sanitizer. 3. Take a shower with hot water and wash with soap (liquid antibacterial soap, not bar soap) following all activities. 4. Avoid sharing towels, equipment, razors, soap. 5. Use a barrier (clothing or a towel) between your skin and shared equipment. 6. Wipe surfaces of equipment before and after use. 7. Clean and properly cover any open wounds such as turf burns, abrasions, lacerations, etc. with an appropriate bandage at all times. 8. Avoid whirlpools, hydrotherapy pools, cold tubs, swimming pools, and other common tubs if you have an open wound. 9. Maintain clean facilities and equipment. 10. Do not ignore skin infections, pimples, pustules, abscesses, etc. Report these to an Athletic Training staff member immediately. 31

33 Specific Prevention of Staph and/or MRSA: Treatment & Taping Tables Treatment tables and taping tables must be cleaned every day and/or following a possible contamination using a Disinfectant Decontaminant Cleaner or Disinfecting Towelettes. Towels & Linens Cloth towels will only be used on a single patient and should be laundered following every use. Disposable towels should be used whenever feasible and be disposed of after single use. Hydrocollator Packs / Covers Whirlpool Clothing or a cloth should be placed between the patient and the hydrocollator pack. Cover if an open wound exists. Hydrocollator covers should be laundered every week and/or following a possible contamination. Whirlpool will be cleaned on a daily basis, or as needed following every possible contamination. Whirlpool will not be used if the student-athlete has an open wound. Responsibilities if an Outbreak is Suspected: 1. If a student-athlete presents with a suspicious infection, the athletic trainer will refer the student-athlete to a physician immediately. 2. Antibiotic of physician s choice will be prescribed. 3. The coaching staff will be notified to make sure the athlete s equipment is being washed by itself and not with the rest of the student-athletes. 4. The head coach will notify the cleaning crew of the outbreak to make sure the locker room and other areas are clean. 32

34 Reference: National Athletic Trainers Association (NATA)- Walsh KM, Bennett B, Cooper M, Holle RL, Kithil R, Lopez RE. National Athletic Trainers Association Position Statement: Lightning Safety for Athletics and Recreation. Journal of Athletic Training. 2000; 35(4):