St. Andrews University Athletic Training Department Philosophy The St. Andrews University Athletic Training Department is responsible for protecting

St. Andrews University Athletic Training Department Philosophy The St. Andrews University Athletic Training Department is responsible for protecting each student-athlete from harm or injury during their involvement in intercollegiate athletics. The primary responsibility for the Athletic Training Staff is to prevent, recognize, manage, and rehabilitate athletic related injuries. If and when an injury or an athletic related medical emergency presents it is of the upmost importance for the athletic training staff to prevent reinjury or reoccurrence. The rapid and safe return of student-athletes back to full participation is the ultimate goal of the Athletic Training Staff at St. Andrews University under the direct supervision of a team physician. In order to fulfill this goal professional judgment that is supported through proper evaluation, adjunct medical referrals, and timely administration of proper care will be instituted. By acting rationally and logically in the handling of an injured or ill student-athlete, the Athletic Training Staff can protect the student athlete from further injury or harm. The purpose of the Athletic Training Department at St. Andrews University is to assist in achieving athletic success and therefore we ask our student-athletes to hold our staff to the same standards. The Athletic Training Department at St. Andrews University has complete authority over medical clearance for intercollegiate participation. Student- athletes competing in intercollegiate athletics must be enrolled at St. Andrews University and be cleared by the Athletic Training Department prior to participation. Should an injury or participation restricting medical condition occur, the supervising athletic trainer for the sport involved, reserves the right to hold an athlete from participation if it is in the best interest for the safety or health of the athlete.

St. Andrews University Athletic Training Department General Medical Policy To assure that the Athletic Training Facility Policies and Procedures are carried out efficiently please read, understand, and abide by these policies: Athletic Training Facility General Hours of Operation: Monday Friday: 10:00 11:30 pm 12:00 1:00 pm Closed for Lunch 1:00 2:30 pm 2:30 4:00 pm Prep/Pre-Practice 5:00 pm Athletic Training Facility Closed to general services Post Practice Care is arranged per team athletic trainer Weekend & Other Hours are by APPOINTMENT ONLY! Injuries: Injuries should be reported to the Athletic Trainer immediately or at the end of practice. Immediate treatment of an injury is crucial in aiding a speedy and effective recovery. Do not wait to report an injury to the athletic trainer time is a key. Never use heat on a new injury unless advised by the athletic trainer or team physician. Illness: Report to the Athletic Training Facility as soon as possible, an Athletic Trainer will assist you in scheduling an appointment or referring you to the best medical professional. If a studentathlete becomes ill during the night or hours out of operation, he/she should contact an Athletic Trainer as soon as the Athletic Training Facility opens the following day. If an emergency occurs, notify a Resident Director or Resident Assistant on duty or if the situation is lifethreatening dial 911. Physician Services: If a student-athlete sustains an athletic injury he/she should report to their supervising Athletic Trainer. Once an evaluation has been performed, the Athletic Trainer will determine if a referral is warranted. The Athletic Department will NOT be held responsible for any charges unless you have secured written permission and proper referral from the St. Andrews University Athletic Training Staff. Please refer to the Insurance Policy and Procedure for further information on coverage of medical expenses. Non-Athletic Events: Injuries or illness sustained via participation in any non-sanctioned St. Andrews University intercollegiate athletic event are solely the responsibility of the studentathlete. This includes but is not limited to club activities, recreational activity, St. Andrews Equestrian, intermural participation, unsupervised athletic practices or games.

Rules and Regulations of the St. Andrews University Athletic Training Facility Please abide by the following rules and regulation when entering the Athletic Training Facility 1. Appropriate dress and attire is required when in the Athletic Training Facility. Studentathletes who are not properly attired for a co-ed facility will be asked to leave. THIS RULE WILL ONLY BE WAIVED IN CASES OF EXTREME EMERGENCY. a. Whirlpool attire: Shirts and shorts must be worn in whirlpool, no spandex or leggings. 2. Sports equipment is to be left outside of the Athletic Training Facility. 3. NO SHOES on treatment tables or other surfaces used for treatment 4. Cleated shoes of any kind are not allowed in the Athletic Training Facility 5. No HORSEPLAY or PROFANITY will be tolerated in the Athletic Training Facility. Student-athletes will be warned and then asked to leave regardless if rehabilitation or treatment has been completed. 6. All student-athletes must speak in English when in the Athletic Training Facility. 7. No student-athlete is allowed to enter the Athletic Training Facility storage closet without permission or unless accompanied by an Athletic Trainer. Removal of equipment of supplies is strictly prohibited without the consent of an Athletic Trainer. 8. No student-athlete is to operate any therapeutic modality machine! 9. No food or drinks should be brought into the Athletic Training Facility, unless under specific/special circumstances. 10. No tobacco products will be tolerated in the Athletic Training Facility. The usage of tobacco products has been banned during all practices and competitions, as supported by the NAIA, Mid-South, and Appalachian Athletic Conference. 11. Whirlpool usage requires that each student-athlete shower prior to entering the whirlpool. There is a limit of 10 minutes unless otherwise instructed by the supervising Athletic Trainer. Student-athletes are also required to bring their own towel. 12. Non-athletic injuries sustained will NOT be treated in the athletic training room, studentathletes are solely responsible for the care of these injuries.

St. Andrews University Athletic Training Insurance Policy and Procedures St. Andrews University is concerned with the overall well-being and health of its students-athletes. The institution provides athletic accident coverage for all full-time students who participate in intercollegiate athletics. The athletic insurance plan is an EXCESS coverage policy only. All claims must be filed with the primary insurance first. Benefits are available for covered expenses after all other plans providing medical expense benefits have considered the expenses. The plan covers from the first date to the last date a student athlete is required to be on campus for participation. In order to be considered eligible for this insurance policy each student-athlete must complete all medical participation forms. These include forms related to parent/guardian information, primary/secondary insurance information, HIPPA Protected Health Information, substance abuse/code of conduct, assumption of risk, health history, and acceptable physical examination. If any of these forms are not completed to acceptable parameters, the studentathlete is not medically eligible for participation at St. Andrews University and will not be covered under the excess insurance policy. It is required that all student-athletes also have a valid primary insurance carrier, and that a current copy of the active insurance card is on file with the Athletic Training Department. All costs incurred due to non-athletic related injury and illness will be submitted to the athlete s primary insurance carrier and the remaining balance is the responsibility of the studentathlete and/or parent(s) or guardian(s). Medical abnormalities or pre-existing conditions are the responsibility of the student-athlete and/or their parent(s) or guardian(s). Any costs that are denied by the excess insurance policy are also the responsibility of the student-athlete and/or their parent(s) or guardian(s). It is the responsibility of the student-athlete and/or their parent(s) or guardian(s) to provide the athletic insurance coordinator any outstanding statements and information within an appropriate time frame for consideration of excess insurance claim.

St. Andrews University Excess Policy Description St. Andrews University has purchased a basic accident insurance policy through K&K Insurance Company to cover students during their participation in NAIA recognized sporting events to help cover any gaps that may arise between a primary insurance policy (required for participation), and the Catastrophic Insurance Policy provided by the NAIA. As this is an excess policy, it only covers medical costs associated with an athletic injury that are not covered by any other valid and collectible insurance. St. Andrews University s policy has a $1,000.00 per injury deductible, which must be met through either primary insurance payments or out of pocket costs. Provider discounts do not count towards this deductible. The maximum benefits for St. Andrews s policy are set at $25,000.00 per injury at which time the NAIA s Catastrophic Insurance Policy would begin. This policy does cover most standard care for athletic injuries, but non-traditional, experimental, elective or highly specialized treatments/braces may not be covered. It is important to check with the Athletic Training Department before receiving any treatments. This policy does not provide coverage for general medical conditions/illnesses or pre-existing conditions. This policy becomes null and void if the student-athlete does not adhere to the St. Andrews University Policies for utilizing the secondary athletic insurance policy.

Excess Insurance Procedures Athletic Injury Claim Form Procedures 1. All injuries must be reported to a SAU Certified Athletic Trainer within 72 hours of the injury occurrence. If you do not report the injury within 72 hours, you may be held responsible for any expenses incurred as a result of treating the injury. 2. All injuries requiring a referral must be documented with an injury claim form. This form must be filled out by a SAU Athletic Trainer. 3. All injury claim forms must be submitted to the excess insurance carrier by a SAU Athletic Trainer. 4. A copy of the excess insurance card will be given to the student-athlete to give to each provider that he/she receives services from. For example: if a student-athlete is seen by Dr. Alexander and Dr. Alexander sends the student-athlete to receive x-rays by Scotland Memorial Hospital, the student-athlete must provide each provider (Dr. Alexander and Scotland Memorial Hospital) with the insurance card. If the insurance card is not given to the provider, payment for services may not be provided within the limits of the SAU Policy. 5. The excess insurance carrier will send an Explanation of Benefits (EOB) to the address listed on the patient information form for the student-athlete stating that a claim has been filed with respect to an athletic injury to the student-athlete. All further EOB s from the excess insurance company will be sent to the athletic training insurance coordinator. Primary and/or Secondary Insurance Procedures 1. A primary insurance carrier is required for each student-athlete. If a commercial carrier (i.e. Anthem, United HealthCare, Cigna, Humana, Blue Cross Blue Shield) is not available, the student-athlete will be required to enroll in the university s primary insurance plan. a. All student-athlete s enrolled in NC Medicaid or out-of-state Medicaid are required to purchase the university s primary insurance for participation. b. All International students are required to purchase the university s primary insurance for participation.

c. Information about obtaining student health insurance can be found by visiting https://www.sa.edu/student-life/insurance-forms. d. Parents and/or legal guardians are able to carry dependents on their insurance up to the age of 26 years. e. If your primary insurance carrier is an HMO plan requiring a Primary Care Physician (PCP), changing the PCP to a local physician in the Laurinburg area will expedite care for athletic and non-athletic injuries or illnesses. In the event the student-athletes PCP cannot be changed to a local PCP the student may be required to enroll in the school s primary insurance plan. 2. Medical bills will always be sent to the student-athletes primary and/or secondary insurance carrier. 3. Your primary and/or secondary insurance carrier will send you an explanation of benefits (EOB) for the medical services provided. If there is a denial of medical services, your primary and/or secondary insurance carrier will send you a DENIAL explanation of benefits (EOB). 4. ALL EOB s and statements should be brought to the athletic insurance coordinator, so that they may be submitted to the athletic insurance company. 5. Once the excess insurance carrier receives all necessary information the underwriter will determine the status of payment based on the limits within the excess athletic insurance policy. a. If the excess insurance carrier determines that the services are within the limits of the athletic insurance policy, payment will be rendered for that service. b. If the excess insurance carrier determines that the services charged are not within the limits of the athletic insurance policy, payment will be denied i. If payment is denied in full, the student-athlete assumes all costs related to that service. ii. If payment is denied in part (typically due to charges over the usual and customary), the student-athlete assumes all costs remaining. 6. All expenses must be incurred within 90 (ninety) days after the covered accident. 7. A student-athlete may only receive benefits for services that have occurred up to 365 days from the date of the covered accident. 8. The student-athlete may submit the incurred expenses for 1 year from the date of the covered accident.

NAIA and SAU Tobacco Policy The NAIA and St. Andrews University ban the use of all tobacco products by all game personnel during practice and competitions. This includes the use of smoked and smokeless products by the officials, coaches, players, managers, and Athletic Trainers in any and all athletic facilities including the Athletic Training Room. NAIA Nutritional/Dietary Supplements Warning Before consuming any nutritional/dietary supplement product, review the product with the appropriate or designated athletics department staff! 1. Dietary supplements, including vitamins and minerals, are not well regulated and may cause a positive drug test result. 2. Student-athletes have tested positive and lost their eligibility using dietary supplements. 3. Many dietary supplements are contaminated with banned drugs not listed on the label. 4. Any product containing a dietary supplement ingredient is taken at your own risk. Note to Student-Athletes: There is no complete list of banned substances. Do not rely on this list to rule out any supplement ingredient. Check with your athletics department staff prior to using a supplement or visit http://www.naia.org/fls/27900/1naia/resources/csa/naia_banned_substances_list.pdf?db_o EM_ID=27900 To prevent testing positive for any banned substances the Athletic Training Department encourages student athletes to visit dfsaxis.com to review all supplements and substances they are taking. When on the website, use the drop box to select NAIA as your organization and password: naialive5. If any questions, contact the Athletic Training Department. Consent to Drug Testing The Student-Athlete is required by St. Andrews University to participate in random drug testing. This policy is not to be construed as a contract between the university and the student-athlete. A signed consent form and notification form shall be confirmation of the student-athlete s agreement to the terms and conditions contained in this policy and shall be a legal contractual obligation of the student-athlete.

Drug Testing Policy The purpose of drug testing at St. Andrews is to provide for the health and safety of athletes who participate in Intercollegiate Athletics. The Athletic Department views drug use as an unacceptable behavior choice and detrimental to our efforts to fulfill the mission of the University. The drug-testing program will seek to identify student-athletes in need of assistance with a drug use problem and provide them with appropriate intervention, education, and supportive counseling. Procedures: St. Andrews University reserves the right to test for any substance of their choosing. Random drug testing will take place on a regular basis with each student-athlete being eligible for selection at each drawing, regardless of whether or not the student-athlete has been tested previously. Each Student-Athlete is also eligible for drug testing during the Championship and Non-Championship segments of competition. Any student-athlete may also be tested at the request of the Head Coach, Athletic Trainer, or Athletic Director, or a member of the Student Affairs office if reasonable suspicion exists that the student- athlete has participated in prohibited drug or substance abuse. The Director of Athletics must authorize Reasonable Suspicion Testing. This testing will follow the normal substance testing protocols and the student-athlete will be subject to established sanctions for testing positive. There are four circumstances that constitute a positive drug test: 1. A positive identification of the adopted policy of NAIA banned substance in the urinalysis. 2. A refusal or failure to take the test when notified. 3. Any manipulation or tampering with the urinalysis that may alter the results of the test. 4. Failure to report to the Athletic Training Room, or mandated testing site, within the allotted time or the specified date. If you are selected for drug testing, an Athletic Trainer will notify you. You must report to the Athletic Training Room within the allotted time. The student-athlete must reply to any attempt of contact by the Athletic Trainer or it is deemed as refusal to take the test. A member of the Athletics Staff may provide you with transportation to the testing site. All drug testing will be

conducted at the Occupational Health Center of Scotland Memorial Hospital. You must bring your driver's license or other picture identification with you to the testing site. In addition, you must remain at the site until you provide a viable urine sample to be tested. The appropriate personal will be notified with the results. The University is aware of the possibility of "false positive" testing. If you are taking any prescription medications: have the pharmacy name, medication name, the dosage of the medications, how often to take medication, and how long you ve been under the direction of the physician available for verification. Any student-athlete taking ADD or ADHD medications must have documentation on file with the Athletic Training Staff before testing is conducted. If no documentation is on file for ADD or ADHD medication, this will be a positive test and the same corrective actions apply Sanctions: A positive drug test for any of the substances on the NAIA list of banned drugs or those of St. Andrews University s choosing will result in the following sanctions: First Offense 1. Suspension up to two competitions 2. Substance assessment and counseling 3. Parental notification The student-athlete must submit to a second test before resuming competition. The follow-up test is at the student-athlete s expense. Second Offense 1. Suspension up to 50% of the remaining competitions 2. 10 hours of community service 3. Mandatory meeting with the Head Coach and the Athletic Director The student-athlete must submit to another test before resuming competition. The follow-up test is at the student-athlete s expense. Once a student-athlete has tested positive for a banned substance, a third positive test that occurs at any time during the student-athletes collegiate career at St. Andrews University may result in non-renewal of athletic scholarship and dismissal from the team or teams. The Athletic Director has the discretion to assign sanctions that may include, but not limited to, a probationary period, frequent substance testing, or suspension or dismissal.

Appeal Process: A student-athlete wishing to appeal the outcome of their drug test must do so within 48 hours of receiving the results of the test. A written appeal request must be submitted to the Compliance Coordinator. Once the appeal process has begun the appeal committee will make a decision within 15 days. This committee will be made up of three members. These members will not be a part of the testing procedure, but rather other areas of the educational institution. If a second appeal is needed that written request would go to the Vice President for Administration within 24 hours of ruling. The same process applies for the second appeal as what was adhered to through the first appeal. A third and final appeal will go to the President of the University. This again will be in writing and within 24 hours of the decision of the second appeal. The President will make the final ruling within the allotted 15 days. *St. Andrews University reserves the right to revise this policy at any time.*

Emergency Action Plans Knights Field (Soccer Game Field) Soccer game field: Enter St. Andrews University by turning onto Dogwood Mile, stay straight, field enclosed by fence on left, turn left onto service road just past the soccer field, go to the end of the road and drive over a small curb and the field access gate located on the far end of the field to the left of the scoreboard. Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Soccer Practice Field Soccer practice field: Enter St. Andrews University by turning onto Dogwood Mile; continue straight, practice fields on the left, no gate so can pull directly off road onto the field Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Football Practice Field Football practice field: Enter St. Andrews University by turning onto Dogwood Mile, take first left onto Magnolia, football practice field on right encircled by track, the gate is located at the first turnoff of the back parking lot Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Knights Field (Football and Lacrosse Game Field) Lacrosse and Football game field: Enter St. Andrews University by turning onto Dogwood Mile, take immediate left behind softball field (through grass) to double gate near field goal post on the backside of the football field. Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Clark Field (Baseball) Baseball field: Enter St. Andrews University by turning onto Dogwood Mile, take first left onto Magnolia, continue past field on right, turn right into first parking lot entrance, access gate is located on the right with direct access to Right Field. Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Softball Field Softball field: Enter St. Andrews University by turning onto Dogwood Mile; take first left, softball field on left, access gate is located in in Right Field Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Lacrosse Practice Field Lacrosse Practice field: Enter St. Andrews University by turning onto Dogwood Mile, first field on left behind softball centerfield and behind Wells Fargo Bank. Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

PE Center and Harris Gym PE Center Gymnasium: Enter St. Andrews University by turning onto Dogwood Mile, take first left onto Magnolia, continue past fields on right, turn right into last parking lot entrance, PE Center is on the left with double door and sliding door and ramp access, enter building and the gym is straight ahead Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

O Herron Swimming Pool PE Center: Enter St. Andrews University by turning onto Dogwood Mile, take first left on Magnolia, continue past fields on right, turn right into backside of PE Center parking lot entrance, Glass door with ramp access, enter building and turn left, then turn right, Pool straight ahead Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Athletic Training Room PE Center: Enter St. Andrews University by turning onto Dogwood Mile, take first left on Magnolia, continue past fields on right, turn right into last parking lot entrance, PE Center on the left with double door and sliding door and ramp access, enter building and turn right, Athletic Training Room straight ahead on the right Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Wrestling Room (Back Gym) PE Center: Enter St. Andrews University by turning onto Dogwood Mile, take first left on Magnolia, continue past fields on right, turn right onto Belk Circle, PE Center on the right with double door and ramp access (1 st entrance to the building), come up the ramp and turn right once inside the doors. Roles of First Responders: (Athletic Trainer OR Coach) *** If the Athletic Trainer is not on site at time of incident, coach will act as first responder and will call/send for the Athletic Trainer. The Athletic Trainer will then assume care for the injured studentathlete. 1. Immediate care of the injured or ill student-athlete: respond to injury situation, assess student-athlete and situation, and decide if emergency equipment is required and/or EMS/emergency vehicles are necessary 2. Emergency equipment retrieval 3. Activation of Emergency Medical System (EMS) a. Call 911 from cellular phone b. Provide the following information: i. Caller name and position ii. Location of emergency iii. Telephone # iv. Explain what happened v. Condition of victim vi. Care being provided vii. Specific directions to injury site viii. Other information as requested ix. Hang up only after dispatcher hangs up 4. Direction of EMS to scene a. Select an individual (coaching staff member or a non-injured athlete) to meet EMS and ensure appropriate gate is open and unlocked b. Designate three individuals to form a chain of visual contact to direct all EMS personnel to the injury site c. Scene control: limit scene to first aid providers and move bystanders away from area 5. Once EMS arrives on injury scene: a. First responder (Athletic Trainer) relinquishes care and responsibility of injured student-athlete b. First responder (Athletic Trainer) relays all pertinent information to EMS providers first, and then to coaching staff as necessary c. Athletic Trainer should accompany student-athlete to hospital if possible d. Athletic Trainer should contact family if necessary only after obtaining the student-athlete's permission, if over 18 years of age Emergency Communication: Athletic Trainers: Kaitlin Griego 609-290-5115, Natalie High 704-989-5002, Shelby Martin 704-254-3312, Hannah Gawor 216-926-7898

Injured Athlete Procedure When Traveling Without an Athletic Trainer For athletic events in which a Certified Athletic Trainer does not travel, a fully stocked medical kit will be given to the appropriate coaching staff. The medical kit will also contain emergency contact and insurance information. If an athlete sustains an injury while on the road, the coaching staff should contact the host schools medical staff for appropriate referral to the nearest medical facility, if needed. Once the athlete has been transported, evaluated, and a plan of care is in place, the appropriate Athletic Trainer at St. Andrew's should then be notified. The Staff Athletic Trainer will then make sure the appropriate insurance is filed and make other arrangements for the athlete's care once back at St. Andrews University. The Staff Athletic Trainer will also notify appropriate staff of the injury. All parties need to be considerate of the HIPPA Rules and its requirements. During this time is crucial to keep private information private such as, athletic injuries. Responsibility of the coaching staff: 1. Communicate with all medical personnel home and away 2. File the student-athlete s personal insurance with the medical facility 3. Get contact information of the medical facility and give to Staff Athletic Trainer Responsibility of the Athletic Training Staff: 1. Get appropriate insurance information and claim filed with K & K Insurance Agency 2. Make arrangements for follow-up care once the student-athlete arrives home 3. Communicate with appropriate personnel about the student-athlete's care Special Note: Efforts should be made to contact a member of the Athletic Department Administration if any injuries require hospital/emergency care. Remember; do not share any information in regards to injuries, to the media or to the public.

Lightning Policy Chain of Command: 1) Athletic Trainers 2) Director of Athletics 3) Game Management Staff 4) Coaches 5) Officials Lightening Regulations: St. Andrews University lightening policy is adopted from the Mid-South Conference. The policy states at the 15-mile radius an alert to the game official and game management will be stated that there is a potential of delay. The 12-mile radius will state an alert to the game official and game management that preparedness for safety procedures should readied. This may include announcement through public announcement at the facility discussing the risks, location of safety shelter/facility, and/or notification that clearance should and safety be completed within the time lightning strikes reach 6 miles. The 8-mile radius will be immediate removal from the facility activation of safety procedures. These procedures should be implemented before the lightning strike reaches the 6-mile radius. It should be clarified that any lightning policy is in regards to cloud-to-ground lightening. The lightning strike distance is measured in statue miles and is in a radius of the point of location in questions. It also should be clarified that any amendment does not replace that best judgment shall take precedent and that if an institution needs longer than any proposed adjustments the institution must activate their policy and procedure for fan safety. St. Andrews University does not provide shelter for fans, it is suggested for all spectators to remove themselves from the bleachers into the safety of their cars or other protective shelter. Designated Weather Watcher: Athletic Trainers will monitor weather forecasts throughout day via WeatherSentry or other lightning monitoring services. In the instance that an Athletic Trainer is not present, the coach will also have responsibility as a weather watcher. Safe Locations: Primary: any fully enclosed building with plumbing, electrical service and telephone (ex: Physical Education Building and dorms). Secondary: a fully enclosed vehicle with a metal roof and windows completely shut. Do not touch any part of the metal framework. Unsafe Locations: Under or near trees, golf carts, under bleachers, middle of field/clearing, in/on water, locker room showers, swimming pools, on land-line phone (a cell phone is safe alternative to land line phones).

Criteria for Resumption of Activities: The NSSL and the National Athletic Trainers Association (NATA) recommends waiting 30 minutes from the last lightning strike seen and/or thunder heard before returning to outdoor activity. Emergency Care for Lightning Strike Victims: 1. Survey the scene for safety 2. Activate Emergency Plan CALL 911 3. Carefully move the victim to a safe area 4. Evaluate and treat for apnea (not breathing) and asystole (no heart beat) 5. Evaluate and treat for hypothermia and shock 6. Evaluate and treat for fractures 7. Evaluate and treat for burns *Note: Lightning strike victims carry no electrical charge therefore it is safe to make physical contact.

Hot Weather Policy All outdoor athletic events at St. Andrews University operate under guidelines highlighted in the following table. The Certified Athletic Trainer is responsible for communicating to all athletic personnel and employing these guidelines. In the event a Certified Athletic Trainer is not present, it is the responsibility of the coaches and student-athletes to adhere to the following table to determine the guidelines recommended for practice conditions. Temperature Zone Guidelines/adjustments Low Risk Zone (WBGT < 65 F) Perform activity as planned Include fluid breaks every 20-30 minutes of practice Moderate Risk Zone (65 F < WBGT < 75 F) Include fluid breaks every 15-20 minutes of practice High Risk Zone (WBGT > 75 F) Consider delaying/canceling/rescheduling activity If applicable, no protective equipment may be worn The Wet Bulb Globe Temperature (WBGT) is a composite temperature used to eliminate the effect of temperature and humidity on humans.

Recognition: Signs & Symptoms of Common Heat Injuries Heat Cramps Dehydration Thirst Sweating Transient muscle cramps Fatigue Heat Syncope Dehydration Fatigue and Dizziness Lightheadedness Pale/Sweaty Skin Tunnel Vision Exercise (heat) Exhaustion Core Temperature (97.0-104.0 F) Dehydration Dizziness Lightheadedness Syncope Headache Nausea Intestinal cramps/diarrhea Pallor Profuse Sweating Cool, Clammy Skin Weakness Hyperventilation Exertional Heat Stroke Core Temperature (> 104.0 F) Dizziness Drowsiness Irrational Behavior Confusion/disorientation/irritability Loss of consciousness Dehydration Weakness Hot and Wet/Dry Skin Tachycardia (100-120 bpm) Hypotension Hyperventilation Vomiting If a Certified Athletic Trainer is NOT PRESENT: 1. Immediately call and refer the athlete to the Athletic Training Facility in the PE Building. 2. Should no member of the St. Andrews University Athletic Training Staff be available at the time, the athlete should be sent to Scotland Memorial Hospital Emergency Room or in cases of extreme circumstances CALL 911. Any athlete that seeks medical assistance outside of St. Andrews University for heatrelated illness MUST follow up with a physician for clearance PRIOR to returning to activity. Unsafe Conditions: Scheduled practices and games shall continually be evaluated. Should conditions be deemed unsafe (due to temperature, wind chill, WBGT or ice/snow field covering) a collaborative decision for cancellation/postponement shall be made between the Head Coach, Facilities Director, Certified Athletic Trainer, Game Officials when applicable and when necessary, the specific Administrative Sports Supervisor.

Fluid Replacement Athletes who practice or compete in an excessively hot and humid environment may have a decrease in essential fluids, carbohydrates, and electrolytes that an ultimately lead to dehydration and potential heat illness. It has been shown that dehydration of just 1-2% of body weight can change an athlete s physiological function and decrease an athlete s performance. Athletes need to be properly hydrated prior to the start of practice or competition to decrease risk of heat illness. Signs and Symptoms of Dehydration Thirst Irritability General discomfort Headache Weakness Dizziness Nausea Cramps Chills Vomiting Head or neck heat sensations Decreased performance Timing Everyday Recommendations Drink adequate fluids. Roughly 1 ml for every calorie consumed. For example, if you eat 4000 calories, drink 4000 ml of fluids (4 L). 2-3 Hours before training/competition 17 oz. of fluid (1 bottle of water) Immediately prior to training/competition Every 15-20 minutes during training/competition Exercise longer than one hour After Exercise 6-12 oz. of fluid 6-12 oz. of fluid Be sure to include a carbohydrate source in the form of solid, gel or sports drinks. Consume roughly 30-60 grams of carbohydrate per hour. 600-1200 ml of a sports drink will fulfill this need. 24 oz. for every pound lost from the training session or competition. Drink fluids early and often to replace water lost through sweating. Drink fluids even if you train in a cold environment. Dehydration and decreased performance can still occur. Your needs may increase on hot and humid days. Fruit juices, carbohydrate gels, and carbonated beverages should NOT be recommended as sole rehydration beverages. Beverages containing alcohol, caffeine, or carbonation should be avoided and discouraged.

Cold Weather Policy Cold exposure can be uncomfortable, impair performance, and even become life threatening. Conditions created by cold exposure include wind chill, frostbite, and hypothermia. Wind chill can also make activity discomforting and can impair muscle performance. Definitions of Common Cold Injuries in Sports 1. Hypothermia- Hypothermia is a significant drop in body temperature below 95 F (35 C) as the body s heat loss exceeds its production. The body is unable to maintain a normal core temperature (98.6 F). Hypothermia can occur at temperatures above freezing. A wet and windy 30-50 temperature exposure can be as serious as subzero exposure due to the body and clothing being wet (from sweat, rain, snow, immersion) so that the cooling is even more pronounced because of the evaporation of the water held close to the skin by wet clothing 2. Frostbite- Frostbite is the actual freezing of the skin or body tissues, usually the face, ears, fingers, and toes and can occur within minutes. It is most usually a localized response to a cold, dry environment but moisture can exacerbate the condition. 3. Chilblain and Immersion (Trench) Foot- Chilblain is a non-freezing cold injury associated with extended cold and wet exposure and results in an exaggerated or inflammatory response. It can be observed in exposure to cold, wet conditions extending beyond one hour in which clothing remain wet. The hands and feet are usually the most affected. Prevention Prevention of cold stress is primarily a matter of dressing properly to control the climate next to the skin. Inadequate energy and fluid intake can significantly decrease cold tolerance. To prevent health concerns due to cold temperatures, student-athletes should: 1. Clothing- Dress in layers and try to stay dry. Layers can be added or removed depending on temperature, activity, and wind chill. Because heat loss from the head and neck may be as much as 40% total heat loss, the head should be covered during cold stress. Hand covering should be worn as needed with mittens being warmer than gloves. 2. Energy/Hydration- Maintain energy level via meals, energy snacks, carbohydrate/ electrolyte sports drinks. Stay hydrated as this will help with regulating the body s temperature and preventing frostbite. 3. Fatigue/Exhaustion- Fatigue and exhaustion increase the susceptibility to hypothermia. 4. Warm-Up- A proper warm up and staying warm throughout practice or competition to prevent a drop in muscle or body temperature. Time the warm up to lead almost immediately to competition. After competition, add clothing layers to prevent rapid cooling. 5. Partner Training- Never train alone. An injury or delay in recognizing early cold exposure symptoms could become life threatening if it occurs during a cold weather workout. NOTE: The coach and Athletic Training Staff should be in constant communication for outdoor participation during cold weather months.

Recognition Recognizing early signs of cold-induced stress may prove to be important in preventing cold weather-related injuries. The following signs and symptoms are considered to be early warning signs: Shivering Abnormal sensation at the distal extremities (i.e. numbness, pain, or burning sensation) Disorientation (i.e. confusion, poor judgment) Slurred speech (i.e. speech is slow, words aren t pronounced correctly) Signs and Symptoms of Common Cold Injuries Hypothermia Shivering Cold sensation, goose bumps, confusion, numbness Intense shivering, lack of coordination, sluggishness Violent shivering, difficulty speaking, mental confusion, memory loss, stumbling, depression Muscle stiffness, slurred speech, vision complications Unconsciousness-drop in Heart Rate Chilblain/Pernio Red or cyanotic lesions Swelling Itching, numbness, burning or tingling Skin necrosis (death) Frostbite Pain Burning Numbness Tingling Skin turns hard and white Skin starts to peel or get blisters Skin starts to itch Skin gets firm, shiny, and grayishyellow in color Skin can become red and mottled Immersion (Trench) Foot Burning, tingling, itching Loss of sensation Cyanotic/blotchy skin Swelling Blisters Skin fissures Treatment 1. On the Field: a. Blankets b. Extra clothes c. Plenty of water or sports drinks for rehydration 2. Athletic Training Room a. Blankets b. Hot Packs/Towels c. Warm Whirlpool d. Plenty of water for rehydration

Mild Hypothermia Remove wet or damp clothing Insulate with warm dry clothing or blankets Cover the head Move to a warm environment with shelter from the wind Re-warm the axilla, chest wall, and groin Provide warm non-alcoholic fluids and foods containing 6%-8% carbohydrates Superficial Frostbite Rewarm slowly (at room temperature or against another persons skin) Use water temperatures that are below 98 Refreezing should be avoided Never pop blisters Protect affected area and transport to Emergency Room Chilblain Remove wet or constrictive clothing Wash and dry area gently Elevate the area Cover with warm, loose, dry clothing or blankets Do not disturb blisters, do not apply friction massage, do not apply lotions or creams Continually monitor affected area for return of circulation and sensation Can experience skin inflammation, redness, itching, swelling, or burning Moderate/Severe Hypothermia Remove wet or damp clothing Insulate with warm dry clothing or blankets Cover the head Move to a warm environment with shelter from the wind Monitor vital signs Transport to Emergency Room while rewarming Deep Frostbite Rewarm affected tissue by immersing in warm water bath (98 F-104 F) for 15-30 min Gently agitate the water Remove restrictive clothing Submerge entire affected area Rewarming can cause pain Thawing is complete when tissue is pliable and color and sensation have returned Do not use dry heat or steam to rewarm affected area Protect affected area and transport to Emergency Room Immersion (Trench) Foot Thoroughly clean and dry feet Apply warm packs or soak feet in warm water (102-110 F) for about 5 min Rotate footwear-do not wear flip flops or sandals.

Environmental Assessment a. Evaluate immediate and projected weather information including air temp, wind, chance of precipitation or water immersion, and altitude b. Identify activity intensity requirements and clothing requirements for each individual c. Have alternate plans in place for deteriorating conditions and activities that must be adjusted or cancelled. d. The following guidelines can be used in planning activity depending on the wind chill temp. Conditions should be constantly reevaluated for change in risk, including the chance of precipitation: 30 F - 25 F -Be aware and ready for possibility of cold injuries -Total exposure time: maximum 2 hours 25 F - 15 F -Cover exposed skin -Offer rewarming: every 20 mins 15 F - 0 F -Considering limiting modifying activity to limit exposure -Offer re-warming: every 15 mins -Total exposure time: maximum of 60 mins < 0 F -Cancel practice, reschedule or move indoors

Game Day Weather Policy A. Lightning 1. Criteria for Postponement of Activities: a. The National Severe Storms Laboratory (NSSL) strongly recommends that when count is 30 seconds or less (lightning within 8 miles), activity should be postponed or suspended and a safe shelter should be sought. When count is greater than 30, consider this a warning to keep careful watch for lightning/thunder and prepare for possibility of suspension of play until unsafe conditions have passed. Warn officials of possible need to suspend play. 2. Criteria for Resumption of Activities: The NSSL, the National Athletic Trainer s Association (NATA), the St. Andrews University Athletic Training Staff recommend waiting 30 minutes after the last lightning strike seen and/or thunder that is heard before returning to outdoor and any swimming activity. 3. Safe Locations: a. Primary: any fully enclosed building with plumbing, electrical service, and/or telephone lines (ex. Physical Education Building and dorms) b. Secondary: a fully enclosed vehicle with a metal roof and windows completely closed. DO not touch any part of the metal framework. 4. Unsafe Locations: Under or near trees, golf carts, under bleachers, middle of field/clearing, in/on water, locker room showers, swimming pools, and on land-line telephones. A cell phone is a safe alternative to a land-line phone. B. Heat Illness Policy 1. Pre-Game a. Monitor Heat Index during the day b. Athletic Training Staff and Coaching Staff should communicate about adjustments to game time, possible water breaks during game (ex. Soccer game-water timeout during each half) c. Wear clothing that is lightweight, light in color, protects from the sun 2. Game Time a. Monitor heat index every 20-25 min b. Perform warm-ups in the shade or indoors to minimize time in the heat c. Communicate with Coaching Staff about allowing increases in water breaks, utilizing more substitutions, or changing the game (ex. Soccer game-instead of 2 45 min halves go to 3 30 min halves) d. Extra coolers of water and injury ice e. Cold whirlpool/tub is available in the Athletic Training Room f. Stress Re-hydration g. Monitor for Heat Illness 3. In the event of a Heat-related Injury, COOL FIRST, TRANSPORT SECOND!

C. Cold Weather Policy 1. Pre-Game a. Monitor weather temperature and wind (which creates wind-chill temperatures) b. Athletic Training Staff and Coaching Staff should communicate about adjustments to game time, possible reschedule of the game, or relocation of the game. c. Dress in layers and try to stay dry. Long sleeves and long pants (thermals) should be worn under uniforms for extra warmth. 2. Game Time a. Monitor weather temperatures and wind (which creates wind-chill temperatures) every 20-30 min b. Communication between Athletic Training Staff and Coaching Staff about rehydration, maintaining energy levels via energy snacks or sports drinks (this helps to regulate body temperature and prevent frostbite) c. Dress in multiple layers for warmth, keep the head covered, mittens or gloves can be worn on the hands. d. Allow time to change clothing if they become wet e. Provide an area for rewarming while on the sidelines (ex. Baseball-heaters inside the dugouts) f. Provide/allow blankets and extra clothing while outside g. Accessible in the Athletic Training Room 1. Blankets 2. Hot Packs/Towels 3. Warm Whirlpool 4. Plenty of water for rehydration 3. Transport to hospital emergency department for cases involving Moderate to Severe Hypothermia, Superficial Frostbite and Deep Frostbite.

Sport Concussion Policy Updated May 1, 2018 The following information on the management of concussions has been established by the St. Andrews Athletic Training Staff to assure the health and well-being of each student-athlete. The Athletic Training Staff acknowledges that concussions pose as a serious health risk to our student-athletes. These policies have been put into place to ensure the safety and proper management of student-athletes suspected of sustaining a concussion. The St. Andrews Athletic Training Staff incorporated four assessments in determining a studentathlete s readiness to return to play. These areas are: 1) symptom evaluation, 2) clinical examination, 3) cognitive testing, and 4) functional/ coordination testing. The above results provide the Athletic Training Staff with the objective information necessary for a safe return to athletic activity. Prior to participation all St. Andrews University Student-Athletes are required to complete a baseline concussion assessment. New baseline assessments will be collected on all student-athletes who sustain a concussion in the previous school year. The findings from the return-to-play assessments will be compared to baseline assessment scores by the Athletic Training Staff before an athlete will be cleared to begin the return to play protocol. These policies and procedures have been developed and adapted from numerous resources including but not limited to, documents created by The University of North Carolina at Chapel Hill, the NCAA Concussion policy and the NATA Position Statement: Management of Sport Concussions. The following concussion policy and management protocol have been adopted by the St. Andrews University Athletic Training Staff and is to be followed by all teams for managing student-athletes suspected of sustaining a concussion.

St. Andrews University Concussion Rules 1. St. Andrews University Athletic Training Department prohibits coaches from serving as the primary health care supervisor for athletic activities (practices, competitions, conditioning, etc.). 2. St. Andrews University Athletic Training Department gives affiliated athletic health care providers with experience in the evaluation and management of Traumatic Brain Injuries (TBI) and concussions the final authority to remove any such student-athlete with possible TBI or concussion from athletic activities. 3. St. Andrews University Athletic Training Department gives affiliated athletic health care providers with experience in the evaluation and management of Traumatic Brain Injuries (TBI) and concussions the final authority to prevent the return to athletic activity of any student-athlete with possible TBI or concussion. 4. St. Andrews University Athletic Training Department gives affiliated athletic health care providers with experience in the evaluation and management of Traumatic Brain Injuries (TBI) and concussions the final authority to immediately refer any such student-athlete with possible TBI or concussion to an appropriately qualified physician. 5. St. Andrews University Athletic Training Department will remove student-athletes who have or who exhibit signs, symptoms, or behaviors consistent with a TBI or concussion from athletic activity for a minimum of 24 hours. 6. St. Andrews University Athletic Training Department requires that any student-athlete s suspected of a possible TBI or concussion have medical clearance (by the team physician or combination of team physician an athletic trainer involved) before returning to any athletic activity.

St. Andrews University Concussion Policy 1. All SAU student- athletes must read the NCAA Concussion Fact Sheet, read the SAU Concussion Policy, and sign the attached form during baseline testing certifying that: a. They have read and understand the NCAA Concussion Fact Sheet and SAU Concussion Policy. b. They accept responsibility for reporting injuries and illness to the SAU Athletic Training Staff, including signs and symptoms of concussions. c. All signed documents will be kept in the student-athlete s medical file. 2. All SAU coaches (head coaches, assistant coaches, graduate assistants, volunteer, and student coaches) must read and sign the attached coaches statement acknowledging that they: a. Have read and understand the NCAA Concussion Fact Sheet and SAU Concussion Policy. b. Will encourage their athletes to report any suspected injuries and illnesses to the SAU Athletic Training Staff, including signs and symptoms of concussions; and that they will accept the responsibility for referring any athlete to the SAU Athletic Training Staff suspected of sustaining a concussion. 3. All SAU Athletic Training Staff (assistants and interns) must read and sign the attached medical provider statement acknowledging that they: a. Will provide student-athletes with the NCAA Concussion Fact Sheet and encourage any student-athletes to report any suspected injuries to the Athletic Training Department, including signs and symptoms of concussions. b. Have read, understand, and will follow the SAU Concussion Management Protocol. 4. The SAU Athletic Training Staff will coordinate the signing of the aforementioned documents on an annual basis for the coaches The St. Andrews Athletic Training Department will keep the signed documents along with the established SAU Concussion Policy on file. A copy of the SAU Concussion Policy will also be distributed through the Policies and Procedures manual. 5. The Athletic Training Staff will coordinate an annual meeting each May to review and update the Concussion Policy. Any changes to the policy will be effective August 1 of that year.

St. Andrews University Concussion Management Protocol Concussions and other brain injuries can be serious and potentially life threatening injuries in sports. Research indicates that these injuries can also have serious consequences later in life if not properly managed. In an effort to combat this injury, the following concussion management protocol will be used for SAU student-athletes suspected of sustaining a concussion. A concussion occurs when there is a direct or indirect injury to the brain. As a result, temporary impairment of mental functions such as memory, balance/equilibrium, and vision may occur. It is important to recognize that many sport-related concussions do not result in loss of consciousness and, therefore, all suspected head injuries should be taken seriously. Coaches and fellow teammates can be helpful in identifying those who may potentially have a concussion, because a concussed athlete may not be aware of their condition or potentially be trying to hide the injury to stay in the game or practice. 1. Concussion management begins with pre-participation baseline testing. Every new SAU studentathlete (first-year or transfer) must complete a comprehensive evaluation involving graded symptom checklist (GSC), Standard Assessment of Concussion (SAC), and Balance Error Scoring System (BESS). a. The respective team s athletic trainer will conduct the following assessments for all new athletes: GSC, SAC, and BESS. b. The respective team s athletic trainers will keep a copy of baseline GSC, SAC, and BESS scores on file. c. Any student-athlete that has sustained a concussion during the previous season must obtain a new pre-participation baseline test. 2. An athlete suspected of sustaining a concussion will be evaluated by the team s athletic trainer using the Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and Graded Symptom Checklist (GSC). Ideally, an assessment of symptoms will be performed at the time of the injury and then serially thereafter (i.e. 2-3 hours post-injury if applicable, 24 hours, 48 hours, etc.). 3. Abnormal Scores will be noted and reviewed by the team s athletic trainer for re-testing and/or direct consultation with the team physician. 4. Any student-athlete diagnosed with a concussion shall not return to activity for the remainder of that day. Medical clearance will be determined by the team physician or combination of team physician and athletic trainers involved with management of the concussion. 5. The following assessment and return to play plan will be used for all concussions

Concussion Assessment No athlete suspected of having a concussion is permitted to return to play the same day and no athlete is permitted to return to play while symptomatic following a concussion. Baseline testing: conducted on each student-athlete upon entering as a first-year student, transfer, or for those athletes sustaining a concussion the previous season. Time of injury: Graded Symptom Checklist and the SAU-AT Concussion Assessment Form. The Concussion Take Home Instruction Sheet must be reviewed and signed by the injured athlete before the athlete may be released from athletic trainer s care. Prolonged unconsciousness: In terms of unconsciousness, any loss of consciousness is considered to be prolonged unconsciousness. If an athlete reports going unconscious and/or blacking out they are put into the concussion protocol even if no signs and symptoms are reported or present. Medications and prescriptions: Basic recommendations for medications and prescriptions are as follows; ADHD meds-ok once the student athlete resumes daily activities, Anxiety/Depression meds- OK, Sleep aid meds-ok, however if athlete can postpone taking sleep aid medications for 24 hours post-concussion that is recommended by the team physician. All reported cases will be handled on an individual basis. 1-12 hours Post-Injury: student-athlete reports symptoms to athletic trainer; referral if necessary. Next day: follow-up assessment using the SAU Concussion Assessment Form and GSC. 2+ days Post-Injury: Follow-up evaluations performed daily to track symptom recovery. Once the athlete becomes asymptomatic for 24 hours: 1. Determine where the athlete is relative to their baseline on the following measures: a. Standardized Assessment of Concussion b. Graded Symptom Checklist c. Balance Assessment (Balance Error Scoring System) 2. If the measures (a-c) listed above are at least 95% of baseline scores and the athlete remains asymptomatic for an additional 24 hours following these tests, the medical staff can instruct the athletic trainer to begin Step 1 of the 5-step Return to Play Protocol with the athlete. Symptoms should be reassessed immediately following exertional activities. 3. If the athlete remains asymptomatic on the day following the first step of the Return to Play Protocol, the athlete will continue with the next steps of the RTP Protocol. The athlete may only complete one step each day and must remain asymptomatic in order to progress through the Return to Play Protocol. The team physician or combination of team physician an athletic trainer involved will return student-athlete to full competition after Step 4 of the Return to Play Protocol has successfully been completed. 4. All scores on the aforementioned assessments or exertional activities will be recorded in the athlete s medical record by the team s athletic trainer.

If at any point during this process the student-athlete becomes symptomatic, the athlete should be reassessed daily until he/she has returned to asymptomatic. Once asymptomatic, the student-athlete should then repeat the last step successfully completed until all four steps are accomplished. If deficits in post-injury scores compared to baseline scores remain at 14 days post-injury, the student-athlete will be referred to the team physician. In the rare case that any of the following occurs, activate the EAP or refer as indicated: prolonged loss of consciousness, neurological deficit suggesting intracranial trauma, repetitive emesis, diminished/worsening mental status, or spine injury. The student-athlete may be referred to the team physician at any point if deemed necessary by the team s athletic trainer. Recommendations for multiple concussions in same season/school year: Second concussion: As long as the student-athlete has fully recovered from the first concussion and has returned to normal baseline on his/her Standard Assessment of Concussion (SAC), and Balance Error Scoring System (BESS), a second concussion sustained in the same season may possibly return to play during that athletic season. Each case will be handled on an individual basis. Third concussion: Recommendations include; student-athlete will be done playing his/her sport for the season, which can include post-season training as well. Student-athletes will be referred to the team s neurologist. The team s athletic trainer and neurologist will determine if retiring from his/her sport is recommended or deemed necessary.

Return to Play Protocol Rehabilitation Stage Functional Exercise Objective of Stage Criteria to Advance Stage 1: NO Activity Complete physical & Cognitive Patience (REST) Recovery No symptoms at rest, neurocognitive and physical tests normal Stage 2: Light Aerobic Activity 30 min of walking on treadmill or stationary bike Increase Heart Rate No return of symptoms Stage 3: Sport-Specific Exercise 15 min Bike plus 30 min of supervised sport-specific exercise Add Movement No return of symptoms Stage 4: NON-Contact Training More complex training drills, resistive training Exercise, coordination and cognitive load No return of symptoms NO Head Impact Stage 5: Full Contact Training Following Medical Clearance, normal training activities Restore confidence, assessment of Functional skills No return of symptoms Returned to play Normal game play Full participation No athlete can return to full activity or competition until they have returned to baseline scores in limited, controlled, and full contact activities, and cleared by the physician or physician s designee.

Graded Symptom Checklist Athlete Name: Sport: Today s Date: Date of Injury: You should score yourself on the following symptoms, based on how you feel now. Headache 0 1 2 3 4 5 6 Pressure in head 0 1 2 3 4 5 6 Neck Pain 0 1 2 3 4 5 6 Nausea or vomiting 0 1 2 3 4 5 6 Dizziness 0 1 2 3 4 5 6 Blurred vision 0 1 2 3 4 5 6 Balance problems 0 1 2 3 4 5 6 Sensitivity to light 0 1 2 3 4 5 6 Sensitivity to noise 0 1 2 3 4 5 6 Feeling slowed down 0 1 2 3 4 5 6 Feeling like in a fog 0 1 2 3 4 5 6 Don t feel right 0 1 2 3 4 5 6 Difficulty concentrating 0 1 2 3 4 5 6 Difficulty remembering 0 1 2 3 4 5 6 Fatigue or low energy 0 1 2 3 4 5 6 Confusion 0 1 2 3 4 5 6 Drowsiness 0 1 2 3 4 5 6 Trouble falling asleep (if applicable) 0 1 2 3 4 5 6 More emotional 0 1 2 3 4 5 6 Irritability 0 1 2 3 4 5 6 Sadness 0 1 2 3 4 5 6 Nervous or Anxious 0 1 2 3 4 5 6 Total number of symptoms (Maximum possible 22) Symptom severity score (Add all scores in table, maximum possible: 22 x 6 = 132) Do the symptoms get worse with mental activity? Y N Overall rating (percentage)

Return to Learn Protocol If a concussion is diagnosed by a medical care provider, then appropriate steps should be taken to address that student s learning, emotional, and behavioral needs throughout the course of recovery. The support provided could include appropriate monitoring of recovery, academic and/or functional accommodations. Prolonged symptoms must be addressed in a manner that matches the student-athlete s needs. If the Return-to-Learn Plan is found to be insufficient in meeting the needs of a student at any point during the monitoring process, the Athletic Training Staff and the Center of Academic Success will assist in identifying the appropriate targeted interventions for the student-athlete. When a student-athlete is suspected of sustaining a concussion, they must first notify the Athletic Training Staff. Once a student enters the St. Andrews University Concussion Protocol, the athletic trainer will notify all appropriate personnel for potential learning accommodations. The Center for Academic success will notify the student-athlete s professors, advisor, and other personnel alerting them of the possible need for accommodations. If the student-athlete is currently required to complete study-hall hours, the NAIA Compliance Coordinator will also be notified in the event accommodations are needed. Available accommodations for students who sustain a concussion can include but are not limited to: 1. Class notes provided by note taker 2. Alternative testing areas 3. Extended testing times 4. Extended deadlines for assignments 5. Reading aloud of test These accommodations are communicated by the St. Andrews University Athletic Training Staff to the Center of Academic Success. It is the role of the athletic trainer to deem which accommodations are necessary for each student. The student-athlete is to attend class to the best of their ability unless deemed otherwise by the St. Andrews Athletic Training Staff. The student-athlete is to follow the guidelines of the return to play protocol as listed above, in reference with reporting for follow-up visits. Once the Athletic Trainer and/or medical personnel have cleared the student-athlete from their concussion they will report the clearance to Robin Lea. Contact Information Robin Lea Elizabeth Burris Director for the Center of Academic Success NAIA Compliance Coordinator Office: 910-277-5040 Office: 910-277-5428 Fax: 910-277-5746 Fax: 910-277-5272 learr@sa.edu burrises@sa.edu