Eastern Guilford High School€¦ · Web viewThe philosophy we are dedicated to is one of student athletes first as well as adherence to the NATA code of ethics and professionalism

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Eastern View High School

Athletic Training

2018-2019

Policies and Procedures Manual16332 Cyclone Way, Culpeper VA 22701

540-825-0621

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Table of ContentsI Vision and Mission Statements…………………. 3

II

III

Athletic Health Care Team (AHCT)…………….

Emergency Action Plan…………………………..

4

6

IV Pre-participation Physical Exam………………... 16

V Heat and Hydration………………………………. 17

VI Inclement Weather Protocol/Guidelines.………… 21

VII Concussion…………………………………………. 23

VIII Communicable Disease…………………………….. 39

IX Athletic Training Room Rules/Athletic Training Student Aides………………………………………………….

41

X On-The-Field Policy/Sports Injury Guidelines for Coaches …………………………………………………………

42

XI

XII

XIII

Mental Health and Psychological Concerns Policy....

Drug Policy……………………………………………

Documentation………………………………………...

44

46

47

XIV Works Cited…………………………………………... 48

XV Signatures/Appendices A-I……………………….. 51

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Vision Statement

The athletic health care team (AHCT) of Eastern View High School is committed to providing high quality injury prevention, care, and rehabilitation to the student athletes of EVHS. Furthermore, we aspire to be a leader in athletic training services for Culpeper County Public Schools.

Mission Statement

The Eastern View High School Athletic Training program is committed to high quality, efficient, timely delivery of athletic training services. These include injury prevention, recognition, evaluation, care/treatment, emergency first aid, rehabilitation, documentation and referral of athletic injuries. The philosophy we are dedicated to is one of student athletes first as well as adherence to the NATA code of ethics and professionalism in our pursuit of being the best provider of athletic training services. We strive to use all technology and equipment available for treatment of student athletes. We aim to represent Eastern View High School, the Virginia High School League, the community of Culpeper County and the profession of Athletic Training with the utmost integrity.

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Athletic Health Care Team (AHCT)

1. Jordan Nougaret: Certified Athletic Trainer (ATC) and Licensed to practice Athletic Training in the State of Virginia. American Red Cross Instructor for CCPS employees and coaches. The ATC is responsible for developing and implementing an Athletic Training Policies and Procedures Manual that includes a comprehensive emergency action plan amongst other policies outlined below; establishing and operating the EVHS Athletic Training Room; determining which EVHS venues require the on-site presence of the Athletic Trainer and team Physician and when they will be available; establishing guidelines for the proper fitting and functioning of athletic equipment; maintaining accurate medical records and documentation; developing and overseeing performance enhancement training and strength and conditioning programs for safety and effectiveness related to injury and illness prevention; offering mental health and nutritional counseling (within the scope of practice); establishing a safe practice and playing environment by monitoring environmental risk factors; communicating with coaches, parents, and guardians about each injured or ill athlete’s condition and progress in regards to return-to-play decisions and referrals, (adhering to HIPAA and FERPA rules when applicable), in cooperation with the team physician when applicable (HIPPA/FERPA rules apply); and the prevention, clinical evaluation and diagnosis, immediate care, treatment, referral, rehabilitation and reconditioning of athletic injuries among the sports at Eastern View. *See “CCPS Athletic Trainer Job Description” in Appendix A for roles and responsibilities 2. Dr. Amauri Gonzalez: Medical Doctor at UVA Primary Care Culpeper Family Practice and Physician Director at Eastern View High School available for injury referrals and on-site coverage at Varsity Football Home Games as well as Pre-Participation Physical Examinations for CCPS.3. Mark Settle: Activities Coordinator and ATC Supervisor. *In charge of making sure the manufacturers’ directions on the maintenance and use of equipment are followed and ensuring that equipment is properly maintained and reconditioned as needed.4. Jeanie Barlow: Registered Nurse for Eastern View High School who, in addition to her normal duties, assists the Certified Athletic Trainer with injured or ill EVHS student athletes including those in the Concussion Protocol (accommodations, recommendations, etc.)5. Dr. Craig Reigel: Medical Doctor at Virginia Orthopedics and Spine Center and Team Orthopedist available for injury referrals. 6. Dr. Armin Harandi: Medical Doctor at UVA Orthopedics Culpeper and Team Orthopedist available for injury referrals.7. Dr. Elizabeth Robinson: Medical Doctor at UVA Orthopedics Culpeper and Team Orthopedist available for injury referrals. 8. EVHS Coaches: Defined as those providing competent supervision of EVHS student athletes and competent health care as First Responders as evidenced by certifications in Adult and Pediatric CPR, AED, and First Aid and requirements to attend yearly in-services to review the Athletic Training Policies and Procedures.*In addition, for sports such as Football and Boys Lacrosse, these coaches ensure that athletes have appropriate equipment, properly fitted to the individual. 9. Athletic Training Student Aides (ATSA): Defined as EVHS students who are enrolled in the Athletic Training/Sports Medicine 1 or 2 class who volunteer to assist at practices and games. Please see Appendix B for their roles and responsibilities.10. Director of Security (Bob Murphy) and Student Resource Officer (Brandon Mack): Responsible for the safety of EVHS staff and students. 11. Brandon Lum and Jackson Tyler-Physical Therapists at Powell Wellness Center who assist in injury screenings and injury referrals.12. Jena Griffith-Registered Dietician Nutritionist at Powell Wellness Center who assists in EVHS student athlete referrals.

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13. Psychosocial Referral Team:Assist with psychological consultation and referral for EVHS students with emotional or mental health problems. County Psychologists and Social Workers will also be enlisted for further evaluation and treatment of these conditions as needed. These members include:Sarah Beamer (Lead School Psychologist CCPS)Jamie David (School Psychologist EVHS)Tracy Sasso (EVHS Social Worker, liaison between the school and the community) Jillian Smith (EVHS Counseling Director) (W-Z) Ext 2003Kristin Frith (A-F) Ext 2022Michael Baird (G-MO) Ext 2004Jennifer Mathieu (MU-V) Ext 2006Brandon Mack (Student Resource Officer)Dr. Felix Addo (Principal)Carlos Seward (Assistant Principal)Shaun Summerscales (Assistant Principal)Shannon Mahiai (Assistant Principal)Mark Settle (Activities Coordinator)Dr. Gonzalez (Supervising Team Physician)Dr. Lorie Davis, PHD (Counselor in Culpeper)*During School Hours: ATC will contact school counselors first *After School Hours: ATC will contact Jillian Smith, Tracy Sasso, or a member of Administration first then contact the Student Resource Officer (SRO) if needed. Dr. Gonzalez will also be available to call.Crisis Intervention Team Assessment Center (CITAC) 540-812-4062 (Suicide Resource)14. Oral Healthcare Team:Dr. Sarah Summers: Oral Surgeon of Central Virginia Oral and Facial Surgeons. Dr. Summers specializes in oral and facial trauma. Her facilities are located in Culpeper and Charlottesville. (540-825-3069)Dr. Sushant Mahajan: Endodontist, Culpeper Endodontics. Dr. Mahajan specializes in trauma to the dental pulp. His facility is located in Culpeper. (540-727-0122)Dr. Holly Eppard: Orthodontist, Eppard Orthodontics. Dr. Eppard specializes in the relationship of teeth to the jaws and surrounding structures. Her facility is located in Culpeper. (540-825-6064)Dr. Shannon Butler: Doctor of Dental Surgery and Oral Healthcare Specialist *See Appendix I for more information15. Phyllis Hurlock-EMS Chief, Richardsville Fire and Rescue. EMS provider at EVHS Home Football Games. Her staff includes Jamie Jenkins, Linda Morris, and Cheree April (EMT’s and Paramedics).

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Emergency Action Plan

Purpose of the Emergency Action Plan

Life threatening emergency situations may arise at any given moment during an athletic event. Despite our best efforts, emergency personnel need to be aware of this possibility and not develop a false sense of security. When limb-threatening or life-threatening injuries occur, it is integral that an emergency action plan be established to clearly delineate the policies and procedures in order to deliver effective and efficient care. Expedient action must be taken to provide the best possible care to the student athletes. Emergency personnel must be qualified, prepared, and fully knowledgeable regarding the development and implementation of an emergency action plan to ensure that the quality of care provided to our student athletes is at its highest. Rapid, controlled and efficient emergency responses could be the difference between life and death. It is the goal of the medical personnel at Eastern View High School to implement this emergency action plan that will aid in minimizing the time needed to provide an immediate response to a potentially life-threatening situation or medical emergency.

Goals:

1. Provide a written document of Eastern View High School’s Emergency Action Plan (EAP), including a venue specific EAP for each of the designated sites listed below.

2. Educate all personnel involved during pre-season meeting.

3. Rehearse the EAP annually in preparation for proper management of a medical emergency.

Guidelines and Components of the EAP:

The following EAP will apply to injured athletes or coaches at Eastern View High School, game officials, fans, or sideline participants, such as a parent. During a medical emergency it will be the responsibility of the athletic trainer to “triage” injuries to determine who takes precedence over anyone else.A written EAP is required for all institutions or organizations as an organizational, professional and legal responsibility. The EAP will be documented and made available to all personnel including the Certified Athletic Trainer (Jordan Nougaret), team physician, activities coordinator, coaches, Director of Security, Administrator on Duty, Novant Health UVA Health System Culpeper Medical Center, local EMT’s and Paramedics, Culpeper Police Department and athletic training student aides (ATSA) All personnel of the EAP are encouraged to be certified in CPR/AED for the professional rescuer. In addition, all personnel are expected to be trained and educated in prevention of transmission of blood-borne pathogens. The EAP will include all of the essential equipment needed and the specific location of the equipment.

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The EAP will establish the mechanism and location for communicating with EMS and transporting the injured individual. The EAP will be specific to the following locations:

1.Cyclone Stadium

2.Cyclone Baseball Field

3.Cyclone Softball Field

4.Cyclone Field Hockey Field/Practice Field

5.Cyclone Tennis Courts

6.Cyclone Wrestling Room

7.EVHS Gymnasium

The EAP will include the phone numbers and directions to Novant Health UVA Health System Culpeper Medical Center, the nearest emergency care facility to which the injured athlete will be taken. These facilities can access the schedule of all home events on easternviewathletics.org prior to the school year so that they are aware of upcoming events and contests. The host ATC will be responsible for taking a “Time Out” before each athletic event to meet the visiting medical personnel and discuss the Emergency Action Plan components (see Appendix C).The EAP will be reviewed and rehearsed annually by the administration, supervising certified athletic trainers, physician and athletic training student aides.

Components of the EAP:

SECTION I. Personnel

SECTION II. Equipment

SECTION III. Communication

SECTION IV. Transportation

SECTION V. Venue Location

SECTION VI. Emergency Care Facility

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SECTION I. PERSONNEL: All personnel are encouraged to have First Aid, CPR/AED Certifications for the professional rescuer. All personnel need to be cognizant of a potential medical emergency which includes cardiac arrest, no pulse, severe bleeding, loss of consciousness, catastrophic head or neck injuries, fractures or dislocations, shock, stroke, diabetic emergency, suspected poisoning, seizures, heat illness (Exertional Heat Stroke (EHS)), exertional hyponatremia, exertional sickling, severe allergic reactions, critical burns, breathing difficulties or dyspnea (such as asthma), lightning, or any type of persistent chest or abdominal pain. An ATC or Physician along with ATSA will be available via cellphone or radio at all times. The ATC or Team Physician (whichever is at the designated location) assumes the primary role at the scene, handling acute care injuries in emergency situations. The Coach or Administrator on Duty at the designated venue will handle the second role, EMS activation, in situations where emergency transport is necessary. Once the ATC or Team Physician deems the situation a medical emergency, the Coach or Administrator on Duty is responsible for immediate and effective activation of EMS via the nearest means of communication designated at each site. The ATSA, Administrator on Duty, or Activities Coordinator will be in charge of the third role, equipment retrieval. They will gather any necessary equipment from the first aid station that the ATC or Team Physician orders. The Coach or Administrator on Duty will then fulfill the fourth role, directing EMS to the scene. As soon as they have fulfilled their obligation of activating EMS and relaying them all the vital information, the Coach or Administrator on Duty will meet EMS at the entrance to the specific venue and guide them to the scene to confirm that they have access to the venue. Both the Coach and Administrator on Duty will have keys to allow emergency vehicle access to all locations. If EMS transport is deemed necessary for an EVHS student athlete, a Coach or the Administrator on Duty will be required to accompany the athlete in the ambulance to the hospital if the parent or legal guardian are unavailable.

MEDICAL PERSONNEL:

-Certified Athletic Trainer (Jordan L. Nougaret)

-Supervising Team Physician (Dr. Amauri Gonzalez)

-EVHS Coaches

-Athletic Training Student Aides (ATSA) defined as EVHS students who are enrolled in the Athletic Training/Sports Medicine 1 or 2 class who volunteer to assist at practices and games

-Activities Coordinator (Mark Settle)

-Director of Security

-Administrator on Duty

-Local EMT’s and Paramedics on duty

-Culpeper Police Department

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Venue Specific Protocol: The role of the medical personnel includes:

*Providing Basic First Aid within the scope of their duties and education, including:

1) Primary Survey/Size up the scene to determine if it is safe. Put on appropriate personal protective equipment and determine the number of victims.

2) Perform an initial assessment and identify any life-threatening conditions. Check consciousness, airway, breathing, circulation and stabilize if necessary. Immediately call 911 if:

Individual is not breathing Individual has no pulse Individual is unconscious

2) The First Responder will immediately contact ATC or Team Physician who will take over care of the individual. This will include summoning the Coach or Administrator on Duty for advanced medical personnel if necessary (activation of EMS); instructing the ATSA or Activities Coordinator to retrieve any equipment needed; beginning CPR, stabilization of the area, or any other necessary procedures; and monitoring the victim until EMS arrives.

3) Athletic Trainer or Team Physician will continue care while the Coach or Administrator on Duty tells EMS the following:

Name and cell phone number of callerNumber of victims; condition of victimsFirst-aid treatment initiatedSpecific directions to the locationAny other additional information requested by the dispatcher

4) The Coach or Administrator on Duty will then will be responsible for meeting EMS at the entrance to the venue and “Traffic Control,” clearing the path for EMS and directing them in to the specific venue. The Coach or Administrator on Duty will also accompany EVHS student athlete in ambulance to hospital if necessary.

SECTION II. EQUIPMENT (located in the Athletic Training Rooms at school and stadium or on ATC): All necessary equipment will be at the designated sites. This equipment will be restocked on a weekly basis, fully functional, in good operating condition and readily accessible. All members of the medical personnel will be properly trained in the use of every piece of equipment annually, which includes the following:

*A First Aid Kit (including gloves, gauze, dressings, bandages, tape, ice bags, etc.) will be at each venue, given to each Coach prior to the start of the season.*ATC will have a traveling AED on him at all times and a second AED will be available in the Stadium Athletic Training Room

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*Crutches, Resuscitation Masks, an Immersion Tub, and Splint Kits are also available in the Stadium Athletic Training Room

SECTION III. COMMUNICATION: Communication is one of the most important aspects of an effective EAP. Access to a working telephone, whether fixed or mobile, will be provided at every venue. It is paramount to confirm that each communication device is in good working order before any event and to discuss the lines of communication with all members of the EAP personnel. There may be a radio on the supervising Athletic Trainer as well as cell phone. Back-up means of communication including radios will be distributed to the ATC, Administrators on Duty, and Coaches if cell phone reception is unavailable or if multiple events are occurring at the same time.

SECTION IV. TRANSPORTATION: Novant Health UVA Health System Culpeper Medical Center is approximately 5-10 minutes from Eastern View High School. Emergency response time must be factored in when determining exact time of arrival at specific venue. EMS will have a schedule of all sporting events and the specific venues that they will take place, in advance (posted on easternviewathletics.org). EMS will arrive and exit via the specific site locations. These designated areas allow the quickest and most accessible route for an ambulance to arrive and park. If at all possible, the staff at EVHS will strive to have EMS at every home football game. Having said this, due to unforeseen circumstances or other possible medical emergencies that may arise at any time, while requested for every home football game, there is NO GUARANTEE that EMS will be present at all times at every home game. At all home games, a member of the EVHS coaching staff will be expected to accompany an injured player on the opposing team in the ambulance if that player does not have a parent, guardian or coach present to do so. In addition to this, a member of the EVHS coaching staff will be required to accompany an EVHS student athlete requiring emergency medical services during an away game if that athlete’s parent or guardian is not present. If another means of transport is needed, the ATC, Team Physician (if available) and Administrator on Duty will decide who transports the student athlete if unable to wait for an ambulance.

SECTION V. VENUE LOCATION: All venues include accessibility to emergency personnel, effectively working communication systems and transportation. The host ATC’s will also provide the name, number and directions of the nearest emergency facility along with the team physicians name and number. Please refer to Appendix D for a map of Eastern View High School sporting venues and the Venue Specific EAP.

SECTION VI. EMERGENCY CARE FACILITY: The designated emergency facility is Novant Health UVA Health System Culpeper Medical Center for emergency/trauma care.

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EMERGENCY ACTION PROTOCOL:

ATC’s or the Team Physician at the specific venue will carry out the following procedures:

1) Check the scene, clear the area and take control.

2) Check ABC’s, stabilize the athlete, and determine if there are any life-threatening or limb-threatening injuries.

3) Activate EMS by ordering the Coach or Administrator on Duty to call EMS via cell phone.

4) Begin CPR, stabilization of area, or any other necessary procedures.

Summary of Emergency Techniques

ADULT

(Ages 12 and up)

CHILD

(Ages 1-12)

INFANT

(Under 1 year)

CPR Cycle 30 Compressions/2 Rescue Breaths

30 Compressions/2 Rescue Breaths

30 Compressions/2 Rescue Breaths

Rescue Breaths Tilt head to past-neutral position; pinch nose shut and form seal over mouth

Tilt head to slightly past-neutral position; pinch nose shut and form seal over mouth

Tilt head to neutral position; form seal over mouth and nose

Hand Position Two hands in center of chest

Two hands in center of chest

Two fingers, just below nipple, line in center of chest

Compress At least 2 inches About 2 inches About 1 ½ inches

Rate 100-120 Compressions/minute

100-120 Compressions/minute

100-120 Compressions/minute

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CONCLUSION: The significance of an emergency action plan cannot be emphasized enough. The importance of educating, planning, communicating, and effectively carrying out the EAP may be the decisive factor in determining the outcome of a medical emergency. All medical personnel are trained and certified in CPR/AED for the professional rescuer. All coaches are encouraged to do the same. The EAP will be reviewed annually and posted at each specific venue; with all members of the personnel receiving an updated copy on the easternviewathletics.org website. Through the development and implementation of the emergency action plan Eastern View High School ensures the utmost quality and care of all its student athletes, coaches, spectators, etc, in the event that an emergency situation arises.

VENUE SPECIFIC DIRECTIONS:

From 29 North take a Right onto Greens Corner Road (Route 666). Take the first Left onto Cyclone Way. Follow this road to Cyclone Tennis Courts on the Right. Follow road around back of school to access Gymnasium through side doors. Follow hallway down and to your Right will be the Gymnasium and further down the hallway to the Left will be the Wrestling Room. To access other venues, take the first Left on Cyclone Way into parking lot. Cyclone Baseball Field will be on the Left and Football/Soccer Practice Field (upper field) and Field Hockey Field (lower field) will be straight ahead. Take Right over bridge to Cyclone Stadium. Cyclone Softball Field is on the Right. Continue Left past concession stand and follow road through gate. To the Right allows access to Lacrosse practice field. Straight ahead, end at second gate, which allows access to Cyclone football field and Track (Cyclone Stadium)

IMPORTANT NUMBERS:

Athletic Training Room: 540-825-0621 Ext: 2377

Jordan Nougaret, ATC: 540-846-8438

Mark Settle, Activities Coordinator: 540-229-8707

Poison Control:

Culpeper Police Department: 540-727-3430

Novant Health UVA Health System Culpeper Medical Center: 540-829-4189

Address:

501 Sunset Lane

PO Box 592

Culpeper, VA 22701

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Sudden Cardiac Death Quick Reference Chart:

Causes of Sudden Cardiac Death (SCD)

Prevention Recognition Treatment

Asthma *Review Pre-Participation Physical Examination

*Proper strength and conditioning program

*Educate athletes regarding use and compliance with taking medication

*Signs and symptoms include trouble breathing, wheezing, coughing, use of accessory muscles, inability to speak, etc.

*Remove from activity and environment

*Give a Short-acting B2-agonist to relieve symptoms

*Call EMS if necessary or refer to appropriate health care facility

Catastrophic Brain Injuries *Review Pre-Participation Physical Examination

*Educate athletes and coaches regarding recognition and severity of a concussion, and the importance of reporting a concussion

*Enforce the use of certified, up to date helmets

*Neck strengthening program

*See EVHS Concussion Protocol

*See EVHS Concussion Protocol

Cervical Spine Injuries *Understand Mechanism of Injury (MOI) (head down contact and hitting with the crown of the helmet/Spearing) and educate athletes and coaches on proper tackling techniques

*Recondition and Recertify helmets

*Practice proper

*Signs and symptoms include unconsciousness or altered level of consciousness, blunt trauma, bilateral numbness and tingling or motor weakness, pain or tenderness over cervical spine, and obvious deformity of the spine

*Manual in line cervical spine stabilization in neutral position until the athlete is stabilized on a full body immobilization device and a head immobilization device has been applied

*Immobilize the head and neck with foam head blocks, rigid cervical

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equipment removal collar, and spine board

*Remove all equipment, to expose airway and chest, prior to transport when possible (if 3 or more trained rescuers experienced in equipment removal are available)

*Spinal Motion Restriction (SMR): Term used to prevent further harm to the spinal cord or spinal column since true spinal immobilization cannot be obtained

*Utilize the 8 person lift to move the athlete to the spine board if supine. Use a log roll push technique to place the athlete on to the spine board if prone.

*See Appendix E for more information

Diabetic Emergency *Review Pre-Participation Physical Examination

*Monitor blood sugar levels

*Have insulin and glucose available

*Signs and symptoms including sweating, palpitations, hunger, headache, trembling, dizziness, fatigue, loss of appetite, increased thirst, etc.

*Administer carbohydrates or glucose tablets and monitor

*Activate EMS

Exertional Heat Stroke (EHS)

*Review Pre-Participation Physical Examination

*Equipment/Practice modification

*Acclimate athletes

*Monitor weather

*Access to fluids to stay

*Core body temperature greater than 104 to 105

*Central Nervous System dysfunction (confused, dizzy, uncontrollable bowels, delirious, hot, dry, skin, etc)

*Cold Water Immersion (CWI) as soon as possible to get temperature below 102

*Activate EMS

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euhydrated

*Educate coaches and athletes on signs and symtpoms

Exertional Hyponatremia *Consume adequate balance of water and sodium at meals

*Signs and symptoms include overdrinking, nausea, vomiting, dizziness, disorientation, swelling of extremities, etc.

*Consume salty foods

*Activate EMS

Exertional Sickling *Review Pre-Participation Physical Examination

*Educate coaches, athletes, and parents about complications

*Provide longer rest periods, end exclude from participation in conditioning drills when necessary

*Signs and symptoms include muscle cramping, pain, swelling, weakness, fatigue, inability to catch ones breath, etc.

*Immediately remove from activity

*Activate EMS and monitor vital signs

Severe Allergic Reaction *Review Pre-Participation Physical Examination

*Signs and symptoms include trouble speaking or breathing, coughing, erythema, swelling, itchiness, rash, etc.

*Activate EMS

*Administer Epipen

Lightning *See EVHS Inclement Weather Protocol

*See EVHS Inclement Weather Protocol

*See EVHS Inclement Weather Protocol

Sudden Cardiac Arrest *Review Pre-Participation Physical Examination

*Ensure rapid and easy access to Automated External Defibrillator (AED) in less than 3-5 minutes

*Anyone who has collapsed and is unresponsive

*No pulse, jerking or seizure-like activity

*Cardiopulmonary Resuscitation (CPR) while AED is being retrieved, with AED applied as soon as it arrives

*Activate EMS

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*Refer to Appendix I for article

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Pre-Participation Physical Exam

Pre-participation physical exams (PPE’s) are instrumental in evaluating student athletes to identify pre-existing medical problems and to gain any other information that will allow the athlete to participate in sports activities without the risk of injury or illness. The primary role of the PPE is to prevent student athletes from participating in a sport when they have an underlying medical condition that could endanger their health and/or their teammate’s health. The PPE’s assist in discovering possible disqualifying conditions in an athlete and will determine their readiness for participation in their chosen sport. In addition, the PPE provides a means of counseling and educating athletes on health related issues such as drugs, alcohol and eating disorders; by providing meaningful feedback so that they are more aware of ways to prevent these problems. In compliance with association rules and standards of practice, Eastern View High School requires all student athletes complete and turn in a PPE form prior to the beginning of their sport’s season. Only a physician may administer and sign off on an athlete’s physical form. The PPE must be performed at least once a year (every 365 days) with annual health history updates. All parents/guardians will be notified of the need for a PPE, including what exactly the PPE will encompass, and they will be required to sign the informed consent form prior to any medical procedure. Every athlete will have to submit the Virginia High School League Athletic Participation/Parental Consent/Physical Examination Form in Appendix F.

*Refer to Appendix I for article and CCPS Policy JHCA

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Heat and Hydration Policy

RationaleHot and humid environments are ever present in Virginia and have the potential of causing dehydration and heat illness, especially during long practices and games. The athletic training staff at Eastern View is committed to recognizing the signs and symptoms of dehydration and Exertional Heat Illness (EHI), caring for any student-athletes who experience them, but above all preventing their development through proper utilization of effective heat and hydration procedures. Please refer to Appendix I for the article with additional information, guidelines and recommendations.

Environment MonitoringDuring the more hot and humid times of the year, a member of the athletic training staff will monitor and record the temperature and relative humidity expected during practice and game times. Records will be maintained using one or more of the following:

1.Heat and Humidity Monitor (VHSL Website)/Wet Bulb Globe Thermometer (WBGT)2.National Weather Service (www.weather.com)/WeatherBug

Based on recorded environmental readings, the athletic training staff will recommend practice or game modification if the WBGT reading is 82.0-86.9 degrees Fahrenheit. Recommended modifications will include one or more of the following:

1.Increased rest breaks to hydrate2.Equipment modifications3.Restricting conditioning activities 4.Cancelling the practice or game5.Moving the practice or game to a less environmentally intense time such as early in the morning or later at night6.Moving the event inside if possible7.Drastically shortening the event if possible

*Any game or practice modifications are at the discretion of the game official and athletic training staff respectively.

DehydrationStudent-athletes and coaches need to be able to recognize the early signs and symptoms of dehydration in order to prevent further heat illness from occurring. Symptoms may include thirst, irritability, headache, weakness, dizziness, nausea, cramps, chills, vomiting, and performance deficit.

http://www.weather.com/

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If a student-athlete experiences any of these symptoms and it is determined that dehydration is the cause, he or she will be removed from activity and will begin hydrating immediately. The student-athlete will be allowed to return to activity when he or she’s symptoms have resided or else are deemed able to continue by a member of the athletic training staff.

Exertional Heat Illness (EHI)The following procedure governs heat illness management including the basis for judgment as to the presence of heat illness as well as the associated treatment afforded the individual experiencing the debilitation. Heat illness is commonly divided into four categories.

Exercise Associated Muscle Cramps (EAMCs)Signs and symptoms may include fatigue, profuse sweating and predominantly temporary intense and painful muscle spasms or contractions of skeletal muscle during or after exercise.Treatment will include removal from activity to a shaded area, followed by hydration, sodium tablets or fluid, and gentle stretching. Monitor vital signs.

Heat Syncope Signs and symptoms may include dizziness, tunnel vision, pale or sweaty skin, decreased

pulse rate, and fainting. Treatment will include removal from activity to a shaded area, followed by hydration,

elevating the legs above the heart, cooling the skin, and monitoring vital signs.

Exertional Heat ExhaustionSymptoms may include flushed, cool and pale skin, headache, fatigue, dizziness, confusion, persistent sweating, nausea, vomiting, and redness to skin.Treatment will include removal of equipment and discontinuation of activity to move into a cooler environment such as the shade or indoors followed by hydration (with electrolyte/carbohydrate rich drink and water) and cooling with ice application or cold water immersion. Monitor vital signs and activate EMS if necessary.

Exertional Heat Stroke (EHS)Symptoms may include hot, red, wet or dry skin, shallow breathing, rapid pulse, dizziness, nausea, vomiting, lack of orientation, confusion, hysteria, delirium, lack of sweating, loss of consciousness, seizure.Treatment is a medical emergency in which the athlete will be removed from activity and rushed into a cooler environment. Emergency medical services will be contacted and the student athlete will receive Cold Water Immersion (CWI) up to the neck while having vital signs monitored. CWI should begin immediately with equipment being removed after they

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have been immersed in a tub. Water should be between 25-59 degrees Fahrenheit and stirred continuously. Cool first until the athlete is stabilized and then transport second!

General Prevention for all SportsAllow acclimatization to environmental stresses over a 7-14 day period. Start with 15-20 minutes of exercise the first day and then add 5 minutes every day thereafter.Identify at-risk athletes for heat illness during pre-season physical examinations.Educate athletes on proper sleep habits (at least 7 hours per night), a balanced diet, and proper hydration with electrolytes (sodium and chloride).Sick athletes should not participate until the condition is resolvedMaintain euhydration and replace any fluids lost through sweat during and after practices and games.Educate relevant personnel on preventing, recognizing, and treating EHI.When environment conditions warrant it, a CWI tub should be available and ready for use. Wear light-weight and light-colored clothing. Wear less padding/uniform on hotter days (football uniforms double or triple insulation causing a barrier to heat loss, reducing sweat evaporation). Allow athletes to take helmets off during water breaks to allow for evaporation to occur more effectively.Schedule activities at the coolest times of the day. Avoid midday practices from 12-4.Allow frequent rest and hydration periods in a shaded or air conditioned area during activity. Adjust the work to rest ratio by decreasing intensity and duration of practice and increasing rest/hydration periods. Please refer to Appendix I for the Recommended Pre-season practice schedule:

1.Day 1 and 2: One practice with helmet, tee shirt, shorts only, 3 hours in length total.2.Day 3-4: Single practice but with shoulder pads added, 3 hours in length.3.Day 5: Full uniform, begin contact drills.4.After Day 5: 1 day between days with multiple practices; 5 hours total practice time*Allow for proper warm-up and cool down periods at every practice session

Hydration for any cases of heat illness or dehydration will include cool water. Gatorade will also be supplemented during game competitions, pre-season, as well as on an individual basis for those with more severe or recurrent cases of heat illness.

Any return to play allowance after heat illness will be made on an individual basis by a member of the athletic training staff and will take into account multiple factors including the student-athletes ability to participate as well as hydration status. Any time an athlete misses part of or the whole practice he or she’s parents will be notified.

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Hydration Policy

In the efforts of maintaining proper hydration at all times, the athletic training staff will recommend individual student-athlete hydration monitoring and will commit to urging proper hydration procedures before, during, and after activity sessions as set out by the 2017 NATA position statement on fluid replacement for the physically active in Appendix I.

Prior to ActivityStudent-athletes are encouraged to monitor their hydration status by observing the color of their urine. The darker the urine (apple juice color), the less hydrated the individual. The lighter the urine (lemonade), the more adequately hydrated the individual. On days in which the WBGT reading is above 87.0 all outdoor athletes will be required to weigh-in before practice, weigh-out after practice, and record the difference in weight.All student-athletes are encouraged to stay euhydrated by recognizing when thirsty, observing their body weight and urine color, and consuming 17-20oz of fluid 2 to 3 hours before activity followed by an additional 7-10oz 10-20 minutes before activity.

During ActivityStudent-athletes are encouraged to consume 28-40oz of fluid every hour of play (7-10 ounces of water or sports drink every 10-20 minutes) to avoid more than a 2% body mass loss.Hydration should occur constantly throughout activity not just drinking when thirsty.

After ActivityStudent-athletes are encouraged to continue drinking up to four hours following activity and supplementing with electrolytes and/or carbohydrates in their diet or fluids.On days in which athletes weigh-in and weigh-out, specific guidelines to drink 20-24oz of fluid for every pound of weight lost will be recommended.

The athletic training staff is committed to providing water at every school sponsored athletic event it is present at. EVHS coaches are responsible for retrieving their assigned cooler, bottles/cups and water for practices or games. In addition, EVHS coaches are responsible for getting water for the opposing team if necessary. As a general rule, those participating in physical activity less than an hour should require no substance other than water. Gatorade sports drinks will be provided at game competitions lasting over an hour as needed.

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Severe Weather Policy

RationaleThe athletic training staff at Eastern View High School recognizes that many of the school sponsored athletic activities take place in an environment often threatened by severe weather such as torrential rainstorm, lightning, tornados, or blizzard. For this reason, the athletic training staff has adopted a severe weather policy for the purpose of protecting all Eastern View student-athletes from the potential threat associated with lightning and other severe weather dangers.

Chain of CommandThe decision to terminate any school sponsored athletic event due to severe weather will rest in the hands of the designated official during a game as well as the Activities Coordinator/Designated Administrator on site. Recommendations for cancellation of practice due to severe weather will be made by the Athletic Trainer and Activities Coordinator. Final Decision on cancellations will be determined by Activities Coordinator and/or Principal. If a member of the athletic training staff is on hand during any practice or game, he or she will be monitoring the potential severe weather and will alert the game official or coach of any inclement danger.

Evacuation Procedure 1.If present at a game or practice, a member of the athletic training staff will inform either the game official and or all present head coaches before the event that there potentially could be a severe weather hazard occurring during the event.

2.The athletic training staff member will monitor any potential severe weather threat by one or more of the following.

a.WeatherBug b.National Weather Service (NWS) (www.weather.com)c.Flash-to-bang method

3. If lightning or other related danger is detected at or closer than 10 miles, the athletic training staff will begin safety procedures. The athletic training staff will alert either the game official or head coach who will then be responsible with terminating the game or practice if necessary. At no time can a head coach or other personnel override a decision to terminate a game made by the designated official. When lightning is within 6 miles, the athletic training staff will alert the game official or head coaches that we are now in danger and safety procedures should be complete.

http://www.weather.com/

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4.If the game or practice is terminated, the playing area will be evacuated to the nearest fully enclosed safe structure as outlined in the table below. Spectators will be cautioned of the inclement weather and encouraged to seek safe shelter. If safe structure is not available, it is recommended that individuals assume the “lightning safe position” which includes a squat position with head tucked, arms over head covering ears, on balls of feet in an open field free from any metal objects, standing water, trees, poles, etc. “No place outside is safe when thunderstorms are in the area!”

5.The athletic training staff will continue to monitor the severe weather, reporting any and all updates to the game official or coach. “When thunder roars, go indoors!”

6.Once the severe weather threat has passed, the athletic training staff member will inform the game official or head coach and it will be at the Activities Coordinator, official’s and head coach’s discretion as to the initiation of a return to play.

Return to Play Procedure1.The severe weather threat will be declared passed only if lighting or other related danger is no longer detected at or closer than 6 miles.

2.Any field evacuation due to severe weather, automatically results in a “30 minute” stoppage. At any point during the stoppage if severe weather is detected, the “30 minute” rule will re-set. “Half an hour since the thunder roars, now it’s safe to go outdoors!”

3.If return to play is initiated the safe structures will be evacuated and activity continued at the discretion of the activities coordinator, game official or head coach.

Location Safe Structure (If Severe Weather)

Cyclone Stadium Cyclone Stadium Restrooms/Locker Rooms

Lacrosse Practice Field Eastern View High School Cafeteria Doors or Cyclone Stadium Locker Rooms

Cyclone Baseball Field Cyclone Baseball Facility

Cyclone Softball Field Cyclone Stadium Restrooms/Locker Rooms

Cyclone Tennis Courts Nearest entry to Eastern View High School

Cyclone Field Hockey/Practice Field Cyclone Baseball Facility or Cyclone Stadium Restrooms/Locker Rooms

* School Buses, cars, and vans are considered safe locations for evacuations if necessary. Shelters, dugouts, concession stands, and any other open areas are considered unsafe locations. Please refer to Appendix I for more information.

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Culpeper County Public Schools

Concussion Policy

Rationale

A “Concussion” is defined as a trauma induced alteration in mental status resulting in impairment in neurologic function and functional disturbances that may or may not involve loss of consciousness. Concussion occurs from direct or indirect forces to the body or head causing rapid acceleration or deceleration of the brain inside the skull. Concussion results in a graded set of clinical symptoms (somatic, cognitive, and/or emotional) that may or may not include physical signs, balance impairment, behavioral changes, cognitive impairment, sleep/wake disturbances and loss of consciousness. Concussion is a common injury in athletics, especially collision sports such as football, though it is possible that a concussion can mask what may be a serious life-threatening head injury. For this reason, the athletic training staff is committed to properly evaluating and managing any head injury cases in order to protect the student-athletes from any life-threatening situations as well as handling any return to play decisions to prevent further injury following concussion. The athletic training staff will carry out these functions as outlined by the Virginia Board of Education, National Federation of State High School Associations (NFHS), Virginia High School League (VHSL), Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016, and the National Athletic Trainer’s Associations Position Statement on Management of Sport Concussion published in the Journal of Athletic Training in March of 2014. (Refer to Appendix I for these articles).

Evaluation and Management

Annually, EVHS student athletes will undergo baseline examinations with the “Immedi-ate Post-Concussion Assessment and Cognitive Testing (ImPACT)” before the competi-tive season. (see Appendix G)

The athletic training staff will conduct on-field evaluations of any suspected head injury by first ruling out any spinal cord involvement and then assessing the level of conscious-ness, the presence or absence of amnesia, and any present symptoms.

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Symptoms of concussion may or may not include, but are not limited to:

Thinking Physical Emotional/Mood Sleep

Difficulty thinking clearly (confusion)

Headache or pressure in the head

Irritability-things bother you more easily

Sleeping more than usual

Taking longer to figure things out

Fuzzy or blurry vision Sadness Sleeping less than usual

Difficulty concentrating

Feeling sick to your stomach/queasy

Being more moody Trouble falling sleep

Difficulty remembering information (amnesia)

Nausea/Vomiting/throwing up

Feeling nervous or worried

Feeling tired

Dizziness Crying more

Balance or coordination Problems

Sensitivity to noise or light (ringing in the ears)

Dazed look or vacant stare (in a fog/”don’t feel right”)

Abnormal fatigue/low energy, lethargic

Athlete will be removed from activity if any symptoms listed above are present and/or if the athlete experienced any loss of consciousness or amnesia. The Athletic Trainer re-serves the right to disqualify athlete from further participation if a concussion is sus-pected. Any athlete with a diagnosed concussion will not be allowed to Return to Play on the day of injury.

If cervical spine injury is suspected or witnessed, emergency medical services will be contacted, the athlete will not be moved, and the head and neck will be stabilized until medical services arrive and take over care. If loss of consciousness of any duration is sus-pected or witnessed, the athlete will be transported to the nearest emergency department. Any athlete who has symptoms of a concussion, and who is not stable (i.e. condition is changing or deteriorating), is to be transported immediately to the nearest emergency de-partment.

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An athlete who exhibits any of the following symptoms may be transported to the nearest emergency department immediately.

1. Deterioration of neurological function2. Loss of, fluctuating, or decreasing level of consciousness3. Decrease or irregularity in any vital signs4. Unequal, dilated, or unreactive pupils5. Any signs or symptoms of associated injuries, spine (numbness or tingling in the

arms or legs) or skull fracture, or bleeding6. Mental status changes: increased confusion, lethargy, difficulty maintaining

arousal, irritability or agitation7. Seizure activity8. Cranial nerve deficits9. Repeated vomiting10. Slurred speech or inability to speak11. Inability to recognize people or places12. Worsening headache

*An athlete who is symptomatic but stable, may be transported by his or her parent. The parent should be advised to contact the athlete’s primary care physician, or seek care at the nearest emergency department, on the day of the injury.

After the athlete has been removed from activity, further evaluation will be conducted including mental status, attention, balance, behavior, speech, memory, dermatomes/myotomes, cranial nerve testing, coordination/balance testing, vital signs assessment and Sport Concussion Assessment Tool 5 (SCAT 5) testing. (Appendix H)

Concussion grading will not be used. Instead, monitoring of symptoms, physical signs, balance impairment, behavioral changes, cognitive impairment and sleep/wake disturbances will be utilized to determine the severity of injury.

Student-athletes will be monitored every five to ten minutes after sustaining a concussion and will have a parent or guardian informed in order to monitor the student-athlete for the next couple of days for either improvement or decline.

The ATC will notify the athlete’s parents and give written and verbal home and follow-up home care instructions (see Page 31 for concussion home care instructions form).

The ATC will monitor the athlete and notify the Attendance Office and School Nurse so that the student athlete’s teachers are informed of the individual’s symptomatology and neurocognitive status, for the purposes of developing or modifying an appropriate health care plan for the student-athlete (which may or may not require cognitive rest for a desig-nated period of time)

The ATC will maintain appropriate documentation regarding assessment and manage-ment of the injury.

Guidelines and Procedures for Coaches:

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“RECOGNIZE, REMOVE, REFER”

A. Recognize concussion1. All coaches should become familiar with the signs and symptoms of concussion includ-ing:dazed look, vacant stare, slowed/incoherent body movements and/or reaction time, difficulty concentrating/remembering, fatigue/low energy, lethargy, unusual behavior/mood changes (depression, overly emotional, aggressive, sad, restless, irritable, etc), confusion, amnesia, headache, pressure in head, feeling slowed down/in a fog, “don’t feel right,” nausea, ringing in ears, dizziness, poor/blurry vision, sensitivity to sounds and/or light, balance/coordination problems, lack of sustained attention or concentration, sleep disturbances

B. Remove from activity

1. If a coach suspects the athlete has sustained a concussion, the athlete should be removed from activity and not allowed to return to play until evaluated by a healthcare professional.

C. Refer the athlete for medical evaluation

1. Coaches should report all head injuries to the EVHS Certified Athletic Trainer (ATC), as soon as possible, for medical assessment and management, and for coordination of home instructions and follow-up care with student athletes primary care physician.

2. Coaches should seek assistance from the host site ATC if at an away contest.

3. If the EVHS ATC is unavailable, or the athlete is injured at an away event, the coach is responsible for: a. Contacting the parents to inform them of the injury and make arrangements for them to pick the athlete up at school (DO NOT allow student athlete to drive home) b. Contact the ATC with the athlete’s name and contact information, so that follow-up can be initiated.

4. In the event that an athlete’s parents cannot be reached, and the athlete is able to be sent home:a. The Coach or ATC should confirm that the athlete will be with a responsible individual, who is capable of monitoring the athlete and understanding the home care instructions, before allowing the athlete to go home.

b. The Coach or ATC should continue efforts to reach the parent.c. If there is any question about the status of the athlete, or if the athlete is not able to be monitored appropriately, the athlete should be referred to the emergency department for evaluation. A coach or ATC should accompany the athlete and remain with the athlete until the parents arrive.d. Athletes with suspected head injuries should not be permitted to drive home.

Return To Play

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1.Student athletes will be evaluated for return to play purposes on an individual basis that will be based on the judgment of the student athletes Primary Care Physician and EVHS Athletic Trainer.

2.Any student-athlete suspected of a concussion will not be allowed to return to play on the day of the injury. This includes student athletes who experience any loss of consciousness and/or amnesia as well as any of the aforementioned symptoms after initial injury. The individual will be removed from activity for the rest of the day, referred to his/her primary care physician, and managed based on a graduated return to play protocol.

3.Return to play judgments, whether on the same day, will be based on a stepwise progression, with each step taking 24 hours. If any post-concussion symptoms occur while in the stepwise program, then the student athlete will drop back to the previous asymptomatic level and try to progress again after a further 24-hour period of rest has passed. This program allows for a full week of recovery at which point the student athlete will be required to pass the following tests: symptom free (will include a symptom checklist), post-concussion ImPACT Testing and sport-specific functional testing (asymptomatic at rest and with exertional maneuvers that start off low-impact and non-contact and progressively become more difficult; including a mental progression of exertion in school), and written medical clearance from a physician.

4.Progression is individualized, and will be determined on a case by case basis. Factors that may affect the rate of progression include: previous history of concussion, duration and type of symptoms, age of the athlete, and sport/activity in which the athlete participates. An athlete with a prior history of concussion, one who has had an extended duration of symptoms, or one who is participating in a collision or contact sport should be progressed more slowly.

5.If a student-athlete returns to play the same day following a head injury, he/she will be monitored closely and will be re-evaluated after the activity and then 24 and 48 hours later.

6.The athlete should see the ATC daily for re-assessment and instructions until he or she, has progressed to unrestricted activity.

7.If the student-athlete sustains two concussions within the same athletic season and or three concussions within the same calendar year, he/she must see a physician for examination and be cleared for participation by way of doctor’s note.

Graduated Return To Play Protocol

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Physical and Cognitive Rehabilitation Stage

Functional Exercise Objective

1. No Activity No School

Complete physical and cognitive rest (no practice, no school)

Recovery

2.Light Aerobic Exercise School for Half Day

Walking, Swimming, Stationary Bike; keeping intensity<70% of maximum predicted Heart Rate

30-40% exertion Increase Heart Rate/Blood Flow

3.Sport-Specific Exercise Full School Day, No Homework

Running Drills 40-60% exertionAdd Movement (jogging, lunges, squats, sport specific drills)

4.Non-Contact Training Drills Full School Day and 30 Minutes of Homework

Progress to more complex training drills; passing drills, shooting, hitting, catching; start resistance training

60-80% exertionExercise, coordination and cognitive load (running, active warm-up, sport specific drills)

5.Full-Contact Practice Full School Day and 60 minutes of Homework

Following Medical Clearance, participate in normal training activities

80% exertion maintainedRestore athlete’s confidence, allow coaches to assess playing status, test functional skills in game simulated situations, full practice with additional drills

6.Return to Play Full School Day and 90+ minutes of Homework

Normal Game Play

*Physical and Cognitive rest are required until symptoms resolve along with a Post-ImPACT and then a graded program of exertion before written medical clearance from a physician and return to play.

Note: If the athlete experiences post-concussion symptoms during any phase, the athlete should drop back to the previous asymptomatic level and resume the progression after 24 hours of rest has passed.

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After reading the NFHS Suggested “Guidelines For Management of Concussion in Sports” and reviewing the Culpeper County Public Schools Concussion Policies and Procedures, I am aware of the following information:

________ A concussion is a brain injury which athletes should report to the appropriate medical staff.

________ A concussion can affect the athlete’s ability to perform everyday activities, and affect

reaction time, balance, sleep, and classroom performance. You cannot see a concussion, but you might notice some of the symptoms right away. Other symptoms can show up hours or days after the injury.

________ I will not knowingly allow the athlete to return to play in a game or practice if

he/she has received a blow to the head or body that results in concussion-related symptoms.

________ Athletes shall not return to play in a game or practice on the same day that

they are suspected of having a concussion.

________ If I suspect one of my athletes has a concussion, it is my responsibility to

have that athlete see the Athletic Trainer.

________I will encourage my athletes to report any suspected injuries and illnesses to

the Athletic Trainer, including signs and symptoms of concussions.

________ Following concussion the brain needs time to heal. Concussed athletes are much more likely to have a repeat concussion if they return to play before their symptoms resolve. In rare cases, repeat concussions can cause permanent brain damage, and even death.

________ I am aware that athletes diagnosed with a concussion will be re-assessed once symptoms have resolved. Athletes will begin a graduated return to play protocol and must have written clearance from their primary care physician and Athletic Trainer along with successful completion of the Post-ImPACT Test

__________________________________ ____________

Signature of Coach Date

__________________________________

Printed name of Coach Date

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Culpeper County Public Schools Parental Information and Home Care Instructions Form

What is a concussion?

A concussion is an injury to the brain. It occurs when the brain is violently rocked back and forth or twisted inside the skull as a result of a blow to the head or body. The resulting injury to the brain changes how the brain functions in a normal manner. The signs and symptoms of a concussion can show up immediately after the injury or may not appear for hours or days after the injury. Concussions can have serious long-term health effects, and even a seemingly mild injury can be serious. A major concern with any concussion is returning to play too soon. Having a second concussion before healing can take place from the initial or previous concussion can lead to serious and potentially fatal health conditions.

What are the signs and symptoms of a concussion?

Signs and symptoms of a concussion are typically noticed right after the injury, but some might not be recognized until days, weeks, or longer after the injury. Symptoms of concussion may or may not include, but are not limited to:

Thinking Physical Emotional/Mood Sleep

Difficulty thinking clearly (confusion)

Headache or pressure in the head

Irritability-things bother you more easily

Sleeping more than usual

Taking longer to figure things out

Fuzzy or blurry vision Sadness Sleeping less than usual

Difficulty concentrating

Feeling sick to your stomach/queasy

Being more moody Trouble falling sleep

Difficulty remembering information (amnesia)

Nausea/Vomiting/throwing up

Feeling nervous or worried

Feeling tired

Dizziness Crying more

Balance or coordination Problems

Sensitivity to noise or light (ringing in the ears)

Dazed look or vacant stare (in a fog/”don’t feel right”)

Abnormal fatigue/low energy, lethargic

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What should be done if a concussion is suspected?

1. Immediately remove student from practice or game

2. Seek medical attention right away

3. Do not allow the student to return to play until proper medical clearance and return to play guidelines have been followed. The permission for return to play will come from the appropriate health care professional or professionals.

If you have any questions concerning concussions or the return to play policy, you may contact the athletic trainer at your school

What should the athlete know about playing with a concussion?

Teach athletes it’s not smart to play with a concussion. Rest is the key after a concussion. Sometimes athletes, parents, and other school or league officials wrongly believe that it shows strength and courage to play injured. Discourage others from pressuring injured athletes to play. Don’t let your athlete convince you that they’re just fine.

What are the risks of returning to activity too soon after sustaining a concussion?

Long term life threatening injuries such as Second Impact Syndrome can and do occur. If an athlete has a concussion, their brain needs time to heal. Don’t let them return to play the day of the injury and until a health care professional, experienced in evaluating and managing concussion, says they are symptom-free and it’s OK to return to play. A repeat concussion that occurs before the brain recovers from the first can be fatal.

What can happen if my child keeps on playing with a concussion?

Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often under report symptoms of injuries, and concussions are no different. As a result, education of administrators, coaches, parents and students is the key for student-athlete’s safety.

Home Instructions for Concussions

I believe that _________________________ sustained a concussion during ______________________ on . Please make sure he/she reports to the Athletic Training Room when they return to school for a follow-up evaluation. To make sure he/she recovers please follow the following important recommendations:

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If any of the following problems develop, seek medical attention immediately:

1. Deterioration of neurological function2. Loss of, fluctuating, or decreasing level of consciousness3. Decrease or irregularity in any vital signs4. Unequal, dilated, or unreactive pupils5. Any signs or symptoms of associated injuries, spine (weakness, numbness or tingling

in the arms or legs, stiffening of the neck, decreased sensation, etc.) or skull fracture (blood or yellowish/clear fluid from nose or ears), or bleeding

6. Mental or emotional status changes: increased confusion, abnormal lethargy or drowsiness, constant fogginess, difficulty maintaining arousal, irritability or agitation

7. Seizure activity or convulsions8. Cranial nerve deficits9. Repeated nausea and vomiting 10. Slurred speech or inability to speak11. Inability to recognize people or places12. Worsening headache or other symptoms that progressively get worse13. Difficulty remembering recent events or meaningful facts (amnesia)14. Dizziness, poor balance, ringing in the ears, or unsteadiness walking or standing15. Cranial nerve deficits (problems with vision, taste, hearing, speech, smell)16. Double or blurred vision or extreme sensitivity to light (photophobia)

Things that are OK to do:

Use acetaminophen (Tylenol) for headaches)

Use ice packs on head or neck as needed for comfort

Eat a light carbohydrate-rich diet

Go to sleep (rest is very important)

Check athlete's pulse and respirations while they are sleeping

Rest (no strenuous activity or sports)

Things that should NOT be allowed:

Drive (do not allow until athlete experiences NO dizziness, or trouble with attention or concentration while turning head)

Eat spicy foods

Watch TV

Listen to ipod or talk on telephone

Read

Use a computer

Play Video Games

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Expose individual to bright lights or loud noises

Drink alcohol

Any Strenuous Activity or Sports

No School until symptom free

NO Ibuprofen, Advil or Tylenol for the first 24-48 hours to avoid “masking” the signs and symptoms of a concussion

Things there is no need to do:

Check eyes with a flashlight

Wake them up every hour (unless otherwise instructed)

Test reflexes

Set alarm clock (allow them to sleep and awake naturally)

Pre-Season Baseline Testing and Education

Coaches, Athletes, Parents and Administrators will be educated on the prevention and management of Concussions at the beginning of the athletic season. Student athletes are required to complete the Baseline ImPACT prior to participation in their sport. This baseline data will help us gather more information in order to return the student athlete as quickly and safely as possible to their respective sport. For more information on when the ImPACT testing will occur go to www.easternviewathletics.org. For more information on the actual ImPACT Test please visit http://www.impacttest.com/.

Protocols for Managing Concussions

Culpeper County Public Schools has developed a protocol for managing concussions. This policy includes a multi-discipline approach involving athletic trainer clearance, physician referral and clearance, successful completion of cognitive and physical progressions related to their sport, and the Post ImPACT. The following is an outline of this procedure. Your son/daughter must pass all of these tests in order to return to sport activity after having a concussion.

1. All athletes who sustain head injuries are required to be evaluated by their primary care physician. They must have a normal physical and neurological exam prior to being permitted to progress to activity. This includes athletes who were initially referred to an emergency department. Post Concussion ImPACT results will be given to the parent of the student athlete to be shared with their primary care physician.

2. The student will be monitored daily at school by the Athletic Trainer. His/Her teachers will be notified of their injury and what to expect by the Certified Athletic Trainer. Accommodations may need to be given according to physician recommendations and observations.

http://www.impacttest.com/

http://www.easternviewathletics.org/

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3. The student must be asymptomatic at rest and with physical exertion.

4. Once cleared to begin activity, the student will start a progressive step-by-step procedure outlined in the following steps. The progressions will advance at the rate of one step per day. The progressions are:

*No activity until the athlete is symptom free

*Physician clearance to begin activity

*Note – Athlete progression continues as long as athlete is asymptomatic at current activity level. If the athlete experiences any post concussion symptoms, he/she will wait 24 hours and start the progressions again at the previous step.





Recovery













Normal Game Play

5. Upon completion of the return to play protocol, the physician of record must provide a written statement that in the physician’s professional judgment it is safe for the athlete to return to play.

6. Once the student athlete has completed steps 1 through 5, he/she may return to their sport activity with no restrictions.

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Information for Treating Physician

Culpeper County Public Schools has developed a protocol for managing concussions. This policy includes a multi-discipline approach involving athletic trainer clearance, physician referral and clearance, and successful completion of activity progressions related to their sport. The following is an outline of this procedure. The injured athlete must complete and successfully pass all of these tests in order to return to sport activity after having a concussion.

1. All athletes who sustain head injuries are required to be evaluated by their primary care physician. They must have a normal physical and neurological exam prior to being permitted to progress to activity. This includes athletes who were initially referred to an emergency department. Post Concussion ImPACT results will be given to the parent of the student athlete to be shared with their primary care physician.

2. The student will be monitored daily at school by the Athletic Trainer and/or school nurse. His/Her teachers will be notified of their injury and what to expect. Accommodations may need to be given according to physician recommendations and observations.

3. Physical and Cognitive rest are required until symptoms resolve and then a graded program of exertion before medical clearance and return to play

4. Once cleared to begin activity, the student will start a progressive step-by-step procedure outlined in the Prague statement. The progressions will advance at the rate of one step per day. The progressions are:





Recovery













Normal Game Play

*Note – Athlete progression continues as long as athlete is asymptomatic at current activity level. If the athlete experiences any post concussion symptoms, he/she will wait 24 hours and start the progressions again at the previous stage.

5. Upon completion of the return to play protocol, the physician of record must provide a written statement that in the physician’s professional judgment it is safe for the athlete to return to play.

6. Once the student has completed steps 1 through 5, he/she may return to their sport activity with no restrictions.

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Culpeper County Public Schools Student-Athlete & Parent/Guardian Concussion Statement

Please initial the following after reading each statement:

I understand that my son/daughter is required to complete the Baseline ImPACT Concussion Test before participation in their sport and may have to take the Post-ImPACT Test if necessary

I understand that my son/daughter must adhere to the Concussion Return to Play Policy

__I understand that it is my responsibility to report all injuries and illnesses to my

athletic trainer and/or team physician.

________ A concussion is a brain injury, which I am responsible for reporting to my

team physician or athletic trainer.

________ A concussion can affect my ability to perform everyday activities, and affect

reaction time, balance, sleep, and classroom performance.

________You cannot see a concussion, but you might notice some of the symptoms

right away. Other symptoms can show up hours or days after the injury.

________ If I suspect a teammate has a concussion, I am responsible for reporting the

injury to my team physician or athletic trainer.

________ I will not return to play in a game or practice if I have received a blow to

the head or body that results in concussion-related symptoms.

________ Following concussion the brain needs time to heal. You are much more likely

to have a repeat concussion if you return to play before your symptoms resolve.

________In rare cases, repeat concussions can cause permanent brain damage, and

even death.

Parental Consent

By signing this form, I understand the risks and dangers related with returning to play too soon after a concussion. Furthermore, in the event that my son/daughter is diagnosed with a concussion, I give my consent for my son/daughter to participate in and comply with the Culpeper County Public Schools return to play protocol. The undersigned, being a parent, guardian, or another person with legal authority, grants this permission.

Athlete’s Name (print) ___________________________________________________

Parent’s or Guardian’s Name (print) _______________________________________

Parent’s or Guardian’s Signature __________________________________________

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Date: ______________

Culpeper County Public Schools Concussion Information for Teachers

Dear Teacher,

______________________, is returning to school after having sustained a concussion. A concussion is a complex injury to the brain caused by movement of the brain within the skull. Please observe this student during class. He/She may still be suffering from post concussion syndrome and may not be able to participate at their normal level. Some things you may notice are headaches, dizziness, nausea, lethargy, moodiness, blurred vision, poor concentration, mentally slow, depression, or aggression. These symptoms may be temporary or long lasting. Because these symptoms may linger for an unspecified period of time, you may need to modify school work until he/she is symptom free. Also, if you see anything unusual, please notify me as soon as possible, or contact the school nurse. I will keep you informed of any medical updates that are pertinent to the classroom. You are an important member of the team that is treating ________________________ for their head injury. The physician and I only get a small snapshot of his/her daily activity. Therefore, any information that you can pass along to us is both appreciated and necessary to the successful recovery from the concussion.

If you have any further questions, please contact me at Extension 2377 or [email protected]

Sincerely,

Jordan Nougaret, MS, ATC, VATL Henry Wolfe, ATC, VATL

Head Athletic Trainer/Teacher Head Athletic Trainer

Eastern View High School Culpeper High School

Recommendations:

Reduce assignments, build in rest periods, allow more time for completion of work

Temporary Accommodations:

Excused Absence, Rest Periods, Deadline Extensions, Extend Test Time, Light/Noise Accommodations, Postpone/Stagger Tests, Excuse from PE/ROTC, Designate a “Note Taker” for student, Temporary Tutor

504 Plans

Section 504 of the Rehabilitation Act and the Americans with Disabilities Act

No one with a disability can be excluded from participating in federally funded programs

mailto:[email protected]

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Disability: “physical or mental impairment which limits one or more major life activities”

Cognitive Return to School Protocol after an Athlete sustains a Concussion:

Day 1: No School (until Symptom Free)

Day 2: Half Day, no homework

Day 3: Full Day, no homework

Day 4: Full Day, homework for 30 minutes

Day 5: Full Day, homework for 60 minutes

Day 6: Full Day, homework for more than 90 minutes

What is a concussion?

A concussion is an injury to the brain. It occurs when the brain is violently rocked back and forth or twisted inside the skull as a result of a blow to the head or body. The resulting injury to the brain changes how the brain functions in a normal manner. The signs and symptoms of a concussion can show up immediately after the injury or may not appear for hours or days after the injury. Concussions can have serious long-term health effects, and even a seemingly mild injury can be serious. A major concern with any concussion is returning to play too soon. Having a second concussion before healing can take place from the initial or previous concussion can lead to serious and potentially fatal health conditions.

What are the symptoms of a concussion?

Signs and symptoms of a concussion are typically noticed right after the injury, but some might not be recognized until days after the injury. Symptoms of concussion may or may not include, but are not limited to: Dazed look, vacant stare, slowed/incoherent body movements and/or reaction time, difficulty concentrating/remembering, fatigue/low energy, lethargy, unusual behavior/mood changes (depression, overly emotional, aggressive, sad, restless, irritable, etc), confusion, amnesia, headache, pressure in head, feeling slowed down/in a fog, “don’t feel right,” nausea, ringing in ears, dizziness, poor/blurry vision, sensitivity to sounds and/or light, balance/coordination problems, lack of sustained attention or concentration, sleep disturbances. The individual may or may not have lost consciousness.

What should be done if a concussion is suspected?

1. Immediately remove student from practice, game or any form of physical activity including physical education or weightlifting

2. Seek medical attention right away

3. Do not allow the student to return to physical education or weightlifting until proper medical clearance has been followed. The permission for return to physical education or weightlifting will come from the appropriate health care professional or professionals.

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Communicable Disease/Blood borne Pathogens Policy and Procedures(*Please note, ALL CCPS staff are required to complete the online Bloodborne Pathogens Training at the

beginning of each SY)

While the risk for blood-borne infectious diseases, such as HIV/Hepatitis B, remains low in sports proper precautions are needed to reduce the risk of spreading diseases. Along with these issues are skin infections, such as MRSA, Tinea Corporis (Ringworm), Folliculitis, Herpes Gladiatorum and Impetigo that occur due to skin contact with competitors and equipment. Any athlete suspected of displaying signs and symptoms of a communicable disease will be withheld from practice until a medical diagnosis from a physician and medical clearance (via written permission) is obtained. Please refer to Appendix I: National Federation of State High School Associations Physician Release Form, for a Wrestler to Participate.

Please refer to Appendix I for the Universal Hygiene Protocol for All Sports and CCPS Policy JHCC and JHCCA:

Shower immediately after all competition and practice Wash all workout clothing after practice Wash personal gear as often as possible Do not share towels or personal hygiene products with others Refrain from cosmetic shavingWash all equipment before and after practice (1:100 bleach to water solution)

Infectious Skin Diseases

Means of reducing the potential exposure to these agents include:

Notify guardian, athletic trainer and coach of any skin lesion or sore before competition or practice. Athlete must have a health-care provider evaluate lesion or sore before returning to competition. If an outbreak occurs on a team, especially in a contact sport, consider evaluating other team members for potential spread of the infectious agent. Follow NFHS or state/local guidelines on "time until return to competition." Allowance of participation with a covered lesion can occur if approved by health-care provider and in accordance with NFHS, state or local guidelines.

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Guidelines for Herpes Gladiatorum – Treatment and Prevention

First time Outbreak:

1.Seek medical attention and oral antiviral treatment to expedite its clearance.2.Regardless if treated, no wrestling until all lesions are healed. This means no new vesicle formation and no swollen lymph nodes are present.3.Consider being placed on prophylactic oral antiviral medication for remainder of season and each subsequent season.

Recurrent Outbreaks:1.Seek medical attention and oral antiviral treatment to expedite its clearance.2.No sports participation until after 120 hours of oral antiviral medication and no swollen lymph nodes near area involved.3.If not treated with antiviral medication, no sports participation until all lesions are healed with

well-adhered scabs. No new vesicle formation and no swollen lymph nodes are present.4. Consider being placed on prophylactic oral antiviral medication for remainder of season and each subsequent season.

*Use of antiviral medication for prevention is only at the discretion of your Health Care provider who can explain the potential risks and benefits.

Means of reducing the potential exposure to these agents include:

Bleeding must be stopped immediately and all wounds covered. All blood-soaked clothing must be removed before continuing competition or practice. Contaminated clothing must be cleaned before subsequent use. Athletic Trainers or caregivers (including coaches) need to wear gloves and take other precautions to prevent blood-splash from contaminating themselves or others. Immediately wash contaminated area with soap and water and/or an antiseptic.Clean all contaminated surfaces and equipment with disinfectant before returning to competition. Be sure to use gloves with cleaning. All contaminated materials must be disposed of properly in a Biohazard Bag per OSHA regulations.

Any blood exposure or bites to the skin that break the surface must be reported and evaluated by a medical provider immediately.

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Athletic Training Room Rules

1. Report all injuries to your coach and the Athletic Trainer as soon as possible. The Athletic Trainer will determine if participation is appropriate.

2. Upon entering the Athletic Training Room, all student athletes must sign in indicating the pur-pose of their visit.

3. An injured student athlete is still considered a part of the team, and expected to be present. If you are not practicing and do not have a fever or serious illness, you need to still be present at practice for treatment/rehabilitation with the athletic trainer. Appropriate clothing/practice attire must be worn.

4. Any student athlete who misses practice or is unable to complete a practice due to injury will be required to obtain clearance from the athletic trainer and/or physician before returning to play.

5. Student athletes are expected to be at practice on-time, despite any appointments with the athletic trainer. The athletic trainer is not responsible for an athletes’ tardiness for practice and any penalty he may suffer with the coaching staff as a result. Injury evaluation and treatment may be scheduled during lunch.

6. Injury care after school will be "first come, first serve,” with priority given to players who have a game that day or who are able to practice. Student athletes must SIGN-IN to the log in sheet as soon as they come in to the Athletic Training Room.

7. All student athletes should notify the athletic trainer before seeing a doctor for sports-related injuries, unless it’s an emergency. A signed medical clearance will be required before returning to participation.

8. It is your responsibility to check your safety equipment daily. Coaches are responsible for carrying the necessary tools needed to repair equipment at/during games. The athletic trainer will not be responsible for equipment repair.

9. The athletic trainer will reserve the right to hold out a student athlete that has been cleared by a doctor when such action will result in a faster/safer return to full competition.

10. The athletic training room is a medical facility, and should be treated as such. Do not touch or remove any items/materials without permission. Student athletes must sign-in for all injuries/treatments. Proper behavior, attire, and language will be required at all times (per the Code of Conduct)

11. The athletic training room will not be used as a “social area.” Student athletes in the athletic training room are expected to be there for a reason (evaluation, treatment, rehabilitation, taping/wrapping/bracing, etc.). All bookbags, equipment, dufflebags, and any other personal items are not to be left in the athletic training room. The athletic trainer will not be responsible for any “missing” personal items left in the athletic training room.

12. Athletic Training Student Aides (ATSA’s) are defined as Sports Medicine 1 and/or Sports Medicine 2 students or Sports Medicine Laboratory Aides who are there strictly to assist the Athletic Trainer.

13. The Athletic Training Room will adhere to the BOC Facility Principles guidelines which will be reviewed annually to ensure compliance with the regulations and guidelines of a safe, effective, and legal healthcare facility (Appendix J).

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On-The-Field Policy

No parents, guardians or spectators shall be allowed on the playing fields at any time during any sporting event home or away unless authorized by the Activities Coordinator or Head Athletic Trainer at EVHS.

SPORTS INJURY GUIDELINES FOR COACHES

Please be cognizant of the fact that it is physically impossible for the Athletic Trainer to be present at every practice and game, although it would be ideal. As a result, the coach must be prepared to handle any injuries that may occur during practices or games. Coaches are encouraged to obtain CPR/AED certifications (and first aid if possible).

In order to provide the best possible care, the following policies and procedures regarding athletic injury care are established:

The athletic trainer, to the extent possible, will be available "on site" as follows:

1. All regularly scheduled home games and home playoff games.2. Away games for varsity football, and all playoff games as

available. 3. One hour before practice every day, 2:30-3:30pm (for evaluation,

treatment, rehabilitation, etc.) 4. All after school practices (up to 8pm)5. During the athletic trainer’s designated "free period" during the

school day (by appointment)6. The athletic trainer may be available for special events,

tournaments, etc. on weekends and/or holidays, by special request of the activities coordinator.

When present, the Athletic Trainer will provide for the initial assessment, first aid, and any other decisions regarding return to play, and parent contact if needed, for all athletic injuries. In the absence of an Athletic Trainer, these become the responsibility of the coach. All such injuries should be reported to the Athletic Trainer as soon as possible.

When the Athletic Trainer is not on site, coaches should follow the emergency action plan specific to each sporting venue. Contact the Athletic Trainer as soon as possible (via cell phone) for all injuries requiring hospital care.

By Virginia state law, the athletic trainer may only provide care for the injuries occurring to students involved in the interscholastic athletic program, and only for those injuries that occur as due to the student’s participation.

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The coach is required to have first aid supplies at all practices and games. It is the responsibility of the coach to have the assigned athletic training kit at each practice and game. Return athletic training kits to EVHS athletic training room immediately upon completion of practice or game.

The coach is required to have emergency contact information for each athlete at all practices and games.

The coach is responsible for water and injury ice for his/her respective team during practices and games. An ice machine is available in the Athletic Training Room. In addition ice chests and water coolers are provided for each team, and stored in the same location. Return items daily, unless other arrangements have been made with the Athletic Trainer.

Any student athlete who is not able to complete a practice or game must receive clearance from the Athletic Trainer and/or physician prior to returning to competition.

A coach must not allow any student athlete to participate unless he/she has a written permission/clearance note from a physician. This is school board policy, and one of the most common causes of legal action.

Coaches must make sure that student athletes properly use protective equipment. All pads and safety devices used during games must be used during practice (including mouthguards). Coaches should periodically inspect the playing area and player equipment for safety hazards. Broken or unsafe equipment must be repaired or discarded immediately. No player will be allowed to participate in practices or games without properly functioning safety equipment.

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Mental Health and Psychological Concerns Policy

Rationale:

The goal of the Athletic Training Staff is to educate EVHS student athletes, parents, coaches, and staff regarding psychological concerns at the secondary school level. This includes recognition and proper referral, and the development of an emergency action plan.

Current Data on Psychological Concerns at the Secondary School level:*1 in 5 High School kids suffer from a mental illness*Only 30% of these are diagnosed*1 in 3 High School kids have an anxiety disorder*1 in 5 or 20% of High School kids have considered suicide*1 in 13 High School kids attempt suicide 1 or more times*The average age for major depression is 11-14 years of age*Bullying occurs in 20% of High School kids with the range being anywhere from 13-75%*Of High School kids who belong to groups, 48% were subjected to hazing activities and 43% were subjected to humiliating activities *36% of hazing would not be reported by most High School kids because there was no one to tell and 27% because adults would not handle it correctly

*Please see Appendix K and CCPS Policies JHH, JHH-BR1, JHH-E1, JHH-E2, JHH-E3 for more information

Recognition:

Triggering Events: Depression Signs and Symptoms

Anxiety Signs and Symptoms

Eating Disorders Signs and Symptoms

Debilitating Injury or Illness causing the Sudden End of the Playing Career (Ex: Concussion)

Sad, hopeless, guilty, restless

Apprehensive, powerless Anorexia:Extreme thinness, fear of gaining weight, distorted body image, restricted eating, compulsive exercise

Substance and Alcohol Abuse

Aches, pains, headaches, digestive problems

Having a sense of impending danger or panic

Brittle hair and nails; thinning of bones; dry and yellow skin; anemia; lethargic

Bullying, Hazing, or exposed to Violence

Lack of energy and loss of interest in activities

Increased Heart Rate, Breathing, Sweating, Trembling, or Feeling weak

Bulimia:Chronic inflamed sore throat; worn tooth enamel; severe dehydration; acid

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reflux; swollen glands in neck

Significant Diet or Weight Loss or possible Eating Disorder

Sleep disorders Worry that interferes with all aspects of life

Conflicts with Coaches or Teammates

Recurring negative thoughts

Depression and/or Substance Abuse

Class Concerns (Ex: Grades)

Problems concentrating, remembering, or making decisions

Suicidal Thoughts or Behaviors

Death of a loved one or close friend

Unusual crying

Referral:

At EVHS, a network of Allied Healthcare Professionals has been established (see AHCT) as an integral component to address psychological concerns in our student athletes. This network includes our team physician, Certified Athletic Trainer, school nurse, school counselors, school psychologist, social worker, and community-based mental health care professionals. At EVHS any student athletes suspected of having a mental health concern will be referred to the appropriate healthcare professional. The Athletic Trainer will adhere to their scope of care and legal limitations as well as to confidentiality considerations when addressing a student athlete suspected of a mental health concern. The Athletic Trainer will meet with the school nurse and counselors at the beginning of each school year to determine when, where, and how to access them during the school year in order to determine a plan of action. In addition, they will devise a plan of action for after-school hours, procedures for contacting parents, and alternate plans for situations in which a parent may be the source of the problem.

Emergency Action Plan:

*Please see “Emergency Action Plan Guidelines: Mental Health Emergency in Secondary School Athletes” in Appendix L. This handout will be in the Athletic Training Room as well as distributed to all EVHS staff prior to the school year so that everyone has access to proper recognition and management procedures.

Drug Policy

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*Please see Culpeper County Public Schools JFCF-BR1 “Drug Testing of Student Athletes” Policy in Appendix M

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Documentation

All suspected Eastern View High School student athlete related injuries will be documented using SportsWare and a Microsoft Word Program. Any suspected Head Injuries (including concussions) will also be documented on an individual basis using ImPACT and the Sport Concussion Assessment Tool 5 (SCAT5).

Works Cited

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J.C. Andersen; Ronald W. Courson; Douglas M. Kleiner; Todd A. McLoda. National Athletic

Trainers’ Association Position Statement: Emergency Planning in Athletics.

J Athl Train. 2002;37(1):99-104.

Steven P. Broglio; Robert C. Cantu; Gerard A. Gioia; Kevin M. Guskiewicz; Jeffrey Kutcher;

Michael Palm; Tamara C. Valovich McLeod. National Athletic Trainer’s Association

Position Statement: Management of Sport Concussion. J Athl Train. 2014;49(2):245-

265.

Douglas J. Casa; Lawrence E. Armstrong; Susan K. Hillman; Scott J. Montain; Ralph V. Reiff;

Brent S.E. Rich; William O. Roberts; Jennifer A. Stone. National Athletic Trainers’ As-

sociation Position Statement: Fluid Replacement for Athletes. J Athl Train.

2000;35(2):212-224.

Douglas J. Casa; Kevin M. Guskiewicz; Scott A. Anderson; Ronald W. Courson; Jonathan F.

Heck; Carolyn C. Jimenez; Brendon P. McDermott; Michael G. Miller; Rebecca L.

Stearns; Erik E. Swartz; Katie M. Walsh. National Athletic Trainers' Association Posi-

tion Statement: Preventing Sudden Death in Sports. J Athl Train. 2012:47(1):96-118.

Douglas J. Casa; Julie K. DeMartini; Michael F. Bergeron; Dave Csillan,; E. Randy Eichner; Re-

becca M. Lopez; Michael S. Ferrara; Kevin C. Miller; Francis O’Connor; Michael N.

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Sawka; Susan W. Yeargin. National Athletic Trainers’ Association Position Statement:

Exertional Heat Illness. J Athl Train. 2015;50(9):986-1000.

Kevin M. Conley; Delmas J. Bolin; Peter J. Carek; Jeff G. Konin,; Timothy L. Neal; Danielle Vi-

olette. National Athletic Trainers’ Association Position Statement: Preparticipation Phys-

ical Examinations and Disqualifying Conditions. J Athl Train. 2014;49(1):102–120.

Trenton E. Gould; Scott G. Piland; Shane V. Caswell; Dennis Ranalli; Stephen Mills; Michael S.

Ferrara; Ron Courson. National Athletic Trainers’ Association Position Statement: Pre-

venting and Managing Sport-Related Dental and Oral Injuries. J Athl Train.

2016;51(10):821–839.

McCrory P, et al. Consensus statement on concussion in sport: the 5th international conference on

concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;0:1-10.

Brendon P. McDermott; Scott A. Anderson; Lawrence E. Armstrong; Douglas J. Casa; Samuel

N. Cheuvront; Larry Cooper; W. Larry Kenney; Francis G. O’Connor; William O.

Roberts. National Athletic Trainers’ Association Position Statement: Fluid Replacement

for the Physically Active. J Athl Train. 2017;52(9):877–895.

Timothy L. Neal; Alex B. Diamond; Scott Goldman; Karl D. Liedtka; Kembra Mathis; Eric D.

Morse; Margot Putukian; Eric Quandt; Stacey J. Ritter; John P. Sullivan; Victor Welzant.

Interassociation Recommendations for Developing a Plan to Recognize and Refer Stu-

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dent-Athletes With Psychological Concerns at the Secondary School Level: A Consensus

Statement. J Athl Train. 2015;50(3):231–249.

Katie M. Walsh; Mary Ann Cooper; Ron Holle; Vladimir A. Rakov; William P. Roede; Michael

Ryan. National Athletic Trainers’ Association Position Statement: Lightning Safety for

Athletics and Recreation. J Athl Train. 2013;48(2):258-70.

Steven M. Zinder; Rodney S. W. Basler; Jack Foley; Chris Scarlata; David B. Vasily. National

Athletic Trainers’ Association Position Statement: Skin Diseases. J Ath Train

2010;45(4):411–428.

Documents

Eastern Guilford High School€¦ · Web viewThe philosophy we are dedicated to is one of student athletes first as well as adherence to the NATA code of ethics and professionalism