henderson county high school sports medicine policies and ...€¦ · certified athletic trainer...

Henderson County High School Sports Medicine Policies and Procedures

Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS

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I. The Athletic Health Care Team (AHCT) Defined

A. Team Members and Duties

1. The athletic health care team (AHCT) shall include but not be limited to:

Certified Athletic Trainer and supervised student athletic trainers, Team

Orthopedic Physician, Team General Practitioner, Family Physicians or

Specialists, Emergency Medical Services/Paramedics, School Nurse(s),

Athletic Director, Athletic Insurance Providers, Maintenance Staff, Game

Officials, Coaches/Assistant Coaches, Academic Teachers or Advisors,

Parents/Guardians of Student-Athletes, and Student-Athletes.

2. These AHCT members shall interact and coordinate care as a unit,

communicating pre-existing conditions, injuries, treatment, limitations, plan

for care, and any other necessary information to best care for student-athletes.

HIPAA and FERPA laws may apply to the privacy of health care information

of the student-athletes; therefore all reasonable effort will be put forth to limit

information to necessary parties.

3. These AHCT members should be up to date on current health care and

KHSAA policies and procedures and any applicable health care skills required

in his or her position, including but not limited to: First Aid, CPR with AED

training, Emergency Care and Management, and referral policies for student-

athletes.

B. The AHCT team members have the following duties in the health care of student-

athletes:

1. Certified Athletic Trainer (AT): prevention of athletic injuries and conditions

through education, pre-rehabilitation, and modification of athletic events to

ensure safety, clinical evaluation and diagnoses of athletic injuries including

orthopedic, general, and neurological issues, immediate and emergency care

of injuries and conditions including involvement of team physician or

paramedics, use of emergency equipment, or referral to outside health care

source, treatment and rehabilitation of minor athletic injuries and co-treatment

with outside healthcare sources, education of family and student-athlete

athletic injuries and rehabilitation, and management/coordination of health

care situations with above ACTH team members including injury reports,

daily rehabilitation and injury logs, aid in the proper fitting and use of

protective equipment and clothing, enforcement of policies, procedures, and

protocols, and management of heat index records, weight charts, and pre-

existing health conditions, maintenance of monitoring and emergency

equipment, encouragement for proper hydration and nutrition of all student-

athletes

a. Coverage by the AT is provided by Community Methodist

Hospital Sports Medicine department in partnership with

Henderson County High School at no cost to student-athletes and

nor parent/guardians. The AT is not an employee of the school



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district, but in an outreach position working closely with the

school system to provide on-site care

b. Direct coverage by the AT will be determined by available hours

as allowed by Methodist Hospital therapy unit supervisor, and

prioritized in this order: contact sports, varsity sports, post-season

play, home events, outdoor sports when weather conditions are

extreme, and events involving student-athletes with known

injuries or issues. Coverage of remaining events is at the

discretion of the Methodist Therapy Director, Athletic Director

and AT.

c. However, student-athletes of events not covered directly may

always contact the AT for treatment or evaluation of injury via his

or her coaching staff or the Athletic Director. Reasonable

adjustments will be made to make sure any student-athlete

needing treatment will be seen by the AT or forwarded to

appropriate healthcare team member in the even the AT is

unavailable. Student-athletes, coaches, and parents are asked to be

patient and flexible in seeking of care by the AT.

d. Coverage notice rules-coaches and/or athletic department must

give notice for events that need coverage and changes in

schedules:

i. Practice-24 hour notice

ii. Game-48 hour notice

iii. Tournament or multiple game event- 1 week notice

2. Student Athletic Trainer: perform above athletic training duties, but under the

supervision of the certified athletic trainer. This may include injury evaluation,

injury rehabilitation, taping, wound care, concussion care, and any other task

given by the certified athletic trainer.

a. A student athletic trainer is not an employee of the school district

or Community Methodist Hospital. They are a learning student-

observer performing on-site education in the form of a clinical

rotation, and a representative of his or her college or university.

b. A student athletic trainer shall not: make a return-to-play decision,

contact a student-athlete or parent/guardian directly, perform any

of the above tasks without supervision, be responsible for injury

reports or involved in insurance dealings, nor have access to

student-athlete physical or personal information except

information directly necessary to his or her care.



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3. Team Physician/General Practitioner: evaluate and treat athletic injuries as

needed to support the AT, referral to appropriate outside health care providers,

family and student-athlete education about athletic injuries and rehabilitation.

At no time is a student-athlete or family required to use Team physicians

versus their own family practitioner. Team physicians volunteer time to be on-

site for games and practices to increase safety by providing immediate care.

4. EMS/Paramedics: on-site for selected events and on-call from Community

Methodist Hospital at most times for emergency management of acute

conditions and coordination of emergency care with the AT and team

physicians.

a. An ambulance/EMT will be called regardless of parental contact in the event a

situation is life-threatening, limb-threatening, or out of the scope of practice or

situation ability of the AT or team physician

b. Immediate parental contact will always be attempted in case of emergency,

and a student-athlete will not be sent to an emergency room without a health

care member present if parents cannot be reached

5. Family Physicians and Specialists: involved in the care of student-athletes at

the family’s choice. Ideally, these health care professions will communicate

his or her opinion to the AT or Team physician either through the family or

directly, so that the best care of the student-athlete may be carried throughout

the health care team.

6. School Nurse: manages the health care of the student-athlete during the school

day, including but not limited to: administration of medications and ice packs

and/or heat packs, assisting to enforce school day limitations, organizing in-

school assistance to injured student-athletes and otherwise communicating

happenings and updates with the AHCT. All health care information faxed

from physicians shall be faxed through the secure fax line into the nurse’s

office and be distributed as necessary.

7. Athletic Director: organizes and communicate regulations, expectations, and

changes in athletic policies and procedures, and assist/support other health

care team members with any duties, liaison of athletic injury reports to

appropriate parties, and overall authority in the sports medicine organization,

overseeing maintenance of safe practice and play locations and conditions,

overseeing maintenance of safety equipment and related regulations

8. Athletic Injury Insurance providers: evaluate and investigate reported athletic

injuries and accidents, and may need student personal and health information

to do so. Accident and Injury insurance through the school district is intended

as a secondary coverage to those involved in KHSAA-sanctioned sports

9. Maintenance staff: involved in ensuring safe play and practice conditions

under the guide of the Athletic Director, responsible for the disinfection and



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cleaning of locker rooms, weight rooms, and play/practice facilities to reduce

risk of infection and keep areas free of litter, responsible for communication

with Athletic Director and other AHCT members

10. Game Officials: aids in ensuring safe play by enforcing KHSAA weather

policies, match rules, and injury and blood-borne pathogen guidelines, and

communicates with AT and/or Athletic Director their needs to fulfill the above

guidelines

11. Coaches/assistant coaches: communication of injury/issue to appropriate

health care team member when the coach is the sole witness of such events,

enforcement of limitations set by the healthcare team, encouragement of

practice and play in safe conditions with regard to playing surface, weather

conditions, and equipment, encouragement for proper hydration and nutrition

of all student-athletes, aid in the proper fitting and use of protective equipment

and clothing

12. School Guidance Counselors: distribution of school day

limitations/accommodations to academic teachers, communication with

student-athletes and families about possible issues with attendance and

schoolwork completion related to athletic activity or injury

13. Academic teachers: enforcement of school day limitations, and

communication with the health care team of issues in the classroom related to

athletic injuries

14. Parents/Guardians of student-athletes: shall secure health insurance for the

student-athlete and communicate coverage and changes in coverage with the

healthcare team, be aware of the risk of injury to their student-athlete while

participating in specific sports and familiarize themselves with sports

medicine Policies and Procedures related to that sport, be available to

communicate health care decisions, conditions, and treatment of the student-

athlete with healthcare team members, and encourage an open line of

communication among the student-athlete and team members by awareness of

Sports Medicine policies and procedures, provide encouragement for proper

hydration and nutrition of student-athletes at home and surrounding athletic

activities.

15. Student-Athletes: display honest communication of symptoms and injuries

with AHCT members to allow for best treatment of issues, be involved and

aware of nutritional and hydration guidelines, be communicative to the AHCT

team of needs and limitations set by healthcare team members, aid in

coordination of team events and treatments/appointments, and to be polite to

and respectful of all AHCT members at all times



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II. Policies and Procedures Statements

A. Purpose of the Sports Medicine Policies and Procedures

1. To outline and encompass the members, proceeding, rules, regulations, and

intentions of the Athletic Health Care Team

2. To attempt to plan for any and all medical emergencies that may occur during

athletic events, and make staff familiar with emergency procedures

3. To allow access to the referenced position statements and entities who apply

rules and regulations to athletic activity and sports medicine in order to

explain why certain policies and procedures are outlined here.

4. To allow for unity of the Athletic Health Care Team through education and

inclusion of members

B. Vision Statement of the Athletic Health Care Team

1. The Athletic Health Care Team strives to provide excellent injury

prevention, injury care, and evaluation, rehabilitation, and education

services to Henderson County High School student-athletes, and are

committed to quality care, compassionate communication, and

ongoing efforts to deliver the best and latest treatments available and

possible.

2. The Athletic Health Care Team aligns with all vision statements of

Henderson County High School, Henderson County School District,

and Henderson County Athletic Department.

C. Mission Statement of the Athletic Healthcare Team

1. The Athletic Health Care Team offers all student-athletes access to the

highest quality healthcare possible, with the safety and health of the

student-athlete always our top priority.

2. In accordance with statues set by the Kentucky High School Athletic

Association, National Collegiate Athletic Association, the National

Federation of State High Schools Associations, the Kentucky Medical

Association, the Center for Disease Control, and the position

statements of the National Athletic Trainer’s Association, the Athletic

Health Care team provides education, referrals to appropriate health

care team members, athletic training services, and minor rehabilitation

in order to prevent and treat injuries and keep Henderson County High

School student-athletes at their highest level of competition.

D. Availability of Documents

1. These policies and procedures, Statements, Emergency Action Plan,

Related Position Statements and Policies and Procedures, Athletic

Department Forms, and other Educational resources shall be made

publicly available on the Henderson County High School Website

under a Sports Medicine tab and available in paper form by reasonable



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request during normal business hours in the Athletic Department

Office.

2. Contact information for the AT, Athletic Director, Athletic Department

Secretary, head coaches, school nurse, and other AHCT team members

shall be made available to student-athletes and their families in pre-

season team meetings and posted in public areas to be accessed during

season

3. Any questions or concerns about the Policies and Procedures of the

Henderson County High School Sports Medicine Program should be

addressed with the AT or the Athletic Director.

III. Henderson County High School Athletic Facilities

A. Campus map- see attached

B. Visitor information: Visitor information may be accessed by calling the

Athletic Department secretary during normal business hours or the host team's

head coach during normal business hours

1. Parking for:

a. Gym events is in the front of the school from Zion Road, with

overflow to the east of the school. (please see attached map)

b. Football, baseball, soccer, and track and field, may be found by taking

the access road that is just east of school south through school grounds

to the large parking lot adjacent to fields (please see attached map).

c. Tennis may be accessed via Garden Mile Rd, with overflow in the

main lot behind football stadium and soccer/baseball fields. (please see

attached map)

d. Softball is available at North Field along the first base line and in the

grassy area outside of the gates near right field. (please see attached

map)

e. Other events' will be communicated through the host team's head

coach.

2. Concessions may be available at the discretion of the athletic department,

and depend on weather, available help, and the nature of the event.

3. Every reasonable effort will be made to have water, injury ice, and a first

aid kit available for all school-sponsored sporting events at Henderson

County High School. Taping areas are available upon prior request by

contacting the Athletic Director or the Athletic Trainer.

4. If a student-athlete from a visiting team requires treatment from the

Athletic Trainer that is more involved than post-competition ice bags or



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minor wound care, it is preferred that the visiting school's healthcare team

contact the Athletic Trainer ahead of time.

5. In the event of emergency, EMS will be activated from Community

Methodist Hospital at 1305 N Elm St, Henderson, KY 42420. The main

phone number to the hospital is: (270) 867-7700. All injured or ill persons

shall be taken to Methodist Hospital unless otherwise specified by

parent/guardian or EMS staff.

6. Contact information:

Ms. Vivian Tomblin, Athletic Director (270) 831-8860

Athletic Trainer: Kaela McDaniel, ATC/L, PTA (270) 844-9632

Head Coaches: please contact by email at

[email protected]

IV. Emergency Action Plan and TimeOut Policy

A. Purpose and Use of School-Wide Emergency Action Plan

1. The Emergency Action Plan (EAP) was implemented to increase awareness of

the cooperation of all AHCT members in the emergency care of injured or ill

student-athletes

2. The EAP includes venue-specific information that is immediately available in

the event of an emergency, and includes a script for calling emergency

medical services, the address and exact directions to each home venue for

Henderson County High School athletic events. The EAP for each location is

posted at the location.

3. The EAP is intended to make a stressful and time-dependent emergency

communication flow more easily, and to remind AHCT members who are

present of their role in emergency management.

4. The EAP is to be reviewed annually and assumes that all AHCT members are

current with CPR with AED, first Aid, and the KHSAA emergency

management course. All coaches and assistant coaches should be familiar with

the details of the locations at which they hold team-sponsored activities.

B. Please see attached EAP for venue-specific postings

C. TimeOut Policy

1. The TimeOut program is a short meeting of head coaches, officials, AHCT

members of home and visiting schools, captains, and any other necessary

staff at the beginning of each event or practice.

2. The purpose is to unify the approach to possible issues that may arise

during the event, alert visiting staff to EAP for the location and location of

emergency equipment and weather shelters, and make all involved aware

of potential hazards such as impending weather, heat or cold indexes, and

field conditions. The location of Community Methodist Hospital shall be



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shared. The TimeOut shall also serve to alert visitors of availability of

AHCT members and coverage for athletic injury.

3. In the event that ACHT members are not available at the beginning of an

event, communication to coaches and game officials may be made later

into the event, or by cellular telephone.

4. If a member of the visiting team’s Athletic Health Care team is available

at the event, communication between AHCT members of both schools

shall suffice for the visiting school’s coaching staff.

V. Athletic Training Equipment and Treatment

A. Emergency Equipment

1. Automatic Emergency Defibrillator (AED) Locations

a. outside the main office in the main gym building

b. in the outdoor Athletic Training room

c. with the AT, OR at North Field during softball season

d. NOTE: in the event an AED is applied, whether or not a shock is

advised by AED equipment, EMS will be activated and contact

will be made with parents/guardians

2. CPR equipment

a. CPR mask, gloves, and disinfectant shall be carried by the AT at

all times

b. all other AHCT members must purchase their own mask or

arrange through the Athletic Department to have one ordered

c. NOTE: in the event CPR is administered, EMS will be activated

and contact will be made with parents/guardians

3. Spine board

a. a spine board with headrest and straps is available during games

covered by the AT.

b. NOTE: in the event the spine board is necessary in the care of a

student-athlete, EMS will be activated and contact will be made

with parents/guardians

4. Splints

a. Splint bag with whole-limb splints is available during games

covered by the AT

b. SAM splint for smaller areas is available during games covered

by the AT

c. NOTE: A splint may be applied to safely remove an athlete from

the field of play for further evaluation if a fracture is suspected.



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EMS may be activated if necessary, and parents/guardians will be

contacted with plan of care for student-athlete.

5. Crutches

a. 4 pairs crutches (2-5’2” to 5’10’’ and 2-5’10” to 6’6”) are

available as needed

b. It is the student-athletes’ responsibility to take care of the

crutches during use and to return the crutches when they are no

longer needed

6. Large plastic tubs, whirlpools, trash cans

a. For immediate cooling or reduction of core body temperature in

event of heat illness/injury, or for recovery-type treatments for

sore, tired, or strained muscles and joints

b. Available for outdoor sports whenever the heat index is expected

to pass 95 degrees and by prior request for recovery treatment

7. Monitoring devices

a. Heat index monitors

b. Lightning/air static monitors

c. Smart phone to view weather, heat index, temperature

d. Blood pressure cuff with stethoscope

e. Oral thermometers

f. Tuning fork to aid in diagnosis of fractures, hearing loss

B. Wound Care

1. Exam Gloves to prevent exposure to AHCT and student-athlete

2. Sterile Gauze to control bleeding and clean or cover wounds

3. Wound wash, saline, and hydrogen peroxide to clean and disinfect wounds

4. Bandages as primary layer to cover wounds and control bleeding

5. Cohesive and/or athletic tape as secondary layer to cover and control exposure

6. Steri-strips, butterfly strips as necessary to keep wounds closed

7. Blood Buster spray to clean blood from jerseys and surfaces

C. Rehabilitation

1. Stationary bicycles, step machine as available for cardiovascular rehabilitation

2. Free weights, weight bars as available in school weight room facilities

3. Latex resistance bands for various upper and lower extremity exercises

4. Wobble board to increase difficulty of balance-type exercises



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5. Foam roller for soft tissue mobilization

6. Calf stretcher for increased gastrocnemius/soleus complex range of motion

7. Computerized exercise plans for home use and increased independence

D. Modalities

1. Moist heat packs in hydroculator, with covers to apply to skin safely

2. Ice in multiple ice machines for ice bags, ice baths, ice water

3. Large plastic tubs and trash cans for ice bath, whether emergency or

therapeutic

4. Small bucket for ice bath of hands, feet, ankle, lower leg

5. TENS electrical stimulator upon necessity and with parent permission

E. Hydration/Electrolyte Balance

1. Coolers for ice water

2. Football only: water reservoir with spray nozzles

3. Bottles or cups to distribute water

4. Gatorade and cooler to dispense- when purchased by specific teams

5. Medi-lyte tablets: condensed electrolyte tablets to prevent and remedy

cramped muscles and heat illness

F. Infection Control and Cleansers

1. Hand Hygiene

a. Soap and water- available in Athletic Training rooms, all restrooms and

locker rooms with restrooms in them

b. Hand sanitizer-in training rooms, in Athletic Training bags, on person

of Athletic Trainer at all times

c. PAWS hand wipes-in Athletic Training bags for cleansing on field or

when sink unavailable

d. Medi-Staph wipes- available in Athletic Training room and on field to

clean any area or skin area potentially exposed to Staphylococcus

2. Wound cleansers- available in Athletic Trainer's bag and upon request

a. Hydrogen peroxide

b. Band-aid wound wash

c. Saline solution

3. Surface Cleansers

a. Mint Quat- Athletic Training room, weight room, and locker room

surfaces for normal soil



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b. Hydrogen Peroxide-for water bottle caps, water bottles, equipment, and

surface cleaning to kill contaminates

c. Blood Buster- for any blood-contaminated surface or cloth to denature

blood proteins to decrease spread of blood-borne pathogens

d. Bleach solution-for water bottle caps, water bottles, equipment, or

surfaces for deep cleaning

VI. Athletic Training Room and Confidentiality

A. Confidentiality of Healthcare and Personal Information- As stated in “HCHS Student-

Athlete Athletic Training Consent to Treat and Statement on Protected Health

Information” Form (please see attached), all reasonable effort will be made to keep

health-related and personal information of the student-athlete private and sacred.

1. That being said, information that affects the safety or well-being of the student-

athlete, information necessary to process athletic insurance claims, or any

other sharing of information that is constructive towards the care of the

student-athlete may be shared among authorized AHCT members

2. Therefore, the Athletic Trainer and other AHCT members may share

information as needed among them, but every effort will be made to

minimize spread of any personal or health-related details beyond those

AHCT members who are absolutely necessary to the care of the student-

athlete

3. It is the policy of the AHCT to decline comment to any media source inquiring

about student-athlete health-related information or play status. No student-

athlete, parent/guardian, or any other fan may inquire about the health of

anyone but their own child.

4. In regards to technology, care will be taken to minimize using text messages,

voicemails, or any other technology form in a way that may result in the

inadvertent release of health-related information. Email and phone calls

should be conducted in a private area so as to reduce sharing of

information to others nearby.

5. In the event that a conference is held involving student-athletes, parents,

coaches, or any other AHCT member, there will be a closed-door atmosphere.

Available private conference locations are: coaches' offices, indoor or outdoor

Athletic Training room during non-peak hours by appointment, Athletic

Director's office, or empty classroom as available.

VII. Personal Protective Equipment

*All of the following policies are based from and in compliance with Kentucky High School

Athletic Association, National Collegiate Athletic Association, National Federation of State High

Schools Associations, Kentucky Medical Association, Center for Disease Control, the position

statements of the National Athletic Trainer’s Association, suggestion from the Board of



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Certification of Athletic Training and the Henderson County School District and Athletic

Department*

A. Fitting of equipment

1. Fitting of equipment will be completed by experienced equipment

managers, coaches, and Athletic Trainers only. Appropriate fitting

instructions will be posted in equipment areas for review and

reminder

2. Adjustments made by the above responsible parties will fit the available

equipment to the student-athlete as best as possible

B. Priority will be given to varsity players, then JV players, then freshmen student-

athletes in regards to available equipment and best quality pieces. No defective piece

of equipment will be issued unless the defect can be repaired to industry standards.

No student-athlete shall share equipment.

1. Adjustments to equipment that detract from safety and best fit are not allowed.

Adjustments are not to be made by student-athletes besides features that tighten

and loosen to allow for donning and doffing.

2. Student-athletes are to keep all equipment in good working order, to avoid

making any changes to fit of equipment, and alert coaches, equipment

manager, or Athletic Trainer if any issues arrive.

B. Required Protective Equipment

1. Baseball

a. Helmet- double-eared protective helmet while at bat, on deck, running

bases, or protecting a pitcher when bullpen opens to the playing surface

b. Catchers-protective helmet with mask and attached throat guard

2. Basketball

a. None required.

b. Any hard cast, brace, support must be covered by at least 1/2 inch high

density foam

3. Football

a. Knee pads 1/2 inch thick must be worn, preferably covering the entire

knee. Hip pads, tailbone guards, and thigh padding must be worn.

Properly-fit shoulder pads with epaulets must be worn. These will be

provided.

b. Helmet with NOCSAE emblem, facemask, and 4 or 6-point chin strap

must be worn by every player. These will be provided

c. If adjustable, air pockets must be adjusted or approved by equipment

personnel, coaches, or Athletic Trainers. If straps, fasteners, facemask,

or any other component is dysfunctional, the student-athlete must alert

an equipment-responsible AHCT member.



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d. Mouthpiece with material approved by the FDA, and of a readily-

visible color, must be worn at all times and cover the entirety of upper

teeth.

e. Any hard cast, brace, support must be covered by at least 1/2 inch high

density foam

4. Soccer

a. Players must wear professionally manufactured, NOCSAE-approved

shin guards.

b. Any hard cast, brace, support must be covered by at least 1/2 inch

high density foam.

c. No jewelry is permitted unless covered by tape, secured to the body

5. Softball

a. Helmet- double-eared protective helmet while at bat, on deck, running

bases, or protecting a pitcher when bullpen opens to the playing

surface

b. Catchers-protective helmet with mask and attached throat guard and

chest protector

6. Swimming and Diving

a. none required

7. Track and Field

a. none required

b. no taping of fingers or thumb is permitted in discus, javelin, shot-put

unless to cover an open wound.

c. forearm padding for pole vaulters is allowed

8. Volleyball

a. none required

b. no jewelry allowed

c. any hard cast, splint, brace must be covered by 1/2 inch dense foam.

Any piece of equipment deemed by officials to give a player unfair

advantage must be removed.

C. Additional/Optional Equipment

1. Eye wear

a. all eye wear must be ASTM or OSHA approved.

b. Student-athlete and parent/guardian are responsible for correct fit,

maintenance, and storage of all eye wear.



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2. Additional padding, bracing, splinting

a. Ankle, knee, wrist, elbow, and thumb braces may be available

through the Athletic Trainer as supplies last. Not all needs may be met

by the stock of the Athletic Trainer. Braces may be requested, but will

be available on a first-come, first-serve basis

b. Foam padding to cover bracing, splinting, or injured areas may be

available upon prior request

c. If a student-athlete requires equipment that the Athletic Trainer does

not stock, it is the responsibility of the parent/guardian to acquire it.

d. If the cost of the equipment exceeds the family's resources, a

conference with the AHCT may be requested to investigate possible

options for funding the equipment

3. Prophylactic Equipment

a. equipment intended to prevent injury, other than equipment listed

above, will be the responsibility of the student-athlete and

parent/guardian

b. It is the student-athlete and parent/guardian to ensure that the

equipment meet all safety standards and rules

c. All equipment worn during game play is subject to the officials’

discretion via KHSAA and NFHS, and may be deemed ineligible.

D. Maintenance of Equipment

a. Equipment issued by HCHS, an individual team, or the Athletic

Trainer will be maintained by the issuing party

b. All other equipment will be the responsibility of the student-athlete

and parent/guardian

VIII. Safe Play and Practice Policies

*All of the following policies are based from and in compliance with Kentucky High School

Athletic Association, National Collegiate Athletic Association, National Federation of State High

Schools Associations, Kentucky Medical Association, Center for Disease Control, the position

statements of the National Athletic Trainer’s Association, suggestion from the Board of

Certification of Athletic Training, and the Henderson County School District and Athletic

Department*

A. Pre-Sports Participation

1. 1. Mandatory physical

a. It is the policy of Henderson County High School Sports Medicine

and the Henderson County School district that all student-athletes

must have a yearly physical on file with the Athletic office in order

to participate in a sporting activity.



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b. A student-athlete may have the physical done by a family doctor,

and orthopedic screening facility, or participate in mass physicals

that are held at HCHS in the fall and spring. The availability and

dates/time of such events shall be made available to coaches to pass

to the student-athletes.

c. A student-athlete who participates in multiple sports may use the

same physical for the remainder of the calendar year from which it

is dated.

d. Physicals must include: family and medical history (especially

orthopedic conditions), general physical exam, cardiovascular

examination, neurological examination, orthopedic screening, and

general screenings such as urine testing, blood testing, etc,

depending on conditions revealed by testing, mental health

screening, medication use, and nutritional and hydration status.

2. 2. Physical information availability

a. Information reported on physical forms, reported by

parent/guardian on health the information form, or by the student-

athlete to AHCT members will be made available to appropriate

AHCT members in order to best care for the student-athlete during

events at HCHS and when traveling to other schools

b. Forms may be copied and given to AHCT members, or be

available in electronic form on a portable device such as a smart

phone. Care will be taken to prevent disclosure to anyone other

than necessary AHCT members.

B. Hold harmless agreements

1. It shall be understood that a student-athlete and his or her parent/guardian

shall hold harmless HCHS, the coaching staffs, administration, AHCT

members, and any other related personnel in the event that student-athlete

suffers injury during a school-sponsored sporting event. There is inherent

risk when participating in sports, even when every precaution is carried

out according to bylaws and regulations.

2. It shall be understood that a student-athlete and his or her parent/guardian

shall hold harmless the Certified Athletic Trainer and Methodist Hospital

should the student-athlete be injured during a school-sponsored sporting

event.

3. The above hold-harmless intentions shall be signed in writing by the

parent/guardian via hold-harmless agreement forms distributed with pre-

season packets.

C. Consent to treatment and HIPAA/FERPA release



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1. If a parent/guardian would like their child to be treated by the Athletic

Training staff during the course of a season, they must sign a consent to treat

and HIPAA/FERPA release. This allows the Certified Athletic Trainer to

perform minor treatments, taping, and wound care without specific

permission from the parent/guardian.

2. Any severe injury, illness, or condition will be brought to the attention of the

parent/guardian before a decision is made. However, in the event of a life-

threatening emergency, the student-athlete will be assessed and/or

transported by EMS regardless of parent/guardian availability.

3. If a parent/guardian chooses not to sign the Consent to Treat and

HIPAA/FERPA, the student-athlete will be assessed and treated in the event

of a life-threatening or severe injury only. No day-to-day care will be

allowed.

4. Signing the Consent to Treat form also indicates the trust by the

parent/guardian of the Athletic Trainer to properly and safely care for the

student-athlete with or without the parent present, regarding minor issues or

injuries. In the event of a severe or life-threatening injury, parent/guardians

will be contacted or united with the student-athlete on the field or in the

Athletic Training Room.

D. Primary and Secondary Insurance for Athletics

1. It is the parent/guardian’s responsibility to acquire primary insurance for

their child, to have that information readily available in case the student-

athlete needs care, and to update the ACHT if changes to the coverage

arise.

2. The school carries an accidental injury insurance on the student-athletes as

a whole. In the event that primary insurance does not cover all charges, the

parent/guardian may inquire about status of excess charges with the

Athletic Office

3. There is an option to purchase accident insurance with regards to athletic

participation that would act as a secondary policy and be applied to charges

resulting from care after an athletic injury after the primary insurance has

been applied to its maximum. Parent/guardians may inquire about details in

the athletic office.

E. Team Meetings

1. Team meeting are held before pre-season and before regular season for

most, if not all, sports. Parent/guardians should make every reasonable

effort to attend such meetings as AHCT staff may be in attendance to

update parent/guardian on policy changes, necessary paperwork, or

processes by which athletic healthcare is delivered.



17 | P a g e

F. Awareness and Resources for Parents

1. The parent/guardian is a vital part of the AHCT. It is expected that the

parent/guardian will ask questions of the ACHT members, be involved in

the healthcare process, and remain a decision-maker for their child

2. Via the Henderson County High School website, resources will be made

available and routinely updated, including required forms, ACHT policies

and procedures, and other information relevant or related to ACH and the

high-school athlete

3. Parent/guardians may access this information at any time, and may find

the information simplifies the process by which the student-athletes are

cared for on a day-to-day basis.

G. Process for Reporting and Following-Up after Athletic Injuries

1. Student-athletes are expected to report athletic injuries as soon as they

happen. This may be at the exact time of occurrence if the injury limits

play, or immediately after the event in which it occurred. The quicker

they are reported, the better care that can be applied.

2. Even if the injury does not require loss of play time OR treatment, the

injury should be reported so as to best record when the injury occurred

and activity since.

3. Each injury will be evaluated and recorded with date, time, and loose

SOAP (subjective, objective, assessment, plan) format.

4. A note shall be sent home with the student-athlete if anything more than

soreness or overuse is found. This note shall include general findings and

treatment plan, as well as Athletic Training opinion of need for follow-up

with healthcare providers.

5. Injury checks/follow-ups will be scheduled around practice times as much

as possible. If daily exercises or ice bag treatments are necessary, the

student-athlete will be expected to attend treatment immediately before

and after practice or game times.

6. If a student-athlete does not comply with treatment plan or attend

scheduled treatment times or complains of continued symptoms without

attending treatments, a meeting will be held with coaches and/or parents

to discuss attendance and referral to outside healthcare providers.

IX. Concussions and Cervical Spine Injuries

A. Background Information



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1. Concussion are a mild traumatic brain injury resulting from direct impact

or indirect forces to the brain, and have the potential to be serious and

life-threatening injuries, sometimes into adulthood.

2. According to the NATA, concussions are trauma-induced alterations in

mental status that may or may not involve loss of consciousness.

3. The terms “ding”, “having their bell rung”, and any variation of these

trivialize a serious injury and shall not be used by ACHT members.

4. When a concussion occurs, there is damage to brain tissue similar to a

bruise. This may affect cognition, memory, mood, awareness, focus, and

other mental and emotional aspects. Headaches are common, as well as

dizziness, nausea, sensitivity to light and sound, feeling out of sorts or

slowed down, difficult remembering, focusing, or understanding, as well

as others.

5. Any impact to the head, witnessed or reported, and any signs or symptoms

of a concussion will be taken seriously by AHCT members. That is not to

say that every student-athlete who reports a headache, etc., has a

concussion, but the student-athlete shall be treated as such until a head

injury is ruled out by Athletic Training staff or a physician

B. ImPACT testing

1. ImpACT is a computerized testing system that evaluates long and short-

term memory, reaction time, visual and spatial capacities, and overall

responsiveness to mental challenges.

2. Every student-athlete who participates in a sport that is potentially a

contact sport will be tested prior to his or her first season and every other

year thereafter. This will serve as a baseline to compare a post-injury test

result to in the event the student-athlete suffers a head injury.

3. The ImPACT program is provided at no cost to student-athletes and shall

be administered and read by trained AHCT members.

D. Emergency Management and Evaluation

1. Any student-athlete who collapses on the field, suffers a blow to the head

via another player or the game surface, or who complains of concussion-

like symptoms will be evaluated by the AT or team physician prior to

returning to play.

2. On-field priority will be to rule out vertebral fractures, severe vertebral

dislocations, and to maintain airway, breathing, and circulation. The AT

will check for consciousness, signs of a bleed in the brain via cranial nerve

testing, and assess awareness of the student-athlete to his or her



19 | P a g e

surroundings. If any of these tests are failed, the student-athlete will be

referred to EMS or emergency medical care.

3. If the student-athlete does not display life-threatening signs, but does show

symptoms of a concussion, the student-athlete shall be moved to the

sidelines to further evaluate and monitor signs and symptoms.

4. The student-athlete will not be allowed to return to play unless a head

injury is ruled out completely.

E. Referral to emergency services

1. If the student-athlete has lost consciousness, shows signs of a vertebral

fracture or spinal cord injury, fails testing for cranial nerve integrity, is

severely confused or disoriented, has symptoms that worsen, or is in any

way displaying signs of a more serious injury, they will be evaluated and

transported by EMS to the Emergency Room.

2. Even if a student-athlete is removed from the field without apparent signs

or symptoms of a concussion, the he or she may still need further care if

the condition changes or worsens.

F. Continued care for a Concussed Student-Athlete

1. If a student-athlete is determined to have a concussion through signs and

symptoms and/or an impact to the head, he or she will:

a. Take a post-injury ImPact test.

b. Rest from all contact sport for at least 72 hours

c. Complete a return to play protocol including aerobic, non-

contact, then contact practice

2. If the student-athlete's symptoms do not resolve within 72 hours, he or she

will referred to a physician who specializes in concussion management for

further evaluation and care. This physician may plan the following

progression depending on severity of symptoms:

a. School Accommodations- partial day scheduling, increased

testing time, decreased test or assignment length, testing in quiet

rooms, decreased homework time per night, increased time to turn

in assignments, increased cues or decreased length of tests

b. Repeat ImPact testing and symptoms score monitoring

c. Return to Practice/Play Protocols-after ImPact scores to Baseline

and symptoms resolved, that includes aerobic, non-contact, then

contact practices before allowing contact competitions. Each of

these phases must be completed without return of symptoms to

progress.

d. Clearance to practice/play.



20 | P a g e

G. Repeat concussions

1. It is a widely held opinion in the sports medicine realm that repeated

concussion and or/impact to the head results in cumulative injury that

may cause lasting injury and impact on quality of life, cognitive function,

and emotional status.

2. The recovery time after a second confirmed concussion versus the first is

almost always longer, and symptoms can be more severe and longer

lasting.

3. Two severe concussions in one season or one school year will disqualify

the student-athlete until the end of the season or school year, even if

return-to-play has been completed

4. A third severe concussion in the high school years will require a formal

meeting with parents, athletic training staff, athletic department, and

coaching staff to determine the health risk versus future in athletics of the

student-athlete in contact sports

H. Additional Concussion Education for Parents and Student-athletes

1. Available under Sports Medicine section on HCHS website

2. Available by request from the Athletic Director or Athletic Trainer

X. Sudden Cardiac Events

A. Emergency Management and Evaluation

1. Sudden cardiac event (SCE) shall be assumed if a student-athlete has

collapsed and is unresponsive. It can be caused by, but is not limited to

hypertrophic heart tissue, an unknown underlying cardiac abnormality, and

ventricular rhythm disruptions by a forceful blow, myocarditis, valve

defects, or coronary artery disease.

2. Immediately, the student-athlete shall be evaluated for breathing

patterns, airway integrity, and signs/symptoms of SCE. CPR shall be

initiated if necessary, and will continue except during AED rhythm

analysis.

3. An AED shall be applied and evaluating heart rhythm within 3-5

minutes of collapse whenever possible to maximize recovery potential. All

ACHT members shall be trained in CPR with AED AND be aware of the

closest AED to each and every practice and play surface. These are also

listed on the emergency action plan written and posted for each facility at

HCHS.

4. EMS (911) shall be called regardless of use of CPR or AED if the

student has been unconscious. The student-athlete's parent/guardian will

also be contacted. The student-athlete will not be sent to the ER alone.



21 | P a g e

B. Referral to emergency services

1. As stated, EMS will be activated in event of any suspected cardiac

event. According to the emergency action plan of the location, EMS will

be directed the location of the student-athlete.

2. CPR, AED use, and care will continue until EMS arrives and takes

over.

C. Continued care for diagnosed cardiac issues

1. Care for cardiac conditions will be under a physician only. A student-

athlete must be cleared for athletic activity by the cardiologist or

physician and the clearance must be in written form, including any

limitations.

2. The ACHT members may be involved in rehabilitation or treatment as

per the physicians' direct written orders

D. Cardiac education for Parents/Student Athletes

1. Available under Sports Medicine section on HCHS website

2. Available by request from the Athletic Director or Athletic Trainer

XI. Other Athletic Injuries

*All athletic injuries are expected to be reported immediately, in order to find the best care plan

possible in as short a time as possible. Though play time is never guaranteed if an injury leaves a

student-athlete at risk, lost play time is minimized with timely reporting of injuries.*

A. Dislocations

1. Dislocations will not be reduced on-site. Circulation and nerve

preservation distal to the joint shall be monitored, associated

wounds cleaned and cared for, and ice will be applied if appropriate.

2. Dislocated joints will be splinted in place and sent to the

Emergency Room or an Orthopedic Urgent Care Facility to be

reduced and cared for.

3. In the event that a joint spontaneously reduces during palpation,

splinting, or transportation, the joint will be re-splinted in the

reduced position.

B. Fractures

1. A known fracture will be splinted and sent to the Emergency Room

or Orthopedic Urgent care. Fractures will not be set on-site.

Circulation and nerve preservation distal to the joint shall be

monitored, associated wounds cleaned and cared for, and ice will

be applied if appropriate



22 | P a g e

2. It is the choice of the parent/guardian as to whether or not the joint

is cared for immediately or during the next business day. However,

the parent/guardian will be asked to take the student-athlete home

if pain and discomfort do not allow AHCT members to manage

care.

3. In the event a fracture is possible, and a tuning fork test, palpation,

or visible distortion test is positive, the site will be treated as if it is

fractured until it is ruled out by imaging.

4. Stress Reaction and Stress Fracture

a. Shall be treated as fractures. Please see above.

b.Stress reaction-an area in a bone that is weakened due to

chronic overuse leading to breakdown of bony strength. This

may be a predisposition to stress fracture.

c. Stress fracture-a fissure or fracture in the bone, resulting

from overuse or undue stress. It may or may not be

displaced.

C. Cuts, avulsions, uncontrolled bleeding

1. All lacerations, cuts, scrapes, punctures, or other skin breakages

will be treated via universal precautions and assumed to be a risk

to the AHCT and other student-athletes.

2. Therefore, skin breakages shall be evaluated with appropriate PPE,

including gloves. All wounds will be cleaned, covered, and

wrapped as necessary to prevent spread of bodily fluids.

3. Any wound that is determined to need stitches to close or for

cosmetic closure, any wound that does not stop bleeding within 15-

20 minutes, and any piece of skin, tissue, or appendages that is

deemed unable to reattach without intervention will be sent to the

Emergency room or Urgent care facility.

D. Internal injuries

1. Any athlete that is found or suspected to have internal injuries will

be sent to the Emergency Room or Urgent Care Facility, and

parent/guardian will be contacted.

2. These include, but are not limited to: rib fracture/bruise, kidney

injury, spleen injury, bladder or urogenital injury, stomach or

intestinal injury.

E. Ligament tears or ruptures



23 | P a g e

1. In the event that a ligament sprain with laxity or a complete

ligament tear is suspected via special testing, mechanism of injury,

and/or swelling around joint, a referral to a team physician, family

physician, or orthopedic physician will be suggested, depending on

specific ligament involved.

2. Rehabilitation, as prescribed by the attending physician, may in

most cases be completed on site at HCHS, or in an external

physical therapy office. Individual cases will be addressed as

needed.

F. Returning to play after an injury

1. “In-house” injury- no physician visit required. The student-

athlete will be guided through the following steps before returning

to play. No step shall be attempted until the previous step has been

accomplished

a. Control is gained of swelling, bruising, pain, and student-

athlete can walk without assistive device. Ice bags, range of

motion exercises, transition to walking exercises,

stretching, and exercise that does not aggravate the

condition may be used.

b. Transition to practice/play in the form of jogging,

calisthenics, weight lifting and progressive resistance

exercises, simulated practice drills, and increased

cardiovascular training.

c. Partial practices, with specific limitations. Examples:

warm-up only, non-contact drills only, straight-line drills

only, 5 minutes each drill only, 10 repetitions only, only

drills that do no exacerbate symptoms, or upper/lower body

only drills.

d. Return to practice with provisions. Examples: all drills

but cutting drills, full practice but no sprints, full practice

besides positions that exacerbate symptoms.

e. Full practice, but special attention to return of symptoms.

f. Full practice, full clearance.

2. Physician-monitored injury

a. per physician or therapist specifications.

b. OR through in-house protocol once cleared by physician

to do so



24 | P a g e

XII. Infectious Disease Prevention

A. It is the policy of the AHCT to reduce the spread of infectious disease from

and to student-athletes. Therefore:

B. All wounds that are brought to the attention of the AHCT will be

cleaned, covered with bandages and/or tape, and monitored.

C. If a wound is actively bleeding, the student-athlete will be held from

competition until the bleeding ceases, and the wound can be cleaned and

covered.

D. The AHCT members will follow CDC recommendations for hand

washing:

1. All treatment areas will be cleaned after use with an industrial

disinfectant for normal exposures and bleach for areas

contaminated with blood or other bodily fluids.

2. It is the responsibility of the student-athlete to alert the AHCT,

especially the Athletic Trainer, of open wounds so that the wound

can be addressed.

XIII. Nutrition and Hydration

A. Nutritional guideline for high school age student-athletes

1. School breakfast/lunch program

a. based on National School Lunch and breakfast programs,

ranging from 750-850 calories per meal, with more

fruits/veggies than protein and carbohydrates

b. via Food Guide Pyramid established by USDA, the average

young adult needs around 2200 kcal/day. Athletes may require

up to 8000kcal/day, especially during periods of increased

training

c. Parent/guardians should be aware that of the energy deficit

between the school lunch program and the needs of their high

school-aged student-athlete

2. Snacks, water, and sports drinks

a. Most student-athletes, especially in times of high-intensity

training, need to eat or snack every few hours.

Parent/guardians are responsible for supplying student-

athletes with these extra snacks.

b. Student-athletes in season with their sport should be taking

in more than the recommended water for their age group.



25 | P a g e

This may require water bottles to be carried during the school

day and frequent visits to water fountains.

c. Sports drinks are a great source of carbohydrates and sugar

energy for student-athletes. They should be reserved for

times around heavy or intense athletic practice and

competition, however, to decrease extra storage of

carbohydrates by the body.

B. Role of the healthcare team in nutrition/hydration

1. Team meals, snacks, and the opportunity to purchase food is

decided by each team’s coaching staff as they plan practices and

trips. It is the parent/guardian’s responsibility to fund or provide

food unless otherwise specified by the coaching staff.

2. Water will be available at all events, home and away. Coolers may

be filled at inside or outside Athletic Training rooms. Coaches and

captains will be responsible for confirming plan and method for

getting water to practice or play location.

3. When purchased by the team, sports drinks will be prepared and

available for student-athletes as well.

4. During the required seasons, daily weigh-ins are required for

football team members and any other student-athlete who displays

repeated heat tolerance issues.

a. If at any time a player has lost more than 2% of his body

weight during a single session of practice or play, he or she

will be required to re-hydrate back to within 1% before the

next practice or competition.

b. If he or she is still not within 1% of previous weight, he or

she will not be allowed to participate that day. If a student-

athlete is down more than 2% for 2 days in a row, the

student-athlete will not be allowed to participate for 48

hours, no matter what weight is.

C. Disordered Eating and Nutritional Supplements

1. A wide variety of improper eating habits, weight management, and

attitudes about weight and nutrition that lead to statuses of

malnutrition, unhealthy weight loss, altered body image, and a

variety of other secondary health risks.

2. These may include obvious and repeated concern about weight or

image-especially when body type does not match mental image,

not eating at all, no eating enough, not eating enough of the right



26 | P a g e

nutrients and minerals, binge eating, unsafe weight loss or gain

via excessive exercise, diet pills, laxatives, or any other substance.

3. It is generally understood that the most disordered eating occurs in

activities that require a smaller physique, such as cheerleading,

dance, and gymnastics, and sports that require weigh-ins such as

wrestling. However, it is not limited to these activities. Also,

certain positions may leave a student-athlete more prone to

disordered eating such as a running back versus a lineman.

4. Disordered eating can lead to cardiac illness, gastrointestinal

issues, hormonal changes, fatigue and weakness, stress fractures,

osteoporosis, dental decay, physical changes that are detrimental

to growth.

a. Stress Fractures- please see section under “Other Athletic

Injuries”

b. Female Athlete Triad

i. Combination of disordered eating, absence of

menstrual period, and presence of osteoporosis

ii. May not be evident until student-athlete suffers

repeat stress fractures, but often reversible.

iii. Education about risks of amenorrhea and

osteoporosis and student-athlete divulgence of

signs/symptoms leading to early detection is key.

5. Nutritional supplements and use of banned substances

a. The AHCT shall endorse the “food first” motto, and

encourage adequate nutrition through healthy eating

b. Care should be taken when adding a supplement, diet

strategy, or vitamin to a student-athletes’ diet. These

substances are often not evaluated by the FDA, and the

safety of such cannot be verified. The AHCT shall not be

involved in this decision, and shall not be assumed to be

knowledgeable of any and or all supplements.

c. And substance banned by the KHSAA, NCAA, NFSHA,

local or federal law, or suggested to be unsafe for a high-

school age student-athlete is to be considered banned by

the HCHS Athletic Department and Sports medicine.

6. Policy for AHCT addressing disordered eating



27 | P a g e

a. The AHCT member shall address the observation of

signs/symptoms of an eating disorder in an informal,

private conversation. The AHCT member shall make all

reasonable effort to be thoughtful and sensitive in

addressing the issue. If the AHCT member is not

comfortable in doing this, the conversation may be

conducted by another AHCT member.

b. A written screening tool, available through the Athletic

Trainer, shall be used to assess risk for Disordered Eating.

All signs/symptoms involved will be documented by the

observing AHCT member.

c. The student-athlete’s parent/guardian shall be contacted and

the student-athlete will be referred to the school

psychologist, a nutritionist, or shall be asked to obtain a

written physician’s clearance for athletic activity in his or

her current condition.

XIV. Environmental Concerns

A. Thermal/Weather monitoring

1. Lighting and storms

a. Per KHSAA rule, any sighting of lightning or thunder heard

shall suspend outdoor activity for 30 minutes after the last strike or

thunder clap. All student-athletes, staff, and fans shall be led to a

safe location as determined by EAP for the location.

b. In addition, at events where the AT is present, air static shall be

monitored by lightning meter, and any static within 5 miles of the

play or practice location will warrant constant attention to

changing weather conditions

c. Care will be taken to monitor storms and fronts as they approach

the school grounds via smart phones and local forecast. In the

event a local storm siren is activated, all present shall be taken to

the safe location for the venue.

B. Thermal injury/illness

1. Heat Index monitoring

a. Per KHSAA rules, heat and humidity shall be monitored

from July 15th to September 15th and April 15th through

elimination from tournament play of all spring sports, and

shall be collected from 30 minutes before activity until the

end of the activity.



28 | P a g e

b. Actions shall be taken, depending on heat index measured,

as follows:

i. under 95 degrees- monitor student-athletes, provide

ample water with water breaks every 30 minutes if

student-athlete desires, provide ice towels for

cooling

ii. 95-99 degrees-monitor student-athletes, provide

ample water with mandatory breaks every 30

minutes, provide ice towels for cooling. Per HCHS

policy, a pop-up tent for shade and water bath for

immediate cooling will also be available.

iii. 100-104-monitor student athletes closely, provide

ample water with mandatory breaks for 10 minutes

every 30 minutes-preferably in the shade, remove

unnecessary equipment and clothing, provide ice

towels and move practice to early or late in day or

inside if possible. Per HCHS policy, a pop-up tent

for shade and water bath for immediate cooling will

also be available.

iv. 104 and up-suspend all outdoor activities until

temperature drops below 104

2. Heat Illness

a. Heat cramps-sweating, fatigue, cramps in arms or legs

b. Heat exhaustion-headaches, dizzy, lightheaded, nauseous,

skin cool or moist, cramps

c. Heat stroke->104 degrees, stomach upset, red skin,

headache, seizures, hallucinating, difficulty speaking

3. Treatment of Heat Illness

a. Heat Cramps-Water and Gatorade (if available) will be

given, slowly. Cramped area shall be stretched and

massaged to alleviate cramp. Student-athlete will be

removed from practice or play until re-hydrated and not

cramping for at least 30 minutes, but will be allowed to

watch the remainder as long as symptoms do not worsen.

b. Heat exhaustion-water and Gatorade (if available), will be

given slowly. Student-athlete will be allowed to rest in a

cool space. Body temperature will be monitored via oral

thermometer, and blood pressure by cuff and stethoscope. If



29 | P a g e

the student-athlete’s body temperature, blood pressure, and

level consciousness/awareness are safe and stable, the

student-athlete will be allowed to continue to rest and re-

hydrate until a parent/guardian can come to pick him or her

up. If student-athlete’s body temperature, blood pressure, or

consciousness/awareness are deemed to be unsafe or

unhealthy by the Certified Athletic Trainer or Team

Physician, EMS and the parent/guardian will be contacted

via the appropriate Emergency Action Plan.

c. Heat stroke-constitutes a medical emergency and EMS will

be activated and the parent/guardian contacted per the

appropriate Emergency Action Plan. Until EMS arrives,

blood pressure and body temperature will be monitored, as

well as the need for CPR or AED use. Every effort will be

made to cool the body temperature of the student-athlete to

a healthy temperature, and care for the immediate needs

depending on signs/symptoms.

4. Cold monitoring

a. There is no official limitation by the KHSAA on cold

monitoring or cessation of athletic activity by cold temperatures

or wind chill index.

b. It is the choice of the host school to suspend or play.

c. However, it is understood that temperatures at and below

freezing, especially combined with wind chill, may cause

injuries such as frostbite and hypothermia, as well as exacerbate

exercise-induced asthma. At -5 degrees, frostbite may occur. At

-18 degrees, frostbite can occur in 30 minutes or less. This

should be taken into account for both planning of contests and

the equipment worn by student-athletes.

d. If playing in cold weather, hats and loose clothing layers

are recommended, as well as gloves when the event allows. Wet

clothing should be changed as soon as possible.

5. Cold Illness/Injury

a. Frostbite: a feeling of numb or “wooden” and heavy skin.

Burning, cooling, or a lack of feeling often accompany,

meaning the student athlete may not feel the injury coming.

Skin is initially red, but can become a waxy, white color.

b. Hypothermia: defined as a body temperature of 95 degrees

or lower. In mild cases, the student-athlete may be



30 | P a g e

shivering, withdrawn from coaches, teammates, or family

members, may or may not complain of being cold, and

displays a slowed-down, apathetic attitude towards

competition. In more severe situations, the student-athlete

may display confusion, sleepiness, slurred speech, or

irrational thinking or behavior.

c. Exercise-Induced Asthma: (please see below section: Pre-

Existing or General Medical Health Care Conditions)

6. Treatment of Cold Illness/Injury

a. Frostbite: student-athlete shall be removed from the cold

situation and allowed to re-warm using clothing or towels,

body heat, or warm (not hot) water. Re-warming should be

not be quick nor involve friction, as this may cause addition

damage to tissue.

b. Hypothermia: if student-athlete is conscious, body

temperature will be increased via removal of wet clothing,

warm water, or layers of clothing or towels. Body

temperature will be encouraged to increase by activity, such

as walking. If the student-athlete is not conscious, EMS will

be activated and parent/guardians contacted via the

appropriate emergency action plan.

7. Pre-Existing or General Medical Health Care Conditions

a. Asthma

i. A chronic inflammatory disease with bronchial

hyperresponsiveness that may lead to wheezing,

shortness of breath, breathlessness, chest tightness,

coughing.

ii. It is often triggered by allergens, cold, or exercise.

iii. It is not a disqualifying condition, but must be well-

managed to allow for athletic competition.

iv. If inhalers or oral medication are used by the student-

athlete, they must be properly declared to the school

nurse.

v. It is suggested that the coach of the team and the

Athletic Trainer are alerted to the condition and

medications taken. It is also suggested that the

parent/guardian alert staff of possible irritants and



31 | P a g e

plan or action card for medication intervention if

needed.

b. Allergies

i. Hypersensitivity to a bite or sting, food product,

airborne substance, or other substance.

ii. Symptoms range from mild irritation to life-

threatening anaphylaxis.

iii. It is suggested that the coach of the team and the



parent/guardian alert staff of possible irritants and

plan or action card for medication intervention if

needed.

iv. If an irritant is encountered and a reaction occurs, the

student-athlete will be separated from the irritant,

given medication according to care plan, and

monitored for changes in status.

c. Cardiac

i. If cleared to participate with a known cardiac

condition, written clearance and instruction from a

physician shall be on file.

ii. It is suggested that the coach of the team and the



parent/guardian alert staff of possible signs/symptoms

of worsening condition and plan or action card for

medication intervention if needed.

d. Diabetes Mellitus

i. Insulin deficiency leading to hyperglycemia, or high

blood sugar. Symptoms include: frequent urination,

thirst, hunger, weight loss, visual disturbances,

fatigue, and ketosis.

ii. Is not disqualifying, but has to be well-managed to

allow for athletic competition. Condition should be

closely monitored by a physician, especially if

exercise creates sharp decreases in blood sugar.

iii. Student-athletes should have a diabetes care plan on

file, especially detailing monitoring of blood sugar,



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timing of monitoring, any medication and timing for

medication, common signs of hyperglycemia and

hypoglycemia, and emergency contact information.

iv. Coaching and athletic training staff shall be made

aware of presence of diabetes and diabetes care plan.

e. Infectious diseases

i. Athletics increases risk for infection and sharing of

infection due to: common close contact, stress of

training’s effect on the immune system, and the

tendency of the student-athlete who is infected to

attend competitions anyway.

ii. Examples

a. Blood borne: HIV, Hepatitis B. Both VERY

rarely transmitted

b. Viral: mononucleosis, norovirus. More

common, but not necessarily dangerous unless

left untreated.

c. Skin/soft tissue-herpes simplex, herpes zoster

(chicken pox), fungal infections,

streptococcal, and staphylococcal infections,

especially MRSA. These are mostly treatable,

but will disqualify a student-athlete from

contact sports until lesions are closed,

symptoms no longer exist, and a physician has

deemed the student-athlete non-contagious.

All exposed lesions, until completed healed,

will be covered during contact.

d. By NCAA rules, 120 hours of antiviral

medication or 72 hours of antibacterial

medication, whichever applies, must be in

system before the student-athlete returns to

any team activity.

f. Seizures

a. Seizures are abnormal movements or behavior

associated with unusual electrical activity in the

brain, and may occur with conditions such as

epilepsy or other seizure disorders.



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b. Are not disqualifying, but has to be well-managed

to allow for athletic competition. Condition should be

closely monitored by a physician, especially if

exercise creates stress that may cause seizure.

c. It is also suggested that the parent/guardian alert

staff of possible signs/symptoms of worsening

condition and plan or action card for medication

intervention if needed.

d. Care for a seizure shall include protection of the

head and extremities WITHOUT restraint, and

monitoring for condition changes.

g. Medications and authorization for use

i. Student-athletes may be dispensed medications at

school IF a parent/guardian writes a note that states

the medication, how much per dose, how many times

per day the student may have it or times per each

dose, and the reason/diagnosis for the medication

with prescribing physician.

ii. For the certified athletic trainer to administer the

medication, a similar or copy of the note must be on

file with the athletic trainer as well.

f. Medications affecting hydration or performance capacity

i. It is suggested that any medication that may have an

adverse effect on performance, hydration, or in any

way impact participation on a sport team be made

known to coaches and the athletic trainer.

ii. It does not mean they preclude a student-athlete from

playing, but may better allow staff to care for the

student-athlete in event of an emergency.

iii. Examples include: ADD/ADHD medications,

antidepressants, antihistamines, or pain medications.