ATHLETIC
MEDICAL
ACTION PLAN
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PREFACE
July 28, 2014
It is the goal of Westminster Christian School to protect the health of, and provide a safe environment for, each of its participating student-athletes. To provide guidance in accomplishing this objective and to assist Parents and student – athletes and coaches develop a safe athletic program; the training staff is providing this action plan for medical treatment.
This handbook is being made available to parents, athletes and coaches online. Parents and student athletes are required to provide to Westminster Christian School prior to any
practice or tryout a completed physical (EL2, EL3 and EL3CH) as well as the Westminster Christian School form (which must be notarized). Physicals are provided by the school each August free of charge. These policies reflect a commitment to protecting your student-athletes’ health and well-being as well as an awareness of the guidelines set forth in this handbook. For more information or copies of the forms, visit the FHSAA website at www.fhsaa.org.
Emergency Numbers EMS – 911
Athletic Trainer – Hayley Garick – 305-282-4589 Athletic Director – Holly Battle – 305-484-8518
6855 SW 152 Street Palmetto Bay, Florida 33157
305-233-2030 www.wcsmiami.org
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2014-2015
Emergency Action Plan
I. Emergency Medical Procedures A. Medical Coverage Personnel
i. Team Physician ii. Team Trainers iii. Team Dentist
iv. Team Concussion Specialist B. Medical Coverage Emergency Personnel C. Medical Coverage Communication D. Emergency Equipment
E. Medical Emergency Transportation II. Concussion/Head Injury Protocol
III. Lightening Safety A. Weather System B. Procedures
IV. Medical Evaluations and Records A. Preparticipation
B. Cardiac
C. Medical Records D. Follow Up
V. Appendix
A. EL3CH – Consent and Release from Liability Certificate for Concussion and Heat-Related Injury (FHSAA)
B. AT18 – Post concussion return to play C. The Heart Program Flyer
D. UHealth Sports Medicine ImPACT Concussion Management E. Medical Staff Contact Information
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EMERGENCY MEDICAL
PROCEDURES
The purpose of this document is to provide a plan in the event of a medical emergency regarding student athletes. An emergency is any sudden life threatening injury or illness that requires immediate medical attention.
A. Medical Coverage Personnel
Sports Medicine Team 1. Team Physician(s):
a. Team Orthopedist: Doctors Hospital Orthopedics 305-662-2424 Dr. Harlan Selesnick
b. Dentists:
Dr. Frank Mantega 305-667-1131 c. Affiliates:
See Appendix E 2. Head Athletic Trainer
Hayley Garick
OFFICE: 305-233-2030 ext. 1293 CELL: 305-282-4589
E-MAIL: [email protected] 3. Assistant Athletic Trainer
Nick Shanstrom
OFFICE: 305-233-2030 ext 1293 CELL: 305-335-4321
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The first responder to an emergency situation is most commonly the Certified Athletic Trainer. A physician may be present at high risk events. Other members of the emergency team may include Emergency Medical Technician and Coaches. In the absence of the Athletic Trainer, coaches should be CPR certified. Emergency procedures include Immediate Care of the Athlete (by those with highest level of health training), Emergency Equipment Retrieval, Activation of Emergency Medical Services, and Directions to the Emergency site. The first and most important
procedure is the immediate care of the athlete. Acute care in an emergency situation will be provided by the most qualified individual on the scene. The second
procedure, emergency equipment retrieval, may be done by anyone on the emergency team who is familiar with the location of specific equipment. Coaches are good staff members for this role. The third procedure, EMS activation, should be done as soon as the situation is deemed an emergency. After EMS has been
activated, one member of the team will be sent to meet the EMT personnel as they arrive at the school. Coaches are good staff members for this role as they have keys to gates and doors.
C. Medical Coverage Emergency Communication
In the event of an emergency, a member of the Emergency Team will contact EMS. The Certified Athletic Trainer is most commonly the member to do this. The
Certified Athletic Trainer is responsible for having a cellular phone at practices and events. All medical information including emergency contact information and insurance providers is on the student athletes’ medical forms in the athletic training room. When contacting EMS, the following information should be given to the dispatcher:
Emergency Call Procedure
What to say:
1. Identify yourself (name and affiliation with WCS)
2. Briefly explain situation (ie: unconscious athlete, breathing, number of injured athletes if more than one)
3. Explain purpose of call (ie: ambulance needed)
4. Explain location (address/ landmarks, exact location of the injured athlete) 5. Care currently being provided
6. Answer questions addressed to you 7. HANG UP LAST!!
6 Have coaches as crowd control. Send someone to meet the rescue at a designated spot, and have a parent or guardian accompany the injured athlete to the hospital. If parent is not present, notify the parent/guardian, and explain the situation and
location of medical facility and athlete that’s being transported. A coach or school administrator/representative must accompany transported athlete if a parent or guardian is not present. Also notify Athletic Director and Principal and explain the emergency. Athletic Trainer must complete an injury report and have a parent complete their information. Send the form with the athlete and parent. D. Emergency Equipment
The Certified Athletic Trainer should determine the type and manner in which the equipment is at or to be delivered to the site. Splints, which are available in the Athletic Training Room, will be applied by the Certified Athletic Trainer. The Automatic Defibrillator (AED) is carried by the Certified Athletic Trainer at all practices and events. The AED can only be used by a certified administrator or as instructed by the dispatcher.
E. Medical Emergency Transportation
In evaluating a medical emergency, the Athletic Trainer, or in the absence of the Athletic Trainer, a coach indentifies the emergency and determines transport
decision. Coaches are not authorized to transport injured athletes. Emergency Care providers should not move unstable victims and in most cases should immobilize the victim. Injuries that occur on the playing fields gymnasium and track, EMS vehicles are to enter the student parking lot located west of the main entrance of the High School. Injuries that occur in the weight room, SAC and Baseball field, EMS vehicles are to enter using the north entrance on 67th avenue by the elementary school.
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Concussion/Head Injury Protocol
As required by the Florida High School Athletic Association
Once a head injury occurs and the student athlete is removed from play, whether practice or game, the following procedure must be followed.
1) The athlete must be referred to a physician. The physician will sign off on the states graded return to play protocol once the athlete is asymptomatic (without out
symptoms) and has returned to baseline (has enough time off to have all neurological and physical states returned to normal levels).
2) Next, a graded return protocol (see appendix A & B) that lasts no less than 4 days is initiated. If your child has returning symptoms in these 4 days all progress is stopped and a return visit to the physician is required.
3) Each step of the graded protocol must be evaluated by the student athlete’s certified athletic trainer and signed off on before the next day can begin.
4) If the student athlete makes it through all 4 days of the graded protocol than a return visit to the original physician is now required for full clearance.
5) Once the physician signs off and makes a concluding formal diagnosis the athlete is allowed to return to organized team activity.
Signs and symptoms of concussion/ head injury Vacant state
Lack of awareness
Emotion unlike normal self Headache/ neck pain Altered vision
Sensitivity to light
Delayed speech or verbal response Disorientation Dizziness Decreased coordination Confusion Memory loss Irritability Vomiting Loss of consciousness
Upon release of the student athlete to their parents, the Certified Athletic trainer will give his recommendation for the immediate care of the athlete. This decision is based on the severity and number of symptoms as well as the athlete level of consciousness and cognitive skills.
*THE FINAL DECISION TO SEEK MEDICAL CARE IS ULTIMATLEY UP THE PARENTS*
Grading the level of the concussion as well the long term course of treatment above and beyond the state of Florida’s graded return to play protocol is always up the physician. If you have further questions regarding this protocol or concussions/head injuries please contact Hayley Garick Head Trainer # 305-233-2030 ext. 1293
***note: all parents and student athletes are required to fill out and sign a concussion awareness form, EL3CH, prior to the student athletes given season. Additional information provided in Appendix D***
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Lightning Safety
Lightning is the most consistent and significant weather hazard that may affect athletics. Within the United States, the National Oceanic and Atmospheric Administration (NOAA) estimates that 60 to 70 fatalities and about 10 times as many injuries occur from lightning strikes every year. While the probability of being struck by lightning is low, the odds are significantly greater when a storm is in the area and proper safety precautions are not
followed. Education and prevention are the keys to lightning safety. Prevention should begin long before any athletics event or practice by being proactive and having a lightning safety plan in place.
1. Weather System
Westminster Christian School has a lightening system called Televent. This is a
satellite system that gauges the distance of a storm from the school. The system sends a text message to a cell phone (Athletic Director, Athletic Trainer, Assistant Athletic Director, and Coach) with details of the storm and then a second message when the all clear is given. Please note Westminster does not adhere to the lightening siren system hosted by our neighbor school for removal of athletes from the playing field. The procedures for the Televent system are as follows:
2. Procedures:
a. The Athletic Trainer (Athletic Director, Assistant Athletic Director and then the Coach) is the designated person to monitor threatening weather and to make the decision to remove a team or individuals from an athletics site or event. When a team is asked to leave the field they are to do so immediately and seek shelter in one of the buildings. Teams or athletes will be asked to leave the fields by the Athletic Trainer directly when the lightening is within 5 miles of the location. b. Once removed from the field the weather will be monitored and an all clear must
be issued before any practice or event may resume. Weather information can be found through various means via local television news coverage, the Internet, cable and satellite weather programming, or the National Weather Service (NWS) website at www.weather.gov. in order to determine the severity of the storm. c. It is the decision of the Athletic Director in conjunction with the officials and the
other Coach or other team’s Athletic Director to cancel a game on site due to weather. If the Athletic Director is not available the Assistant Athletic Director or Superintendent can make that decision.
d. Know where the closest “safe structure or location” is to the field or playing area, and know how long it takes to get to that location.
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Medical Evaluations and Records
1. Preparticipation medical evaluation.
a. A preparticipation medical evaluation is required upon a student-athlete’s entrance into the institution’s athletics program. This evaluation should include a relevant physical exam, with strong emphasis on the cardiovascular, neurologic and musculoskeletal evaluation. It is recommended for some sports that a baseline
readiness be performed for concussion Further preparticipation physical examinations are not believed to be necessary unless warranted by physician to see a specialist prior to participation.
b. Form EL2, EL3, EL3CH and Westminster Christian School participation form must be completed, signed and notarized prior to participation.
2. Cardiac
a. Sudden cardiac death (SCD) is the leading medical cause of death in NCAA athletes and represents 75 percent of all sudden death cases that occur during training, exercise or competition. In a five-year review of sudden deaths involving NCAA student athletes, the incidence of SCD was approximately one in every 40,000 student-athletes per year.
b. It is recommended on the EL2 that a cardiovascular screening as a part of the physical exam for the student-athlete’s. Important changes in medical status or abnormalities may require more formal cardiovascular evaluation.
c. Miami Children’s Hospital offers free EKG testing. Westminster strongly
recommends EKG testing for athletes. See appendix C for information on free testing. 3. Medical records.
a. Student-athletes have a responsibility to truthfully and fully disclose their medical history and to report any changes in their health to the team’s healthcare provider. Medical records should be maintained during the student-athlete’s career and should include:
1. A record of injuries, illnesses, new medications or allergies, pregnancies and operations, whether sustained during the competitive season or the off-season; 2. Referrals for and feedback from consultation, treatment or rehabilitation; 3. Subsequent care and clearances;
b. Westminster Christian School has implemented an electronic medical records system called Athletic Trainer System (ATS). The software is secure and complies with all HIPPA Regulations.
1. Your child’s information can be accessed from home with your unique log-in and password by visiting wcsmiami2.atsusers.com. Please use this website to update athlete information and insurance information.
10 c. Records maintained in the athletic training facility are medical records, and therefore
subject to state and federal laws with regard to confidentiality and content. Medical records and the information they contain should be created, maintained and released in accordance with clear written guidelines. All personnel who have access to a student-athlete’s medical records should be familiar with such guidelines and
informed of their role in maintaining the student-athlete’s right to privacy. Institutions should consider state statutes for medical records retention (e.g., 7 years, 10 years); institutional policy (e.g., insurance long term retention policy); and professional liability statute of limitations.
4. Follow-up examinations.
Those who have sustained a significant injury or illness during the sport season should be given a follow-up examination to re-establish medical clearance before resuming
participation in a particular sport. Clearance for individuals to return to activity is solely the responsibility of the team physician or the physician treating the athlete.
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Appendix A
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Appendix B
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Appendix C
The Heart Program
Free EKG Screening
Protect the young athletes you know and love with a free screening!
For more information or to schedule an appointment please call The Heart Program at Miami Children's Hospital (305) 662-8301.The Main Hospital offers free tests M – F from 3:00 to 4:00 p.m. All MCH urgent care facilities are available from 4:00 – 5:00 p.m. 7 days a week.
The leading cause of sudden death among young athletes is sudden cardiac death (SCD). Every three days in the U.S., a student athlete dies of SCD. Usually there are no advance signs or symptoms.
Miami Children’s Hospital is reaching out to the region’s young athletes
by offering free EKG screening to middle and high school sports
participants.
Westminster Christian School knows personally how this test can save a life. Fellow Warrior Ramiro "Toti" Mendez passed away on April 2, 2000. Toti's life was cut short by a condition known as sudden cardiac death (SCD) caused by undetected Cardiomyopathy. Mendez attended Westminster Christian High School, where he was named Miami-Dade County's Class 4A-lA Player of the Year as a senior in 1998 after going 13-2 with 165 strikeouts in 97 innings. Westminster won three state championships and the mythical 1996 national title during Mendez's career at the school.
The FHSAA states on its EL2 physical form for all athletes that “a
routine medical evaluation as well as a cardiovascular assessment which may include diagnostic tests such as EKG, ECG or stress test are advised”. Take advantage of this free service and have your child tested. It is Free at Westminster Christian School in August
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Appendix D
UHEALTH SPORTS MEDICINE ImPACT
Concussion Management Clinic
Concussion
Head injuries are the most serious injuries that occur among athletes. Fortunately, serious injuries are rare. Potential complications from a head injury can be identified by parents, coaches and medical professionals by
observing any changes in the athlete’s
behavior.
Definition
Concussion is a type of brain injury, caused by a bump or blow to the head. A concussion can occur with or without a loss of
consciousness. The biomechanical forces from such a hit can alter the way your brain functions.
Statistics
Those who have sustained a head injury are two to four times more likely to have another head injury.
20% of the 1.5 million head injuries that occur in the United States each year are sports-related.
47% of high school football players say they suffer a concussion each season, with 35% of those reporting experience multiple concussions in a season.
UHealth Sports Medicine Concussion Program
At UHealth, we offer a comprehensive and multidisciplinary approach to the evaluation and management of concussions, and returning athletes to activity. The program treats many patients from throughout the community, including student athletes from area high schools, colleges, and universities. We assist elite athletes in a variety of sports including football, soccer, basketball, lacrosse, hockey and wrestling return to play quickly and safely.
Signs and Symptoms
Confusion or feeling “in a fog” Dizziness and/or balance problems Headache Visual problems Unsteadiness Nausea Vomiting Fatigue or Drowsiness Trouble falling asleep
Sleeping more or less than usual Sensitivity to light and/or noise
Feeling more emotional, irritable, or nervous Difficulty concentrating
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What to watch for After a Head Injury
Signs and symptoms can last for days or weeks following a concussion. One can expect:
Fatigue and need for extra sleep (awakened normally)
Headache (mild, not worsening) Nausea and vomiting (occasional, not persistent)
Problems with concentration and attention span (may persist for extended periods) Difficulty with schoolwork
When to seek Medical Attention
Symptoms that worsen should promote a phone call to the athlete’s physician immediately. Including:
Marked changes in personality, often with confusion and irritability
Worsening headaches, especially if associated with nausea or vomiting. Numbness, tingling or weakness in the arms or legs
Changes in breathing patterns or seizures Eye or visual changes (double vision, blurred vision, unequal sized pupils)
How does ImPACT work?
ImPACT, (Immediate Post-Concussion Assessment and Cognitive Testing) is a
computer-based program designed specifically for the management of sports-related
concussions.
ImPACT is used by a wide variety of professional, collegiate and high-schools teams.
The UHealth Sports Medicine team offers ImPACT concussion management to athletes who have sustained a head injury. Dr. Hotz, Director of the concussion Program, is a credentialed ImPACT consultant, who uses the test to evaluate post-concussion cognitive function with baseline data. This provides the sports medicine team with objective
information to assist in developing an appropriate treatment plan to ensure the athlete’s safety.
Athletes who have sustained a concussion should:
Call the UHealth Sports Medicine Concussion Clinic at (305)-243-3000 to schedule an appointment.
Gillian A. Hotz, Ph.D.
Director KiDZ Neuroscience Center
Director Concussion Program ∙ Director WalkSafe & BikeSafe Programs Phone: 305-243-4004 ∙ Fax: 305-243-4006
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Appendix E
Medical Staff Contact Information
Orthopedic Surgery & Sports MedicineHarlan Selesnick, MD
Doctors Hospital
1150 Camp Sano Ave. Suite 301 Coral Gables, Fl 33146
(305) 662-2424
Iris – Assistant Diagnostic Scheduling
(305) 308-3370
Arthroscopic & Orthopedic Surgery UHZ Sports Medicine Institute John E. Zvijac, MD
Doctors Hospital
1150 Campo Sano Avenue, Suite 200 Coral Gables, FL 33146 (786) 268-6200 Cesar E. Ceballos, MD 11801 SW 90th Street, Suite 203 Miami, Fl 33186 (305) 596-2828 www.coremiami.com
Miami Sports Medicine
Dr. Joseph Fernandez, MD
Baptist Medical Arts Building – E. Tower.
8940 North Kendall Drive, Suite 101-E Miami, Florida 33176
(305) 275-5677
KiDZ Neuroscience Center
Gillian A. Hotz, Ph.D
Director Concussion Program/Director WalkSafe & Bike Safe Programs
University of Miami Miller School of
Medicine – Miami Project to Cure
Paralysis
Lois Pope LIFE Center 1 – 41
1095 NW 14th Terrace (R-48)
Miami, Fl 33136
(305) 243-4004
UHealth – University of Miami Health
Lee D. Kaplan, MD
Chief of UHealth Sports Medicine
400 NW 12th Avenue Miami, FL 33136
(305) 325-5511
Pinecrest Physical Therapy
Ron Yacoub, MSPT, ATC, CSCS
9492 S. Dixie Highway Miami, Fl 33156
(305) 772-0568
Head Athletic Trainer
Hayley Garick 6855 SW 152 Street Miami, Fl 33157 (305) 233-2030 x1293 (305) 282-4589 [email protected]
