St.

Marys High School Athletic Training

Policies and Procedures Manual

Policies & Procedures

Table of Contents
General Information
Mission Statement Athletic Training/Sports Medicine Staff Athletic Department Staff Event Locations Local Hospitals 3 3 3 4 4

Policies
Thunder & Lightening Policies Hot Weather Guidelines Hydration Heat Illness Cold Weather Guidelines 17 18 19 20-21 22

Athletic Training Information

Certified Athletic Trainer ATC Qualifications Athletic Training Coverage Notifying the ATC Athletic Training Room Procedures for Student-Athletes Athletic Paperwork Athlete Insurance Information Athletic Equipment 5 5 5 5 6 6 6 7 7

Appendix A
Emergency Action Plan Support Personnel & Roles High School EAP Turf Field EAP Bate/Weems EAP Germantown EAP NMCS EAP Generals Hwy Park EAP Truxton Park Mears Marina 24 25 26 27 28 29 30 31 32 33

Student-Athlete Healthcare Information

Athletic Injuries Return to Play Criteria Injury Referral Emergency Protocol for Injuries Automated External Defibrillator 8 8 9 10 10

Therapeutic Modalities
Cryotherapy Thermotherapy Electrical Agents Mechanical Agents 10 11 11 12

Injury Care
Management of Head and Spinal Cord Injuries 12 Signs and Symptoms of a Concussion 13 Concussion Grading Symptoms 13 Blood Borne Pathogens 14 Bleeding 14 Shock 14 Allergic Reaction 15 Fractures 15 Burns 16 Dental Injuries 16 Sprains/Strains 16 Bees & Stings 16 Human Bites 16

MISSION STATEMENT The mission of St. Marys High School Athletic Training Program is to provide the best possible health care for its students. This is to be accomplished through prevention, recognition, evaluation, assessment, immediate care, treatment, rehabilitation, and reconditioning of athletic injuries and illnesses. Emphasis is also placed on education the St. Marys community about Athletic Training and the importance of Certified Athletic Trainers in helping provide the best health care for its student-athletes. ATHLETIC TRAINING/SPORTS MEDICINE STAFF Team Physicians: Dr. Lou Ruland, MD Orthopedic Surgeon Anne Arundel Orthopedic Surgeons 2003 Medical Parkway, Suite 400 Annapolis, MD 21401-3088 Office: 410-573-2530 www.aaos.net Doug Wallop, PT Physical Therapist Annapolis Family Physical Therapy 2661 Riva Road, Bldg 600, Suite 601 Annapolis, MD 21401 Office: 410-266-6626 Kimberly Holt, MEd, ATC Certified Athletic Trainer St. Marys High School 113 Duke of Gloucester Street Annapolis, MD 21401 Office: 410-990-4130 Cell: 443-336-2433

Physical Therapists:

Athletic Trainer:

ATHLETIC DEPARTMENT STAFF Athletic Director: Matt Hogan St. Marys High School Office: 410-990-4218 Cell: 443-336-0543 Patti Gateau St. Marys High School Office: 410-990-4234

Athletic Administrative Assistant

ATHLETIC EVENT LOCATIONS St. Marys High School 113 Duke of Gloucester Street Annapolis, MD 21401 ** Volleyball, Basketball, Wrestling ** St. John Neuman Turf Field 620 Bestgate Road Annapolis, MD 21401 ** Field Hockey, Football, Soccer, Lacrosse ** Bates/Weems Whalen Athletic Complex Spa Road Behind Maryland Hall Annapolis, MD 21401 ** Football, Soccer, Lacrosse ** Germantown Elementary Fields Poplar Avenue Annapolis, MD 21401 ** Field Hockey, Soccer, Lacrosse ** Naval Marine Corp Stadium 304 Farragut Rd Annapolis, MD 21401 ** Football, Lacrosse ** Generals Highway Corridor Park 1758 Crownsville Rd Crownsville, MD 21032 ** Baseball, Softball ** Truxton Park Primrose Rd Annapolis, MD 21401 ** Cross Country, Tennis** Mears Marina 519 Chester Ave Annapolis, MD 21403 ** Tennis** LOCAL HOSPITALS Anne Arundel Medical Center 2001 Medical Parkway Annapolis, MD 21401 4

CERTIFIED ATHLETIC TRAINER Certified Athletic Trainers (ATCs) are medical experts in preventing, recognizing, managing, and rehabilitating injuries that result from physical activity. Athletic Training is recognized as an allied health care profession by the American Medical Association (AMA). The AMA also recommends that an ATC be in every high school since an ATC can help athletes avoid unnecessary medical treatment and disruption of normal daily life. (NATA 12/03) ATC QUALIFICATIONS A certified athletic trainer must obtain a degree from a CAAHEP accredited athletic training program. Upon receiving a degree, the athletic trainer must pass the Board of Certification exam to practice as a certified athletic trainer. Certification must then be maintained with continuing education units (80 hours/units every 3 years). As of October 2011 all ATCs in the State of Maryland must be licensed by the State in order to practice Athletic Training. ATHLETIC TRAINING COVERAGE The St. Marys Certified Athletic Trainer will provide healthcare coverage for all home athletic events. Should there be more than one home event at the same time, the ATC will cover the highest risk event (i.e., Football over Soccer, Varsity of JV, etc.). However, the ATC will still be available on call for the non-covered home event. The Certified Athletic Trainer will provide healthcare coverage for practices if possible. Since there are numerous practices at various locations and at times during a home event, if the ATC is not present at a particular practice, he/she will still be on call should an injury/illness occur during any practice. Practices that take place on a non-school day may not be covered by the ATC unless prior arrangements are made between the coach and ATC. All coaches are responsible for notifying the ATC of schedule changes (practice or event).

NOTIFYING THE ATC There are a number of ways to contact the Athletic Trainer. If one does not work, try the next. In person: School Hours 11am till 30 minutes after the last event Phone: Office 410-990-4233 (gym) VM: 410-990-4130 Cell 443-336-2433 Email: kholt@stmarysannapolis.org

ATHLETIC TRAINING ROOM The St. Marys ATC is available for treatment and rehabilitation of injured athletes on school days after 4th period. However, an injured athlete may not miss class to receive care unless it is an emergency, or unless there is an early athletic event dismissal. Under these circumstances the student must have a written note or email sent directly to the teacher in order to leave class early. All teachers will receive early dismissal requests the day prior to the early dismissal, student-athletes may not walk into the Athletic Training room and ask for an early dismissal the day of an athletic event. Exceptions will be made to acute injury situations. Availability of care after school may also be limited if the ATC is covering a game. Athletic health care on non-school days is only available if prior arrangements have been made with the ATC. Procedures for Athletes: 1. Report all injuries to the ATC as soon as possible. 2. Report any and all skin infection immediately to the ATC. 3. Immediate and daily communication with the ATC will expedite your recovery time. 4. If you have seen a physician for your injury, written documentation from that physician is required prior to any treatment or return to play. 5. No over the counter medication will be administered. (Tylenol, Advil, Aleve, etc) 6. Proper attire is required for treatment. (shorts, t-shirt, & sneakers) 7. Bags and equipment are not to be left in the Athletic Training Room 8. Taping is reserved for injured athletes only. Lace-up ankle braces should be worn by those who are looking for daily support. No game day taping on non-injured athletes will be done. 9. Disrespectful behavior, unsafe behavior, or foul language will not be tolerated.

ATHLETIC PAPERWORK The following paperwork is required by all student-athletes prior to being cleared to participate in athletics at St. Marys High School. Regardless of the season the student-athlete participates in, all paperwork is DUE to the ATC no later than AUGUST 1 in order to be cleared for athletics for the academic year. Any paperwork turned in late or turned in the day of tryouts will be subject to missing the first day of participation while paperwork is reviewed. The ATC has the ultimate authority to not allow a student-athlete to participate on an athletic team until all required paperwork has been received and approved by the ATC. Additional copies of all required athletic paperwork can be found on the St. Marys athletic website.

Physicals All student-athletes are required to have a physical evaluation by a physician each year prior to participation on an athletic team at St. Marys. Athletes cannot try out, practice, or play without turning in the physical to the ATC. Physicals for the upcoming school year must be dated after May 25th. Physicals are only valid for 365 days. Therefore, student-athletes must see a physician for an exam each year in order to participate in athletics. Parent Consent Form ONLINE FORM SUBMISSION All sections of the Parent Consent Form must be completed by the parents online. Parents must log-in to their St. Marys Parent Community to access this information. Athletic Handbook Compliance Form ONLINE FORM SUMBISSION All student-athletes and parents are required to read the Athletic Handbook prior to signing the Athletic Handbook Compliance Signature Form. Parents must log-in to their St. Marys Parent Community to access this information and complete online.

ATHLETE INSURNACE INFORMATION All coaches are required to turn in a roster to the ATC as soon as it is set. The ATC must be notified of any student-athlete joining the team after the roster is set BEFORE he/she can begin participation. Based on the athletic roster each coach will receive a travel roster to be placed in their blue athletic binders. These travel rosters will include all demographic, emergency notifications, and insurance information for all student-athletes in your program. This information must be carried with the coaches to all practices and games. The travel rosters include sensitive information necessary for emergency treatment, and must be returned to the ATC at the end of each season to be destroyed due to HIPPA policies.

ATHLETIC EQUIPMENT Coaches are required to sign out all athletic equipment from the ATC at the beginning of the season. It is the responsibility of the coaches to keep track of all equipment, and return all items in good condition at the end of the season to the ATC. Any missing equipment will be charged to the coachs stipend/budget for replacement.

All coaches are required to keep a medical kit with them at all practices/games. It is the coaches responsibility to make sure the kit is fully stocked and obtain necessary supplies from the ATC when needed. The coaches and team are responsible for its designated water supplies which are signed out by the coaches the beginning of each season. The team is responsible for filling its designated water supplies and taking it to practice and games. Water MUST be provided for the athletes at practices and games. To prevent contamination and cross-contamination do not allow athletes to drink directly from the coolers by putting their mouths on the spigots, and putting their hands in the coolers to fill up water bottles or grab ice to eat. All water coolers must be cleaned, and dried after every practice to prevent illnesses. The ATC will not distribute water bottles to athletic teams unless requested. It is the recommendation of the ATC that all athletes bring their own water bottles to practice and games and to fill with the water cooler provided to the team. This helps decrease the amount of transmitted colds and viruses between athletes Teams may find ice and water to fill their coolers in the wet room between the boys and girls locker rooms in the gymnasium, and in the training room at the team house, the hose is located on the house, pump and turf at the turf field. There are no water sources at the Germantown or Bates/Weems Fields.

ATHLETIC INJURIES All coaches are responsible for notifying the Athletic Trainer of any injuries or illnesses that occur to a member of their team. In turn, the Athletic Trainer will notify the coach of any athlete injury/illness information. Since a coach is generally not trained to handle athletic injuries, other than first aid, a coach does not have the authority to return an athlete to play if that athlete has sustained an injury requiring more than first aid care. Clearance for athletic participation can only be provided by the Certified Athletic Trainer or treating physician with written note that must first be presented to the ATC not the coach prior to returning to play. All student-athletes sustaining an injury or illness, whether at home or at school, should be referred to the Athletic Trainer. Coaches are not to refer an injured athlete to a physician without first discussing the proper plan of action with the ATC. Any athlete seeing a physician must provide a physicians note to return to the Athletic Trainer. The ATC will then care for the injury/illness under the direction of that treating physician. If an athlete sees a physician for an injury/illness and does not return with a note from the physician, the athlete will be held from practices/games until a note is received by the ATC. Any athlete not seeing a physician for their injury/illness, will be cared for by the ATC under the direction of the team physician.

RETURN TO PLAY CRITERIA The decision to return a student-athlete to competition after sustaining an injury/illness will be made by the ATC, taking into consideration the athletes well being, physicians order, and parents wishes. A student-athlete seeing a physician for an injury, must provide a written document stating the athlete is cleared to play. However, at no time will an athlete be allowed to participate in athletics if, in the professional opinion of the ATC, that athlete is medically unfit to play. In the event that a treating physician has cleared an athlete for participation, but the ATC does not feel the athlete is ready, the ATC may require the athlete complete rehabilitative or functional activities before being allowed to return to play. INJURY REFERRAL The ATC must evaluate and initiate the first level of care on all athletic injuries. A studentathlete that sustains an injury meeting any of the following guidelines, must be referred to a physician by the ATC for further treatment. Head: All cases of unconsciousness or memory loss, indicating a serious concussion. All other cases with concussion symptoms that do not resolve within 15 minutes. Neck: Brachial plexus injuries with motor weakness or abnormal nerve function. All suspected neck sprains or other serious neck injuries. Extremities: Suspected fractures and dislocations. Suspected 3rd degree sprains and strains. Other: Evaluate, treat, and refer as indicated. Since student-athlete insurances vary widely, physician referral ultimately depends on insurance mandates. In most cases, it will be recommended that the student-athlete sustaining an injury be referred to an orthopedic surgeon. If insurance dictates that the student-athlete see their primary care physician (PCP) first, the student-athlete and parent will be instructed to request from their PCP a referral to an orthopedic surgeon. The parent has the final decision as to which orthopedic surgeon their child sees for an injury. If a parent does not have an orthopedic preference, the ATC will recommend the team physicians practice.
Anne Arundel Orthopedic Surgeons 2003 Medical Parkway, Suite 400 Annapolis, MD 21401-3088 Office: 410-573-2530 www.aaos.net

Since a primary responsibility of the ATC is to provide home event health care, game schedules make it difficult to provide extensive rehabilitative services to injured studentathletes. Therefore, if the treating physician prescribes rehabilitative care, it is recommended that the athlete see a physical therapist for treatment. The decision of physical therapy location is again, ultimately the parents. However , it is recommend that the athlete see a physical therapist with a sports medicine background, preferably at one of the following facilities.
Annapolis Family Physical Therapy 410-266-6626 AAOS Physical Therapy (In-House) 410-573-2530

EMERGENCY PROTOCOL FOR INJURIES An emergency action plan has been developed for situations involving an injury occurrence at any of the St. Marys athletic facilities. (Please refer to Appendix A for the Emergency Action Plans (EAP)). Should an injury occur while the ATC is present, the ATC becomes the first responder and the coach is the second responder. Should an injury occur without the ATC present, the first responder must be the head coach with an assistant coach as the second responder. AUTOMATED EXTERNAL DIFIBRILLATOR (AED) Currently, St. Marys High School has two (2) AEDs. One of the AEDs is located in the Athletic Training Room off of the Weight Room in the Gymnasium. The second AED is located in the team house located at the turf field. The ATC is responsible for obtaining and maintaining the AED facility program in accordance with state regulation (MIEMSS). Coaches are encouraged to obtain CPR/AED certification. USE OF THERAPEUTIC MODALITIES Therapeutic modalities are thermal, electrical, or mechanical mechanisms used to help provide the best environment for healing an injury. THERAPEUTIC MODALITIES Cryotherapy
Applications of a cold (32F - 65F) modality to the human body.

Indications:
Acute injury or inflammation Acute or Chronic Pain Acute or Chronic Muscle Spasm Decreased Range of Motion st Small, superficial 1 degree burns Post-surgical pain and edema In conjunction with rehabilitative exercises

Contraindications:
Cardiac or Respiratory involvement Uncovered open wounds Insufficient circulation Cold allergy Anesthetic skin Raynauds phenomenon Ice Pack, Ice Bath, Cold Whirlpool

Examples:

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THERAPEUTIC MODALITIES (CONTD) Thermotherapy

Application of a heat modality to a human body

Indications:
Subacute or chronic inflammation Subacute or chronic pain Subacute or chronic muscle spasm Decreased Range of Motion Hemotoma resolution Joint contractures

Contraindications:
Acute injuries Impaired circulation Poor thermal regulation Anesthetic area

Examples:
Moist Heat Pack, Warm Whirlpool

Electrical Agents
Application of electricity through an electrical device to an injured area.

Indications:
Acute or chronic pain Joint contracture Muscle Re-education Facilitate tissue healing Atrophy Edema Muscle spasm

Contraindications:
Cardiac disability Exposed metal implants Severe obesity Areas of increased sensitivity Skin irritation Pregnancy

Examples:
High Voltage Pulsed Stimulation (HVPS), Interferential Stimulation, Neuromuscular Electrical Stimulation (NMES or Russian)

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THERAPEUTIC MODALITIES (CONTD) Mechanical Agents Application of mechanical energy to elicit involuntary response in the human body. Indications:
Joint contractures Muscle spasm Neuroma Scar tissue Postacute reduction of myositis ossificans Acute or Chronic inflammation

Contraindications:
Acute conditions Ischemic areas Tendency to hemorrhage Cancer Pregnancy Anesthetic area Fracture Active infection Decreased circulation Sensitive areas (spinal cord, eyes, heart, skull, genitals)

Examples:
Ultrasound, Traction, Massage, Intermittent Compression

MANAGEMENT OF HEAD AND SPINAL CORD INJURIES Head and spinal cord injuries are serious injuries with a potential for death and paralysis. As such, any suspected head or spine/spinal cord injury should be approached with extreme caution. Identifying a possible head or spinal injury varies case by case. However, for the safety of the athlete, when an injury is suspected always assume the injury is present until proven otherwise. The following are general guidelines to follow. Identify the mechanism of injury o This can often determine if the injury involves the head or spine o I.e. fall down stairs, block with head down, etc. Identify the athletes current state of health o Airway, breathing, circulation, consciousness o Ability to move arms and legs (NOT head and neck) o Ability to feel arms and legs o Signs/symptoms of a concussion

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MANAGEMENT OF HEAD AND SPINAL CORD INJURIES (CONTD) If a student-athlete is suspected of sustaining a head or spinal cord injury, the St. Marys Emergency Action Plan should be put into action. DO NOT ATTEMPT TO MOVE THE ATHLETE, unless the athletes position prevents necessary CPR and thus his/her life is in immediate danger. If the athlete HAS NOT LOST CONSCIOUSNESS, but may have sustained a head or neck injury, contact the ATC immediately. Keep the athlete calm and still until the ATC arrives to evaluate the injury. Even rolling an athlete can cause paralysis and should only be done by trained personnel. SIGNS AND SYMPTOMS OF A CONCUSSION Headache Nausea/Vomiting Blurred Vision Unequal Pupils Disorientation Dizziness Amnesia Loss of Consciousness Personality Changes Increased Blood Pressure Decreased Heart Rate Photophobia (sensitivity to light) Tinnitis (ringing sound heard in the ears) If an athlete exhibits any signs or symptoms of a concussion after sustaining a blow to the head or face, the athlete must be removed from participation and evaluated by the ATC. The athlete cannot return to participation. Playing with a concussion or with any residual symptoms after a concussion, can cause a rapid, fatal swelling of the brain from even a minor head trauma. This so-called second impact syndrome claims the life of 10 high school athletes yearly and is totally preventable. Coaches must not allow athletes to participate if they suspect the symptoms are present, as athletes often under report symptoms to be cleared for play. The following protocol will be used for ALL concussions: If a concussion exists, the athletic trainer and/or team physician will determine a mandatory rest period based on symptoms severity and predetermined minimum rest time. The athlete will be given the ImPACT test 24-48 hours after the initial head injury, and after the athlete is symptom free for 24 hours. Once the athlete has successfully completed the ImPACT test, he will then begin return to play protocol under the guidance of the athletic trainer and with conjunction of the coach. Return to play protocol includes: Day 1: cardiovascular exercise and/or lifting without any symptoms Day 2: sport-specific drills without any symptoms Day 3: non-contact practice without any symptoms Day 4: contact drills without any symptoms Day 5: full contact/game play Any return of symptoms during the progression will start the protocol over from the beginning

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BLOOD BORNE PATHOGENS Blood borne pathogens are microorganisms that can potentially cause disease and may be present in human blood and bodily fluids. Proper protection must be used to prevent exposure to the pathogens to other students, athletes, or personnel. All open skin wounds must be covered prior to any athletic participation. Athletes with active bleeding, must be removed from participation and have the wound bandaged. Blood on the uniform must be removed or uniform must be changed prior to participation. Hands and all skin surfaces that come into contact with blood or body fluids, should be washed with soap and water or antigermicidal agent immediately. Appropriate protective clothing (gloves, apron, mask/shield, eye goggles, etc.) should be worn when coming in contact with the blood or body fluids. All contaminated surfaces should be cleaned immediately with an antigermicidal solution. (Bleach 1:10 or other EPA/OSHA approved solution) Proper disposal of wastes containing blood or body fluid should be followed. Places wastes in a biohazard waste container. Soiled lines need to be washed separately in hot water with an antigermicidal detergent.

FIRST AID AND INJURY MANAGEMENT The following are guidelines for treating injuries in the absence of the ATC. If the ATC is present, he/she is responsible for injury care. Bleeding Treatment:
Apply direct pressures to the wound using gauze or a clean cloth Maintain pressure until the bleeding stops, apply additional gauze or cloths on top of original dressing if blood seeps through CAUTION: if there is an embedded object, DO NOT put pressure on the object itself. Apply pressure around the object and activate 911. DO NOT REMOVED THE OBJECT. Apply pressure to closest artery if bleeding continues for more than 5 minutes and activate 911 When bleeding stops, bandage the wound with clean gauze or cloths

Shock
A medical condition caused by a diminished amount of circulating blood.

Signs/Symptoms:
Moist, pale, cool, clammy skin Increased & shallow respiratory rate Weak & rapid pulse Decreased blood pressure Irritability, restlessness, or excitement Extreme thirst

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Treatment:
Assess, monitor, control ABCs Maintain body temperature as close to normal as possible Elevate feet and legs (if not injured) 8-12 Activate 911/ St. Marys Emergency Action Plan

Allergic Reaction
Anaphylactic shock is a severe, often immediate, and sometimes fatal allergic reaction to certain foods, drugs, or insects.

Signs/Symptoms:
Itching or Hives Flushed face or warm skin Dizziness Nausea, vomiting, or abdominal cramps Increased heart rate Swollen face or tongue Wheezing or difficulty breathing Loss of consciousness

Treatment:
Call 911 immediately and keep the victim calm Check the victims ABCs and treat accordingly Lay the victim on his/her back and elevate feet 12 inches Recheck ABCs: if choking or vomiting begins, turn the head to one side Check for bleeding and treat if necessary Loosen any tight clothing Do NOT give the victim anything to eat or drink If victim has a known allergy, administer EpiPen or Benedryl Remain with victim until EMS arrives

Fractures Signs/Symptoms:
Obvious deformity Numbness and/or tingling Bruising Paleness Intense pain and swelling Limitation of movement No pulse in limb Pain when bearing weight

Treatment:
Do NOT move the athlete Activate St. Marys Emergency Action Plan Keep the athlete calm and still Check, treat, and monitor ABCs for shock

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Burns
1 Degree Burn of outer layer of skin nd 2 Degree Burn of outer and inner layer of skin, often producing blisters and causing severe pain and swelling rd 3 Degree Burn of all layers of skin, typically not painful because nerve endings have been burned
st

Treatment:
Cover all burns with sterile dressing Cool the burn with sterile saline poured over sterile dressing Do NOT apply ice or ointments to burn rd Activate 911 if burn affects the face or neck or its a 3 degree

Dental Injuries Loss of Broken Adult Tooth:

Locate tooth and handle with care Do NOT clean tooth Place tooth in Save-a-Tooth solution or an enclosed container of sports drink (i.e. Gatorade) Send athlete and tooth immediately to the dentist

Broken Braces and Wires

Remove broken appliances if able to easily. If not, cover sharp, protruding portion with gauze, cotton ball, or gum If loose or broken appliance is bothersome, send the athlete to the dentist immediately. If not, send athlete home with instructions to get the problem fixed.

Sprains/Strains
A traumatic joint twist resulting in the stretching or tearing of the stabilizing tissues st 1 Degree MILD Some pain, minimal loss of function, mild point tenderness, little, or no swelling, no abnormal motion in testing nd 2 Degree MODERATE Pain, moderate loss of function, swelling, and some instability rd 3 Degree SEVERE Extreme pain, major loss of function, sever instability, tenderness, and swelling

Treatment:
RICE Rest, Ice, Compression, Elevation Refer to the ATC for further treatment

Bees & Stings Treatment:

Remove stinger as soon as possible by scraping it horizontally (Do NOT pull stinger out with your fingers or tweezers as this will squeeze the venom into the body) Apply topical bite/sting solution (After Bite or Sting Relief) Apply ice to area

Human Bites Treatment:

Wash the affected area with soap and water for at least 30 seconds Apply antibiotic ointment and cover wound with a bandaid Notify parents and refer to a primary care physician for wound management and infection control

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FOOTBALL PRE-SEASON PRACTICE POLICY Preseason Football Policy: Acclimatization to both the environment and the physical nature of the sport is essential. o Day 1 Participants may wear no more than helmets o Day 2 Participants may wear no more than helmets o Day 3 Participants may wear no more than helmets Second practice of Day 3 may add shoulder pads with no contact o Day 4 Participants may practice in shell only (helmets and shoulder pads) o Day 5 Participants may practice in shell only (helmets and shoulder pads) Second practice of Day 5 may add girdles with no person to person contact o Day 6 Participants may begin full pads and collision contact. Contact cannot be made between participants until Day 6. Up to that point, the participants may only make contact with hand shields, tackling dummies and blocking sleds. No more than 2 physical practices per day, not to exceed 3 hours per practice for a total of 6 hours per day. Class room work (i.e. Chalk talk) is not included n the 6 hour maximum. The St. Marys Heat Exertion Policy must be adhered to at all times, and takes precedence over the Preseason Football Policy. See below for the Heat Exertion Policy.

INCLEMENT WEATHER POLICIES It is the policy of St. Marys High School athletics that during any thunder and/or lightening storm athletic practice and/or competition should be stopped. Activity may resume 30 minutes after the last thunder bolt or lightening strike. Athletes and coaches should seek shelter inside a building or vehicles. coaches should stand under trees to seek shelter during a storm. No athletes or

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Heat Index Chart

HEAT INDEX INDE: RED Extreme Danger (106 + (HI) Danger! Discontinue regular practice. All outside athletic events are to be canceled. Full practices may be held only in air-conditioned spaces at this point. Any on field practice may be walk through session only with no conditioning. DARK ORANGE Danger (101-105 HI) Extreme Caution! Modify practice with frequent (required) water breaks. Games/events may continue with mandatory official time outs midway through quarters. Provide a water stop (mandatory) midway in cross county meets. Observe athletes carefully for signs of heat injuries. Athletes should receive a 10 minute rest and fluid break every 15-20 minutes of exertion. Free access to water at all times. Equipment should be kept to short and tshirts only. ORANGE Extreme Caution (97-100 HI) WARNING: Mandatory 10 minutes of rest for every 20-30 minutes of work Free access to water at all times. Practices should be conducted helmets, shoulder pads and shorts (not full equipment. YELLOW Caution (<97 HI) NO RESTRICTIONS: Regular practices with full practice gear can be conducted. A rest to work ratio of 10 minutes rest and fluid replacement for every 30-45 minutes of exertion is recommended.

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Hydration Guidelines for Exercising in the Heat

Guidelines for keeping athletes properly hydrated:

1. Before: Drink plenty of fluids (at least 15-20 oz.) 2-3 hours prior to practices and/or games. 2. During: Stay hydrated by drinking 7-10 oz. of fluid every 15-20 minutes during activity. Note: one gulp is equal to approximately 1 oz. 3. After: Rehydrate with plenty of fluids after activity. Weighing yourself before and after practice will give you a rough idea of how much sweat has been lost. Drink at least 20 oz. per pound of weight lost.

Guidelines for scheduling water breaks:

Temperature * 80-90 F * 80-90 F * 90-100 F * 90-100 F * >100 F Humidity < 70% > 70% < 70% > 70% > 70% Water Breaks (5-10 minutes in duration) 2 3 3 4 NO PRACTICE

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Coaches Guide to Heat & Dehydration

Tips:
Be aware of temperature and humidity level, follow Heat Index for practice guidelines Change practice length, intensity, and equipment based on Heat Index Fluid break should be scheduled for all practices and become more frequent as the Heat Index increases Tips for reducing the likelihood of heat illnesses: o Drink fluids before, during and after exercise or prolonged heat exposure o Check the color of your urine to see if fluid intake is adequate o Avoid caffeine

Dehydration:
Dehydration occurs when athletes do not replace body fluids lost by sweat. Drink water or sports drinks before, during, and after exercise. The amount of fluid needed depends on the temperature and size of the athlete.

Signs & Symptoms:

Dry Mouth Thirst Being irritable or crank Headache Seeming bored or disinterested Dizziness Cramps Excessive fatigue

If an athlete displays any signs or symptoms, they should be moved to a shaded or air-conditioned area, & given fluids to drink They may return to play as soon as they are symptom-free.

Heat Cramps:
Heat Cramps are a mild heat illness that can be easily treated. These are intense muscle spasms that develop during exercise when the athlete has lost large amounts of fluid and salt from sweating. Heat cramps can be avoided by adequate conditioning, getting used to the heat and humidity slowly, and proper nutrition.

Signs & Symptoms:

Intense pain Persistent muscle contractions that continue during and after exercise

If an athlete displays any signs or symptoms, they should be given a sports drink to help replace fluid and sodium loss. Light stretching, relaxations, and massage of the cramped muscles may help. They may return to play as soon as the cramps have gone away, and fluid has been replaced.

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Heat Exhaustion:
Most common type of heat illness, caused by decreased blood volume due to dehydration.

Signs & Symptoms:

Loss of coordination, dizziness, or fainting Dehydration Profuse sweating or pale skin Headache, nausea, vomiting or diarrhea Stomach/intestinal cramps or persistent muscle cramps

If any athlete displays any signs or symptoms move athlete to shaded or air-conditioned area. Remove any extra clothing or equipment. Cool the body with water, fans or cold towels. Have the athlete lie comfortably with legs raised above heart level. If the athlete is not nauseated have them drink chilled water or sports drinks. The athletes condition should improve rapidly, but if there is little or no improvement, take the child to the ER for medical treatment. The athlete will not be allowed to return to play until all symptoms of heat exhaustion and dehydration are gone. Avoid intense practice in heat until at least the next day or per direction of physician, or athletic trainer.

Heat Stroke:
The least common heat illness, but the most serious, and even fatal. Heat stroke is caused when the athletes body creates more heat than it can release, due to the strain of exercising n the heat. This results in the rapid increase in core body temperature, which can lead to permanent disability or even death if left untreated.

Signs & Symptoms:

Increase in core body temperature, usually above 104 degrees CNS dysfunction: altered consciousness, seizures, confusion, emotions instability, irrational behavior or decreased mental acuity Nausea, vomiting or diarrhea Headache, dizziness or weakness Hot, dry skin Increased heart rate, decreased blood pressure or fast breathing Dehydration Combativeness

If there is no medical personnel on site, call 911 for immediate transport. Begin cooling the athlete while waiting for EMS this means removing all equipment If there is medical personnel on site, locate them immediately. Remove extra clothing and equipment. Begin aggressive whole-body cooling or equipment immersion, cold water, fans, or cold towels covering as much of the body as possible. No athlete who has suffered heat stroke will be allowed to return to play until released by physician.

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Cold Weather Guidelines

In excessive cold, when outdoor temperatures and wind chills are 32 degrees or less (below freezing), there will be no outdoor practices permitted. ****Note: This guideline will be changing as soon as the new MIAA/IAAM recommendation and policy has been established to coincided with their guidelines.

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Appendix A

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Saint Marys High School Athletic Training Emergency Policies and Procedures Prologue
The following are recommended procedures to follow in the handling of a serious and/or potentially serious injury to a student-athlete. All waivers, medical conditions, medical clearance, and insurance information required for participation must be in the possession of the Athletic Trainer. The Certified Athletic Trainer (ATC) should perform only those procedures that he/she is qualified and certified to perform. In the case of a medical emergency and there is no ATC on-site, proper first aid should be administered by qualified/certified individuals and the appropriate support personnel should be notified immediately (ATC and/or EMS). The supervising ATC should be contacted as soon as possible via phone in any emergency or non-emergency situations. At no time should an official or coach on-site perform any non-emergency procedure, act, or practice on the injured athlete without proper certifications/qualification and the consent of the ATC. ALL injuries and illnesses must be reported to the Athletic Trainer IMMEDIATELY.

Emergency Plan
1. Determine the extent and severity of the injury and contact the necessary personnel (ATC, EMS). IF the ATC is not present, DO NOT attempt to move the athlete if a suspected neck and/or back injury has occurred. 2. If the injured student-athlete is not breathing and/or has no pulse, contact 911 immediately. 3. The first person on the scene (ATC, CPR/First-Aid certified coach) will stabilize, assess, treat for shock, control bleeding, and monitor vital signs to include airway, breathing, and circulation within their personal qualification/certifications until a more qualified individual arrives. 4. Assistant coach or administrator should maintain control of the evolving situation (crowd, teammates, etc.) 5. If the injury is non-life threatening and the individual requires transportation to a medical facility, first determine the availability of support personnel, or parent to transport the student-athlete or activate EMS by dialing 911. If unsure of the severity of the injury, error on the side of caution and dial 911 immediately to activate EMS. 6. In the case of ANY life or limb-threatening injury/condition contact 911 IMMEDIATELY! 7. Life or limb-threatening injuries and conditions include, but are not limited to: cardiac arrest, respiratory arrest, stroke, sudden illness, suspected fractures, suspected dislocations and/or subluxations, head trauma, neck and/or back injury, and any medical condition which renders the individual unable to make a decision. 8. Emergency equipment available for use at practices and games supplied to coaches prior to the start of the season include emergency kits. 9. Emergency equipment located with the ATC includes: emergency kit, Automated External Defibrillator (AED), splints, crutches, and immobilization devices. 10. AED Locations: a. St. Marys gymnasium i. One (1) unit mounted on the wall in the Athletic Training room in the back of the weight room. b. Location of the ATC i. One (1) unit travels with the ATC to all games he/she attends. 11. Every effort will be made by the Athletic Trainer to contact parents, athletic administration, and coaches to notify them of any emergency or non-emergency situation(s) with a student-athlete.

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Support Personnel and Roles Certified Athletic Trainer (ATC)

Primary responsibility to oversee emergency situations and initiate emergency procedures Activate EMS or instruct support personnel (coach, athletic administration) to call 911 - DO NOT HANG UP UNTIL INSTRUCTED TO DO SO BY THE DISPATCHER! Assess student-athlete and administer emergency medical care as necessary (CPR, rescue breathing, immobilization, etc.). Direct support personnel in emergency care procedures. Aid EMS in preparing the student-athlete for transport. Contact parents of student-athlete once EMS has arrived and begun transport if parents not on scene.

Head Coach
Know phone location and be capable of activating EMS (911) when instructed by the ATC DO NOT HANG UP UNTIL INSTRUCTED TO DO SO BY THE DISPATCHER! Assist with emergency care under the direction of the ATC Obtain necessary emergency medical equipment as instructed by the ATC If the ATC is not present assess the severity of the scene and determine if EMS (911) needs to be activated Call ATC Provide all appropriate medical and insurance information to send with EMS and the student-athlete - All information should be located in blue notebook.

Assistant Coach
Assist with crowd and team control Assist in direction of emergency vehicles Travel with student-athlete to hospital (if necessary) and remain until parents arrive. Assist with the duties of the head coach. If there is no Assistant Coach, responsibilities will be delegated to Head Coach, or other Athletic Administrator

Athletic Administrator
Be capable of activating EMS (911) when instructed by the ATC Assist in crowd and team control Assist in direction of emergency vehicles Assist coaches or Athletic Trainer if necessary

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St. Marys Injury Emergency Plan

Location:
St. Marys High School 113 Duke of Gloucester Street Annapolis, MD 21401

Phones:

Weight Room ATC Office Coaches Cell Phones

Field Entrances:

GYM, WEIGHT ROOM, & MARIAN HALL Meet ambulance at entrance in front of the school in the Horseshoe on Duke of Gloucester.

First Responder Second Responder

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543

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St. Marys Injury Emergency Plan

Location:
St. John Neumann Turf Field 620 Bestgate Road Annapolis, MD 21401 TURF FIELD

Phones:

Coaches Cell Phones

Field Entrances: First Responder Second Responder

South End Zone Entrance

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543

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St. Marys Injury Emergency Plan

Location:
Bates/Weems Athletic Complex Spa Road Annapolis, MD 21401

Phones:

Coaches Cell Phones

Field Entrances:

PANTHER STADIUM Field on right at end of driveway UPPER PRACTICE FIELD First field on left at end of driveway LOWER PRACTICE FIELD Field in the far back, enter bike path road at end of driveway to access TRACK Field on the far left at the end of the driveway, in the back of the parking lot

First Responder Second Responder

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543 28

St. Marys Injury Emergency Plan

Location:
Germantown Elementary Fields (Annapolis Sports Complex) Poplar & Locust Avenue Annapolis, MD 21401

Phones:

Coaches cell phones

Field Entrances:

UPPER FIELDS Located off of Poplar Ave LOWER FIELDS (ANNAPOLIS SPORTS COMPLEX) Locust Ave

Located off of

First Responder Second Responder

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543

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St. Marys Injury Emergency Plan

Location:
Navy Marine Corp Stadium 304 Farragut Rd Annapolis, MD 21401

Phones:

Coaches cell phones

Field Entrances:

TURF FIELD Enter off of Taylor Road through south end zone entrance (by the Blue Angel jet)

First Responder Second Responder

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543

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St. Marys Injury Emergency Plan

Location:
General Hwy Corridor Park 1758 Crownsville Rd Crownsville, MD 21032 BASEBALL park SOFTBALL

Phones:

Coaches Cell Phones

Field Entrances:

Bottom baseball field on the right as you first enter the Continue to back of park, field last fields on right

First Responder Second Responder

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543

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St. Marys Injury Emergency Plan

Location:
Truxton Park Primrose Rd Annapolis, MD 21401

Phones:

Coaches Cell Phones

Field Entrances:

COURTS Follow Primrose down aprox. 50yds, courts will be on the left

First Responder Second Responder

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543

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St. Marys Injury Emergency Plan

Location:
Mears Marina 519 Chester Ave Annapolis, MD 21403 TENNIS COURTS

Phones:

Coaches Cell Phones

Field Entrances: First Responder Second Responder

Marina located on right side of road.

Assesses situation, determines plan of action, and gives immediate first aid care. Clears the area of people, assists First Responder with first aid care.

Severe Situation: Call EMS (911) o Give them the following information: YOUR NAME Injury Information Exact Location Phone Number Contact Parent(s), informing them of the situation o If parent is NOT at event to travel with athlete, an adult MUST accompany the athlete to the hospital and bring the athletes emergency information sheet with them. Contact Athletic Trainer, relay emergency information. Relay EMS information to First Responder, then proceed to entrance to direct EMS to situation Non-Severe Situation: Call the Athletic Trainer

Important Numbers
Anne Arundel County Emergency Athletic Trainer: Athletic Director: Kimberly Holt Matt Hogan 9-1-1 work: 410-990-4130 Cell: 443-336-2433 work: 410-990-4218 Cell: 443-336-0543

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