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Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
1 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
2 | P a g e
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.
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
3 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
4 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
5 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
6 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
7 | P a g e
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
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
8 | P a g e
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.
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
9 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
10 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
11 | P a g e
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
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
12 | P a g e
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.
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
13 | P a g e
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.
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
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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.
Henderson County High School Sports Medicine Policies and Procedures
Updated/Reviewed January 2017 By Kaela McDaniel, ATC/L, PTA, CSCS
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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.
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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
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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.
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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.
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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
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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
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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
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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.
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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
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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
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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.
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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
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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
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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
Henderson County High School Sports Medicine Policies and Procedures
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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
Athletic Trainer are alerted to the condition and
medications taken. It is also suggested that 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
Athletic Trainer are alerted to the condition and
medications taken. 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. 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.