SPORTS MEDICINE POLICIES AND PROCEDURES ......2019/10/24 · 1 2019-2020 SPORTS MEDICINE POLICIES AND PROCEDURES HANDBOOK Department of Intercollegiate Athletics Saint Leo University

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2019-2020

SPORTS MEDICINE POLICIES AND PROCEDURES HANDBOOK

Department of Intercollegiate Athletics Saint Leo University

PO Box 6665, MC 2038 Saint Leo, FL 33574

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SECTION I – SPORTS MEDICINE INFORMATION ...................................................................... 5

Sports Medicine mission statement ....................................................................................................... 5 SPORTS MEDICINE DEPARTMENT RESPONSIBILITIES .................................................................. 5 THE CERTIFIED ATHLETIC TRAINER’S RESPONSIBILITY (ATC) ............................................. 5 THE COACH’S RESPONSIBILITY ...................................................................................................... 6 THE ATHLETE’S RESPONSIBILITY ................................................................................................... 6 SPORTS MEDICINE DEPARTMENT HOURS ........................................................................................ 7 ATHLETIC INJURY REPORTING SOFTWARE ................................................................................ 7 TREATMENT .......................................................................................................................................... 7 RETURN TO PLAY POLICY ................................................................................................................. 8 MEDICAL DECISION MAKING ................................................................................................................. 8 TRANSPORTATION .................................................................................................................................... 8 IMPORTANT PHONE NUMBERS ...................................................................................................... 9

SECTION II - PHYSICAL EXAMINATIONS ................................................................................... 10

PRE-PARTICIPATION PHYSICALS ................................................................................................. 10 PAPERWORK ....................................................................................................................................... 10

SECTION III- COVERAGE POLICIES .............................................................................................. 10

PRACTICE ................................................................................................................................................ 11 COMPETITION ......................................................................................................................................... 11 SUMMER CAMPS POLICY ........................................................................................................................ 11

SECTION IV- ATHLETIC INSURANCE ........................................................................................... 12

INSURANCE COVERAGE ......................................................................................................................... 12 COVERAGE FOR APPOINTMENTS AND FURTHER TESTING .................................................................... 12 MEDICAL EXPENSES ......................................................................................................................... 13

Athletic Insurance Claim Procedure ................................................................................................... 13 PRESCRIPTION MEDICATIONS1 .............................................................................................................. 14 NON-PRESCRIPTION MEDICATION ....................................................................................................... 14

SECTION VI - DRUG TESTING POLICY ......................................................................................... 15

OBJECTIVES .......................................................................................................................................... 15 CONSENT FORMS .................................................................................................................................... 15 BANNED SUBSTANCES ............................................................................................................................ 15 SUPPLEMENTS ......................................................................................................................................... 15 TESTING ................................................................................................................................................... 16

NCAA Year round drug testing .......................................................................................................... 16 Testing in response to individualized reasonable suspicion ................................................................ 16 Testing for an entire athletic team ....................................................................................................... 16 Failure to Report for a Test .................................................................................................................. 16 Collection & Testing Methodology ...................................................................................................... 17 Results ................................................................................................................................................. 17

DRUG TESTING APPEAL PROCESS ........................................................................................................... 18 FINANCIAL RESPONSIBILITIES ................................................................................................... 18

SECTION VII - COMMUNICATION POLICY ................................................................................ 19

PARENT/GUARDIAN COMMUNICATION ............................................................................................. 19 COACHING STAFF COMMUNICATION POLICY ..................................................................................... 19

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SECTION VIII – MENTAL HEALTH POLICY ................................................................................. 20

SECTION VIII - SPECIFIC POLICIES AND PROCEDURES ....................................................... 31

SPINE INJURY PROTOCOL ............................................................................................................... 31 Assessment ........................................................................................................................................... 31 Immobilization and Transport ............................................................................................................. 31 Emergency Equipment ........................................................................................................................ 32

SICKLE CELL ANEMIA TRAIT POLICY .......................................................................................... 32 PREGNANT STUDENT ATHLETE POLICY ...................................................................................... 32 ASTHMA POLICY ............................................................................................................................... 34 HEAT ILLNESS ..................................................................................................................................... 35

Education & Prevention ...................................................................................................................... 35 Acclimaztization Recommednations .................................................................................................... 36 Hydration RecommeNDations ............................................................................................................ 36

DEFINITIONS ....................................................................................................................................... 37 Heat Syncope ....................................................................................................................................... 37 Exercise-Associated Heat Cramps ....................................................................................................... 37 Exertional Heat Exhaustion ................................................................................................................ 37 Exertional Heat STROKE (EHS) ........................................................................................................ 37

RECOGNITION .................................................................................................................................... 38 Heat Syncope ....................................................................................................................................... 38 Exercise-Associated Heat Cramps ....................................................................................................... 38 Exertional Heat Exhaustion ................................................................................................................ 38 Exertional Heat Stroke ......................................................................................................................... 38

TREATMENT ........................................................................................................................................ 38 Heat Syncope ....................................................................................................................................... 38 Exercise-Associated Heat Cramps ....................................................................................................... 38 Exertional Heat Exhaustion ................................................................................................................ 39 Exertional Heat Stroke ......................................................................................................................... 39

RETURN TO PLAY ............................................................................................................................... 39

CONCUSSION POLICIES AND PROCEDURES ............................................................................ 41

SAINT LEO UNIVERSITY PRE PARTICIPATION CONCUSSION POLICY ............................................ 41 SAINT LEO UNIVERSITY CONCUSSION MANAGEMENT PROTOCOL .................................................... 42

SECTION X - BLOOD & FLUID EXPOSURE ................................................................................... 44

EXPOSURE DETERMINATION ........................................................................................................ 44 IMPLEMENTATION SCHEDULE AND METHODOLOGY ......................................................... 44

Compliance Methods ........................................................................................................................... 44 Needles ................................................................................................................................................. 45 Containers for Reusable Sharps ........................................................................................................... 45 Work Area Restrictions ....................................................................................................................... 45 Contaminated Equipment .................................................................................................................... 46 Personal Protective Equipment ........................................................................................................... 46

REGULATED WASTE DISPOSAL .............................................................................................................. 47 LAUNDRY PROCEDURES ......................................................................................................................... 47 HEPATITIS B VACCINE ........................................................................................................................... 48 POST-EXPOSURE EVALUATION AND FOLLOW-UP ................................................................................ 48 BLOODBORNE PATHOGENS TRAINING ................................................................................................. 49 RECORDKEEPING .................................................................................................................................... 50

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SECTION XI - INCLEMENT WEATHER PROCEDURES ............................................................. 51

GENERAL POLICY ........................................................................................................................... 51 LIGHTNING ....................................................................................................................................... 51

EVENT PROCEDURES ........................................................................................................................ 53

SECTION XII – EMERGENCY ACTION PLAN ............................................................................... 54

EMERGENCY PERSONNEL .............................................................................................................. 54 EMERGENCY EQUIPMENT .............................................................................................................. 54 ROLE OF FIRST RESPONDERS ......................................................................................................... 54 VENUE DIRECTIONS ......................................................................................................................... 55 DUE TO THE VARYING NUMBER OF PRACTICE LOCATIONS THE HEAD COACH WILL NOTIFY SAINT LEO UNIVERSITY SPORTS MEDICINE STAFF OF ANY SITUATION THAT HAS ARISEN AND EMS AS DIRECTED ................................................................................................................................................ 55 AFTER HOURS RESPONSE PLAN ................................................................................................... 56 CATASTROPHIC INJURY – CRISIS MANAGEMENT PLAN ...................................................... 57

About Sickle Cell Trait ........................................................................................................................ 62 Sickle Cell Trait Testing ...................................................................................................................... 62

ASTHMA EVALUATION ........................................................................................................................... 63

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SECTION I – SPORTS MEDICINE INFORMATION

SPORTS MEDICINE MISSION STATEMENT

The mission of the Sports Medicine Department at Saint Leo University seeks to preserve and enhance the mission of the University along with its culture and values through professional health care. The Saint Leo University Sports Medicine Department focuses on the student-athlete’s physical and emotional well-being by providing professional education & prevention, assessment, treatment, and rehabilitation of athletic injuries and illnesses. The Sports Medicine Department is made up of certified athletic trainers, primary care physicians, orthopedic specialists and other ancillary personnel representing 21 intercollegiate sports and cheerleading. This department strives to continue to look for new and creative ways to provide a safe environment for our student-athletes while being an advocate for Saint Leo University.

SPORTS MEDICINE DEPARTMENT RESPONSIBILITIES

• Conduct services under the direction of team physicians, NCAA Position Statements and NCAA Best Practices

• Provide the highest quality services in the form of education, prevention, and rehabilitation of athletic injuries as well as the overall strength and conditioning of each athlete.

• Provide an interdisciplinary approach with the Strength & Conditioning Department to provide functional and specific athletic performance

• Provide a pre-professional development program that facilitates and oversees all methods and modalities available

• Comply with all HIPAA standards

• Provide informative seminars to educate student-athletes

• Conduct drug testing for student-athletes

• Assist student-athletes with insurance issues and claims

THE ATHLETIC TRAINER’S RESPONSIBILITY (AT)

• Collection and verification of student-athlete annual physical exams

• Notifying coaching staff of all injuries as they are made aware

• Ensure that no injured athlete will participate in a game or practice without AT approval or consent of the team doctor

• Provide documentation for each injury including treatment, rehab and other management in accordance with HIPAA guidelines

• Set up appointments with the team physicians as needed with referrals made via the athletic training room procedures

• Inspection of athletic training equipment annually alongside modality calibration

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• Collaborate with the Strength & Conditioning staff in the development of techniques to prevent, manage and rehabilitate injuries

• Psychosocial referrals at his/her discretion

• Completing all insurance forms related to injury management of athletes

• Attend all home games and travel with the team at the discretion of the Director of Athletics and Assisant AD of Sports Medicine. SSC policy will be used to determine conflict situations

• Responsible for taking care of the officials for each home game regarding towels, water, etc

• Communicate with Strength & Conditioning Department

o Awareness of any previous medical history prior to activity

o Necessary modifications pertaining to individual student-athletes and his/her injuries

o Communicate on student-athlete’s returning to play after receiving clearance from overseeing physician which may include post-surgical modifications

THE COACH’S RESPONSIBILITY

• Ensure the medical history form is completed by incoming roster additions prior to commitment to Saint Leo Athletics

• Must provide the sports medicine staff with a tentative practice schedule at the beginning of each season

• Must notify the Sports Medicine Staff within forty-eight hours of a change of scheduled practice, game, venue or time. Any timeframe less does not guarantee permitted practice, excluding weather

• Must notify the team AT of any athletes’ injury/illness when he/she becomes aware

• Enforce treatment, rehabilitation and referrals as directed by the AT

• Make sure that players have been cleared to play by the sports medicine staff and/or overseeing physician when returning from injury

• Assist the Sports Medicine staff in getting all insurance, health forms and other information on each athlete

• Assist sports medicine staff in properly fitting and maintaining equipment

• Maintain current certifications in accordance with Saint Leo University Athletic Department Policies and Procedures (i.e. CPR, Concussion Awareness, Heat Illness and Mental Health)

THE ATHLETE’S RESPONSIBILITY

• Read over Policy and Procedure Manual upon entering Saint Leo University, and direct any questions to the Sports Medicine Team.

• Modest dress is required at all times inside the athletic training room in accordance with regulations set forth by the University’s dress code, especially during cold tub usage

• Protective footwear is required throughout the athletic training room; no spiked shoes in the athletic training room, weight room, locker room or hallways.

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• Obey all safety rules and regulations; use prescribed pads and equipment, strapping, wrapping, and other protective equipment.

• Treat Sports Medicine staff with respect.

• Avoid removal of supplies or equipment from the athletic training room without the permission of the AT. All equipment must be signed out and returned.

• Carry out to the fullest all conditioning and rehabilitation programs prescribed by the Sports Medicine and Strength & Conditioning Staff.

• Report all injuries to the coach and AT.

• Report all current prescription medication to AT.

• Report on time for all treatments and doctor appointments and document when needed.

SPORTS MEDICINE DEPARTMENT HOURS During the academic calendar the athletic training room will be open a maximum of one hour prior to practice, and two hours prior to a game for treatments and taping.

• Weekend hours are scheduled around in-season practice & competition

• Rehabilitation appointments will be scheduled according to AT and student-athlete’s schedule

ATHLETIC INJURY REPORTING SOFTWARE Athletic injuries are to be recorded into Sportsware Online (SWOL) by the evaluating AT and/or Athletic Training Student. All physician referrals and further testing should also be noted on the injury form and electronic copies will be added to each athlete's file in SWOL when applicable. If the injury has been resolved or the athlete has not come in for treatment the AT should document accordingly.

TREATMENT Each student-athlete must report all injuries and illnesses to the sports medicine staff. An evaluation will determine the extent of the injury or illness as well as the athlete’s ability to practice or compete. If the injury is not an emergency situation the Sports Medicine Staff will refer the athlete to a necessary physician. Compliance with directions given by the AT or team physician is required. Rehabilitation or treatment continues until the physician and/or AT releases the athlete to be cleared for participation. If the athletic training room is closed and emergency treatment is required, the student-athlete should go directly to the emergency care center of his/her choice. The AT should then be notified concerning the nature of the emergency. The athletic department assumes no financial responsibility for the athlete’s care if proper procedures are not followed.

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RETURN TO PLAY POLICY The AT may return an athlete to the level of participation deemed appropriate at his/her discretion after a full history and physical assessment unless otherwise ordered by a team physician. Any athlete under care of a physician, other than a Saint Leo University Team Physician, will not be permitted to return to activity unless cleared in writing. Verbal communication with the Saint Leo Team Physician is accepted as clearance for participation.

MEDICAL DECISION MAKING All medical decisions will be made in accordance with the established Medical Chain of Command. All decisions regarding a student-athlete’s medical status or ability to return to play are to be made only by a member of the Saint Leo University Sports Medicine Staff. Recommendations by outside physicians will be considered in all situations although decisions regarding participation may be at the discretion of the Saint Leo University Team Physician. Coaches are expected to follow all decisions made by the Saint Leo University Sport Medicine Staff, and are at no time permitted to alter any orders or decisions made in regard to an athlete’s medical status.

TRANSPORTATION Transportation to the doctor for non-emergency matters such as diagnostic imaging, examination or follow-up or is the responsibility of the student-athlete. If team members cannot transport the athlete due to class schedule, then the coaching staff will make arrangements. Students may not use school vehicles to transport the student-athletes.

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IMPORTANT PHONE NUMBERS

Emergency 911

Advent Health Zephyrhills 813-788-0411

Advent Health Wesley Chapel 813-929-5432

Advent Health Dade City 352-521-1100

Advent Heath Prompt Care 352-567-3325 Athletic Training Room X7557, x7559, x8112 x7169 Student Health Services x8347 Barbara Wilson, Asst Athletic Director for Sports Medicine (Cell) 352-467-0292

Susan Cross, Director of Sports Medicine (Cell) 757-503-7766

Thomas Spock, Athletic Trainer (Cell) 813-468-1355

Steven Jurnak, Athletic Trainer (Cell) 802-399-6948

Kayla Cross, Athletic Trainer (Cell) 863-558-4832

Dr. Charles Nofsinger – Team Ortho Surgeon 813-396-9422

Dr. Trey Remaley – Team Orthopedic Surgeon 813-396-9422 Dr. Byron Moran– Sports Medicine Primary Physician 813-396-9422 Dr. Dusty Narducci – Sports Medicine Primary Physician 813-396-9422

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SECTION II - PHYSICAL EXAMINATIONS Physical examinations are mandatory for all student-athletes including prospects who want to try-out for a sport. Prospects must undergo a physical exam before they are permitted to engage in athletic activity. This exam must be approved by NCAA standards and the Saint Leo University Sports Medicine Team, which includes a health questionnaire and medical history paperwork. Once the prospect becomes an eligible student-athlete there is a required physical examination conducted by a Saint Leo University Sports Medicine Physician.

PRE-PARTICIPATION PHYSICALS Saint Leo University Sports Medicine Staff requires a pre-season physical exam for all student-athletes. Missing the official sports physical may result in the athlete missing practice or competition time until cleared by the sports medicine staff. If a physician recommends a test prior to passing the pre-participation physical, the athlete is required to pay for it on his/her own and will not be covered under Saint Leo Athletic Insurance.

PAPERWORK Proper documentation and completion of all paperwork is required by the Sports Medicine team before any new or returning student-athlete is deemed eligible to participate. In addition to the pre-participation physical the student-athlete must provide the sports medicine staff with the following:

• Completed SWOL Profile

• Medical History Questionnaire

• Mental Health Evaluation

• Saint Leo Sports Medicine Consent Forms

• Primary Health Insurance Card (Copy of Front & Back)

• ADHD & Asthma Form (as needed)

• SWAY Baseline and/or re-testing

• Concussion Vital Signs Baseline and/or re-testing

SECTION III- COVERAGE POLICIES

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PRACTICE An attempt will be made to provide all teams with on-site coverage by an AT. Practices will be covered based on NCAA Guidelines for Contact Sports. If circumstances do not allow for an AT to be present on-site during practice communication by cellular phone will be in place. For any emergency situation there will be an AT available to respond within five minutes during practice times for all on-campus practice facilities. In the event of an emergency and an AT is not present on-site the supervising coach should act in accordance with the Saint Leo University Sport Medicine Emergency Action Plan. The same procedures should be followed for those teams with off-site practices. The Assistant Athletic Director for Sports Medicine and primary AT need to be notified of any change in the practice schedule 48 hours prior to that change. The sports medicine staff will not be required to cover practices that are scheduled or re-scheduled without adequate notification; exceptions to this rule include inclement weather and unforeseeable circumstances.

COMPETITION On-site coverage by an AT will be provided for all competitions hosted by Saint Leo University.

An AT will travel for away in-season competitions as schedule allows or unless a home athletic event takes priority, with the exception of the following sports:

Men’s and Women’s Tennis Men’s and Women’s Golf

Men’s and Women’s Swimming Men’s and Women’s Cross Country

Men’s and Women’s Track & Field Women’s Acrobatic and Tumbling

Out of season away competitions will be afforded coverage based on the availability determined by in-season scheduling priorities. If a team is unable to be provided with away coverage the AT will contact the host institution of those athletes that require treatment prior to competition. All teams traveling will travel with a stocked medical kit.

SUMMER CAMPS POLICY All summer camps held on the campus of Saint Leo University are subject to the policies and procedures established by the director of summer camps in regards to the health, safety and coverage by an AT. Please refer to Saint Leo University Summer Camps Policy & Procedure Manual for more information.

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SECTION IV- ATHLETIC INSURANCE

INSURANCE COVERAGE Student-athletes must have primary insurance that has a US based claims address and telephone number on file upon entering Saint Leo athletics in order to be eligible. Those not covered by a family insurance policy must ensure insurance coverage that is comparable to Saint Leo University insurance standards. Student-athletes that arrive with primary insurance will have the Saint Leo University Athletic Insurance as secondary insurance for athletic related injuries. Insurance verification will occur through SWOL online; any failure of verification or changes to insurance coverage are to be reported as soon as possible to the sports medicine staff. Failure to do so could result in the student-athlete incurring costs. Primary insurance information to be provided to the athletic training room:

• Athlete’s Name and Social Security Number

• Personal Campus Address and Telephone Number

• Home Address and Telephone Number

• Birth Date/Sex

• Copy of Insurance Card (Front & Back)

• Address and Phone Number for Claims

• Contract Number and Group Number

• Policy Holder’s Name, Relationship, Date of Birth, Social Security number, and employer

The University insurance carrier accepts no responsibility for a pre-existing injury or condition. If an athlete fails to disclose a preexisting condition to the head coach and the sports medicine staff athletic scholarship may be revoked. All athletic injuries sustained during varsity athletic activity may be fully or partially covered for the amount not covered by the athlete’s personal insurance. The University’s athletic insurance will be billed after the student-athlete’s primary is billed with the exception of University sponsored or government issued insurance.

COVERAGE FOR APPOINTMENTS AND FURTHER TESTING In the chance that a Saint Leo University Team Physician deems further tests or appointments for participation in athletic events the sports medicine staff will initiate this process. The AT must keep several things in mind when making further appointments including:

Primary Insurance Restrictions – network only, referrals, pre-certifications Scheduling Difficulties – class schedule, transportation Saint Leo Athletic Insurance Restrictions – bills, E.O.B.s, proper filing

When making arrangements for an athlete take the following steps:

1. Pull the athlete’s insurance information. 2. Identify the type of insurance and any restrictions

a. Does the athlete need a referral from a primary physician? b. Does the athlete need pre-certification for any testing?

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c. Do they need to see a doctor within their insurance network? 3. If the answer is YES to any of these questions, the AT and/or student-athlete must call the primary care physician or the insurance company and secure what is needed. If the insurance company refuses to speak with you, it will then be up to the athlete or parents to secure the necessary permission. 4. If the answer is No and you are sure that they should be allowed to see the physician to whom you are referring them, you may then collect information from the athlete in order to make the appointment (when possible have the athlete present when you make the appointment in case the physician’s office needs to speak directly to them).

a. Class Schedule b. Transportation (see section on transportation)

5. Make the appointment and notify the athlete of date and time and what they need to bring with them (insurance info). Provide the athlete with directions to the physician’s office. Provide the USF Appointment Form electronically to clinic staff prior to appointment. 6. Athlete is required to take the “Physician Examination” form to be filled out by the physician and returned to a Saint Leo AT on duty. 7. Explain the athletic injury claim procedure to the athlete. (See the athletic injury claim procedure) 8. Collect any bills and E.O.B.s that the student-athlete receives after they have followed the proper procedure and give to the Assistant Athletic Director for Sports Medicine.

MEDICAL EXPENSES The Department of Athletics assumes no financial responsibility for medical treatment obtained without referral from the Sports Medicine Staff. If a student-athlete chooses to see a physician on his/her own (injury or illness) he/she could incur the fees related to the service performed. Proper documentation will be required to be provided to the Saint Leo University Sports Medicine Staff from their physician clarifying evaluation and/or clearance. All coverage provided by the department complies with guidelines issued by the NCAA, and therefore does not allow for payments from injuries/illnesses that are not the result of a supervised intercollegiate practice or competition. If injury occurs in an intramural sports game, coverage is not applicable. Illness is not a part of the sports medicine purview.

ATHLETIC INSURANCE CLAIM PROCEDURE If an athlete is injured as a result of participation in intercollegiate varsity activity the AT must fill out and submit claim form for the university’s athletic insurance policy as well as any necessary claim for the student-athlete’s primary insurance. Once submitted the claim is uploaded into the student-athletes’ file in SWOL.

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SECTION V - MEDICATION

PRESCRIPTION MEDICATIONS1

• Prescription medications are to be stored in one location under lock and key. A location will be selected in which temperature is regulated year round.

• Dispensing of medications will be done in accordance within the established state and federal law.

• All prescription medications that are dispensed will be uploaded to SWOL with Saint Leo Prescription Medication Form under their profile

• If an athlete has documented proof of ADHD they need to provide Sports Medicine Staff of annual documentation for medication. Documentation is required in order for the athlete to participate in any practice or competition.

NON-PRESCRIPTION MEDICATION All non-prescription medications that are dispensed will be documented on a login sheet located at the storage site with the following information: athlete’s name, date, medication given, dosage, time and initials of AT dispensing the medication. Dosage will be determined by Sports Medicine Staff on an individual basis for each student-athlete for his/her condition.

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SECTION VI - DRUG TESTING POLICY OBJECTIVES The Department of Athletics has established the following Drug and Alcohol Policy and Program objectives:

• To provide a drug free environment

• To educate student-athletes, about the physical, social, psychological, financial, and legal problems associated with drug and alcohol use

• To identify student-athletes who are abusing drugs and alcohol and assure prompt counseling and treatment

• To provide a program to assist individuals who use or abuse drugs to recognize their problem and be referred for counseling and rehabilitation

• To provide a fair administrative process for sanctions and appeals

• To provide information and warnings about the use of supplements

CONSENT FORMS Each student-athlete must sign the NCAA Consent Form package provided by the Assistant Athletic Director for Compliance at the beginning of each year. These forms will be kept on file with the Assistant Athletic Director for Compliance. A student-athlete who does not sign the authorization forms will not be permitted to participate in practice or competition.

BANNED SUBSTANCES Student-athletes may be tested for drugs listed on the NCAA Banned Drug List. Note: Physician documentation will be required for all prescriptions. Student-athletes will be in violation of this policy if he/she test positive for a prescription drug that has not been prescribed to the individual student-athlete. SUPPLEMENTS The student-athlete is responsible for knowing what is contained in any supplement that he/she takes. Student-athletes can improve their strength and performance through proper nutrition, conditioning, and rest. Resources are available for all student-athletes via the sports medicine staff as requested. According to NCAA policy, the Department of Athletics can only provide non-ergogenic nutritional supplements provided they do not contain any NCAA banned substances. Permissible supplements include: carbohydrate/electrolyte drinks, energy bars, carbohydrate boosters, vitamins, and minerals.

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TESTING A drug-testing program through urine sample methodology will be utilized. NCAA YEAR ROUND DRUG TESTING Saint Leo University will participate in the NCAA Year Round Drug Testing Program for Men’s and Women’s sports. Any student-athlete who tests positive in the NCAA Program will be required to comply with all NCAA and the Saint Leo Department of Athletics disciplinary actions. The NCAA has the ability to test all year round, and will notify the student-athlete when applicable. TESTING IN RESPONSE TO INDIVIDUALIZED REASONABLE SUSPICION Reasonable suspicion may be based on information presented to the Director of Athletics or Head Coach, including, but not limited to, the following:

• Observed possession or use of substances that reasonably appear to be those listed as a banned.

• An arrest and/or conviction for a criminal offense related to the possession, use of, or trafficking substances listed as banned

• Observed activity or appearance which varies from the normal routine of a student-athlete. (example: changes in physical appearance, conduct, behavior, or unusual/unexplained patterns of absence from class, training, or competition)

• Charged with a violation of the University or Department of Athletics Code of Conduct or other published University policy based on the possession, use, or affiliation with alcohol and/or banned substances

TESTING FOR AN ENTIRE ATHLETIC TEAM There may be times that an entire team is tested. This may include but is not limited to the following reasons:

• Prior to post-season competition • Suspected widespread use of/or association with Banned Substances by team members

NOTIFICATION

Any Saint Leo University student-athlete may be selected for testing beginning the 2nd week of August through post-season play in May per the Saint Leo University Drug Testing Program. Individual student-athletes will be randomly chosen for screening by Drug Free Sport. They are given the names of all Saint Leo University Student-Athletes who will participate in the drug test screening. The Director of Athletics or Head Coaches has the authority to request an additional individual (with probable cause) or team screenings at any time.

FAILURE TO REPORT FOR A TEST Any student-athlete that fails or refuses to report for a drug test will be considered having a positive test and will follow the First Offense disciplinary action outlined below.

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COLLECTION & TESTING METHODOLOGY Saint Leo Sports Medicine staff will collect urine samples in accordance with Drug Free Sport College/University Drug Testing: Urine Sample Collection Guidelines. Testing of urine samples will be done by Drug Free Sport in accordance with their protocols. Student-athletes are assigned a numeric code which appears on all lab forms thus protecting their identities. RESULTS Negative The Assistant AD of Sports Medicine will notify each Head Coach with negative results for their student-athletes. Positive The Assistant AD of Sports Medicine will notify the Director of Athletics with any student-athlete with a positive test result. The Director of athletes will notify the head coach, and then meet with the student-athlete to review the positive test result, disciplinary policy and procedures (including the appeal process), and explain the program of evaluation, counseling, and future screening consequences. DISCIPLINARY ACTION All student-athletes with positive results will be subject, but not limited, to the following disciplinary actions.

First Offense - First offenders receive counseling requiring completion of the entire counseling program. Testing will be subsequent and at the student-athlete’s expense. The athlete is required to permit disclosure of the test results to their parents. Athletic game suspension will be subject to review by the Director of Athletics and the Head Coach. Second Offense - Second offenders will be suspended for 1 year of the date for all sports. The athlete is required to permit disclosure of the test results to their parents. If the student-athlete returns they will be required to submit to testing during the first week of the academic year to be reinstated on an athletic team and will also submit to testing monthly at the student-athlete’s expense. Third Offense - The student-athlete will be permanently banned from participating in all sports and athletic department financial aid terminated. The student may be suspended per the Student Affairs policy from the University.

The University, without charge, will provide a limited counseling program to student-athletes to the extent that similar services are provided to all University students. Counseling beyond that which is available to all University students will be at the expense of the student-athlete.

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DRUG TESTING APPEAL PROCESS If a student-athlete tests positive for a banned substance, he/she have the right to appeal the test result and/or disciplinary action. The Director of Athletics must receive a written request within 48 hours of the notification of the positive test. Upon the Director of Athletics approval of the student-athlete’s appeal the Assistant Athletic Director for Sports Medicine will contact the Drug Testing Laboratory. A second drug screen can be performed at a certified laboratory using the original sample at the student-athlete’s expense (~$100). If the student-athlete wishes to appeal a disciplinary decision or procedure the Director of Athletics must receive the written request for appeal within 48 hours of the student-athlete’s notification of the penalty. FINANCIAL RESPONSIBILITIES Any appeals or required additional testing will be the student-athlete’s financial responsibility. Counseling beyond that which is available to all University students will be at the expense of the student-athlete.

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SECTION VII - COMMUNICATION POLICY

The National Athletic Trainer’s Association Bylaws and the Florida Athletic Training Act requires the sports medicine staff is bound by confidentiality. If an athlete requests specific information to be held in confidence and doing so does not compromise future care the sports medicine staff cannot disclose information to coaches, administrators, and/or parents/guardians without consent from that athlete.

PARENT/GUARDIAN COMMUNICATION The sports medicine staff is unable to discuss any athlete’s medical situation with a parent without first gaining consent from that athlete. Once consent from the athlete is received and/or documented the sports medicine staff will be able to discuss the care that the student-athlete is receiving and any need for further testing. Parents/Guardians will only be contacted in case of an emergency unless specifically requested by the athlete. It is the responsibility of the athlete to communicate injury information to their parents especially when the need for a specialized physician is determined by the sports medicine staff under the supervision of the Team Physician (i.e. emergency room care, neurologist, surgeon, etc.).

COACHING STAFF COMMUNICATION POLICY The method of communication most efficient will be established on a sport-to-sport basis by the primary AT and the coaching staff. All attempts will be made to notify coaching staff of injuries as they occur to their athletes. However, due to the volume of athletes seen, coaches should regularly check with their AT for updates on their athletes. The coaching staff will be notified by already established means of communication of any athletes who have specific limitations or who are completely restricted from participation. The coaching staff will not be notified of each individual treatment provided to their athletes. If the coaching staff wishes to monitor whether or not an athlete has shown up for treatment/rehabilitation they are welcome to communicate with their covering AT. During evaluation and re-evaluation the AT will give recommendations to the athlete for modifying his/her practice regimen in order to speed up the healing process or avoid re-injury. Due to the sheer number of athletes and the number of evaluations performed in the athletic training room it is impossible for the sports medicine staff to report all of this information to the coaches in a timely manner. It is the responsibility of the athlete to communicate these recommendations to the coaching staff. Furthermore, it is the responsibility of the coach to consult with the Sports Medicine staff regarding the playing status of their student athletes; every attempt will be made to contact the coaching staff prior to the start of practice.

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SECTION VIII – MENTAL HEALTH POLICY

Mental Health Emergency Action Plan

If a student-athlete exhibits the following, but is not limited to, then immediate attention and further management required.

a. Thoughts or plans of killing or hurting yourself or others b. Hearing voices or seeing things that no one else can see or hear c. Unexplained changes in thinking, speech or writing d. Being overly suspicious or fearful e. Serious drop in school performance f. Sexual Assault

ROLE OF FIRST RESPONDERS

1. Immediate care of the seriously injured or ill student athlete a. Check ABC’s, Severe Bleeding and/or level of consciousness b. CPR if necessary

2. Activation of EMS a. Call 911

i. Number and condition of injured person(s) ii. Treatment begin given

iii. Specific location of emergency iv. Other information as requested

b. Notify Campus Security c. Notify Mental Health Professional

3. Direction of EMS to Scene (See attached venue directions) a. Open appropriate gates b. Designate individual to flag down EMS and direct to scene. c. Scene Control: Limit scene to first aid providers and move bystanders away from

area. 4. Emergency Equipment Retrieval, Documentation and Debriefing, Post-follow up

arrangements as necessary. a. Notify Team Physician b. Coordinate documentation for return to campus with Campus Security, Team

Physician, and Mental Health Coordinator i. Reporting a Title IX Complaint

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Saint Leo University recognizes that mental health is an important factor in the overall health and success of the student-athlete. In an effort to address any mental health issues that may arise or may already be present the Saint Leo University Sports Medicine Department has established the following policies. These will provide a plan for the sports medicine staff to utilize in collaboration with other mental health professionals to facilitate psychological care for our student-athletes by recognizing potential psychological concerns, providing a plan of education, and developing a referral system to mental health professionals. Athletic Trainers and Coaches will encounter athletes with mental health issues and should be prepared for the proper steps to ensure an appropriate standard of care and safety of the student-athlete and others. The Sports Medicine Staff and athletic department staff should be aware that there is a difference between mental health and a mental illness. Mental health can be defined as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. The definition of a mental illness is collectively all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning. Prevention & Screening Tools All attempts will be made by the Assistant Athletic Director of Sports Medicine to ensure mental health programs are available for student-athletes and athletics staff each year. This may be limited to events sponsored by University Campus or through the Saint Leo University Athletic Department. Each student-athlete will complete a generic mental health screening during pre-participation exams with any red flags noted and be reviewed the Sports Medicine Staff and/or team physician. Screening tools are available to each student-athlete and are available upon request. DISORDERED EATING SCREENING Respond YES or NO

a. Do you make yourself sick because you feel uncomfortably full? b. Do you worry that you have lost control over how much you eat? c. Have you recently lost more than 15 pounds in a three-month period? d. Do you believe yourself to be fat when others say you are thin? e. Would you say food dominates your life?

Interpretation: Any response of “Yes” should lead to follow-up discussion between the student-athlete and a member of the primary athletics health care provider team and/or point person for determination about whether the student-athlete should be referred to a licensed mental health professional for further evaluation.

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DEPRESSION SCREENING 0 = None or little of the time 1 = some of the time 2 = most of the time 3 = all the time

a. Over the past two weeks, how often have you: b. Been feeling low in energy, slowed down? c. Blamed yourself for things? d. Had poor appetite? e. Had difficulty falling asleep, staying asleep? f. Been feeling hopeless about the future? g. Been feeling blue? h. Been feeling no interest in things? i. Had feelings of worthlessness? j. Thought about or wanted to commit suicide? k. Had difficulty concentrating or making decisions?

Interpretation: Score of 0-8: symptoms are not consistent with a major depressive episode. A complete evaluation is not recommended, except in the case of a positive response to the suicide question (item 9). Score of 9-16: Symptoms are consistent with a major depressive episode. Presence of a major depressive disorder is likely. A complete evaluation is recommended. Severity level is typically mild or moderate, depending upon the degree of impairment. Score of 17-30: Symptoms are strongly consistent with criteria for a major depressive episode. Presence of major depressive disorder is very likely. A complete evaluation is strongly recommended. In this higher range, the severity level may be more severe and require immediate attention. Note: Further evaluation is recommended for any individual who scores one point or more on the suicide question (item 9), regardless of the total score.

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ANXIETY SCREENING Below is a list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by that symptom during the past month, including today, by indicating the response 0 = not at all 1 = mildly but it didn’t bother me too much 2 = moderately – it wasn’t pleasant at times 3 = severely – it bothered me a lot.

a. Feeling hot b. Wobbliness in legs c. Unable to relax d. Fear of worst happening e. Dizzy or lightheaded f. Heart pounding/racing g. Unsteady h. Terrified or afraid i. Nervous j. Feeling of choking k. Hands trembling l. Shaky/unsteady m. Fear of losing control n. Difficulty in breathing o. Fear of dying p. Scared q. Indigestion r. Faint/lightheaded s. Face flushed t. Hot/cold sweats u. Numbness/tingling

Interpretation: 0-21 indicates low anxiety, 21-35 indicates moderate anxiety, more than 36 indicates high anxiety. Individuals scoring in the moderate anxiety range or higher should have a follow-up discussion between the student-athlete and a member of the primary athletics health care provider team and/or point person for determination about whether the student-athlete should be referred to a licensed mental health professional for further evaluation.

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ALOCHOL ABUSE SCREENING Each question is scored 0-4 for a total sum of points

a. How often do you have a drink containing alcohol? [score 0 for never, 1 for monthly or less, 2 for two-four times a month, 3 for two-three times a week, 4 for four or more times a week]

b. How many drinks containing alcohol do you have on a typical day when you are drinking? [score 0 for one or two drinks, 1 for three or four drinks, 2 for five or six drinks, 3 for seven to nine drinks, and 4 for 10 or more drinks]

c. How often do you have six or more drinks on one occasion? [score 0 for never, 1 for less than monthly, 2 for monthly, 3 for weekly, 4 for daily or almost daily]

Interpretation: Maximum score is 12. A score of >4 identifies 86 percent of men who report drinking above recommended levels that meet the criteria for alcohol use disorders. A score of >2 identifies 84 percent of women who report hazardous drinking or alcohol use disorders. Individuals meeting or exceeding these thresholds should be referred for further evaluation from a mental health professional.

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ADHD SCREENING Response options are never, rarely, sometimes, often and very often. For each of questions 1, 2 and 3, assign one point to a response of sometimes, often or very often. For each of questions 4, 5 and 6, assign one point to a response of often or very often. Sum all scores.

a. Select the response option that best describes how you have felt and conducted yourself over the past six months.

b. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?

c. How often do you have difficulty getting things in order when you have to do a task that requires organization?

d. How often do you have problems remembering appointments or obligations? e. When you have a task that requires a lot of thought, how often do you avoid or

delay getting started? f. How often do you fidget or squirm with your hands or feet when you have to sit

down for a long time? g. How often do you feel overly active and compelled to do things, like you were

driven by a motor?

Interpretation: A score of four or more indicates that symptoms may be consistent with Adult ADHD, and a follow-up consultation with a health care provider can determine whether a further evaluation is appropriate.

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Mental Health Sports Medicine Staff Structure

The following make up the Mental Health Sports Medicine Team:

1. Sports Medicine Staff Refer student-athletes that have been evaluated for and/or request mental health counseling

i. Barbara Wilson - Assistant Athletic Director for Sports Medicine/SWA ii. Susan Cross – Director of Sports Medicine

iii. Tom Spock - Athletic Trainer iv. Steven Jurnak - Athletic Trainer v. Kayla Cross - Athletic Trainer

2. Team Physician a. Oversight of primary evaluation and diagnosis b. Unchallengeable authority to determine participation level c. Communicate with mental health coordinator to help determine best treatment

i. Byron Moran and Dusty Narducci– Team Physician

3. Mental Health Coordinator a. Will act as the point person for determining the best treatment path for mental health

and counseling issues in coordination with the Assistant Athletic Director for Sports Medicine and the team physician.

i. Lawson Jolly – Director Counseling Services ii. Krista Jones – Asst. Director of Counseling Services

Signs & Symptoms

The following are signs and symptoms of each mental health disorder but should not be limited to the ones listed below.

ADHD

a. Difficulty Concentrating b. Aggression c. Irritability d. Fidgeting e. Short Attention Span f. Mood Swings

Mood Disorder

a. Low or sad moods, often with crying episodes b. Irritability or anger c. Feeling worthless, helpless or hopeless d. A decrease in energy and activity level with feelings of fatigue or tiredness e. Eating and sleeping disturbance f. Decrease in concentration, interest and motivation g. Negative thinking h. Thoughts of death or suicide

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i. Intent to commit suicide with a specific plan followed by multiple attempts

Disordered Eating

a. Creating dietary restraints or dieting b. Excessive exercise c. Self-induced vomiting, laxatives or diuretic use d. Eating large quantities of food without purging

Substance Abuse

a. May vary with type and amount of alcohol consumed and the individual’s personality

b. Irresponsible with academic, sport and relationship responsibility c. Propensity for getting into trouble when drinking d. Drinking alone

Mental Health Emergency

If a student-athlete exhibits the following, but is not limited to, then immediate attention and further management is required by following the emergency action plan at the beginning of this section.

g. Thoughts or plans of killing or hurting yourself or others h. Hearing voices or seeing things that no one else can see or hear i. Unexplained changes in thinking, speech or writing j. Being overly suspicious or fearful k. Serious drop in school performance l. Sudden personality changes that are bizarre or out of character m. Sexual Assault

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Management & Referrals

Saint Leo University student-athletes have access to University counseling services just like other students on University campus. Communication about a student-athlete’s condition with the coaching staff will be left up to the discretion of the student-athlete. Saint Leo University Counseling Services, Health Services or University Ministry are not required to report conversations in accordance with University policies.

1. ADHD a. A student-athlete who has previously been diagnosed with ADHD who is currently

under the care of their own personal physician will need to provide a current and completed ADHD form before being allowed to participate in any team activities.

b. The Athletic Training Staff shall evaluate any athlete that they determine may have ADHD using the screening tools in the policy and procedure manual. If the screening is positive or the student-athlete requests a referral for ADHD they should be referred to Saint Leo team physician’s office for further evaluation.

2. Mood Disorder

a. The Athletic Training Staff shall evaluate any athlete they determine may have a mood disorder using one of the screening tools provided in the policy and procedures manual. The athlete may be immediately referred to Saint Leo University Counseling Services if there is an obvious sign of distress that requires immediate consultation.

b. Provide information or referral to any student-athlete that requests information about speaking to a mental healthcare provider without question or reservation.

c. Provide appropriate documentation in sports medicine software regarding referral. d. If hospitalization is required an Incident report notification will involve campus

safety, residence life, counseling services and the Assistant Athletic Director for Sports Medicine

e. Follow University Interim Medical Leave policy

3. Disordered Eating a. The Athletic Training Staff shall evaluate any student-athlete they determine may

have disordered eating using the screening tools provided in the policy and procedures manual.

b. If there is concern that there is disordered eating following the initial evaluation the Team Physician should be informed and determine the best course of action. The Team Physician shall have unchallengeable authority in regards to participation in intercollegiate sports.

c. If hospitalization is required an Incident report notification will involve campus safety, residence life, counseling services and the Assistant Athletic Director for Sports Medicine

d. Follow University Interim Medical Leave policy

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4. Substance Abuse a. The Athletic Training Staff shall evaluate any athlete they determine may have a

substance abuse problem by using the screening tolls provided in the policy and procedures manual. In addition, they may require a random drug screen from the student athlete if they or the coaching staff deems there is reasonable concern.

b. If there is concern regarding substance abuse following the screening the student-athlete should be encouraged to seek counseling at either the on campus counseling center or at an off campus facility. Attendance at a counseling session will be encouraged and shall have no oversight.

c. If the student-athlete fails a drug screening, they will be placed in the substance abuse prevention program and will follow the steps outlined in the Drug Testing Policy & Procedure section of the Saint Leo University Sports Medicine Handbook.

d. If hospitalization is required an Incident report notification will involve campus safety, residence life, counseling services and the Assistant Athletic Director for Sports Medicine

e. Follow University Interim Medical Leave policy

5. Suicide a. The Athletic Training Staff may be involved if and when an athlete decides to talk

with a staff member. b. If hospitalization is required an Incident report notification will involve campus


c. Follow University Interim Medical Leave policy 6. Sexual Assault

a. The Athletic Training Staff may be involved if and when an athlete decides to talk with a staff member.

b. Information will be sent to Title IX Coordinator and investigation may be opened c. If hospitalization is required an Incident report notification will involve campus


d. Follow University Interim Medical Leave policy

Sexual Assault Policy Saint Leo University Athletics, in line with its core values—especially respect, integrity, community, and excellence—is committed to providing environments that are free of discrimination, including sexual harassment, sexual misconduct, and sexual violence. Title IX of the Education Amendments of 1972 protects students from sex discrimination in educational programs and activities at institutions that receive federal financial assistance (see 20 U.S. Code 1681). Title VII of the Civil Rights Act of 1964 is a federal law that prohibits employers from discriminating against employees on the basis of sex, race, color, national origin, and religion. Titles IX and VII apply to Saint Leo University Athletics programs and activities. Sexual misconduct can deny or limit a student’s ability to participate in or to receive benefits, services, or opportunities from the institution’s programs. Therefore, it is a form of gender-based discrimination prohibited by Title IX. According to the Department of Education’s Office for Civil

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Rights, sexual misconduct is conduct that is unwelcome, is based on sex or gender, is severe or pervasive enough to interfere with an individual’s campus employment, academic performance, or participation in college programs and activities, and creates an intimidating, hostile, or offensive working, learning, or activity environment. The following are examples, but not limited to, sexual misconduct: Making sexual propositions or pressuring individuals for sexual favors Unwelcome sexual advances Writing graffiti of a sexual nature Displaying or distributing sexually explicit drawings, pictures, or written materials Performing sexual gestures or touching oneself sexually in front of others Telling sexual or dirty jokes Spreading rumors or rating other students as regarding sexual activity or performance Circulating or showing emails or websites of a sexual nature Sexual misconduct can take different forms depending on the harasser and the nature of the harassment. The conduct can be verbal, nonverbal, or physical. People of all genders can be victims of sexual harassment, and the harasser and the victim may be of the same or different sexes. Sexual harassment can occur in any school program or activity and can take place in institutional facilities or at off-campus locations, such as a school-sponsored retreat or training program at another location. If a case of alleged sexual harassment or sexual violence occurs, Saint Leo University Athletics will promptly and equitably investigate under Title IX to determine what occurred. Incidents of sexual harassment and gender violence should be reported to the Title IX coordinator at [email protected], Campus Security & Safety and the Senior Women’s Administrator. All reasonable steps will be taken to investigate and respond in a manner consistent with a student’s confidentiality request. Those employed through Counseling Services, Campus Ministry and the University Health Center have confidentiality clauses unless a risk to health and safety becomes apparent. We will let you know if we cannot ensure confidentiality due to overall community safety concerns. Return to Participation

Communication with the Saint Leo Sports Medicine team and University Counseling services will be required in order for a student-athlete to be cleared to return to participation after any mental health concern that requires hospitalization. Documentation of clearance from a licensed professional as well as a staff member of counseling services must be received before the athlete can return to campus, academics, and athletic activity. All other mental health issues that do not require hospitalization will require documentation from the team physician and counseling services clearing the student-athlete for athletic participation.

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Important Phone Numbers Campus Safety 352-588-8333 SLU Counseling Center 352-588-8354 Assistant Athletic Director/SWA 352-588-8222 Suicide Prevention Hotline 1-800-273-8255 Domestic Violence Hotline 1-800-799-7233 Title IX Coordinator 352-588-8406

SECTION VIII - SPECIFIC POLICIES AND PROCEDURES

SPINE INJURY PROTOCOL

ASSESSMENT 1. Initial on-field assessment of a potentially spine injured athlete should only be performed

by a member of the Saint Leo University Sports Medicine Staff. If a member of the Saint Leo University Sports Medicine Staff is not present the Emergency Action Plan should be followed.

2. This initial assessment should include Basic Life Support: airway, breathing, and circulation. If any concerns regarding Basic Life Support arise the Sports Medicine staff should act accordingly based on the Saint Leo University Sports Medicine Emergency Action Plan. The evaluation should also include an assessment of the athlete's level of consciousness and their orientation or lack thereof to person, place, time, and incident. An on-field neurological screening assessing the motor and sensory function of the four extremities should also be completed.

3. Any athlete who is suspected of having an unknown spinal injury should not be cleared based on an on-field assessment. The student-athlete should not be moved until the appropriate medical personnel have arrived and transfer of care has been initiated2. Coaches and teammates should refrain from touching or moving a potentially spine injured athlete. If unconscious, it should be presumed that the athlete has sustained a spinal injury until proven otherwise. Proper immobilization and transportation procedures will be used to safely deliver the athlete to the emergency department.

IMMOBILIZATION AND TRANSPORT In the event transport is necessary, the athlete should be secured to an adequate immobilization device using appropriate procedures2. Since it would be rare for there to be an adequate number of sports medicine staff members to properly move the injured athlete, any movement or immobilization procedures should be delayed until the arrival of EMS unless the presence of vomiting or the need for Basic Life Support makes movement necessary. In this event the sports medicine staff member should utilize other athletic department staff to assist until the arrival of EMS. Upon the arrival of EMS the sports medicine staff member will lead the emergency crew though the immobilization procedure using the EMS immobilization equipment. When possible the sports medicine staff member should be in control of the athlete's head to provide in-line stabilization. The

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appropriate transfer procedure (log roll, six-plus person lift) used to place the athlete on an immobilization device should be chosen based on the number of trained individuals available and the shared knowledge and comfort amongst those individuals. EMERGENCY EQUIPMENT Basic Life Support and emergency equipment (AED, splints, bag valve mask, pulse ox and first aid care) will be available in the athletic training room for on-site practices, and on the field by Saint Leo Sports Medicine Staff during all home competition. EMS will provide all equipment necessary for the immobilization and transport of the spine injured athlete.

SICKLE CELL ANEMIA TRAIT POLICY A testing waiver (see Appendix) is included in every student-athlete’s physical paperwork packet that should be completed prior to participation at Saint Leo. Knowledge of a student-athletes’ sickle cell trait should be brought to the attention of the coach and the Sports Medicine Team. If an athlete has been diagnosed with having the sickle cell trait he/she is required to provide documentation of all associated medical material, and is not able to participate in any athletic activity until cleared by the Sports Medicine Team. Coaches and student-athletes will be given the proper education about the precautions they should take when dealing with sickle cell anemia. These precautions include but aren’t limited to conducting appropriate sport-specific conditioning sessions, signs & symptoms, and proper management.

PREGNANT STUDENT ATHLETE POLICY Saint Leo University has established guidelines to protect our student-athletes who may be pregnant while participating in intercollegiate athletics. It is mandatory for the athlete to notify the Sports Medicine staff when a pregnancy is suspected. The first course of action will be to determine a confirmation or denial of pregnancy with necessary documentation provided. Early notification is necessary in order to offer all parties involved the best possible care and protection in a timely fashion. Current guidelines for exercise during pregnancy and the postpartum period from the American College of Obstetricians and Gynecologists indicate that regular, moderate intensity exercise concurrent with established levels have a benefit to both the mother and the fetus. The Athletic Department will abide by the recommendations of the student-athlete’s attending physician and Saint Leo team physician regarding participation during and following pregnancy, but assumes no responsibility for complications which may result from continued participation in athletics. The student-athlete will participate at her own risk. Although potential risks of injury during play are rare a complete evaluation must be completed by the athlete’s obstetrician to allow continued participation. Athletes with any of the following conditions will not be allowed to participate:

§ Hemodynamically significant heart disease § Restrictive lung disease § Incompetent cervix/cerclage § Multiple gestation at risk for premature labor

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§ Persistent second and third trimester bleeding § Placenta previa after 26 weeks of gestation § Premature labor during current pregnancy § Ruptured membrane § Preeclampsia/pregnancy induced hypertension

Due to morphological changes that increase the risk of injury, activities that may result in balance loss or even mild abdominal trauma are strongly discouraged. Travel with the team will also be forbidden after the first trimester due to the potential for significant medical complications. Sport related-contact activity will not be allowed after the first trimester due to a risk of damage to both the athlete and the fetus, however athletes may continue to exercise with the team or on her own with the following guidelines:

§ Athlete will continue to maintain regular scheduled visits with their obstetrician § Exercise in the supine position will be avoided due to decreased cardiac output in this

position § Exertion should be moderate and not to exhaustion § Exertion at high altitudes (over 6,000 feet) should be strictly monitored § Resumption of full activity in the post-partum period after clearance by the athlete’s

obstetrician is encouraged as tolerated § Exercise will be discontinued in lieu of the following conditions

o Vaginal bleeding o Dyspnea prior to exertions o Dizziness o Headache o Chest pain o Muscle weakness o Calf pain or swelling o Preterm labor o Decreased fetal movement o Amniotic fluid leakage

Saint Leo’s athletic insurance carrier only addresses injury and illness related to athletic participation. Since pregnancy is a condition not related to participation in athletics, no insurance coverage will be provided. It is therefore the responsibility of the student-athlete to seek medical confirmation of pregnancy and to be responsible for all medical expenses related to testing or actual pregnancy.

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ASTHMA POLICY The Saint Leo University Sports Medicine Asthma Policy provides those athletes who have a history of asthma and have been medically cleared to participate in sports conditional clearance based on the following criteria3. The athlete must give notice of history of asthma and/or asthmatic symptoms as part of the student-athlete history forms. If it is listed the student-athlete will then undergo an evaluation by a member of the sports medicine staff which includes a thorough asthma history and a base line peak flow reading. If there is no official history of asthma or asthmatic symptoms written on the history form then further evaluation will not be performed. See the Health Evaluation Form in the Appendix.

The asthmatic athlete’s inhaler(s) must always be present on the field during competition or practice. The athlete must also provide the sports medicine staff an additional inhaler(s) to be carried in the medical kit in case their inhaler is unavailable or has run out.

The athlete must be stable with the proper medication.

a. An athlete is considered to be unstable if they must resort to using their rescue inhaler two or more times in any one exercise period, more than three times in any given week beyond normal preventive use, or has been awakened by their asthma more than twice a month.

b. Once an athlete has been deemed unstable, they will be referred to the Team

Physician for evaluation and possible adjustment to their medication protocol.

The athlete must be forthcoming to the sports medicine staff about their asthma stability. For instance, if the player was up the previous night with an asthma attack, he/she must tell the Sports Medicine staff so proper decisions can be made about participation on the following day.

The athlete must also notify the sports medicine staff of any change in their medication protocol that was initiated by a physician other than the Saint Leo University Team Physician. If at any time, during competition or practice, an athlete suffers an asthma attack strong enough to warrant use of their rescue inhaler, that athlete will not be permitted to return to competition or practice on that day until they provide a peak flow reading that is at least 80% of their baseline peak flow reading.

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HEAT ILLNESS The intent of this policy is to provide implementation of policies and procedures to ensure proper preseason acclimatization as well as proper education, prevention, management and treatment of heat illness. The primary focus of the preseason period should be to provide an adjustment period to the intensity and duration of exercise and environmental conditions. The guidelines and procedures are based on medical literature that differentiates sports with equipment due to the unique stress on the body’s heat dissipation capabilities. Equally important, consideration should be given to the varying levels of fitness in the college student-athlete. The following policy provides guidelines and procedures for conducting preseason practices and activities to insure the well-being of student-athletes at Saint Leo University. The guidelines listed provide general recommendations for conducting preseason practices as well as during the academic year to ensure athletes arrive with adequate sport-specific conditioning. Application of these guidelines should not be based solely on the information provided within this protocol, but should be customized to the specific team/individuals. Individuals using these guidelines are responsible for prudent judgment with respect to each practice, athlete, and facility and each athlete is responsible for exercising caution when following these general requirements. It is important to remember that some student-athletes may be more susceptible to heat illness, including those with excess body fat, decreased aerobic fitness, a fever, inadequate hydration, sickle cell trait, as well as those with a history of heat illness. These specific athletes should be monitored and proper precautions should be taken to further prevent heat illness from occurring. EDUCATION & PREVENTION

• Student-athletes should be educated on the signs and symptoms of exertional heat illness, and be advised that if symptoms are experienced they should see the AT immediately. In the case that an AT is unavailable student-athletes should report to the coaching staff. In case of an emergency call 911.

• All relevant personnel (including coaches, strength & conditioning staff, administrators, and emergency medical staff) should be well versed in common prevention, recognition, and treatment strategies for heat illnesses.

• A heat illness education pamphlet that describes prevention, recognition (signs and symptoms), and treatment should be readily available for all student-athletes and relevant personnel.

• Student-athletes should also be educated on the physiological benefits of being conditioned prior to training sessions, and should be encouraged to maintain cardiovascular fitness over breaks to increase tolerance and therefore benefit more from the acclimatization period.

• Education is the most important step in prevention of exertional heat illness. Proper steps should be taken to ensure student-athletes, faculty, and staff are able to help prevent heat illness from occurring and recognize the signs and symptoms when cases do occur.

• It is important to take into consideration predisposing factors including environmental and non-environment factors (dehydration, barriers to evaporation, illness, history of heat illness, increased BMI, poor physical condition, excessive or dark clothing, etc). Some predisposing

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factors include: illness that includes vomiting and/or fever, dehydration, sunburn, certain medications, sleep loss, and excessive alcohol use, lack of heat acclimatization.

• An ice water immersion tub should be pre-filled and made available daily inside the athletic training room and/or outside.

ACCLIMATIZATION RECOMMENDATIONS

• Prior to participation in any preseason practice activities, all student-athletes are required to undergo a Pre-Participation Physical Evaluation that includes a risk factor for heat illness and history of heat illness questionnaire

• Training sessions should be scheduled to avoid the hottest part of the day (10am to 2pm) during the acclimatization period.

• Lacrosse: The first two full days of practice shall be restricted to conditioning drills. Pads and helmets may be issued on day three, but deliberate contact during this three-day period is prohibited.

• The same acclimatization steps should be followed for all indoor sports that participate in outdoor practice sessions:

• Acclimatization periods should be phased in gradually and progressively at the beginning of any new conditioning cycle (including but not limited to return in January, after spring break, return in summer, and return after injury).

HYDRATION RECOMMENDATIONS The following procedures relate to hydration and rest periods during a practice or contest (where applicable)

• For every thirty minutes of practice, there should be a five-minute rest and hydration break. Saint Leo Sports Medicine recommends that during conditioning/fitness sessions, student-athletes be provided with a two-minute hydration break for every fifteen minutes of conditioning.

• During every practice and contest, there should be unrestricted access to water at all times.

• A student-athlete should never be denied access to water if he/she requests.

• Based on sport and climate condition as well as the discretion of the athletic trainer weight measurements should be recorded before and after every workout, practice and competition to ensure proper hydration status is maintained. Student-athletes should be instructed to drink significant sodium-containing fluids to maintain less than a 2% change in body-weight.

• Extra salt during the first few days of heat exposure improves acclimatization, so student-athletes should be encouraged to eat salty foods and use the salt shaker liberally during the first few days.

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It is important to remember that some student-athletes may be more susceptible to heat illness, including those with excess body fat, decreased aerobic fitness, a fever, inadequate hydration, sickle cell trait, as well as those with a history of heat illness. These specific athletes should be monitored and proper precautions should be taken to further prevent heat illness from occurring.

DEFINITIONS

HEAT SYNCOPE • Also called orthostatic dizziness

• Episode of fainting normally occurring after long periods of standing, immediately after stopping activity, or after quickly moving into an upright position after a period of rest.

• Usually occurs during the first five days of acclimatization or in persons with heart disease

• Often due to peripheral vasodilation, postural pooling of blood, decrease return of blood through veins, dehydration, decreased cardiac output, and cerebral ischemia.

EXERCISE-ASSOCIATED HEAT CRAMPS

• Acute, painful, involuntary muscular contraction

• Presents during or after intense exercise sessions

• Proposed causes of cramps include dehydration, electrolyte imbalances, neuromuscular fatigue, or a combination.

EXERTIONAL HEAT EXHAUSTION

• Inability to continue an activity that is associated with a normal or slightly elevated core temperature of 97˚F (36˚C) to 104˚F (40˚C).

EXERTIONAL HEAT STROKE (EHS)

• Elevated core temperature of greater than 104˚F (40˚C) normally associated with signs of organ failure that occurs during physical activity.

• Occurs when the body’s temperature regulation system is overwhelmed due to excess heat production in challenging environmental conditions.

• Can progress to complete thermoregulatory failure and can be fatal.

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RECOGNITION The following procedures relate to the recognition of exertional heat illnesses. HEAT SYNCOPE

• Episode of fainting associated with dizziness, tunnel vision, pale or sweaty skin, and a diminished pulse rate. Student-athlete will have a normal rectal temperature.


• Signs and symptoms include dehydration, thirst, sweating, involuntary painful muscle cramps, and fatigue.

EXERTIONAL HEAT EXHAUSTION

• Minimal cognitive changes occur, but assess central nervous system function to rule out more serious illness such as EHS.

• Normal or slightly elevated (98.6˚F than 104˚F) core temperature taken with a rectal thermometer.

EXERTIONAL HEAT STROKE

• Core body temperature greater than 104˚F (40.0˚C)

• CNS dysfunction including disorientation, loss of balance, staggering, irritability, irrational or unusual behavior, apathy, aggressiveness, hysteria, delirium, collapse, loss of consciousness, or coma.

TREATMENT The following procedures relate to the treatment of exertional heat illnesses. HEAT SYNCOPE

• Move to shaded area, monitor vital signs, elevate legs above the level of the heart, and provide student-athlete with fluids to rehydrate.


• Stop activity, replace lost fluids and electrolytes, and begin mild stretching with massage to decrease the spasm.

• Ensure electrolytes return to homeostatic state by providing sodium-rich fluids.

• A recumbent position may allow more rapid redistribution of blood flow, especially when cramps are located in lower extremities.

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EXERTIONAL HEAT EXHAUSTION • Remove student-athlete from activity and into a cool, shaded environment. Begin fluid

replacement immediately. Assess cognitive function, and monitor vital signs continuously to determine progress.

• If temperature is elevated, remove excess clothing to facilitate cooling.

• Cool with ice water immersion, fans, ice towels, or ice bags if temperature is greater than 102˚F (38.8˚C).

• If recovery is stagnant transfer care to EMS

EXERTIONAL HEAT STROKE

• If exertional heat stroke is suspected and confirmed with core body temperature higher than 104˚ F then emergency medical services should be activated immediately. Core body temperature must be decreased to below 102˚F (38.9˚C) as soon as possible; therefore, cooling should be initiated within five minutes of collapse to limit morbidity and mortality. The goal is to decrease temperature to below 102˚F (38.9˚C) within thirty minutes of collapse.

• Monitor the student-athlete’s vital signs and other signs and symptoms. If a physician is available, intravenous fluid replacement should be used to rehydrate.

• Cold-water immersion is the most effective cooling modality. The water temperature for immersion should be 35˚F (1.7˚C) to 59˚F (15.0˚C) and continuously stirred to maximize cooling. If immersion is unavailable, cold-water dousing or ice towel rotation may be used to assist with cooling.

• Student-athletes should be cooled prior to transportation to a hospital except under circumstances where proper cooling and medical care are unavailable onsite.

• Once the core temperature reaches 101˚F (38.3˚C) to 102˚F (38.9˚C), the student-athlete should be removed from the cooling modality, since the temperature will continue to drop.

• The student-athlete should be referred to the emergency room and evaluated for complications.

RETURN TO PLAY The following guidelines are required to allow a student-athlete to return to play (RTP) after suffering from exertional heat stroke or any heat illness requiring hospitalization. Student-athlete needs to be cleared by a physician to begin a RTP protocol. A student-athlete should be in an asymptomatic state before returning to play progression as indicated and directed under the team physician and AT. The elapsed time after collapse or cessation of exercise should be taken into consideration when determining RTP.

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Once released from the hospital, student-athletes who have suffered from exertional heat stroke should refrain from activity until asymptomatic using the Heat Illness Symptom Checklist.

1.) These student-athletes should be cleared by a physician prior to beginning RTP progression. 2.) If student-athlete had lost significant amount of weight during the episode, the student-athlete’s weight should be monitored to determine if weight has returned to normal (weight prior to the episode).

Once cleared for return to play, the student-athlete should begin a gradual RTP progression under direct medical supervision to re-establish heat acclimatization.

1.) The progression should begin at a low intensity in a cool environment and gradually advance to high intensity exercise in a warm environment.

2.) Exercise duration, intensity, and environmental factors as well as equipment used should be factored into the RTP progression and made sports-specific.

3.) Athlete should continue to be asymptomatic in both cool and warm environments at different intensities.

The medical staff should then investigate why the heat illness occurred and make modifications to and modify to reduce the risk of recurrence. Binkley, H. M., Beckett, J., Casa, D. J., & Kleiner, D. M. (2002). National Athletic Trainers' Association

Position Statement: Exertional Heat Illness. Journal of Athletic Training, 37(3), 329-343. Klosner, D. (2012). 2012-2013 NCAA Sports Medicine Handbook (23rd ed.). Indianapolis, Indiana, USA:

National Collegiate Athletic Association. Lopez, R. M., Casa, D. J., McDermott, B. P., Stearns, R. L., Armstrong, L. E., & Maresh, C. M. (2010).

Exertional Heat Stroke in the Athletic Setting. Athletic Training and Sports Healthcare, 10, 189-200.

Casa, D. J., Armstrong, L. E., Kenny, G. P., O'Connor, F. G., & Huggins, R. A. (2012). Exertional Heat

Stroke: New Concepts Regarding Cause and Care. Sideline and Event Management, 115-123. Helen M. Binkley, J. B. (2002). National Athletic Trainers' Association Position Statement: Exertional

Heat Illness. Journal of Athletic Training, 37(3), 329-343. Klosner, D. (2012). 2012-2013 NCAA Sports Medicine Handbook (23rd ed.). Indianapolis, Indiana, USA:

National Collegiate Athletic Association. Lopez, R. M., Casa, D. J., McDermott, B. P., Stearns, R. L., Armstrong, L. E., & Maresh, C. M. (2010).

Exertional Heat Stroke in the Athletic Setting. Athletic Training and Sports Healthcare, 10, 189-200.

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CONCUSSION POLICIES AND PROCEDURES Based on all available research the Saint Leo University Sports Medicine Team has developed the following concussion management plan. The Saint Leo University Sports Medicine staff utilizes a three-fold approach when determining an athlete’s readiness to return to play following a concussion. In the event of a suspected concussion, the concussion management protocol requires the evaluation of the athlete's symptoms, neurocognitive function, and balance which provide the sports medicine staff with the objective information necessary to return the athlete to play safely. The findings of these post-injury assessments are then compared to pre-season baseline assessments, conducted on all student athletes during their first year. The following concussion policy and concussion management protocol has been adopted by Saint Leo University Sports Medicine and is to be followed by all teams for managing athletes suspected of sustaining a concussion.

SAINT LEO UNIVERSITY PRE PARTICIPATION CONCUSSION POLICY All Saint Leo University student-athletes must undergo the following before being cleared by the team physician:

a. they have read and understand the NCAA Concussion Fact Sheet

b. they accept the responsibility for reporting their injuries and illnesses to the institutional medical staff, including signs and symptoms of concussions.

c. every 2 years complete a baseline concussion test that addresses:

any brain injury and concussion history

symptom evaluation

cognitive assessment

reaction time

d. annually completes a SWAY test that addresses:

balance evaluation

symptom evaluation

reaction time

All Saint Leo University coaches, certified athletic trainers, team physician and athletic director must read and sign the attached coaches’ statement acknowledging that they:

a. Have read and understand the NCAA Concussion Fact Sheet (see Appendix)

b. Will encourage their athletes to report any suspected injuries and illnesses to the sports medicine staff, including signs and symptoms of concussions; and that they accept the responsibility for referring any athlete to the medical staff suspected of sustaining a concussion.

c. Have read and understand the Saint Leo University Concussion Management Protocol

d. Will continue to emphasize safety first approach to sport activity focusing on safe play and proper technique.

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The Assistant Athletic Director of Sports Medicine will coordinate the distribution, educational session, signing, and collection of the necessary documents to the following: student-athletes, coaches, certified athletic trainers, team physician and athletic director. Student-athletes will complete their statement online via ARMS. Coaching staff will be made aware of any changes made to the policy and a review will take place.

Saint Leo University Sports Medicine Staff members shall be empowered to determine management and return to play of any ill or injured student athlete as he or she deems appropriate.

SAINT LEO UNIVERSITY CONCUSSION MANAGEMENT PROTOCOL A concussion is more appropriately termed a mild traumatic brain injury. A brain injury impairs both cognitive and physical functions. It can take anywhere from days to weeks for the brain to return to normal function1. Every concussion is different and must be treated as such. Concussions and other brain injuries can be serious and potentially life threatening injuries in sports. Research indicates that these injuries can also have serious consequences later in life if not managed properly1. In an effort to combat this injury the following concussion management protocol will be used for Saint Leo University student athletes suspected of sustaining a concussion. A concussion occurs when there is a direct or indirect injury to the brain. As a result, transient impairment of mental functions such as memory, balance/equilibrium and vision may occur. It is important to recognize that many sport-related concussions do not result in loss of consciousness and, therefore, all suspected head injuries should be taken seriously. Coaches and fellow teammates can be helpful in identifying those who may potentially have a concussion, because a concussed athlete may not be aware of their condition or potentially be trying to hide the injury to stay in the game or practice. To ensure the best possible outcome for all concussion injuries the Saint Leo University Sports Medicine Team has adopted the following guidelines: Concussion Management

a. Management and diagnosis will occur according to the Berlin Consensus Statement1 b. If there are any of the following the student-athlete will immediately be referred to the

hospital via ambulance for further evaluation 1. Loss of consciousness 2. Neurological Deficit or Deterioration 3. Repetitive Vomiting 4. Spinal Injury

c. Any student-athlete who displays, self-reports, or is pointed out by a teammate as showing signs & symptoms of a concussion will be examined by a member of the Saint Leo Sports Medicine Team to assess further for a concussion. In such an event the student-athlete will be removed from practice or competition, and be further evaluated for cervical spine trauma, skull fracture and/or intracranial bleed. Diagnostic tools will include SWAY for assessing symptoms, balance and reaction time alongside cognitive testing and a cranial nerve assessment. Documentation of care will be noted for all involved parties.

d. Any student-athlete diagnosed with a concussion will not return to sport activity or academics on the same day as well as being seen by our team physician before final clearance.

e. An assessment of the symptoms will be performed at the time of the injury, and then serially thereafter (i.e. 2-3 hours post injury, 24 hours, 48 hours, etc). The presence or absence of symptoms will dictate the inclusion of additional neurocognitive and baseline testing.

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f. Medical clearance will be determined by the team physician and AT. 1. For the student-athlete with prolonged recovery additional evaluation may

include but is not limited to: i. Post-concussion syndrome

ii. Sleep dysfunction iii. Migraine disorder iv. Mood disorders v. Ocular or vestibular dysfunction

g. Athlete will be given the Take Home Instructions and expected to sign as confirmation of recommended guidelines.

h. If the athlete is experiencing any symptoms that would affect his/her ability in classroom the Sports Medicine team will assist in the return-to-learn process.

1. The Sports Medicine Team will be made up of the Certified Athletic Trainer, Team Physician, Coaching Staff, and Office of Disability Services

i. If the student-athlete continues to have symptoms throughout any time during the return-to-learn process, he/she may be referred for further evaluation by our team physician.

2. The student-athlete’s professors will be contacted for official excused absence from academic responsibilities. The AT will continue communication until the athlete is fully returned to classes without symptoms.

i. Individualized plans will be made for each student athlete dependent on his/her symptoms

3. Campus resources will be available to the student athlete that include the Saint Leo University Learning Resource Center and the Office of Disability Services.

Activity Progression & Return to Play Clearance

A return to activity progression may begin when the student-athlete:

- has returned to all academic activities without an increase in symptoms

- Concussion Vital Sign scores return to within normal limits of his/her individual baseline

- Balance testing via SWAY is within his/her individual baseline levels

Step 1: 20 minutes of cardio at no more than 70% maximum heart rate

Step 2: 40 minutes of functional sport movement

Step 3: Non-contact functional movement

Step 4: Contact functional movement

Step 5: Return to competition

Each step is recommended to be done every 24 hours, and if any signs or symptoms return during or after activity the athlete will discontinue the progression until asymptomatic. Activity progression will be resumed at the previously completed step determined by the Sports Medicine Team. Only after the student-athlete has met all of the above conditions and been cleared by the team physician will they be allowed to return to full participation.

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1. McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016; Br J Sports Med Published Online First: 26 April 2017

SECTION X - BLOOD & FLUID EXPOSURE

In accordance with the OSHA Bloodborne Pathogens standard the following plan has been developed for Saint Leo Sports Medicine Department in order to minimize and/or prevent exposures of our employees and student-athletes.

EXPOSURE DETERMINATION OSHA requires employers to perform an exposure determination concerning which employees may incur occupational exposure to blood or other potentially infectious materials. This exposure determination is made without regard to the use of personal protective equipment (i.e. employees are considered to be exposed even if they wear personal protective equipment). This exposure determination is required to list all job classifications in which all employees may be expected to incur such occupational exposure, regardless of frequency. At this facility the following job classifications are in this category:

• Athletic Trainers • Athletic Training Students • Work Study Students

In addition, OSHA requires a listing of job classifications in which some employees may have an occupational exposure. Since not all the employees in these categories would be expected to incur exposure to blood or other potentially infectious materials, tasks or procedures that would cause these employees to have occupational exposure are also required to be listed in order to clearly understand which employees in these categories are considered to have occupational exposure. The job classifications and associated tasks for these categories are as follows: Housekeeping

IMPLEMENTATION SCHEDULE AND METHODOLOGY OSHA also requires that this plan include a schedule and method of implementation for the various requirements of the standard. The following complies with this requirement: COMPLIANCE METHODS Universal precautions will be observed at this facility in order to prevent contact with blood or other potentially infectious materials. All blood or other potentially infectious material will be considered infectious regardless of the perceived status of the source individual. Engineering and work practice controls will be utilized to eliminate or minimize exposure to employees at this facility. Where occupational exposure remains after institution of these controls, personal protective equipment shall also be utilized. At this facility the following engineering controls will be utilized:

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Sharps containers - syringe type Biohazard waste basket container Red biohazard bags-step-lid biohazard waste can BioZide or 1:10 chlorine bleach solution - surface decontaminant Handwashing facilities are also available to the employees who incur exposure to blood or other potentially infectious materials. OSHA requires that these facilities be readily accessible after incurring exposure. At this facility hand washing facilities are located: On the north wall of the athletic training room, in all locker rooms and public restrooms. After removal of personal protective gloves, employees shall wash hands and any other potentially contaminated skin area immediately or as soon as feasible with antimicrobial soap and water. If employees incur exposure to their skin or mucous membranes then those areas shall be washed or flushed with water as appropriate as soon as feasible following contact. NEEDLES Contaminated needles and other contaminated sharps will not be bent, recapped, removed, sheared or purposely broken. OSHA allows an exception to this if the procedure would require that the contaminated needle be recapped or removed and no alternative is feasible and the action is required by the medical procedure. If such action is required then the recapping or removal of the needle must be done by the use of a mechanical device or a one handed technique. At this facility recapping or removal is only permitted for the following procedures:

• Disposable scalpels/needles/syringes are disposed of directly into OSHA approved sharps containers. Recapping and removal of needles and/or scalpel blades is not permitted.

If someone has suffered a needle stick, follow the following procedures:

• Immediately wash area thoroughly with soap and water.

• Follow-up with a health care professional

CONTAINERS FOR REUSABLE SHARPS Contaminated sharps that are reusable are to be placed immediately, or as soon as possible, after use into appropriate sharps containers. At this facility the sharps containers are puncture resistant, labeled with a biohazard label, and are leak proof. Sharps containers are located in the athletic training room adjacent to the first aid section of cabinets.

WORK AREA RESTRICTIONS In work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious materials, employees are not to eat, drink, apply cosmetics or lip balm, smoke, or handle contact lenses. Food and beverages are not to be kept in refrigerators, freezers, shelves, cabinets, or on counter tops or bench tops where blood or other potentially infectious materials are present.

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All procedures will be conducted in a manner which will minimize splashing, spraying, splattering, and generation of droplets of blood or other potentially infectious materials. Methods which will be employed at this facility to accomplish this goal are:

• Any aseptic method that will wall off any pooled infectants and allow its absorption into a gauze or similar substance for the purpose of minimizing the exposure potential prior to biohazard disposal.

CONTAMINATED EQUIPMENT Equipment which has become contaminated with blood or other potentially infectious materials shall be examined prior to servicing or shipping and shall be decontaminated as necessary unless the decontamination of the equipment is not feasible.

• All equipment in this facility is able to be decontaminated.

PERSONAL PROTECTIVE EQUIPMENT All personal protective equipment used at this facility will be provided without cost to employees. Personal protective equipment will be chosen based on the anticipated exposure to blood or other potentially infectious materials. The protective equipment will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employees' clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. Gloves shall be worn where it is reasonably anticipated that employees will have hand contact with blood, other potentially infectious materials, non-intact skin, and mucous membranes.

• Gloves will be available in the athletic training room next to the sink and by the first aid cabinets as well as in the athletic training kits.

Gloves will be used for the following procedures:

• Gloves are used in accordance with the CDC universal precautions and are worn for all specimen harvesting and all wound care. Contaminated laundry will be disposed of only with gloved hands as will any biohazard material.

Disposable gloves used at this facility are not to be washed or decontaminated for re-use and are to be replaced as soon as possible when they become contaminated or as soon as feasible if they are torn, punctured or when their ability to function as a barrier is compromised. Utility gloves may be decontaminated for re-use provided that the integrity of the glove is not compromised. Utility gloves will be discarded if they are cracked, peeled, torn, punctured, or exhibit other signs of deterioration or when their ability to function as a barrier is compromised. This facility will be cleaned and decontaminated according to the following schedule:

• Modalities, Treatment and Taping Tables- Following each athlete/patient use

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• Floors – Weekly, and as requested

Decontamination will be accomplished by using the following materials:

• Water/chlorine bleach solution in a 10:1 ratio on all treatment and equipment surfaces or antimicrobial agent (Whizzer).

o Antimicrobial agent in all whirlpools at the end of each day

o Hibiclens or Bactoshield for all hand washing

o EPA registered germicides for flooring and other areas

o Detergent in all laundry loads

All contaminated work surfaces will be decontaminated after completion of procedures and immediately or as soon as feasible after any spill of blood or other potentially infectious materials, as well as the end of the work shift if the surface may have become contaminated since the last cleaning.

• All treatment areas are completely decontaminated at the end of each day

All bins, pails, cans, and similar receptacles shall be inspected and decontaminated on a regularly scheduled basis.

• All biohazard receptacles and waste baskets are decontaminated by the clinical faculty with the medical waste disposal company personnel.

Any broken glassware which may be contaminated will not be picked up directly with the hands. The following procedures will be used:

• Any broken glass will be picked up with a broom and dust pan. Broken glass will be decontaminated immediately following the procedures prior to sharps disposal.

REGULATED WASTE DISPOSAL All contaminated sharps shall be discarded as soon as feasible in sharps containers which are located in the facility.

• Sharps containers are located on the counter adjacent to the fist aid station in the athletic training room

LAUNDRY PROCEDURES Laundry contaminated with blood or other potentially infectious materials will be handled as little as possible. Such laundry will be placed in appropriately marked bags at the location where it was used. Such laundry will not be sorted or rinsed in the area of use. All employees who handle contaminated laundry will utilize personal protective equipment to prevent contact with blood or other potentially infectious materials.

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• Laundry at this facility will be cleaned in the laundry room outside the athletic training room

HEPATITIS B VACCINE All employees who have been identified as having exposure to blood or other potentially infectious materials will be offered the Hepatitis B vaccine, at no cost to the employee. The vaccine will be offered within 10 working days of their initial assignment to work involving the potential for occupational exposure to or other potentially infectious materials unless the employee has previously had the vaccine or who wishes to submit to antibody testing which shows the employee to have sufficient immunity. Clinical student athletic trainers are offered the vaccine at cost for the three injections. Employees/clinical students who decline the Hepatitis B vaccine will sign a waiver which uses the wording in Appendix A of the OSHA standard. Employees/clinical students who initially decline the vaccine but who later wish to have it may then have the vaccine at no cost. The Director of Human Resources is responsible for offering the Hepatitis B vaccine to all at risk employees. The vaccine is administered through a licensed physician or other practitioner. The program coordinators are responsible for offering the vaccine to students. Vaccines are administered through the Student Health Service at Saint Leo University or the student’s personal or family physician.

POST-EXPOSURE EVALUATION AND FOLLOW-UP When the employee incurs an exposure incident, it should be reported to:

• The Director of Human Resources

When the clinical student athletic trainer incurs an exposure incident, it should be reported to:

• The Assistant Athletic Director of Sports Medicine and Student Health coordinator

All employees/clinical students who incur an exposure incident are required to notify their designated Director within two hours post exposure. All employees/clinical students who incur an exposure incident will be offered post-exposure evaluation and follow-up in accordance with the OSHA standard. This follow-up will include the following:

• Documentation of the route of exposure and the circumstances related to the incident within two hours post exposure.

• If possible, the identification of the source individual and, if possible, the status of the source individual. The blood of the source individual will be tested (after consent is obtained) for HIV/HBV infectivity.

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• Results of testing of the source individual will be made available to the exposed employee/clinical student with the exposed employee/clinical student informed about the applicable laws and regulations concerning disclosure of the identity and infectivity of the source individual.

The policy of Saint Leo University is consistent with Florida laws:

• The employee will be offered the option of having their blood collected for testing of the employee's student's HIV/HBV serological status. The blood sample will be preserved for up to 90 days to allow the employee/ clinical student to decide if the blood should be tested for HIV serologic status. However, if the employee/clinical student decides prior to that time that testing will or will not be conducted then the appropriate action can be taken and the blood sample discarded.

• The employee student will be offered post exposure prophylaxis in accordance with the current recommendations of the U. S. Public Health Service. These recommendations shall be offered by the employee's/clinical student's personal physician or student's physician in the University Student Health Service.

• The employee student will be given appropriate counseling concerning precautions to take during the period after the exposure incident. The employee/clinical student will also be given information on what potential illnesses to be alert for and to report any related experiences to appropriate personnel.

• The following persons have been designated to assure that the policy outlined here is effectively carried out as well as to maintain records related to this policy:

o Director of Human Resources

o Coordinator of Student Health Services

o Assistant Athletic Director of Sports Medicine

o Athletic Training Staff

BLOODBORNE PATHOGENS TRAINING Training for all employees/clinical students will be conducted prior to initial assignment to tasks where occupational exposure may occur. Documented training will be conducted in the following manner every 2 years according to licensure standards. Annual training for employees/clinical students will include the following explanation of:

• The OSHA standard for Bloodborne Pathogens

• Epidemiology and symptomatology of bloodborne diseases

• Modes of transmission of bloodborne pathogens

• The Exposure Control Plan, (i.e. points of plan, lines of responsibility, how the plan will be implemented, etc.)

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• Procedures which might cause exposure to blood or other potentially infectious materials at this facility

• Control methods which will be used at this facility to control exposure to blood or other potentially infectious materials

• Personal protective equipment available at this facility and who should be contacted concerning:

• Post-exposure evaluation and follow-up training

• Signs and labels used at this facility

• Hepatitis B vaccine program at this facility

RECORDKEEPING All records/documentation required by the OSHA standard will be maintained by:

• The Director of Human Resources Office-Employees

• Program Director/Coordinator’s Office-Clinical Students

1. Kahanov, L., Frust, D., Johnson, S., Roberts J. Adherence to Drug-Dispensation and Drug

Administration Laws and Guidelines in Collegiate Athletic Training Rooms. Journal of Athletic Training 2003;38:252-258.

2. Swartz E.E., et al. National Athletic Trainers’ Association Position Statement: Acute Management of the Cervical Spine-Injured Athlete. 2009;44(3):306-311.

3. Miller, M.G., Weiler J.M., Baker R., Collins J., D’Alonzo G. National Athletic Trainers’ Association Position Statement: Management of Asthma in Athletes.2005;40(3):224-245

4. Walsh, K.M., et al. National Athletic Trainers’ Association Position Statement: Lightning Safety for Athletics and Recreation. 2013;48(2):258-270.

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SECTION XI - INCLEMENT WEATHER PROCEDURES GENERAL POLICY In the case of inclement weather, (i.e. thunderstorms/lightning, hail, hurricane, and tornado), it will be under the direct discretion of the on-site Athletic Trainer or the Administrator on site to determine if the practice/game fields should be evacuated. Exceptions will be made for golf and cross country, in which case, the Head Coach will have to suspend activity in the absence of a Sports Medicine staff member. (Refer to NCAA and NATA Guidelines) LIGHTNING Lightning is a dangerous phenomenon. The Sports Medicine staff has developed a lightning policy to minimize the risk of injury from lightning strike to student-athletes, coaches, support staff and fans. To monitor lightning the Sports Medicine staff will utilize both the Flash-Bang method and Weather Sentry Transportation Edition. Athletic teams that practice and compete outdoors are at risk when the weather is inclement. Florida is one of the worse states for lightning deaths. For this reason the following guidelines, adopted from the NCAA and NATA must be observed if it appears that lightning is possible for the area: 1. WeatherSentry Online - Transportation Edition Weather Sentry is a website that provides up-to-date information about inclement weather. An Athletic Trainer is required to log on using the information provided by Weather Sentry. Once signed on to the website, the Athletic Trainer can determine if inclement weather is in the area. 2. If Weather Sentry is not available, use the countdown or "Flash Bang” Method. To use the Flash Bang method, count the seconds from the time lightning/flash is sighted to when the clap/bang of thunder is heard. Divide this number by 5 and equals how far away (in miles) the lightning is occurring. For example, 20 second count = 4 miles). As a minimum, the NCAA and the National Severe Storms Laboratory (NSSL), strongly recommend that all individuals have left the athletic sites and reach a safe location by the flash-to-bang count of 30 seconds (6 miles). However, lightning can strike as far as 10 miles and it does not have to rain for lightning to strike. Activities will be terminated at the 30 seconds or 6 miles. 3. If lightning is in the immediate area, the Athletic Trainer will notify the on-site administrator and Head Coach as to the status of the inclement weather and of need to take shelter. Teams may return to field 30 minutes from last sight of lightning or text message release from Weather Sentry Transportation Edition. 4. If no safe structure is within a reasonable distance then other ideas for shelter include: Safe Shelter areas: enclosed buildings, fully enclosed metal vehicles with windows up (no convertibles or golf carts) low ground areas or dry ditch (as a last resort).

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Unsafe shelter areas: water, open fields, dugouts, batting cages, golf carts, metal objects (bleachers, fences, etc.), individual tall trees, light poles. AVOID BEING THE HIGHEST OBJECT IN AN OPEN FIELD. ***Athletes/coaches etc. should not stand in groups or near a single tree. There should be 15 ft between athletes (NLSI, 2000). Note: sports with metal equipment. Golfers drop your clubs and remove shoes, baseball/softball drop bats and remove shoes/helmets, tennis drop rackets, lacrosse drop sticks, remove helmets, and shoes if metal. If unable to reach safe shelter, assume a crouched position on the ground with only the balls of the feet touching the ground, wrap your arms around your knees and lower your head. Minimize contact with the ground, because lightning current often enters the victim through the ground rather than by a direct overhead strike. Do not lie flat! If safe shelter is only a short distance away, its been suggested to run for shelter, rather than stay in middle of field. 5. If a person feels that his/her hair standing on end, they should immediately crouch as described in item # 4. If someone is struck by lightning, activate the Emergency Action Plan. A person struck by lightning does not carry an electrical charge; immediately initiate the EAP and begin the primary survey. If possible move victim to a safe location. 6. Avoid using the telephone except in emergency situations. People have been struck by lightning while using a land-line phone. A cellular phone or a portable phone is a safe alternative to land-line phones, if the person and the antenna are located within a safe structure, and if all other precautions are followed.

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EVENT PROCEDURES

Prior to competition: A member of the Sports Medicine staff will greet the officials, explain that we have the means to monitor lightning, and offer to notify the officials during the game if there is imminent danger from the lightning. Announcement of suspension of activity: Once it is determined that there is danger of a lightning strike, the Administrator on-site, in consultation with the Sports Medicine staff member, will notify the Head Coach and official and subsequently summon athletes (via horn or whistle) from the playing field or court. Evacuation of the playing field: Immediately following the announcement of suspension of activity all athletes, coaches, officials and support personnel are to evacuate to an enclosed grounded structure (Student Activities Building/Gymnasium/Locker rooms). Evacuation of the stands: During competition once the official signals to suspend activity, a member of the Sports Information staff will announce via the PA system something like: “May I have your attention. We have been notified of approaching inclement weather. Activity will cease until we have determined it is safe and the risk of lightning is diminished. We advise you to seek appropriate shelter at the following areas: Student Activities Building /Gymnasium. Though protection from lightning is not guaranteed, you may seek shelter in an automobile. Thank you for your cooperation”. Resumption of Activity: Activity may resume once a member of the Sports Medicine staff gives permission. Thirty (30) minutes AFTER the last lightning strike or activity using the Flash-Bang-Method or a text message release from Weather Sentry Transportation Edition. Away events: Apply the home/facility EAP or modify the SLU guidelines that apply accordingly. Lightning Detection Procedures for Non-Supervised Activities: (Example: Athletes using facilities in the off season or outside of regular practice hours) No method of lightning detection can detect every strike nor is prevention from lighting a guaranteed. However, we encourage you to follow the Flash-Bang-Method to monitor the approximation of lightning. Hurricane/ Tornados: Follow University/School Plan

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SECTION XII – EMERGENCY ACTION PLAN These emergency procedures are applicable at the following locations at Saint Leo University: Baseball Field, Softball Field, Soccer Fields, Turf Stadium, Tennis Courts, and Marion Bowman Activities Center. Golf and Cross Country have venue specific instructions.

EMERGENCY PERSONNEL Campus Security Marion Bowman Athletic Training Room Asst Athletic Director for Sports Medicine - Barb Wilson

352-588-8333 352-588-7559 (c) 352-467-0292

Director of Sports Medicine - Susan Cross (c) 757-503-7766 Athletic Trainer - Tom Spock (c) 813-468-1355 Athletic Trainer - Steven Jurnak (c) 802-399-6948 Athletic Trainer – Kayla Cross (c) 863-558-4832

EMERGENCY EQUIPMENT Supplies (Cervical Collar, Crutches, Splint Bag, Kits, Rectal Thermometer, Pulse Ox, and OSHA Materials) located in athletic training room. An AED (Automated External Defibrillation) unit is available through security, in the breezeway of the Marion Bowman Activities Center, the athletic training room, the batting cages and the Fitness Center.

ROLE OF FIRST RESPONDERS 1. Immediate care of the seriously injured or ill student athlete.

A. Check ABC's, Severe Bleeding, and Level of Consciousness. B. Notify the AT on duty immediately C. Begin CPR if needed or necessary first-aid care

2. Activation of Emergency Medical System (EMS) A. Call 911 B. Name of individual making call C. Number of Injured Athlete(s) & Condition of Injured Athlete(s) D. Treatment being given E. Specific location of emergency. Give athletic field or building. (See venue directions,

include street names and how to access sites) F. Other information as requested

3. Direction of EMS to Scene (See attached venue directions) A. Open appropriate gates B. Designate individual to "flag down" EMS and direct to scene. C. Scene Control: Limit scene to first aid providers and move bystanders away from

area. 4. Emergency Equipment Retrieval, Documentation and Debriefing, Post-follow up

arrangements as necessary.

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VENUE DIRECTIONS Soccer Game Field: Enter through main entrance off SR 52. Take a right around circle on East Way and follow onto Lions Street. Emergency gate will be on the right before the cul-de-sac. University Turf Stadium: Enter through main entrance off SR 52. Take a right around circle on East Way and follow onto Lions Street. Stadium will be to the right, and emergency gate will be on the right hand side before entrance to the parking garage. Baseball Field: Enter through main entrance off SR 52. Take a right around circle on East Way and follow onto Lions Street.; take first left after parking lot. Turn right onto Lions Court, and emergency gate will be on the right hand side after 3rd base dugout. University Softball Stadium: Enter through main entrance off SR 52. Take a right around circle on East Way and follow onto Lions Street.; take first left after parking lot. Turn right onto Lions Court, and emergency gate will be on the left hand side after batting cages. Practice Field & Tennis Courts: Enter through main entrance off SR 52. Take a right around circle on East Way following around to Lions Street, and turning right onto Lions Court. Continue to go past baseball/softball fields. Courts and field will be straight ahead past the parking lot. Marion Bowman Activities Center/Fitness Center/Pool: Enter through main entrance on SR 52. Take a right around circle on Easy Way, and follow past parking lot. Pool and Fitness Center access will be through the parking lot directly in from of MBAC. Gymnasium access will be through the access road between the parking garage and MBAC. Golf & Cross Country/Track & Field

DUE TO THE VARYING NUMBER OF PRACTICE LOCATIONS THE HEAD COACH WILL NOTIFY SAINT LEO UNIVERSITY SPORTS MEDICINE STAFF OF ANY SITUATION THAT HAS ARISEN AND EMS AS DIRECTED

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AFTER HOURS RESPONSE PLAN

In the event of an emergency after office hours, the following plan should be initiated:

1 Call 911 and/or go to the nearest hospital. 2 Bayfront Health Fort King Road, Dade City. 352-521-1100 3 Notify Sports Medicine Staff of Emergency:

Asst Athletic Director for Sports Medicine- Barb Wilson (c) 352-467-0292 Director of Sports Medicine - Susan Cross (c) 757-503-7766 Athletic Trainer - Tom Spock (c) 813-468-1355 Athletic Trainer - Steven Jurnak (c) 802-399-6948 Athletic Trainer – Kayla Cross (c) 863-558-4832

4 Contact your head coach/staff and a family member (if necessary)

IN CASE OF LOCKED GATES TO FIELDS: CONTACT CAMPUS SAFETY AT 325-588-8333.

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CATASTROPHIC INJURY – CRISIS MANAGEMENT PLAN 1. Contact Athletic Training and Sports Medicine Personnel: Assistant Athletic Director for Sports Medicine - Barb Wilson

(c) 352-476-0292

Director of Sports Medicine - Susan Cross (c) 757-5037766 Athletic Trainer - Tom Spock (c) 813-468-1355 Athletic Trainer - Steven Jurnak (c) 802-399-6948 Athletic Trainer – Kayla Cross (c) 863-558-4832

2. Contact Saint Leo University Athletics Administration

- Fran Reidy, Director of Athletics (o) 352-588-8221 (c) 352-467-0043 3. Contact family by appropriate individual (use assistance as needed): 4. Understand media plan:

• NO CONTACT WITH MEDIA from the Sports Medicine staff, Hospital Staff or Medical Personnel or Coaching Staff except through Athletics Communication

• NO OUTSIDE DISCUSSION OF MEETING WITH MEDIA

5. Establish hospital contact person 6. Meeting with athletes to discuss situation 7. Complete documentation of events include everyone involved with signatures 8. Collect and secure all equipment and materials involved 9. Construct a detailed time line of events related to the incident 10. Involve appropriate counseling and ministerial personnel 11. Assign athletic staff member to be with family at all times upon arrival; assist family as needed; protect from outside persons 12. Critical incident stress debriefing/ counseling as necessary for individuals involved in incident

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STUDENT-ATHLETE STATEMENT I have been given counseling about what a concussion is, common signs and symptoms and the seriousness of this injury. I understand that it is my responsibility to report to a member of the Saint Leo University Sports Medicine Team, if myself, or a teammate is experiencing any signs or symptoms associated with a concussion. I certify that I understand: A concussion is a brain injury, which I am responsible for reporting to a

member of the Saint Leo University Sports Medicine Team. Initial

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

reaction time, balance, sleep, and classroom performance. Initial

I understand that you cannot see a concussion, but might notice some of the

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

Initial

If I suspect a teammate has a concussion, I am responsible for reporting the injury to my team physician or athletic trainer.

Initial

I will not return to play in a game or practice if I have received a blow to the head or body that results in concussion –related symptoms

Initial

Following a concussion the brain needs time to heal. I understand that I am much more likely to have a repeat concussion if I return to play before my symptoms resolve.

Initial In rare cases, repeat concussions can cause permanent brain damage, and

even death. Initial

Student Signature: Date: Printed Name: ___________________________________ Date: _______________________________

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COACHES STATEMENT ☐ I have read and understand the Saint Leo University Concussion Management Protocol. ☐ I have read and understand the NCAA Concussion Fact Sheet. After reading the NCAA Concussion fact sheet and reviewing the Saint Leo University Concussion Management Protocol, I am aware of the following information:

A concussion is a brain injury which athletes should report to the medical staff Initial

A concussion can affect the athlete’s ability to perform everyday activities, and affect reaction time, balance, sleep, and classroom performance. You cannot see a concussion, but you might notice some of the symptoms right away. Other symptoms can show up hours or days after the injury.

Initial I will not knowingly allow the athlete to return to play in a game or practice if he/she has received a blow to the head or body that results in concussion related symptoms.

Initial Athletes shall not return to play in a game or practice on the same day that they are suspected of having a concussion.

Initial If I suspect one of my athletes has a concussion, it is my responsibility to have that athlete see the medical staff.

Initial I will encourage my athletes to report any suspected injuries and illnesses to the medical staff, including signs and symptoms of concussions.

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

Initial I am aware that every first-year student-athlete participating on specified Saint Leo University teams must be baseline tested prior to participation in sport. These tests allow for comparison of symptoms, neurocognition, and balance if the athlete were to become injured.

Initial I am aware that athletes diagnosed with a concussion will be assessed at the Sports Medicine Center once symptoms have resolved. Athletes will begin a graduated return to play protocol following full recovery of neurocognition and balance.

Initial __________________________________ _____________ Signature of Coach Date __________________________________ ______________ Printed name of Coach Date

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CONCUSSION What is a concussion? A concussion is a brain injury that: Is caused by a blow to the head or body.

• From contact with another player, hitting a hard surface such as the ground, ice or floor, or being hit by a piece of equipment such as a bat, lacrosse stick or field hockey ball.

• Can change the way your brain normally works. • Can range from mild to severe. • Presents itself differently for each athlete. • Can occur during practice or competition in ANY sport. • Can happen even if you do not lose consciousness.

How can I prevent a concussion? Basic steps you can take to protect yourself from concussion:

• Do not initiate contact with your head or helmet. You can still get a concussion if you are wearing a helmet.

• Avoid striking an opponent in the head. Undercutting, flying elbows, stepping on a head, checking an unprotected opponent, and sticks to the head all cause concussions.

• Follow your athletics department’s rules for safety and the rules of the sport. • Practice good sportsmanship at all times. • Practice and perfect the skills of the sport. • It’s better to miss one game than the whole season. • When in doubt, get checked out.

For more information and resources, visit www.NCAA.org/health-safety and www.CDC.gov/Concussion. What are the symptoms of a concussion? You can’t see a concussion, but you might notice some of the symptoms right away. Other symptoms can show up hours or days after the injury.

• Concussion symptoms include: • Amnesia. • Confusion. • Headache. • Loss of consciousness. • Balance problems or dizziness. • Double or fuzzy vision. • Sensitivity to light or noise. • Nausea (feeling that you might vomit). • Feeling sluggish, foggy or groggy. • Feeling unusually irritable. • Concentration or memory problems (forgetting game plays, facts, meeting times). • Slowed reaction time.

Exercise or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games may cause concussion symptoms (such as headache or tiredness) to reappear or get worse.

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What should I do if I think I have a concussion? Don’t hide it. Tell your athletic trainer and coach. Never ignore a blow to the head. Also, tell your athletic trainer and coach if one of your teammates might have a concussion. Sports have injury timeouts and player substitutions so that you can get checked out. Report it. Do not return to participation in a game, practice or other activity with symptoms. The sooner you get checked out, the sooner you may be able to return to play. Get checked out. Your team physician, athletic trainer, or health care professional can tell you if you have had a concussion and when you are cleared to return to play. A concussion can affect your ability to perform everyday activities, your reaction time, balance, sleep and classroom performance. Take time to recover. If you have had a concussion, your brain needs time to heal. While your brain is still healing, you are much more likely to have a repeat concussion. In rare cases, repeat concussions can cause permanent brain damage, and even death. Severe brain injury can change your whole life. Reference to any commercial entity or product or service on this page should not be construed as an endorsement by the Government of the company or its products or services.

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Sickle Cell Trait Waiver

ABOUT SICKLE CELL TRAIT • Sickle cell trait is an inherited condition of the oxygen-carrying protein, hemoglobin, in

the red blood cells. • Sickle cell trait is a common condition (>three million Americans) • Although Sickle cell trait is most predominant in African-Americans and those of

Mediterranean, Middle Eastern, Indian, Caribbean, and South and Central American ancestry, persons of all races and ancestry may test positive for sickle cell trait.

• Sickle cell trait is usually benign, but during intense, sustained exercise, hypoxia (lack of oxygen) in the muscles may cause sickling of red blood cells (red blood cells changing from a normal disc shape to a crescent or “sickle” shape), which can accumulate in the bloodstream and “logjam” blood vessels, leading to collapse from the rapid breakdown of muscles starved of blood.

SICKLE CELL TRAIT TESTING • The NCAA mandates that all NCAA student-athletes have knowledge of their sickle cell

trait status before the student-athlete participates in any intercollegiate athletics event, including strength and conditioning sessions, practices, competitions, etc.

• The Saint Leo University Department of Intercollegiate Athletics offers sickle cell trait screening in the form of a blood test to all student-athletes as part of the pre-participation physical examination process.

• Testing will be conducted prior to the beginning of your season and the results will be reported to a Saint Leo University Team Physician.

SICKLE CELL TRAIT TESTING WAIVER I, _________________________________________, understand and acknowledge that the NCAA Student-Athlete Name and the Saint Leo University Department of Intercollegiate Athletics mandate that all student-athletes have knowledge of their sickle cell trait status. Additionally, I have read and fully understand the aforementioned facts about sickle cell trait and sickle cell trait testing. Recognizing that my true physical condition is dependent upon an accurate medical history and a full disclosure of any symptoms, complaints, prior injuries, ailments, and/or disabilities experienced, I hereby affirm that I have fully disclosed in writing any prior medical history and/or knowledge of sickle cell trait status to the Saint Leo University department of Intercollegiate Athletics. I do not wish to undergo sickle cell trait testing as part of my pre-participation physical examination and I voluntarily agree to release, discharge, indemnify and hold harmless the State of Florida, the University, its officers, employees and agents from any and all costs, liabilities, expenses, claims, demands, or causes of action on account of any loss or personal injury that might result from my non-compliance with the mandate of the NCAA and the Saint Leo University Department of Intercollegiate Athletics. ____________________________________________ ____________________________________ Student-Athlete Signature Date ____________________________________________ ____________________________________ Sport SS# ____________________________________________ ____________________________________

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Asthma Follow Up Evaluation Sheet Name ______________________ SS#___________________ Sport__________________

ASTHMA EVALUATION

When you were first diagnosed with asthma?_____________________________________ Name of Physician making the diagnosis:_________________________________________ Physician Contact Information: ________________________________________________ Did you have any Pulmonary Function Tests Done? ____________________________________ Do you know your Peak Flow Reading? __________________________________________ Give names of any medication using at the present time to control your asthma: ______________________________________________________________________________ ______________________________________________________________________________ Describe when, how, and how frequently you use each of these medications: _____________________________________________________________________________ ______________________________________________________________________________ Describe any problems you have had with you asthma in the last year – i.e. emergency room visits, hospitalization, night time symptoms: ______________________________________________________________________________ ______________________________________________________________________________ Peak Flow Reading: ___________________________

Evaluating Athletic Trainer ___________________

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SPORTS MEDICINE POLICIES AND PROCEDURES ......2019/10/24 · 1 2019-2020 SPORTS MEDICINE POLICIES AND PROCEDURES HANDBOOK Department of Intercollegiate Athletics Saint Leo University

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