Department of Intercollegiate Athletics

Department of Intercollegiate Athletics

Athletic Training and Medical Policies and Procedures

The purpose of this information sheet is to explain Niagara University’s Department of Athletics Policies and Procedures regarding medical coverage for injuries/illnesses directly related to participation in one of our intercollegiate athletic teams. Included are policies on physical examinations, athletic training staff, athletic training room schedule, coverage of games/ practices/ travel, injury procedures, injury reports, treatments, referrals to medical specialists, concussion injuries, and health insurance. The athletic training staff will provide the best sports medicine care to the Niagara University student student-athletes with the resources that are available.

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  A complete list of all eligible student student-athletes that will participate in a sport must be presented to the Head Athletic Trainer by mid July.
  
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  An updated roster must be submitted by August 1^st of that academic year.
  

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  Student-athletes must have an Athletic Physical Examination on file in the athletic training room to compete or practice in intercollegiate athletics.
  
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  All freshman, transfer, and first year student-athletes receive a full Athletic Physical Examination done by one of the Team Physicians. At the discretion of the Athletic Training Staff/Team Physicians, the student-athlete may receive an additional Orthopedic screening done by the Team Orthopedic. Returning student student-athletes may also receive these services at the discretion of the Athletic Training Staff/Team Physicians. This will relate to prior history of injuries.
  
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  The Athletic Training Staff and the Team Physicians will arrange a schedule for all Athletic Physical Examinations and screenings.
  
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  All freshman, transfer, and first-year student- student-athletes must receive a physical before they are allowed to participate (practice/games) in their intercollegiate sport.
  
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  Blood Pressure checks are performed yearly for all student-athletes.
  
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  All student-athletes are required to fill out a medical history/ questionnaire, insurance form, and injury verification form yearly which can be accessed via an e-mail sent to all student-athletes to log onto the Sportsware database.
  
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  Each student-athlete must have a completed parent insurance information form and a copy of the insurance card on file.
  

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  The physical examination and clearance is to be completed by the Team Physician and reviewed by the Athletic Training Staff and filed in the student-athlete’s file.
  

** Student-athletes must report all injuries including the head, neck, back, upper and lower extremities, internal injuries, fractures, dislocations, severe sprains, or any infectious diseases to the University Team Physician.

Volleyball M&W XC W. Soccer M. Soccer M&W Swim

M. Basketball M. Hockey W. Basketball W. Hockey -AT room coverage

Baseball W. Lacrosse Softball M&W Tennis -Weekends

Cheerleading Golf -Conflict coverage

ATHLETIC TRAINING STAFF OFFICE & CELL PHONE NUMBERS

John Munro 286-8615 (cell) 628-9404

Scott Mastrobattista 286-8642 (cell) 997-6355

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  Athletic Training Room operation hours are 10am-12pm and 1pm-6pm, M-F, or until the practices of the specific season are done for the day.
  
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  Saturdays and Sundays the athletic training room will be open for games and practices only.
  
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  Treatment/Evaluation times are arranged at the discretion of each individual athletic trainer.
  
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  Traditional in-season sports take precedence over all non-traditional out of season sports.
  
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  Practices held off university grounds will not be covered unless prior notice is provided to the athletic training staff, and coverage of these events is at the discretion of the Head Athletic Trainer and Director of Athletics.
  
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  Practices held late at night or early in the morning will be covered only at the discretion of the Athletic Training Staff and Director of Athletics.
  

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  An athletic trainer will be on site or on campus for all home contests in all sports.
  
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  An ambulance is available at all men’s and women’s basketball and men’s and women’s hockey home games.
  
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  A Team Physician will be present for all men’s and women’s basketball and men’s and women’s hockey home contests.
  
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  The Team Orthopedic will be on call for all athletic contests.
  
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  Athletic training courtesies will be extended to all visiting opponents.
  
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  All home contests have priority over home practices.
  

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  When available, an athletic trainer will be on site for high risk sport practices. If an ATC is not present at practice, communication will be provided via telephone or walkie talkie to the training room.
  
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  High risk sports, as defined by the Athletic Training Staff/Director of Athletics are: men’s and women’s soccer, men’s and women’s basketball and men’s and women’s ice hockey. The NCAA injury surveillance system is used as a reference.
  

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  At the discretion of the Athletic Training Staff and Director of Athletics, there will be no athletic trainer coverage available for practices during non-operational hours. In these cases the coach must have their first aid kit available at the practice.
  
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  If necessary for emergencies, athletic trainers are available at home numbers.
  
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  In the event of an injury, refer to the flow charts at the end of the manual or the Catastrophic/Emergency plan.
  

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  An athletic trainer will travel with all high risk sports when possible: men’s and women’s soccer, men’s and women’s basketball and men’s and women’s ice hockey.
  
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  The coach must allocate appropriate travel funds for the athletic trainer, the same as any team member or coach.
  
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  When an athletic trainer is not traveling, the coach must pick up a stocked first aid kit from the athletic training room before departing for the trip.
  
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  When a Niagara University athletic trainer is not traveling, he or she will call ahead to the host school’s athletic trainer.
  
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  An athletic trainer will travel with any team making post-season play when possible.
  
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  An athletic trainer, when available, will travel on all local/ day trips during traditional season.
  
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  Home contests take precedence over away contests.
  

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  All Niagara University coaches will be certified in Adult CPR/AED/First Aid and will receive training on blood borne pathogens and the use of protective equipment.
  
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  All Niagara University coaches should call for medical assistance (Athletic Trainer, Public Safety, Ambulance) if they have any doubt about the correct treatment for an injured athlete.
  
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  The student-athlete and/or the coaches must report all injuries to the Athletic Training Staff within 48 hours, with exception to teams on the road. These student-athletes must report the injury within 48 hours of returning to campus.
  
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  Attached are flow charts showing the procedures to abide by following any injury:
  
  1. 
     Injury with ATC coverage at home
     
  2. 
     Injury without ATC coverage at home
     
  3. 
     Injury with ATC coverage on the road
     
  4. 
     Injury without ATC coverage on the road
     
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       Student-athletes appearing to be seriously injured are not to be moved until the extent of the injury is carefully evaluated by ATC, Team Physician or EMT.
       
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       If a student-athlete is unconscious or has suffered a significant back, neck, head or eye injury, always consider this a serious injury and classify it as severe, immediately initiate the Niagara University Emergency Action Plan.
       
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       Student-athletes with minor injuries (sprains, strains, cuts, abrasions, scratches, bruises, blisters) should report to the athletic training room immediately after a practice or game.
       
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       No student-athlete will be excused from practice for a cold, diarrhea, upset stomach or minor injuries without the consent of the Athletic Training staff or the Team Physician.
       
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       Coaches will be kept informed of the status of all injured or ill student-athletes by the Athletic Training staff.
       
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       The student-athlete should not seek medical attention without prior communication with the Athletic Training Staff except in the case of an emergency.
       
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       If a student-athlete sustains a serious injury, is hospitalized or requires surgery, the student-athlete’s parents will be notified by the Athletic Trainer, Doctor, Coach, or Director of Athletics.
       
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       The Team Physician or athletic trainer is the sole judge as to when an injured student-athlete is able to return to practice for conditioning or full duty. Coaches cannot override the decision of these individuals. A student-athlete will be returned to competition as soon as it is deemed safe to do so. If surgery was performed, the attending surgeon is responsible for signing a written release for participation to athletics.
       

** Failure to comply by either the student-athlete and/or the coach with these decisions shall relieve the Athletic Training Staff and Team Physician of any responsibility for the injured or ill student-athlete.

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  All evaluations and treatments done by a Niagara University Athletic Trainer are documented on the SportsWare computer program.
  
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  Coaches can request to see their student-athlete’s injury notes and treatment reports. With prior notice a coach can arrange to have weekly reports about his/her student-athletes.
  

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  The athletic training room is open from 10 a.m. to 12 p.m. and 1 p.m. to 6 p.m. Monday-Friday during normal class time. Hours may vary depending on practice times. Saturday and Sunday the training room is only open for practices and games. An athletic trainer will be available one hour before activity and 30 minutes after or as needed.
  
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  When at all possible a student-athlete should see the ATC assigned to his or her particular sport.
  
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  New injury evaluations and treatments must be arranged with each sports assigned athletic trainer.
  
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  Student-athletes arriving late for treatments, evaluations or rehabilitation may not be treated at the discretion of the athletic trainer.
  
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  Coaches are requested to reinforce the need for student-athletes to attend arranged treatment sessions. The health care of the student-athlete is mutually shared by the student-athlete, coach, and athletic training room staff.
  
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  The student-athlete, at times, will be requested to administer self-care at home which must also be reinforced by the coach.
  

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  Currently Niagara University has a Team Orthopedic Physician that conducts clinics at Niagara University when deemed necessary. Appointments are only made through the Athletic Training Staff. There are NO walk-ins.
  
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  If there is a need to see the Team Orthopedic Doctor right away, the athletic training staff will make an appointment for the student-athlete to see the Doctor at his office.
  
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  The Athletic Training Staff or the Team Physician will refer the student-athlete to any other specialist when deemed necessary.
  
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  If hospitalization, x-rays etc. are needed, the student-athlete must be referred by the Athletic Training Staff or Team Physician except in an emergency.
  
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  For any non-athletic related illness (asthma, ear infection, bronchitis, hernia, antibiotic distribution, etc.) student-athletes are referred to one of Niagara University’s Team Physicians (Family Medicine or Internal Medicine).
  
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  If the student-athlete goes home to see another Physician for some reason, the student-athlete is not cleared to participate until the examining Physician signs a clearance.
  

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  These injuries should be reported to the athletic training staff immediately.
  
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  The Athletic Training Staff/Team Physicians utilize the following guidelines from the, American Academy of Neurology and the National Athletic Trainers’ Association Position Statement: Management of Sport Related Concussion when evaluating concussions.
  
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  Return to competition is at the discretion of the evaluating ATC/Team Physician.
  

1. 
   Transient confusion (inattention, inability to maintain a coherent stream of thought and carry out goal-directed movements)
   
2. 
   No loss of consciousness
   
3. 
   Concussion symptoms or mental status abnormalities on examination resolve in less than 20 minutes
   

Grade 1 concussion is the most common yet the most difficult to recognize. The student-athlete is not rendered unconscious and suffers only momentary confusion (e.g., inattention, poor concentration, inability to process information or sequence tasks) or mental status alterations.

1. 
   Transient confusion
   
2. 
   No loss of consciousness
   
3. 
   Concussion symptoms or mental status abnormalities (including amnesia) on examination last more than 20 minutes
   

Grade 2 concussion, the student-athlete is not rendered unconscious but experiences symptoms or exhibits signs of concussion or mental status abnormalities on examination that last longer than 20 minutes (e.g., poor concentration or post-traumatic amnesia).

1. 
   Any loss of consciousness, either brief (seconds) or prolonged (minutes).
   

Grade 3 concussion is usually easy to recognize if the student-athlete is unconscious for any period of time.

1. 
   Student-athletes participating in contact/collision sports will be pre-tested prior to the start of their season. This baseline testing will include the Standardized Assessment of Concussion (SAC) and Balance Error Scoring System (BESS) evaluations. Follow-up SAC and BESS scores will be used during the recovery process to provide the most reliable measure of pre-injury performance.
   

2. 
   At the time of injury, ATCs will also use a Graded Symptom Checklist (GSC) to determine the extent of the student-athlete’s symptoms. The GSC will also be used during the recovery process.
   

3. 
   Student-athletes participating in non-contact sports will not be pre-tested. At the time of injury, ATCs and/or Team Physicians will still utilize the SAC, BESS, and GSC after injury to monitor progress and help determine return to play decisions.
   

1. Remove from contest.

2. 
   Examine immediately and at five-minute intervals for the development of mental status abnormalities or post-concussive symptoms at rest and with exertion.
   
3. 
   May return to contest if mental status abnormalities or post-concussive symptoms clear within 20 minutes.
   
4. 
   A second Grade 1 concussion in the same contest eliminates the player from competition that day. Once symptom free, the student-athlete will be reassessed using the SAC, BESS and GSC evaluations, as well as cardiovascular activities. The student-athlete can be released to full participation as long as no recurrent signs and symptoms are present.
   

1. 
   Remove from contest and disallow return that day.
   
2. 
   Examine on-site frequently for signs of evolving intracranial pathology.
   
3. 
   A trained person should reexamine the student-athlete the following day.
   
4. 
   A physician should perform a neurological examination to clear the student-athlete for return to play if symptoms persist for longer than one full week at either rest or with exertion.
   
5. 
   CT or MRI scanning is also recommended in all instances where headache or other associated symptoms worsen or persist longer than one week.
   
6. 
   Following a second Grade 2 concussion, return to play should be deferred until the student-athlete is symptom free at rest and with exertion and reassessed using the SAC, BESS, and GSC evaluations. This process could take two weeks or longer.
   
7. 
   Terminating the season for that player is mandated by any abnormality on CT or MRI scan consistent with brain swelling, contusion, or other intracranial pathology.
   

1. 
   Transport the student-athlete from the field to the nearest emergency department by ambulance if still unconscious or if worrisome signs are detected (with cervical spine immobilization, if indicated).
   
2. 
   A thorough neurological evaluation should be performed emergently, including appropriate neuro-imaging procedures when indicated.
   
3. 
   Hospital admission is indicated if any signs of pathology are detected, or if the mental status of the athlete remains abnormal.
   
4. 
   ** Following a second Grade 3 concussion, the student-athlete should be withheld from play until an evaluation by a Neurologist. The return to play decision will then be determined upon clinical evaluation by the neurologist and team physician.
   

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  Once the student-athlete’s concussion symptoms are gone, the grade of the concussion can be determined. At that point, the Team Physician or Athletic Trainer will decide if the student-athlete can return to play. Grade I concussions, the student-athlete may return to physical activity if asymptotic, under the discretion of the Sports Medicine Staff. If symptoms persist or worsen the student-athlete will be sent to see the Team Doctor.
  

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  The student-athlete will be given a head injury sheet, in all cases, by the athletic trainer, which should be followed by the student-athlete. Also the athletic trainer must inform parent/roommate or whomever the student-athlete is staying with of this sheet.
  
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  If the student-athlete suffers a grade 2 or a second concussion of any degree in one season, the student-athlete will be sent to the Team Doctor.
  
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  If the student-athlete suffers any loss of consciousness, he/she will be referred to the Team Doctor.
  
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  Once the student-athlete is sent to the Team Doctor, the student-athlete must be cleared by that evaluating Physician for physical activity.
  
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  In cases of severe concussions the student-athlete will be sent to the emergency room immediately.
  

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  Any student-athlete suspected of having a spinal injury should not be moved and should be managed as though a spinal injury exists. C-spine in-line stabilization should be maintained.
  
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  The student-athlete’s airway, breathing, circulation, level of consciousness (AVPU/Glasgow Coma Scale) and neurological status should be assessed. If airway is impaired, maintain c-spine in-line stabilization simultaneously with airway using a jaw thrust maneuver. If the student-athlete’s breathing is inadequate, assist ventilations with bag-valve-mask and supplemental oxygen when available.
  
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  EMS should be activated.
  
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  In a situation where it may not be appropriate for on-site medical personnel to transfer the student-athlete to a long board prior to EMS arrival (lack of enough qualified help or other factors), the rescuer(s) should maintain in-line stabilization, place a rigid cervical collar on (if possible), and continue to monitor baseline vital signs and complete secondary evaluation while awaiting EMS.
  

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  The Department of Athletics is NOT responsible for injuries when the student-athlete is not engaged in a formal intercollegiate athletic activity.
  
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  The student-athlete is responsible for all medical expenses incurred when an injury or illness in not directly related to intercollegiate athletic participation at Niagara University.
  

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  The University encourages that all full-time students be insured. It is the responsibility of the student-athlete and his or her parent(s)/guardian(s) to provide insurance coverage.
  
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  If the student-athlete is not insured by self, parent or legal guardian, he or she may purchase a School Health Insurance Policy; inquire at the Athletic Training room or Health Services.
  
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  The Department of Athletics provides secondary coverage for injuries that are a direct result of participation in intercollegiate athletics. This policy only takes effect after all claims have been acted upon by the primary insurance and the appropriate information has been given to the Athletic Training Staff and Christina Templin at Business Services.
  
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  When an student-athlete is injured while participating in intercollegiate athletics the following procedures are followed:
  

1. 
   Injury is reported to the Athletic Training Staff immediately, within 48 hours, with the exception of being on the road without an athletic trainer. An injury report is filled out as soon as possible by Niagara University athletic training staff.
   
2. 
   The student-athlete is to meet with the athletic training staff member that is assigned that sport and fill out and sign an insurance claim form. The student-athlete will be given an instruction sheet to follow to be sure the bills will be paid. They will meet then with Christina Templin from Business Services.
   
3. 
   Original Medical bills are to be submitted to the student-athlete’s primary insurance.
   
4. 
   The insurance company will send an explanation of benefits indicating what has and had not been paid to the student-athlete or the student-athlete’s parents.
   
5. 
   A copy of the explanation of benefits and bills not paid for by the primary insurance must be taken over to Christina Templin in Business Services.
   
6. 
   The student-athlete and/or parents/guardian must continue work with Christina Templin of Business Services regarding status of payment of medical bills.
   
7. 
   It is the student-athlete’s responsibility to follow-up on insurance concerns.
   

The Department of Athletics liability for medical expenses resulting from injuries and/or illnesses sustained by student-athletes is defined in the following manner.

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  Only those injuries reported to the Athletic Training Staff and/or the Team Physicians within 48 hours from the injury/incident, and only if, it is a direct result of intercollegiate athletics participation.
  
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  Those injuries or illnesses that accrue during the student-athlete’s season which in the opinion of the Team Physician(s) and the Director of Athletics are directly attributable to participation in intercollegiate athletics while a full-time student at Niagara University.
  
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  Medical Expenses from injuries and only when the student-athlete is enrolled in school at Niagara University
  
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  Those expenses resulting from medical services, which have been authorized by the Team Physician through a referral to a Medical Specialist.
  

ATHLETIC INJURY FLOW CHART ON THE ROAD WITHOUT ATHLETIC TRAINER COVERAGE ON SITE Coach Seeks Assistance From Host Athletic Trainer
Host ATC Present		Unable to locate Host Athletic Trainer
Host ATC Evaluates		Non-Emergency		Emergency
Host ATC Makes Recommendation for Tx. Of injury		Head Coach utilizes first aid skills or Contacts NU ATC for Assistance with situation if needed		Coach calls Ambulance
Upon arrival Home, ATC makes Necessary Arrangements		NU ATC will attempt to make Arrangements for the Athlete to be seen		Hospital
				Head Coach Contacts NU ATC and explains the situation
UPON RETURN TO NU CAMPUS ATHLETE IS EVALUATED BY AN NU ATHLETIC TRAINER WITHIN 48 HOURS

Balance Error Scoring System (BESS)