Table of contents section #

John Munro (O) x8615

It is extremely important that all athletic staff be properly prepared when athletic emergencies arise. A student-athlete’s survival may hinge on how well trained and prepared athletic personnel are. It is prudent that the entire athletic department (athletic administrators, coaches and sports medicine staff) review the emergency plan once a year and participate in CPR and first aid refresher training. Through development and implementation of the emergency plan, the athletic department helps to ensure that the student-athlete will have the best care provided when an emergency situation does arise.

Exertional Heat Illnesses (EHI’s) are a classification of illnesses resulting from the body’s inability to tolerate activity in warm weather conditions. EHI’s have the potential to be life- threatening and should be treated as a medical emergency. EHI’s are caused by several factors:

1. 
   Intrinsic Factors:
   
   • 
     Inadequate heat acclimatization
     
   • 
     Lower levels of fitness (poor conditioning; increased percentage of body fat)
     
   • 
     Underlying medical conditions
     
   • 
     Certain medications or supplements
     
   • 
     Previous history of an EHI
     
2. 
   Extrinsic Factors:
   
   • 
     Prolonged activity during high temperature and high humidity conditions
     
   • 
     Limited access to fluids
     
   • 
     Sports equipment and clothing
     

The key to the management of all EHI’s is prevention:

1. 
   Proper Hydration. Student-athletes should be given unlimited access to fluids. Water breaks should be scheduled into practices at regular intervals. Student-athletes should be encouraged to continuously consume fluids before, in between, and after all practice sessions and games.
   
2. 
   Adequate Rest. Rest breaks should be scheduled into practice at regular intervals. A minimum of 2 hours should be scheduled in between practice sessions. Student-athletes should be encouraged to get 6-8 hours of sleep per night.
   
3. 
   Proper Nutrition. Student-athletes should be encouraged to eat well balanced meals throughout the day. At no time should student-athletes skip meals. Student-athletes should also be encouraged to increase sodium intake (via sports drinks or foods) during warm weather conditions to help prevent dehydration.
   
4. 
   Activity Level. Activity levels should be minimized during hot, humid weather conditions, especially during midday hours. Optimal times for outdoor practices are morning and evening.
   
5. 
   Equipment. Use of heavy sporting equipment or clothing should be minimized during hot, humid conditions.
   

Thirst Loss of Performance

Irritability Muscle Cramps

Fatigue Vomiting

Nausea

Treatment

The student-athlete should be removed to cooler environment and

re-hydrate with a sports drink, if possible. The carbohydrates and sodium in sports drinks can help to prevent fatigue and muscle cramping.

Return-to play

Continued participation is acceptable if dehydration is minimal, the student-athlete is re-hydrated and the student-athlete is symptom-free. Periodic checks from on-site medical personnel are recommended.

Dizziness Cold clammy skin

Rapid pulse Nausea

Headache Vomiting

Weakness

Treatment

The student-athlete must replace the lost fluids; re-hydration is critical! Have the student-athlete rest in a cool, shaded or air-conditioned area until symptoms have passed. If student-athlete cannot tolerate oral fluids or rapid improvement is not noted transportation to an emergency facility is needed.

Student-athletes should be symptom-free, fully hydrated and cleared by an athletic trainer/ team physician before returning to play. Gradual return to full-intensity training and competition is recommended.

Dangerously high temperature

Confused or disoriented

Irrational behavior

Drowsiness

Hot and dry skin

Nausea

Heat Stroke: Treatment

This is a MEDICAL EMERGENCY. The student-athlete has to be removed from the heat and EMS has to be activated immediately. The student-athlete should be cooled as quickly as possible in a cold water (35-58 *F) immersion. If this is not available ice bags should be used on the neck and groin area. The student-athlete’s ABC’s , core temperature and CNS status must be monitored until the ambulance has arrived.

The severity of the student-athlete’s condition will dictate the amount of time off the student-athlete must take before returning to activity. Return to competition is only when the student-athlete is completely asymptomatic and cleared by a team physician. Gradually return to full practice is monitored.

• 
  A student-athlete experiencing ANY signs or symptoms of EHI should be removed from activity immediately and be seen by the athletic trainer IMMEDIATELY.
  
• 
  The athletic trainer and/or team physician will be the only individuals to evaluate the condition of the student-athlete and determine the appropriate steps of medical care.
  
• 
  The athletic trainer and/or team physician will have the final say in determining the status of a student-athlete exhibiting EHI symptoms.
  
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  A student-athlete experiencing ANY symptom of an EHI must receive clearance from the athletic trainer and/or team physician prior to returning to ANY activity.
  
• 
  The Sports Medicine Staff reserves the right to postpone and/or cancel any athletic event due to high heat and humidity, or any weather condition that may jeopardize the welfare of the participants.
  

• 
  Follow the Emergency Plan
  
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  Student-athlete should immediately be removed from activity, be cooled via being placed out of direct sunlight (indoors if possible), drinking fluids if possible, and cold compresses/ice application.
  
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  On Campus:
  
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  Coach calls 911 (9-911 from a campus phone)
  
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  Coach designates someone to call Campus Safety to inform an ambulance has been called
  
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  Coach designates someone to meet/direct ambulance
  
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  Coach designates someone to travel in ambulance
  
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  Follow up with the athletic trainer
  
  • 
    Off Campus:
    
• 
  Coach calls 911
  
• 
  Coach designates someone to meet/direct ambulance
  
• 
  Coach designates someone to travel in ambulance
  
• 
  Follow up with athletic trainer
  

Eating disorders are real psychiatric conditions that affect a person’s emotional and physical health. Eating disorders do NOT discriminate on the basis of gender. The National Eating Disorders Association documented that about 10% of cases are male. In the athletic community, student-athletes are given greater opportunities to justify, legitimize, and disguise an eating disorder. Therefore, identification, intervention and treatment become much more difficult. Eating disorders are serious and can potentially be life threatening conditions however, there is help available and recovery is possible!

body weight (85% of normal weight for height), or both

2. An intense fear of gaining weight or becoming fat, even though underweight

3. Amenorrhea (absence of three or more consecutive menstrual periods)

1. 
   Episodes of binge eating (i.e., consuming a “large amount” of food - large amount being larger then most individuals would eat under similar circumstances - in a short period of time) followed by purging (via laxatives, diuretics, enemas, or self-induced vomiting) that have occurred at least twice a week for three months
   
2. 
   A sense of lack of control during the bingeing or purging episodes,
   
3. 
   Severe body image dissatisfaction and undue influence of body image on self-evaluation
   

This category is used to describe conditions that meet some but not all of the criteria for anorexia nervosa and bulimia nervosa.

1. 
   All the criteria for anorexia nervosa are met except amenorrhea.
   
2. 
   All the criteria for anorexia nervosa are met except that, despite significant weight loss, the individual’s current weight is within the normal range.
   
3. 
   All the criteria for bulimia nervosa are met except that the binge and purge cycles occur at a frequency of less then twice a week for a duration of less then three months.
   
4. 
   An individual of normal body weight regularly uses purging behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies)
   
5. 
   An individual repeatedly chews and spits out, but does not swallow, large amounts of food.
   

a) Obsessed about weight, diet and appearance

b) Ritualistic eating behaviors

c) Exercising compulsively

d) Need for perfectionism followed by self-criticism

e) Steady decline in athletic and school performances

f) Avoiding social situations; especially social eating
2. Physical Signs:

a) Amenorrhea (lack of menstrual period)

b) Feeling of fatigue, weakness and dizziness

c) Dehydration

d) Gastrointestinal problems

e) Lanugo (soft, downy hair growth on body)

f) Hypotension

g) Dental problems

h) Overuse injuries; stress fractures
II. Bulimia Nervosa
1. Behavioral Signs:

a) Frequent visits to the bathroom; especially following meals

b) Binging or eating uncontrollably

c) Drug and or alcohol abuse

d) Irregular weight loss or gain

e) Excessive work-outs beyond the scheduled team practices

f) Depression and/or fluctuations in mood

g) Low self-esteem

a) Red puffy eyes- “bags under their eyes”

b) Callous on knuckles

c) Bad breathe – dental and gum problems

d) Broken facial blood vessels

e) Swollen cheeks – “chipmunk cheeks”

f) Frequent sore throats

g) Low or normal weight

h) Dry mouth – cracked lips

i) Muscle cramps/weakness

j) Irregular menstrual cycle (oligomenorrhea)

Treatment and Intervention

1. 
   Once a student-athlete is suspected of having an eating disorder (see “Behavioral and Physical Signs of an Eating Disorder”), then the coach and athletic trainer should be contacted.
   
2. 
   The coaches and the athletic trainer will then decide who has the best rapport with the student-athlete and that person will approach the student-athlete.
   
   1. 
      The meeting should be private and should be at a time and place convenient for both parties.
      
   2. 
      In a calm and respectful manner, indicate specific observations that aroused your concerns. Give the student-athlete time to respond.
      
   3. 
      Use “I” statements and avoid “you” statements (“I have noticed…” not “You are too thin”)
      
   4. 
      Avoid giving the simple solutions.
      
3. 
   After the meeting the student-athlete will be asked to see our Team Physician and given information on counseling.
   
   1. 
      The team physician will determine to what extent the athlete should be held out of athletic activities.
      
   2. 
      The Director of Athletics should be informed about the situation once the student-athlete is with held from activity.
      
   3. 
      The student-athlete will be encouraged to contact parents/guardians themselves or the coach, athletic trainer or athletic director will do so.
      
   4. 
      The student-athlete can not return to activity until the team physician has cleared him or her.
      
   5. 
      Counseling should be done only by a person who is trained in dealing with eating disorders.
      
4. 
   If the student-athlete denies that he or she has an eating disorder and will not see the team physician, the student-athlete will not be allowed to participate in athletics.
   
5. 
   It is important that the student-athlete understand that outside help is often necessary for treatment of eating disorders and that it is not a sign of weakness.
   

Approved by_______________________________________ _________________

Physician Date

Approved by______________________________________ __________________

Head Athletic Trainer Date


Niagara University Sports Medicine

Lightning Safety Policy
Lightning is an extremely dangerous phenomenon. Any athletic team which participates outdoors is at risk to being struck by lightning. Lightning is the most consistent and significant weather condition that may affect intercollegiate athletics. The Niagara University Sports Medicine Staff has implemented a lightning safety policy which will help minimize the risk of a lightning injury to student-athletes, coaches, administrators and fans.
General Plan:

• 
  Athletic Trainers (ATC) will monitor the weather and make a decision to notify the head coach and/or official of inclement weather. If no ATC is in attendance the decision is made by the head coach, officials, or athletic administrator. The decision of whether to suspend activity or not is based on the following:
  
  • 
    FLASH TO BANG METHOD
    

• 
  LIGHTNING DETECTOR
  

• 
  Practices
  

and informs student-athletes to seek nearest shelter.

• 
  Games
  

• 
  All sports playing on Niagara University’s athletic fields (soccer, women’s lacrosse, softball and baseball) will evacuate fields to the Kiernan Center.
  
• 
  The men’s and women’s tennis team will evacuate to their clubhouse directly next to their courts.
  
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  Any teams not on campus that are caught in a lightning storm will seek the closest shelter in their vicinity.
  

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  If no shelter is available find a thick grove of small trees surrounded by taller trees or a dry ditch. 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.
  
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  Do NOT lay flat on the ground! Stay away from metal objects, tall trees, standing pools of water, open fields and individual trees.
  

• 
  Activity may resume 30 minutes after the last sound of thunder or 30 minutes after the last flash of lightning is sighted.
  

• 
  People who are struck by lightning do NOT carry an electrical charge!
  
• 
  If it is possible to move the person without further harm to them, try to move them to a safer area.
  
• 
  Follow the Niagara University Emergency Plan.