Policies and Procedures Athletic Training Program Weber State University

Contents

ADMINISTRATION ...... 2 Policy 1.0 Purpose of the WSU Athletic Training Program ...... 2 Policy 2.0 Personnel ...... 2 Policy 3.0 Relationships ...... 3 Policy 4.0 Athletic Training Room at WSU ...... 4 Policy 5.0 Emergencies ...... 5 Policy 6.0 Health Services ...... 21 Policy 7.0 Physical Examinations ...... 22 Policy 8.0 Dispensing of Medications ...... 22 Policy 9.0 Lightning Safety ...... 22 Policy 10.0 Drug Abuse Prevention and Education ...... 23 MEDICAL ISSUES ...... 27 Policy 1.0 Medical Disqualification of Student Athletes ...... 27 Policy 2.0 Heat illness ...... 27 Policy 3.0 Eating Disorders ...... 28 Policy 4.0 Local Anesthetics ...... 28 Policy 5.0 Injectable Corticosteroids ...... 28 Policy 6.0 Concussion or Mild Traumatic Brain Injury ...... 29 Policy 7.0 Diabetes ...... 33 Policy 8.0 Athletic Injury Procedures ...... 34 Policy 9.0 Athletic Injury Rehabilitation Procedures ...... 35

-1-

ADMINISTRATION

Forward

This section has been compiled to inform all those interested of policies and procedures of the Weber State University Athletic Training Program. Its intent is to ensure efficient operation of the athletic training program, thus to provide better care for Weber State University student athletes.

Policy 1.0 Purpose of the WSU Athletic Training Program

The Athletic Training Program at WSU is primarily responsible for the delivery of health care to all student athletes participating in Weber State University Intercollegiate Athletic Programs. This health care includes prevention, evaluation, treatment, and rehabilitation of athletic injuries and illness sustained during organized weight lifting, conditioning, practices or games.

Policy 2.0 Personnel

The athletic training staff consists of a Head Athletic Trainer, assistant athletic trainers, team physicians, physical therapists, and consulting medical specialists. The medical care for any student athlete is coordinated primarily by the team physicians and team Athletic Trainer.

2.1 Team Physician 2.1.1 Team Physician Definition The team physician must have an unrestricted medical license and be an MD or DO who is responsible for treating and coordinating the medical care of student athletes at Weber State University. The principal responsibility of the team physician is to provide for the well-being of individual student athletes - enabling each to realize his/her full potential. The team physician should possess special proficiency in the care of musculoskeletal injuries and medical conditions encountered in sports. The team physician also must actively integrate medical expertise with other healthcare providers, including medical specialists, athletic trainers, and allied health professionals. The team physician must ultimately assume responsibility within the team structure for making medical decisions that affect the student athlete's safe participation. 2.1.2 Qualifications of a Team Physician The primary concern of the team physician is to provide the best medical care for student athletes at Weber State University. To this end, the following qualifications are necessary for team physicians at WSU: · Have an MD or DO in good standing, with an unrestricted license to practice medicine · Possess a fundamental knowledge of emergency care regarding sporting events · Be trained in CPR · Have a working knowledge of trauma, musculoskeletal injuries, and medical conditions affecting the student athlete · Maintain Liability insurance In addition, it is desirable for team physicians to have clinical training/experience and administrative skills in some or all of the following: · Specialty Board certification · Continuing medical education in sports medicine · Formal training in sports medicine (fellowship training, board recognized subspecialty in sports medicine [formerly known as a certificate of added qualification in sports medicine]) · Additional training in sports medicine · Fifty percent or more of practice involving sports medicine · Membership and participation in a sports medicine society · Involvement in teaching, research and publications relating to sports medicine

-2-

· Training in advanced cardiac life support · Knowledge of medical/legal, disability, and workers' compensation issues · Media skills training · Knowledge of the NCAA rules and regulations concerning medical care · Familiar with the NCAA banned substance list

2.1.3 Duties of a Team Physician The team physician must be willing to commit the necessary time and effort to provide care to the student athlete and team. In addition, the team physician must develop and maintain a current, appropriate knowledge base of the sport(s) for which he/she is accepting responsibility. The duties for which the team physician has ultimate responsibility include the following: Medical management of the student athlete · Coordinate pre-participation screening, examination, and evaluation · Manage injuries on the field · Provide for medical management of injury and illness · Coordinate rehabilitation and return to participation · Provide for proper preparation for safe return to participation after an illness or injury · Integrate medical expertise with other health care providers, including medical specialists, athletic trainers and allied health professionals

2.1.4 Education of a Team Physician Ongoing education pertinent to the team physician is essential. Currently, there are several state, regional and national stand- alone courses for team physician education. **A list of our Team Physicians and other medical specialists are located in Policy 5.2** 2.2 Consulting Medical Specialists The Weber State University athletic training program will utilize licensed allied health professionals whenever deemed necessary. (Chiropractor, Massage Therapist, ...)

2.3 Physical Therapist The athletic training program houses a physical therapy office consisting of one physical therapist and assistant(s) as needed. The physical therapy offices is directed by the head athletic trainer. The working relationship with this office includes the following. 2.3.1 Weber State student athletes within the athletics department have first priority to patient scheduling with the PT. 2.3.2 Physical therapy visits will be by referral only by a Team Physician or Certified Athletic Trainer. 2.3.3 The PT will meet at least weekly with the head athletic trainer and staff to communicate and coordinate rehabilitation efforts. 2.3.4 The PT will schedule “outside” patients to fill time slots not occupied by Weber State Student athletes.

2.4 Certified Athletic Trainers The athletic training program is directed by the Head Athletic Trainer with the aid of the assistant athletic trainers and certified graduate students. The staff athletic trainers have the following duties and responsibilities: 2.4.1 Work with and under the supervision of the team physician. 2.4.2 Cover selected athletic contests. 2.4.3 Administer first aid and basic health care to injured student athletes under the supervision of a physician. 2.4.4 Administer therapeutic modalities under the supervision of a physician. In addition to the staff athletic trainers duties, the Head Athletic Trainer will: 2.4.5 Direct and supervise the daily operation of the athletic training room. 2.4.6 Direct the injury/illness prevention efforts of the Athletic Training Program. 2.4.7 Maintain the budget and the ordering of supplies. 2.4.8 Supervise undergraduate student athletic trainers in their daily duties in the athletic training room.

2.5 Athletic Training Students Students working and studying in the area of the athletic training room will strive to project themselves as knowledgeable, sincere and enthusiastic towards the delivery of health care in the sports environment. Basic to the personality of one who is destined to succeed in athletic training are several attributes: dependability, initiative, integrity, confidence, and friendliness.

Policy 3.0 Relationships

-3-

As an athletic trainer or athletic training students at Weber State University, you have many relationships with others as follows: 3.1 Certified Athletic Trainer and Head Coach 3.1.1 Your relationships with coaches shall be punctuated with respect, courtesy, cooperation, and loyalty. 3.1.2 Inform coaches, to whom you are responsible, as to the health status of their student athletes. 3.1.3 Be firm, do not be intimidated, coerced, etc., into rationalizing. 3.1.4 Develop discretion. Know when you have said all that needs to be said. 3.1.5 If you feel that you are being pressured, intimidated, or unfairly treated by a coach, ask for the assistance of the head athletic trainer. 3.2 Athletic Training Students and Head Athletic Trainer and/or Assistant Athletic Trainer - the head athletic trainer and assistant athletic trainers are your immediate supervisors, and you will be responsible to them at all times. Feel free to discuss anything with them at any time. 3.3 Certified Athletic Trainer and Team Physician - Our team physicians at Weber State University are all highly qualified and should be treated with the utmost respect. Please do not second guess their decisions regarding athletic injuries as this is extremely unprofessional. 3.4 Certified Athletic Trainer or Athletic Training Student and Student Athletes 3.4.1 Maintain a degree of separation from student athletes. This will enable us to maintain an atmosphere of professionalism. 3.4.2 Do not repeat gossip. 3.4.3 Do not "second guess" and "judge" coaches and staff with student athletes or anyone else. 3.4.4 Do not get involved (even as a sympathetic listener) in "I am getting a raw deal" sessions. 3.4.5 Regarding athletic training studens, socializing with student athletes will not be restricted; although, you are expected to perform high-quality professional work regardless of the feelings you may have developed for someone. If your relationship affects your work negatively, it will be discussed with you. If the problem(s) is not corrected, more definite corrective steps will be taken. 3.4.6 All student athletes are to be treated as equals regardless of ability, sport, sex, race, etc.

Policy 4.0 Athletic Training Room at WSU

4.1 Hours of Operation 4.1.1 The athletic training room is open according to the needs of the teams they serve. Generally this is from 8:00 AM to 6:00 PM, Monday through Friday, and during evening and weekend hours as needed. 4.1.2 The athletic training room is to be locked at all times when it is not in use.

4.2 Use of Facilities 4.2.1 The athletic training facilities are first and foremost for the student athletes participating in NCAA athletic programs at Weber State University. Treatments rendered to these student athletes are on a first come first serve basis. 4.2.2 The facilities are also available to visiting teams on a reciprocal, courtesy basis. 4.2.3 Non-athletes will be permitted to use the facilities with the authorization of the head athletic trainer. In addition, the following conditions must be met: a. The Needs of student athletes take precedence. Services to non-athletes will be provided only when it does not interfere with caring for student athletes. b. Treatments, other than first aid, can be administered only if a medical prescription from a physician is provided.

4.3 Athletic Training Room Rules & Regulations Rules are established to make things run more orderly and help facilitate the function of the athletic training room. Certified and student athletic trainers will be expected to abide by these rules and see that student athletes abide by them. 4.3.1 Student athletes are not to be in the athletic training room without supervision. 4.3.2 Nothing (equipment, supplies, records, information, books etc) is to be taken from the athletic training room without permission. 4.3.3 The athletic training room is a place of business; not a lounge. Although people will often come in to sit and talk, rough- housing or any other activity that interferes with our purposes and operation will not be tolerated. 4.3.4 The athletic training room is divided into specific areas for performing different athletic training activities such as examination, taping and bandaging, first aid, electrical modality, hydrotherapy, and therapeutic exercise. Specific activities should take place in the appropriate areas. Ask the student athlete to move, rather than move the equipment to him/her. 4.3.5 Student athletes are not allowed in supply rooms and cabinets. These areas are to be used by the athletic trainers only. 4.3.6 No one is to administer his/her own treatment. Most of our equipment is hazardous to the unknowing and too expensive to be abused. 4.3.7 No vulgarity. 4.3.8 Tobacco is not to be smoked or chewed in the athletic training room at any time.

-4-

Policy 5.0 Emergency Action Plan

The following Emergency Action Plan (EAP) has been developed to provide proper emergency management in the event of a severe injury or illness to an athlete, coach, official, or spectator at a Weber State University Athletics venue. This plan is intended to provide guidelines for management of emergencies and should be adapted to each situation. The EAP should be reviewed and rehearsed by the Weber State sports medicine staff, coaching staff, and athletics department administrators. Emergency situations may arise anytime during Athletics events. Expedient action must be taken in order to provide the best possible care to the injured or ill sport participant in emergency and/or life threatening conditions. The development and implementation of an EAP will help ensure that the best care will be provided. Knowing that emergencies may occur at any time during an activity, the WSU sports medicine staff and coaching staffs must be prepared. This preparation involves formulation of an EAP, proper coverage of events, maintenance of appropriate medical emergency equipment and supplies, utilization of appropriate medical emergency personnel, and continuing education in the area of emergency medicine and planning.

Responsible Personnel and Qualifications Responsible personnel include the WSU sports medicine staff and/or coaching staff, in the event that a certified athletic trainer is not present, all of which are required by the NCAA to maintain current training in CPR (cardiopulmonary resuscitation), AED (automated external defibrillator), first aid, and the prevention of disease transmission. During a typical athletic practice or competition, the first responder to an emergency will be a member of the sports medicine staff, most commonly a certified athletic trainer. A team physician may not always be present at every organized practice or competition. The first responder in some situations may be a coach or other institutional personnel.

Role of the First Responders The development of an emergency action plan cannot be complete without the formation of an emergency team. The emergency team may consist of a number of healthcare providers including physicians, emergency medical technicians, certified athletic trainers, student athletic trainers, coaches, managers, and possibly bystanders. Roles of these individuals within the emergency team may vary depending on various factors such as the number of members of the team, and the athletic venue itself. There are four basic roles of the first responder within the emergency medical team. § The first and most important role is establishing safety of the scene and immediate care of the athlete. Acute care (immediate care) should be provided by the most qualified individual on the scene. Individuals with lower credentials should yield to those with more appropriate training. § EMS (Emergency Medical Services) activation may be necessary in situations where emergency transportation is not already present at the sporting event. This should be done as soon as the situation is deemed an emergency or a life-threatening event. Time is the most critical factor under emergency conditions. Activating the EMS system may be done by anyone on the team. However, the person chosen for this duty should be someone who is calm under pressure and who communicates well over the telephone. This person should also be familiar with the location and address of the sporting event. § Equipment retrieval may be done by anyone on the emergency team who is familiar with the types and locations of the specific equipment needed. Student athletic trainers, managers, and coaches are good choices for this role. § Directing EMS to the scene is the fourth role. One member of the team should be responsible for meeting emergency medical personnel as they arrive at the site of the emergency. Depending on the ease of access, this person should have keys to any locked gates or doors that may slow the arrival of the medical personnel. A student athletic trainer, manager, or coach may be appropriate for this role.

Emergency Communication Communication is key to a quick emergency response. Athletic trainers and emergency medical personnel must work together to provide the best response for an emergency situations. Communication prior to the event is a good way to establish boundaries and to build rapport between both groups of professionals. If emergency medical transportation is not available on site during a particular sporting event, then direct communication with the emergency medical system at the time of the injury or illness is necessary. Access to a working telephone or other telecommunication device, whether fixed or mobile, should be assured. The communications system should be checked prior to each practice or competition to ensure proper working order. A back- up communication plan should be in effect should there be failure of the primary communication system. The most common method of communication is a public telephone. However, a cellular phone is preferred if available. At any athletic venue, whether home or away, it is important to know the location of a workable telephone. Pre-arranged access to the phone should be established if not easily accessible.

Emergency Equipment All necessary emergency equipment should be at the site and quickly accessible. Personnel should be familiar with the function and operation of each type of emergency equipment. Equipment should be in good operating condition, and personnel must be trained in advance to use it properly. Emergency equipment available should be appropriate for the level of training for the emergency medical providers. Creating an equipment inspection log book for continued inspection is strongly recommended. Inspection of emergency equipment should be repeated at least monthly.

-5-

It is important to know the proper way to care for and store the equipment as well. Equipment should be stored in a clean and environmentally controlled area. It should be readily available when emergency situations arise.

Medical Emergency Transportation Emphasis is placed at having an ambulance on site at high risk sporting events. EMS response time is additionally factored in when determining on site ambulance coverage. The athletic department coordinates on site ambulances for competition in football. Ambulances may be coordinated on site for other special events/sports such as for conference tournaments/championships. Consideration is given to the capabilities of transportation service available (i.e. basic life support and advanced life support) and the equipment and level of trained personnel on board the ambulance. In the event that an ambulance is on site, there should be a designated location with rapid access to the site and a cleared route for entering/exiting the venue. In an emergency situation, the athlete should be transported by ambulance, where the necessary staff and equipment is available to deliver appropriate medical care. Certified athletic trainers and/or emergency care providers should refrain from transporting unstable athletes in personal/inappropriate vehicles. Any emergency situations where there is impairment in level of consciousness (LOC), airway, breathing, or circulation (ABC) or there is neurovascular compromise should be considered a “load and go” situation and emphasis placed on rapid evaluation, treatment and transportation. In order to provide the best possible care for WSU Athletics, all athletes should be transported to McKay Dee Hospital. Care must be taken to ensure that the activity areas are supervised should the athletic trainer or emergency care provider leave the site in transporting the athlete.

Emergency Medical Facilities The preferred medical emergency facility for accidents occurring on the campus of Weber State University is McKay Dee Hospital. The emergency room at McKay Dee Hospital is only 5 minutes from campus and is a level 2 trauma center providing emergency services 24 hours a day, seven days a week. All physicians at this facility are board-certified in emergency medicine. This ER facility is supported by all IHC hospitals and services, including Life Flight.

Medical Emergency Documentation The WSU Athletic Training Staff will document all emergency incidents using NExTT Software database. Documentation should consist of: Events leading up to the injury or condition, mechanism of injury, past history of condition/injury, evaluation of injury/condition, actions taken, care given, vital signs taken, and outcome. Documentation of each emergency incident will be reviewed by the WSU Sports Medicine Staff for the improvement of future responses to emergencies.

Visiting Team EAP Emergency Action Plans for all visiting teams will be posted on the WSU Athletics Department web site. Each visiting team’s athletic trainer will also be sent an email containing this information prior to the teams visit. Upon arriving on campus, someone from the WSU Sports Medicine Staff will meet with the visiting team athletic trainer to review the EAP.

Non-Medical Emergencies For the following non-medical emergencies; fires, bomb threats, and violent or criminal behavior, refer to the Weber State University Campus Emergency Action. This document can be found at: https://www.weber.edu/wsuimages/police/EOPOutline.pdf

Important Phone Numbers Stadium Athletic Training Room 801-626-6501 WSU Police 801-626-6460 Ambulance, Fire 911 McKay-Dee Emergency Room 801-387-7000 Dr. Steve Scharmann (Family Practice/Sports Med) 801-387-5300 Dr. Dave Tensmeyer (Family Practice/Sports Med) 801-779-6200 Dr. Jeff Harrison (Orthopedic Surgeon/ Sports Med) 801-387-2750 Dr. Thomas Johnston (Dentist) 801-475-4646 Dr. Scott Sykes (Ophthalmologist) 801-476-0494

Athletic Training Staff Joel Bass Head AT Football, MBB (801) 698-2016 Nancy Weir AT WVB, WBB, Golf (801) 689-2006 Paul Bugnet AT MTF, WTF (801) 726-0565 Talon Bird AT Football, M&W Tennis (801) 389-9744 Alex Leonardi AT W Soccer, W Softball (801) 698-4863 Whitney Batchelor AT Cheer (801) 682-5340

-6-

Guidelines For Emergency Care to Specific Injuries or Illness Cardiac Problems § Check the airway, breathing, and circulation, and administer CPR as needed § Treat for shock § Activate EMS § Put athlete in a comfortable position § Retrieve oxygen, CPR mask and AED incase needed. Spinal Injury § Check the airway, breathing, and circulation, and administer CPR as needed. § Have someone else call 911 (EMS) § Support cervical spine by positioning hands on side of head. Do not leave this position until instructed to do so by the EMS crew. § Have someone else prevent or treat for shock while you maintain your position at the head. § DO NOT ATTEMPT TO MOVE THE ATHLETE unless the athlete is in danger as a result of his/her location. § If the athlete is moved, proper backboard and cervical support must be used § Retrieve oxygen, CPR mask and AED incase needed. § Reassure the athlete to stay calm. Major Fracture § Treat the athlete for shock § Apply basic first aid § DO NOT ATTEMPT TO REDUCE THE FRACTURE § Splint, making sure the athlete continues to have a distal pulse and sensation. § Transport the athlete to the hospital. Major Joint Dislocations § Treat the athlete for shock § Apply basic first aid § DO NOT ATTEMPT TO REDUCE THE DISLOCATION § Splint, making sure the athlete continues to have a distal pulse and sensation. § Transport the athlete to the hospital. Heat Illness § Remove the athlete from the heat. § Remove excess clothing § Determine severity of the illness § Monitor ABC’s § Attempt to cool the body (ice bath preferred) § Stay with the athlete at all times § Call 911 if needed Athlete That is Sickling § Check vital signs § Administer high-flow oxygen (15 lpm with non-rebreather mask) § Cool the athlete is necessary § If vital signs decline call 911, retrieve AED, immediately transport § Inform EMS to expect explosive rhabdomyolysis and grave metabolic complications Moderate Hypoglycemia § Give athlete fast-acting sugar source § Wait 10 to 15 minutes. § Recheck blood glucose § Repeat food if symptoms persist OR blood glucose is less than 70. § Follow with a snack of carbohydrate and protein (e.g., cheese and crackers) § Stay with the athlete at all times § Call 911 if needed Severe Hypoglycemia § Don’t attempt to give anything by mouth. § Position on side, if possible. § Disconnect insulin pump. § Administer glucagon, if prescribed § Call 911 § Stay with athlete Asthma Attack § If athlete has any of the following symptoms: chest tightness, difficulty breathing, wheezing, excessive coughing, or shortness of breath: § Stop activity and help athlete to a sitting position. § Stay calm, reassure athlete § Assist athlete with the use of their inhaler. § Administer oxygen if available. (15 lpm with non-rebreather mask)

-7-

§ Call 911 if: o No improvement within 15-20 min. o Athlete is struggling to breath o Neck and/or chest, and ribs pulled in with breathing o Athlete’s lips are blue o Athlete must hunch over to breathe Any Other Emergency Situation § Check the ABCs § Apply basic first aid § Prevent and/or treat for shock § When in doubt activate EMS § Retrieve oxygen, CPR mask and AED incase needed.

Guidelines for Severe Weather

Guidelines for Lightning § During athletics events, not supervised by game management or game officials, the Certified Athletic Trainer present shall monitor threatening weather and make the decision to remove a team or individuals from an athletics sight or event. § If you hear thunder, begin preparation for evacuation; if you see lightning, consider suspending activities and heading for your designated safer locations. § All teams or individuals should leave the athletics sight and reach a safe structure or location when the monitor (ATC) obtains a flash-to-bang count of 40 seconds or less. (Storm is estimated to be with 8 miles). § All teams or individuals shall wait at least 30 minutes after the last flash of lighting or sound of thunder before returning to the field or activity. § All teams or individuals should move from the field to a lightning save shelter. A building with wiring and plumbing (e.g., school, field house, library, home) that is fully enclosed can be used as a safe shelter. Metal vehicles (e.g., school bus, car, van) can also be used as safe evacuation locations. § All teams or individuals should avoid moving to an unsafe lightning shelter. Small covered shelters are not safe from lightning. Dugouts, refreshment stands, open press boxes, rain shelters, golf shelters and picnic shelters, even if they are properly grounded for structural safety, are usually not properly grounded from the effects of lightning and side flashes to people. They are usually very unsafe and may actually increase the risk of lightning injury. Other dangerous locations include bodies of water (pools, ponds, lakes) and areas connected to, or near, light poles, towers and fences that can carry a nearby strike to people. Also dangerous is any location that makes the person the highest point in the area.

Venue Specific Lightning Safety Plan

Venue Safe Location Emergency Phone AED Location Location Stewart Stadium (football) Stadium locker rooms, Athletic training room Athletic training room, athletic training room, Emergency backpack, Skysuites lobby Second floor of Skysuites Wildcat Soccer Field Stromberg Gym Offices Wall Mount b6 Wildcat softball field Dee Events Center Offices In Dee Events Center (Northwest tunnel) tunnel

Tennis Facilities Swenson Gym Issue Desk Main Entrance wall mount PT Practice fields Alumni Center, Cars Alumni Center front desk Mobil emergency (red) backpack Wildcat Hammer Field University Village, Cars Offices Mobil emergency (red) backpack Golf Course Course Clubhouse Clubhouse desk Clubhouse wall mount

-8-

Guidelines for Hot and Humid Weather

The following chart shall be used to identify heat stress conditions and provide guidelines for participation.

Heat Exhaustion § Symptoms usually include profound weakness and exhaustion, and often dizziness, syncope, muscle cramps, nausea and core temperature below 104 degrees F with excessive seating and flushed appearance. Treatment for Heat Exhaustion § Remove from activity § Taking off all equipment and placing the student-athlete in an ice water immersion. § Shaded the athlete if possible. § Fluids should be given orally is patient is conscious and can swallow. § Core temperature (rectal) and vital signs should be serially assessed. § IV fluids replacement should be utilized if available but should be determined by a physician.

Exertional Heatstroke § Heatstroke is a medical emergency. Medical care should be obtained at once; a delay in treatment can be fatal. This condition is characterized by a very high body temperature, 104 degrees F or greater. The student-athlete likely will still be sweating profusely at the time of collapse, but may have hot, dry skin, which indicates failure of the primary temperature-regulating mechanism (sweating), and CNS dysfunction. Treatment for Exertional Heatstroke § Activation of the emergency action plan § Assessment of core temperature/vital signs § Immediate cooling of the body with ice water immersion. (If ice water immersion is not available, wet ice towels should be used on a rotating basis.) § Student-athletes who incur heatstroke should be hospitalized and monitored carefully.

Guidelines for Cold Weather This policy is intended to guide patient care. Medical conditions and specific medical situations are often complex and require health care providers to make independent judgments. These policies may be modified by practitioners to achieve maximal patient outcomes.

Exposure to cold presents an inherent risk of injury. It is important to note that the following guidelines for activity and associated limitations apply only in the absence of precipitation. Precipitation, most notably rain and snow, will affect the risk of environmental cold injury. It is unclear in the literature at exactly what rate of rain or snow fall, in conjunction with the air temperature and wind rate, conditions become unsafe. However, it is clear that precipitation significantly increases the risk of environmental cold injury. Therefore, in circumstances involving precipitation, decisions about participation restrictions will be made by the certified athletic trainer on an individual basis based upon the current conditions.

All outdoor athletic events at Weber State University operate under the guidelines in the following table. The certified athletic trainer is responsible for communicating to all athletic personnel and employing these guidelines. Please note the following temperatures ranges account for wind-chill.

-9-

Wind-Chill Guidelines/adjustment Temp. < 20°F § Be aware and ready for possibility of cold injuries. § It is recommended that all practice participants take reasonable precautions to cover exposed skin. This includes wearing long sleeves, pants, gloves, and hats during warm up activities. Hats and gloves should remain on during practice. § All non- participating student-athletes should have exposed skin covered.

< 10°F § All practice participants must wear appropriate clothing/equipment at all times while outdoors. This includes, at minimum: long sleeves, pants, gloves, and hats. The certified athletic training will make additional clothing or equipment recommendations as seen fit. § All non-participating student-athletes should have exposed skin covered.

< 0°F § Must comply with previously stated clothing/equipment requirements. § It is recommended that warm up and cool down activities occur indoors. - § Practice plan should be altered to decrease “down time” where participants are not moving. § Appropriate practice length should be determined, in advance, by head coach and the certified athletic trainer based upon the intensity of the practice plan. § It is recommended that all non-participating student-athletes remain indoors.

All temperature readings for interpretation of the above chart will be taken by the certified athletic trainer immediately preceding the scheduled practice or game. Communication and decisions regarding readings will occur between the head coach and certified athletic training on an individual basis. NOTE: the above guidelines may be altered by the certified athletic trainer in the presence of other mitigating factors, such as, portable heaters, temporary re-warming facilities, altering game play rules (e.g. extended half-times for rewarming), etc. These decisions will be made on an individual basis.

Recognizing early signs of cold-induced stress may prove to be important in preventing cold weather-related injuries. The following signs and symptoms are considered to be early warning signs: § Shivering § abnormal sensation at the distal extremities (e.g. numbness, pain, or burning sensation) § disorientation

-10-

§ slurred speech

Treatment for Hypothermia § Determine if the emergency action plan needs to be activated. § Treat the individual according to current medical practices. See guidelines below. § When emergency medical services arrive, accompany or designate a responsible liaison to accompany the individual to the hospital. Treatment Guidelines: § Move individual to warm area, with great caution to avoid cardiac arrhythmia. § Remove all wet clothing and replace with dry. § Assess airway, breathing, and circulation: treat if abnormal § Monitor temperature using rectal thermometer o Mild: 98.7 - 95.0 deg. F o Mod/Severe: 94.9 – 90.0 deg. F § Do not rub or massage extremities § Rewarm by applying gentle heat to axillae, chest, and groin.

-11-

Managing an Emergency Mental Health Issue:

Identify whether there is an immediate threat to safety To identify whether the situation is an immediate threat to safety, as the following: § Am I concerned the student-athlete may harm himself/herself? § Am I concerned the student-athlete many harm others? § Did the student-athlete make verbal or physical threats? § Do I feel threatened or uncomfortable? § Is the student-athlete exhibiting unusual ideation or thought disturbance that may or may not be due to substance use? § Does the student-athlete have access to a weapon? § Is there potential for danger or harm in the future?

Manage Student in Immediate Danger In the case of an immediate risk to safety: § Keep yourself safe—do not attempt to intervene.

-12-

§ Keep others safe—try to keep a safe distance between the student-athlete in distress and others in the area. § Get help from colleagues. § If the student-athlete seems volatile or disruptive, alert a co-worker for assistance. § Do not leave the student-athlete alone. However, do not put yourself in harm’s ’way if he/she tries to leave. § Call 911 or campus police. Have the person taken directly to the emergency department at the hospital. § When you call, be prepared to provide the following information: o Student-athlete’s name and contact information. o Physical description of the student-athlete. o Height, weight, hair and eye color, clothing, etc. o Description of the situation and assistance needed. o Exact location of the student-athlete. o If the student-athlete leaves the area or refuses assistance, note the direction in which he/she leaves. o Follow campus and department protocols and policies.

Manage Student When Uncertain of Immediate Danger § If possible, offer a quiet and secure place to talk. § Listen to the student-athlete; maintain a consistent, straightforward and helpful attitude. § If the student-athlete is expressing suicidal ideation: o Listen o Show your genuine concern. o Emphasize risk to safety. o Do NOT leave the person alone. o QPR o Make arrangements for appropriate university intervention and aid. o If medical care seems appropriate, head to the nearest Hospital or Call 911

Guidelines during a Serious/Catastrophic On-Field Player Injury: 1 Player and coaches should go to and remain in the bench area once medical assistance arrives. Adequate lines of vision between the medical staffs and all available emergency personnel should be established and maintained. 2 Players, parents and non-authorized personnel should be kept a significant distance away from the seriously injured player or players. 3 Players or non-medical personnel should not touch, move or roll an injured player. 4 Players should not try to assist a teammate who is lying on the field (i.e. removing the helmet or chin strap, or attempting to assist breathing by elevating the waist. 5 Players should not pull on an injured teammate or opponent from a pile-up. 6 Once the medical staff begins to work on an injured player, they should be allowed to perform services without interruption or interference. 7 Players and coaches should avoid dictating medical services to the athletic trainer or team physicians or taking up their time to perform such services.

When to Activate the Catastrophic Incident Action Plan: The Weber State Athletic Department Catastrophic Incident Action Plan will be activated when the following incidents occur: § Sudden Death of a Student-Athlete, Coach or Staff Member § Death during competition, practice, or conditioning. § Death during travel. o Official business (while traveling with a team). o Personal (e.g. automobile, airline accidents). § Non-athletic accidents (e.g. falls at home). § Unknown medical anomalies (e.g. heart attack, stroke, illness). § Victim of a crime (e.g. homicide). § Suicide. Disability/ Life Altering Injuries § During Weber State University Athletics participation and/ or travel, or non-athletic activities. § Spinal Cord Injury resulting in partial or complete paralysis. § Loss of Paired Organ. § Severe Head Injury. § Injuries resulting in severely diminished mental capacity or other neurological injury that results in inability to perform daily functions (e.g. coma, post concussion syndrome).

-13-

§ Diminished/ or loss of speech, hearing, sight. § Loss of one extremity. § Loss of both extremities.

Catastrophic Incident Action Plan: The following action plan will be initiated by the on-site personnel (Certified Athletic Trainer/Coach) to manage a catastrophic incident: § Obtain pertinent facts regarding the incident accurately. § Document all events including participants and witnesses. § Secure any or all available materials/equipment utilized. § Initiate communication within the catastrophic incident management team (CIMT). § Members of the CIMT, or designated individuals, shall communicate about the incident to family members, staff members, student-athletes or athletic department personnel. § NOTE: Any communication with the media should be coordinated through the Athletics Media Relations Office.

CIMT Flow Chart

Assistant Athletics Director of Director for Team Athletics Physician Sports Medicine

Senior Team Counseling Risk Athletics Athletic Center Management Admin. Trainer

Athletics University Media Chaplain President Relations

VP for Admin. Services

Training Of Emergency Procedures Training sessions will be conducted by at the beginning of each academic year and throughout the year as needed. Emergency procedure training sessions will include: The review of emergency care providers and phone numbers, minimum supplies and personnel for all scheduled practices, strength and conditioning workouts, skill-instruction sessions, and competitions, guidelines for emergency care to specific injuries or illness, and guidelines for emergency care at specific locations on campus at WSU.

-14-

Guidelines For Emergency Care to Specific locations At WSU

Football Stadium (Football, Track and Field, Cheerleading)

Emergency Personnel: Athletic trainer (AT) assigned to football, men’s and women’s track and field or cheerleading assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice and competition as well as additional sports medicine staff as needed. An ambulance and team physician will be on location during football competitions.

Emergency Communication: Assigned ATs are to have cell phones on person. Also, a fixed telephone line is located in the athletic training room under the football stadium.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, oxygen, AED) are maintained in the stadium athletic training room and/or on sidelines of football and track and field practices and competitions.

Roles of First Responder: 1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval a. AT directs the athletic training student and/or coach present to retrieve emergency equipment while AT attends to the ill or injured athlete. 3. Activation of emergency medical system (EMS) a. If possible, the AT directs the athletic training student or coach present to activate EMS while AT attends to the ill or injured athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Directions for EMS to the Football Stadium. a. The stadium can be accessed by taking 36th street east from Harrison blvd., right (south) on Birch street, left (east) on Edvalson street, and right (south) at football stadium parking lot entrance. b. Ambulance should enter the south gate of football stadium. c. Personnel (available coaching staff or athletic training student) will be located at south gate to direct ambulance.

Post Event Administration Notification: 1. Head Athletic Trainer a. Joel Bass (801) 698-2016 1. Team Physicians a. Dr. Jeffery Harrison (801) 710-5921 b. Dr. Steve Scharmann (801) 698-1932 c. Dr. Dave Tensemeyer (801) 698-2897 2. Athletics Director a. Jerry Bovee (801) 682-3952

Documentation: It is the responsibility of the first responder to document actions taken during the emergency response. These documents will be used to evaluate the emergency response. This record will aid in decisions made concerning future training and possible improvements in the emergency action plan.

Venue Map: A map of campus is located at the end of this section.

Dee Events Center (Basketball, Softball)

Emergency Personnel: Athletic trainer (AT) assigned to men’s basketball, women’s basketball, and women’s softball assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice and competition as well as additional sports medicine staff as needed. A paramedic and/or team physician will be on location during men’s basketball, women’s basketball, and women’s softball competitions.

Emergency Communication: Assigned ATs are to have cell phones on person. Also, a fixed telephone line is located in the athletic training room in the Dee Events Center tunnel.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, oxygen, AED, and emergency gurney) are maintained in the Dee Events Center, located on the court next to the northwest basket.

Roles of First Responder:

-15-

1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval a. AT directs the athletic training student and/or coach present to retrieve emergency equipment while AT attends to the ill or injured athlete. 3. Activation of emergency medical system (EMS) a. If possible, the AT directs the athletic training students or coach present to activate EMS while AT attends to the collapsed athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Directions for EMS to the Dee Events Center. a. The Dee Events Center and softball field can be accessed by turning into the main entrance east from Harrison blvd. at about 4200 S. (refer to map below) b. Ambulance should enter the Dee Events Center through the tunnel on the west side of the building. c. Ambulance should enter the softball field through the southwest gate of the field. d. Personnel will be located at tunnel entrance to direct ambulance.

Venue Map: A map of campus is located at the end of this section.

Promontory Field (Football Practice, Soccer Practice)

Emergency Personnel: Athletic trainer (AT) assigned to football or women’s soccer assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice as well as additional sports medicine staff as needed.

Emergency Communication: Assigned ATs are to have cell phones on person.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, oxygen, AED) are maintained in the stadium athletic training room and/or on the Pt field as needed.

Roles of First Responder: 1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval 3. Activation of emergency medical system (EMS) a. If possible, the ATC directs the athletic training student or a coach present to activate EMS while AT attends to the collapsed athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Direction for EMS to the Promontory field. a. Ambulance has access to field via 4100 south and should enter the field at the south east corner, directly north of Promontory Tower Building. (refer to map below) b. Personnel will be located at the southeast gate to direct ambulance

Post Event Administration Notification: 1. Head Athletic Trainer

-16-

a. Joel Bass (801) 698-2016 1. Team Physicians a. Dr. Jeffery Harrison (801) 710-5921 b. Dr. Steve Scharmann (801) 698-1932 c. Dr. Dave Tensemeyer (801) 698-2897 2. Athletics Director a. Jerry Bovee (801) 682-3952

Venue Map: A map of campus is located at the end of this section.

Upper Swenson Gym (Women’s Volleyball / Men’s and Women’s Basketball)

Emergency Personnel: Athletic trainer (AT) assigned to women’s volleyball, women’s basketball or men’s basketball assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice and competition as well as additional sports medicine staff as needed. A physician will be on location during volleyball competitions.

Emergency Communication: Assigned ATs are to have cell phones on person. Also, a fixed telephone line is located in the front desk of the upper Swenson Gym.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, AED) are maintained in Swenson Gym athletic training room located north east of the court.

Roles of First Responder: 1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval 3. Activation of emergency medical system (EMS) a. If possible, the AT directs the athletic training student or a coach present to activate EMS while AT attends to the collapsed athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Directions for EMS to the Swenson Gym. a. Ambulance has access to court via 4100 south and should enter the court at the south side parking lot which directly south of Swenson Gymnasium. (refer to map below) b. Personnel will be located at the parking lot to direct ambulance.

Venue Map: A map of campus is located at the end of this section.

Stromberg Center (Indoor Track and Field, Cheerleading)

Emergency Personnel: Athletic trainer (AT) assigned to indoor track and field or cheerleading assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice as well as

-17-

additional sports medicine staff as needed.

Emergency Communication: Assigned ATs are to have cell phones on person. Also, there is a fixed telephone line at the issue desk south east of indoor track.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, oxygen, AED) are maintained in the Stromberg Center athletic training room and/or on the indoor track as needed.

Roles of First Responder: 1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval 3. Activation of emergency medical system (EMS) a. If possible, the AT directs the athletic training student or a coach present to activate EMS while AT attends to the collapsed athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Direction for EMS to the Stromberg Center. a. Ambulance has access to field via 4100 south and should enter the building at the west doors. (refer to map below) b. Personnel will be located at the southeast corner to direct ambulance

Venue Map: A map of campus is located at the end of this section.

Soccer Field (Soccer)

Emergency Personnel: Athletic trainer (AT) assigned to women’s soccer assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice and competition as well as additional sports medicine staff as needed. A physician will be on location during all home soccer competitions.

Emergency Communication: Assigned AT is to have cell phones on person. Also, there is a fixed telephone line at the lower entrance to the Stromberg Center.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, oxygen, AED) are maintained in the Stromberg Center athletic training room and/or on sidelines during soccer competitions.

Roles of First Responder: 1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval 3. Activation of emergency medical system (EMS) a. If possible, the AT directs the athletic training student or a coach present to activate EMS while AT attends to the collapsed athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Direction for EMS to the P.E. field. a. Ambulance has access to field via 4100 south and should enter the field at the west gate. (refer to map

-18-

below) b. Personnel will be located at the backstop to direct ambulance

Venue Map: A map of campus is located at the end of this section.

Edman Tennis Courts (Tennis)

Emergency Personnel: Athletic trainer (AT) assigned to men’s and women’s tennis assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice and competition as well as additional sports medicine staff as needed. A physician will be on call during all home tennis competitions.

Emergency Communication: Assigned ATs are to have cell phones on person. Also, there is a fixed telephone line at the west entrance to the Swenson Gym.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, oxygen, AED) are maintained in the Stromberg Center athletic training room and/or on sidelines during tennis competitions.

Roles of First Responder: 1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval 3. Activation of emergency medical system (EMS) a. If possible, the ATC directs the athletic training student or a coach present to activate EMS while AT attends to the collapsed athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Direction for EMS to the Edman Tennis Courts a. Ambulance has access to court via 4100 south and should enter the court at the south side parking lot which directly south of Swenson Gymnasium. (refer to map below) b. Personnel will be located at the parking lot to direct ambulance.

Venue Map: A map of campus is located at the end of this section.

-19-

Marquart Fieldhouse (All Sports)

Emergency Personnel: Athletic trainer (AT) assigned to team assisted by athletic training students assigned to AT. The above mentioned emergency personnel will be on site for practice and competition as well as additional sports medicine staff as needed.

Emergency Communication: Assigned ATs are to have cell phones on person. Also, a fixed telephone line is located in the facility office adjacent to the indoor turf field.

Emergency Equipment: Supplies (trauma kit, splint kit, spine board, oxygen, AED, and emergency gurney) are maintained in the fieldhouse, located adjacent to the indoor turf field.

Roles of First Responder: 1. Immediate care of the injured or ill student-athlete 2. Emergency equipment retrieval a. AT directs the athletic training student and/or coach present to retrieve emergency equipment while AT attends to the ill or injured athlete. 3. Activation of emergency medical system (EMS) a. If possible, the AT directs the athletic training students or coach present to activate EMS while AT attends to the collapsed athlete. b. Call 9-911 when using an on-campus phone and 911 when using a cell phone. (Provide your name, location, telephone number, number of individuals injured, nature of injury, first aid treatment rendered, specific directions to location, other information as requested, and be the last one to hang up.) c. Notify campus police at 626-6460 4. Directions for EMS to the Marquart Fieldhouse. a. The Marquart Fieldhouse can be accessed by turning into the main entrance east from Harrison blvd. at about 4200 S. b. Ambulance should enter the Marquart Fieldhouse through the double doors on the east side of the building. d. Personnel will be located at double doors to direct ambulance.

Venue Map: A map of campus is located at the end of this section.

-20-

Basketball Football Stadium Softball

Tennis Volley Ball

Track Soccer

Football Practice

Policy 6.0 Health Services

6.1 Student Health Service 6.1.1 The Student Health Center is located centrally on campus in the Student Services Building. The Center is staffed by full- time medical doctors as well as office personnel. Students are seen by appointment during regular weekday hours. 6.1.2 Services Available a. Office appointments can be made in person or by phone. The main entrance is open only while school is in session from 8:00 a.m.- 3:00 p.m. on weekdays. b. ACUTE EMERGENCIES ARE TREATED ANYTIME ON A WALK-IN BASIS when the Health Center is open and staffed. **IT IS RECOMMENDED THAT EMERGENCIES OF A SEVERE NATURE BE TAKEN TO THE MCKAY DEE HOSPITAL EMERGENCY ROOM**

6.2 Referring Student athletes to a Medical Facility The following procedures must be followed: 6.2.1 Any student athlete referred to a medical facility must meet with the Athletic Insurance Secretary with an Injury

-21-

Evaluation form and Medical Referral form before making an appointment. Student athletes that use medical facility without being referred by a certified athletic trainer and meeting with the Athletic Insurance Secretary will be on their own expense and must report the visit to a certified athletic trainer as soon as possible. 6.2.2 Referral forms must be filled out by a certified athletic trainer. 6.2.3 All student athletes referred to medical facility must return the Medical Referral form to a certified athletic trainer before further treatments are given.

6.3 Visits to Physicians 6.3.1 Visits to physicians and health care providers other than team physicians and student health service physicians need to be OK'd with the team physician or certified athletic trainer prior to any services.

6.4 Prescription Drugs 6.4.1 Prescription drugs will be paid for by the WSU Athletic Department only if they are prescribed for a condition, injury, or illness that occurs as a result of participation in a scheduled practice or game. 6.4.2 Fall sports seasons shall begin at the first official practice. 6.4.3 All other sports seasons shall begin thirty (30) calendar days prior to the first competition, unless the season is defined by the NCAA. (i.e. basketball) 6.4.4 All seasons are concluded at the last scheduled contest or by elimination from post-season competition.

6.5 Prescription Glasses and Contacts 6.5.1 Prescription glasses or contacts will be replaced if broken or lost during a scheduled practice or game.

6.6 Payment of Bills 6.6.1 If the above noted procedures are not followed, any or all bills incurred by the student athlete will be the responsibility of the student athlete.

Policy 7.0 Physical Examinations

7.1 Medical and insurance forms must be completed and on file prior to athletic participation. 7.2 Student athletes will not be permitted to practice or check out athletic department equipment until he/she has had a physical examination. 7.3 Physicals will be arranged in conjunction with the head coach and the certified athletic trainer assigned to his/her sport prior to the first practice. 7.4 Coaches must give the certified athletic trainer a list of the names of the student athletes to be examined at least three days prior to the date of examination. 7.5 Examinations will be scheduled through the certified athletic trainer. 7.6 Refer to student procedures for student athletic trainer physical examination requirements.

Policy 8.0 Dispensing of Medications

8.1 1. Certified Athletic Trainers shall not dispense prescription medications. The ATC should not be assigned duties that may be performed only by physicians or pharmacists. A team physician cannot delegate diagnosis, prescription-drug control, or prescription-dispensing duties to the ATC. 8.2 2. All prescription and over-the-counter (OTC) medications should be stored in designated areas that assure proper environmental and security conditions. 8.3 3. All drug stocks should be examined at each year for removal of any outdated, deteriorated or recalled medications. 8.4 4. Student athletes receiving medication should be properly informed about what they are taking and how they should take it. This should include: Name of drug, dosage form, dose, route of administration, duration of therapy, intended use of the drug and expected action. 8.5 5. Student Athletic Trainers are not permitted to dispense any medications without the direct supervision of an ATC.

Policy 9.0 Lightning Safety

9.1 During athletics events, not supervised by game management or game officials, the Certified Athletic Trainer present

-22-

shall monitor threatening weather and make the decision to remove a team or individuals from an athletics sight or event. 9.1.1 If you hear thunder, begin preparation for evacuation; if you see lightning, consider suspending activities and heading for your designated safer locations. 9.2 All teams or individuals should leave the athletics sight and reach a safe structure or location when the monitor (ATC) obtains a flash-to-bang count of 40 seconds or less. (Storm is estimated to be with 8 miles). 9.2.1 All teams or individuals shall wait at least 30 minutes after the last flash of lighting or sound of thunder before returning to the field or activity. 9.2.2 All teams or individuals should move from the field to a lightning save shelter. A building with wiring and plumbing (e.g., school, field house, library, home) that is fully enclosed can be used as a safe shelter. Metal vehicles (e.g., school bus, car, van) can also be used as safe evacuation locations. 9.2.3 All teams or individuals should avoid moving to an unsafe lightning shelter. Small covered shelters are not safe from lightning. Dugouts, refreshment stands, open press boxes, rain shelters, golf shelters and picnic shelters, even if they are properly grounded for structural safety, are usually not properly grounded from the effects of lightning and side flashes to people. They are usually very unsafe and may actually increase the risk of lightning injury. Other dangerous locations include bodies of water (pools, ponds, lakes) and areas connected to, or near, light poles, towers and fences that can carry a nearby strike to people. Also dangerous is any location that makes the person the highest point in the area.

9.4 Venue Specific Lightning Safety Plan 9.4.1 Venue Safe Location Emergency Phone Location AED Location Stewart Stadium (football) Stadium locker rooms, Athletic training room Athletic training room, athletic training room, Emergency backpack, Skysuites lobby Second floor of Skysuites Wildcat Soccer Field Stromberg Gym Offices Wall Mount b6 Wildcat softball field Dee Events Center Offices In Dee Events Center (Northwest tunnel) tunnel

Policy 10.0 Drug Abuse Prevention and Education

The department of intercollegiate athletics at Weber State University its coaching personnel and administrators, strongly believe that the use and/or abuse of drugs (excluding those drugs prescribed by a physician to treat a specific medical condition) can:

1. Be detrimental to the physical and mental well being of its student-athletes, no matter when such usage should occur during the year;

2. Seriously interfere with the performance of individuals both as students and athletes;

3. Be extremely dangerous to the student-athlete and his/her teammates, particularly with regard to participation in athletic competition or practice.

4. The unauthorized use of banned drugs or abuse of alcohol constitutes an abuse of the privilege of participating for and representing Weber State University in intercollegiate athletic competition.

Therefore, beginning with the 1985-86 academic year, and for subsequent years thereafter the Athletic Department has implemented a program of drug education, screening and counseling to assist and benefit the men and women athletes of Weber

-23-

State University.

Purpose of Program

The purpose of the Weber State University Intercollegiate Athletic Substance Abuse Education Program is to aid and assist student-athletes to make individual, informed, and intelligent decisions with reference to drug usage, both now and in the future.

Specific goals fo the program are as follows:

1. To generally educate Weber State University athletes concerning the problems of drug abuse;

2. To prevent any illicit drug use and/or abuse by Weber State Athletes;

3. To identify any athlete who may be using illicit drugs and to identify the drug;

4. To educate any athlete so identified regarding such usage as it may affect the athlete and his/her teammates;

5. To see that any chronic dependency is treated and addressed properly;

6. To provide reasonable safeguards that every athlete is medically competent to participate in

7. To encourage discussion about any questions the athlete may have, either specifically or generally, about usage of drugs.

8. To attempt to assure that athletes are physically and mentally fit for the rigors of intercollegiate athletic participation in an effort to minimize the risks of serous injury to the athlete and/or his/her teammates.

Implementation of Program

At the beginning of the academic year, a presentation will be made to all intercollegiate athletic squads at Weber State, to outline and review the Intercollegiate Athletic Substance Abuse Education Program, its purposes and implementation. A copy of the program will be given to each athlete, and is posted on www.weberstatesports.com

Each athlete will thereafter be asked to sign a form acknowledging receipt and understanding of the program and provide voluntary consent to the administration of the urinalysis testing required by the program and a release of testing information to a limited and select group.

Any Athlete who does not wish to sign the consent form may choose not to do so and thereby forego the privilege of participation in intercollegiate athletics at Weber State. The Drug Screening Consent Form is a part of the preparticipation physical examination.

Athletes and parents or legal guardians are encouraged to ask questions or make suggestions at any time with reference to the program; and athletes will be asked to participate in ongoing reviews and revisions of the program. The athletic department is very serious about this program and expects the athletes to be equally interested and concerned.

This program and its administration/operation is subject to change/modification at any time. However, any change/modification will only be implemented by action of the Director of Intercollegiate Athletics and will no be applied retroactively if that would adversely affect an athlete’s rights. Drug Education

Educational programs that focus on a variety of aspects of drug use have been established. The nature of these programs will include topics such as the symptoms of chemical dependency. Seminars will be scheduled and all athletes will be invited and encouraged to attend. The functional objective of this program is the thorough education of athletes about the nature of drug abuse in order to encourage their resistance to taking these drugs. Also, regularly scheduled academic courses in drug abuse and reinforcement of positive self image will help someone to “say no”. Pertinent literature will be made available in the athletic

-24- training room for any athlete who requests it.

Prohibited Substances

The use of the following drugs is prohibited before, during, and after the varsity season except as may be prescribed by a physician qualified to treat the medical condition for which the prescription is made;

These substances include, but are not limited to: Anabolic Steroids, and /or masking agents. Cocaine/and other stimulants, such as amphetamines. Depressants (Barbiturates, Methaqualone) Hallucinogens (LSD, PCP) Marijuana, Heroin, THC. Opiates (narcotics, including heroin, opium, morphine). Weber State adheres to the NCAA’s list of Banned Substances. This list is on file in the Athletic Training Room, and can be found at www.drugfreesport.com.

Procedures

During the year a random selection process shall be used to select participants. Student athletes selected randomly from each sport will be required to participate in drug screening at various times during the academic year.

Manner of Testing

The drug screening shall consist of the collection of a urine sample from the athlete under the supervision of a certified athletic trainer, team physician, or other qualified health care professional. The donors’ names will be replaced with coded designations prior to sending the sample to a qualified laboratory for testing. The collection of the specimen may be observed, and the athlete may be asked to disrobe in order to protect the integrity of the testing procedure. Each urine sample shall be analyzed for the presence of prohibited drugs by a qualified laboratory. The testing lab shall report all test results to the certified athletic trainer within 24 - 48 hours.

The initial screen will be performed by a One Step Drug Screen Test Card. This card utilizes monoclonal antibodies to selectively detect elevated levels of specific drugs in the urine. A positive test will be confirmed by testing an aliquot of the same sample by an alternative method using the Gas Chromatograph procedure.

For purposes of this program, a positive shall meet a test result which indicates, in the opinion of the agency preforming such testing, the presence of one or more of the above listed drugs in the athletes’s urine.

ANY ATHLETE WHO HAS BEEN REQUESTED TO PROVIDE A SPECIMEN FOR TESTING PURPOSES AND WHO FAILS TO COMPILE WITH SUCH A REQUEST WILL BE DEEMED TO HAVE TESTED POSITIVE.

Any student athlete who is notified of a confirmed positive result may, within 24 hours of being notified, request the Athletic Director to meet with the student-athlete to review the test procedure used, to discuss the situation with the student athlete, and/or allow thee student athlete to provide any pertinent facts or mitigating circumstances. This meeting will occur as soon as possible.

Accuracy and Confidentiality

Reasonable precautions will be taken to assure and maintain the accuracy and confidentiality of the test results including the maintenance of a documented chain of specimen custody to insure the identity and integrity of the sample throughout the collection and testing process. Additionally, Reasonable precautions will be taken to assure that subsequent tests are conducted on a random basis.

All information and records, including test results, obtained under this policy, shall remain confidential and will be released only to the following persons as may be necessary and appropriate to carry out the purposes of this program; the athlete, the team physician (s), the athletic director, the athletic trainer (s), the head coach, the athlete’s parent (s), spouse, legal guardian(s), and his/her professional advisor(s) or counselor(s) Effect of Positive Test Results

First positive: If the positive result is thus verified and confirmed, the Head Athletic Trainer, and or Assistant Athletic Trainer will notify the athlete, the Athlete’s Head Coach and the Athletic Director. The athlete will be urged and advised to initiate immediate contact with he/her parents(s), legal guardian(s), or spouse to advise them of the positive result.

-25-

The athlete will be required to complete a mandatory drug counseling program under the supervision of a professional advisor. The advisor shall determine the length and manner of counseling best suited to the needs of the athlete. Refusal to participate in the counseling program set forth in this paragraph will be treated and handled as a second positive test result.

Student - athletes with positive results will be tested on a regular basis, recognizing that some prohibited substances take time to clear the body.

Second positive: If the positive result is thus verified and confirmed, the Head Athletic Trainer, and or the Assistant Athletic Trainer will notify the athlete, the Athletic Director, and the athlete’s Head Coach. Additionally, the Athletic Director shall notify the parent(s), legal guardian(s) or spouse of the second positive test results for the purpose of securing their assistance in the prevention of further illicit drug use by the athlete.

The athlete will be suspended from play or practice for a period of five (5) consecutive days. This suspension will include any practice, game or weight room hours during that time. If the 5 day suspension does not include a sanctioned competition, the student athlete will sit out the first sanctioned competition after the positive drug test. Prior to the implementation of the suspension period, the athlete will have the opportunity to discuss the matter with the Athletic Director and present evidence of any mitigating circumstances which the athlete feels important.. Refusal to participate in the steps and program as set forth in this paragraph and the immediately preceding paragraph will be treated and handled as a third positive test result.

The athlete will also be required to undergo professional therapy until the drug use has ceased. Termination of the drug rehabilitation program will be made by a trained Drug Rehabilitation Professional.

ALL EXPENSES OCCURRED AS A RESULT OF COUNSELING AND DRUG REHABILITATION SHALL BE PAID FOR BY THE ATHLETE.

Third positive: If a positive result is verified and confirmed, the Head Athletic Trainer, and or the Assistant Athletic Trainer will again notify the athlete, the Athletic Director, and the athlete’s Had Coach. Additionally the Athletic Director shall notify the athlete’s parent(s), legal guardian (s), or spouse.

At this time, the college will operate upon the assumption that the athlete has a serous problem and /or has made some conscious value judgements as to drug use, and deal with the athlete accordingly.

All athletic-related financial aid will cease at the earliest possible date consistent with the by-laws and constitution of the NCAA. The student athlete will be suspended from Weber State University athletic competition, and the team he/she is participating on.

Prior to the suspension of financial aid and athletic participation referred to above, the athlete will be given an opportunity to meet with the Athletic Director to present his/her side of the case together with evidence of any mitigating circumstances. No final action will be taken until after this meeting has been held. The Athletic Director shall have discretion to make any adjustments he/she finds to be necessary or appropriate based upon such information.

Testing for Cause

In addition to pre-season and random testing If the Athletic Director has reasonable cause that a student athlete has been abusing banned substances the Athletic Director may mandate that the student-athlete be tested. Specific and articulate facts which maybe accompanied by a logical deductions must be present. Vague or unspecified hunches are insufficient. The decision to test an individual athlete will be made by The Athletic Director, and the Weber State School attorney.

Consecutive Sanctions

ANY SANCTIONS BROUGHT AGAINST AN ATHLETE FOR VIOLATION OF THIS DRUG POLICY WILL BE MAINTAINED CONSECUTIVELY THROUGHOUT THE ATHLETE’S CAREER AT WEBER STATE UNIVERSITY.

Drug Counseling

If an athlete feels a need for counseling regarding chemical or alcohol should feel secure knowing that the athletic department

-26- shares this concern and will try to help. Professional outpatient therapy can be arranged for an athlete upon request. However all expenses will be paid for by the athlete.

Once the athlete is released from therapy and allowed to resume participation, any future violation of the policy will count as the next violation in the sequence, and those sanctions will be consistent with the policy.

Conclusion

The use of illicit drugs has no place in society as well as competitive athletics at Weber State University. While decisions with reference to drug usage and/or substance abuse ultimately depend upon the interests, values, motivations and determinations to the individual involved, it is believed that participation in this program will help Weber State athletes make more informed and intelligent decisions regarding drug usage both now and in the future.

MEDICAL ISSUES

Policy 1.0 Medical Disqualification of Student Athletes

The team physician has the final responsibility to determine when a student athlete is removed or withheld from participation due to an injury, an illness or pregnancy. In addition, clearance for that individual to return to activity is solely the responsibility of the team physician or that physician’s designated representative.

Policy 2.0 Heat illness

2.1 The following chart shall be used to identify heat stress conditions and provide guidelines for participation.

High - Only fit and heat-acclimatized student athletes can participate safely Moderate - Heat sensitive and unacclimatized student athletes may suffer. Low - Little danger of heat stress for acclimatized student athletes.

2.2 Heat Exhaustion – Symptoms usually include profound weakness and exhaustion, and often dizziness, syncope, muscle craps, nausea and core temperature below 104 degrees F with excessive seating and flushed appearance.

-27-

Treatment for Heat Exhaustion: Remove from activity, taking off all equipment and placing the student-athlete in a cool, shaded environment. Fluids should be given orally. Core temperature and vital signs should be serially assessed. To insure prompt cooling, the student-athlete may be cooled by ice water immersion. IV fluids replacement should be utilized if available but should be determined by a physician.

2.3 Exertional Heatstroke – Heatstroke is a medical emergency. Medical care should be obtained at once; a delay in treatment can be fatal. This condition is characterized by a very high body temperature, 104 degrees F or greater. The student-athlete likely will still be sweating profusely at the time of collapse, but may have hot, dry skin, which indicates failure of the primary temperature-regulating mechanism (sweating), and CNS dysfunction. Treatment for Exertional Heatstroke: Activation of the emergency action plan, assessment of core temperature/vital signs and immediate cooling of the body with ice water immersion. If ice water immersion is not available, wet ice towels should be used on a rotating basis. Student-athletes who incur heatstroke should be hospitalized and monitored carefully.

Policy 3.0 Eating Disorders

3.1 Weight loss should be agreed upon by both the coach and the student athlete with consultation with appropriate medical and nutritional personnel. 3.1.1 1. A responsible and realistic plan should be developed by all individuals involved. 3.1.2 2. Weight-loss plans should be developed on an individual basis. 3.2 Student athletes with suspected disordered eating patterns may be categorized into two groups as determined by the team’s certified athletic trainer (ATC). Group 1 Student athletes with significant body image distortions and manifesting behaviors such as obsession with body weight or food, binging, purging, purposeful starvation and/or a compulsion with exercise far above that required for sport performance. Group 2 Student athletes with unusual or uninformed eating habits (i.e. vegans, vegetarians, those over reliant on nutritional supplements) and/or female student athletes that have gone 3 or more consecutive months without a menstrual period but do not exhibit behaviors noted in group 1 above. 3.2.1 Those student athletes deemed by the certified athletic trainer (ATC) to be in group 1 will be referred to the Disordered Eating Response Team .

WSU Disordered Eating Response Team. - Steve Scharmann, M.D. - Carolie Meccico, LCSW - Julie Hansen RD 3.2.2 Student athletes determined by the certified athletic trainer to be in group 2 should first be evaluated by a nutritionist (Julie Hansen RD on campus). The nutritionist may then determine to involve the Disordered Eating Response Team as needed. 3.2.3 Student athlete confidentiality is paramount. Notification of coaches and parents must be done with discretion and ideally with the consent of the student athlete. Involvement of friends or teammates should be avoided. 3.2.4 1. Expenses incurred as a result of treatment will be the responsibility of the student athlete. NCAA ‘Needy Student Fund’ could be a possible source for assistance. 3.2.5 2. Noncompliant student athletes may be disqualified from sport participation by Team Physician, based on medical status.

Policy 4.0 Local Anesthetics

4.1 1. The use of local injectable anesthetics shall only be administered by a qualified clinician who is licensed to perform this procedure and who is familiar with these agents’ actions, reactions, interactions and complications. The treating clinician shall be aware of the quantity of these agents that can be safely injected. 4.2 2. Local injectable anesthetics shall only be administered in facilities equipped to handle any allergic reaction including a cardiopulmonary emergency that may follow their use. 4.3 3. Local injectable anesthetics shall only be administered when medically justified, when the risk of administration is fully explained to the student athlete, when the use is not harmful to continued athletics activity and when there is no enhancement of a risk of injury.

Policy 5.0 Injectable Corticosteroids

-28-

5.1 1. Injectable corticosteroids shall be administered only after more conservative treatments, including nonsteroidal anti- inflammatory agents, rest, ice, ultrasound and various treatment modalities, have been exhausted. 5.2 2. Only those physicians who are knowledgeable about the chemical makeup, dosage, onset of action, duration and potential toxicity of these agents shall administer corticosteroids. 5.3 3. Injectable corticosteroids shall be administered only in facilities which are equipped to deal with allergic reactions including cardiopulmonary emergencies. 5.4 4. Repeated corticosteroid injections at a specific site should be done only after the consequences and benefits of the infections have been thoroughly evaluated. 5.5 5. Corticosteroid injections only shall be done if a therapeutic effect is medically warranted and the student athlete is not subject to either short or long-term significant risk. 5.6 6. Injectable corticosteroids shall only be administered when medically justified, when the risk of administration is fully explained to the patient, when the use is not harmful to continued athletic activity and when there is no enhancement of a risk of injury.

Policy 6.0 Concussion or Mild Traumatic Brain Injury

Weber State University Athletics Department recognizes that sport induced concussions pose a significant health risk for those student-athletes participating in athletics at Weber State University. With this in mind, the WSU Athletics Department has implemented policies and procedures addressing concussion awareness, shared responsibility, general guidelines, concussion assessment, management, and return to play procedures. The Department also recognizes that baseline neurocognitive testing on student-athletes who participate in those sports which have been identified as collision, and/or contact sports, and/or who have had a history of concussions prior to entering Weber State University, will provide significant data for return to competition decisions. This baseline data along with a pre-participation physical examination, and/or further diagnostic testing will be used in conjunction in determining when it is safe for a student-athlete to return to competition. Weber State University Athletics Department recognizes that while risk of concussion my not be completely eliminated, there are ways to minimize head trauma exposure. To accomplish this, WSU Athletics is committed to: Adhering to Inter-Association Consensus: Year-Round Football Practice Contact Guidelines, and adhering to Inter-Association Consensus: Independent Medical Care Guidelines.

6.1 Concussion Awareness, Education Management and Shared Responsibility Policy 6.1.1 The Athletics Health Care Administrator will provide a copy of the NCAA Concussion Fact Sheet and WSU Concussion Policy & Management Protocol to all student-athletes and their parents/legal guardians, as well as to all WSU coaches, administrators, and medical staff. 6.1.2 After receiving and reviewing the NCAA Concussion Fact Sheet and WSU Concussion Policy & Management Protocol, All WSU student-athletes must read and sign the attached Student Athlete Concussion Statement acknowledging that: They have read and understand the NCAA Concussion Fact Sheet, and they accept the responsibility for reporting their injuries and illnesses to the sports medicine staff, including the signs and symptoms of concussions. 6.1.3 After receiving and reviewing the NCAA Concussion Fact Sheet and WSU Concussion Policy & Management Protocol, ALL WSU coaches (Head Coaches and Assistant Coaches) must read and sign the attached Coaches Concussion Statement acknowledging that they: Read and understand the NCAA Concussion Fact Sheet, 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 sports medicine staff suspected of sustaining a concussion. 6.1.4 After receiving and reviewing the NCAA Concussion Fact Sheet and WSU Concussion Policy & Management Protocol, All WSU Team Physicians, Staff Athletic Trainers, and Athletic Training Students, must read and sign the attached Medical Provider Concussion Statement acknowledging that they: will encourage their athletes to report any suspected injuries and illnesses to the WSU Sports medicine staff, including signs and symptoms of concussions, and will follow the WSU Concussion Policy and Management Protocol, and have read and understand the NCAA Concussion Fact Sheet. 6.1.5 After receiving and reviewing the NCAA Concussion Fact Sheet and WSU Concussion Policy & Management Protocol, ALL WSU Athletics Administrators must read and sign the attached Athletics Administrator Concussion Statement acknowledging that they: Have read and understand the WSU Concussion Policy Management Protocol, and have read and understand the NCAA Concussion Fact Sheet. 6.1.6 The Athletics Health Care Administrator will coordinate the distribution, educational session, signing, and collection of the necessary documents. The signed documents will be kept in each student-athlete’s medical file. 6.1.7 The Athletics Health Care Administrator will coordinate the signing of the above-mentioned documents on an annual basis for the medical personnel and coaches and will keep the signed documents on file. 6.2 Concussion Prevention / Minimizing Head Trauma Exposure. 6.2.1 In the attempt to minimize head trauma exposure, WSU Department of Athletics is committed to the Following:

-29-

6.2.1.1 Adherence to Interassociation Consensus: Year-Round Football Practice Contact Recommendations. 6.2.1.2 Adherence to Interassociation Consensus: Independent Medical Care for College Student-Athletes Best Practices. 6.2.1.3 Reducing gratuitous contact during practice. 6.2.1.4 Taking a ‘safety-first’ approach to sport. 6.2.1.5 Taking the head out of contact. 6.2.1.6 Coaching and student-athlete education regarding safe play and proper technique. 6.2.1.6.1 The WSU Athletics Equipment Staff are responsible for the ordering of all new football helmets, reconditioning of used helmets, fitting, and air pressure maintenance. 6.2.1.7 The football coaching staff will review and teach proper blocking and tackling techniques to minimize head and neck injuries. 6.2.1.8 The volleyball coaching staff will employ drills to improve blocking skills and teach proper rolling and diving skills to reduce collisions when diving on the floor. 6.2.1.9 The women’s soccer coaching staff will utilize drills to teach proper technique for heading the ball and raise awareness to open field head to head contact. 6.2.1.10 The softball coaching staff will utilize drills for batting, catching fly balls at the fence, and proper sliding techniques. Batting helmets will be inspected regularly by the coaching staff to insure proper working condition. 6.2.1.11 The spirit squad coaching staff will teach safety skills during vaulting, mounting, and dismounting maneuvers. 6.2.1.12 The strength and conditioning staff will provide exercises for all contact and collision sports to strengthen the core and cervical spine muscles to help decrease the amount of whiplash type injuries to the head and neck. 6.3 General Guidelines, Record Keeping and Training 6.3.1 The Athletics Health Care Administrator will coordinate an annual meeting to review and update the Concussion Policy & Management Protocol. 6.3.2 The Athletics Health Care Administrator will have on file an annually updated Emergency Action Plan for each Athletics venue to respond to catastrophic injuries and illnesses, including but not limited to concussions, heat illness, spine injury, cardiac arrest, respiratory distress, and sickle cell collapse. All athletics healthcare providers shall review and practice the plan annually. 6.3.3 The WSU Sports Medicine team will document the incident, evaluation, continued management, and clearance of the student-athlete with a concussion. 6.4 Role of Athletics Healthcare Providers 6.4.1 In general, all athletics healthcare providers and consultants will practice within the standards established for their professional practice. 6.4.2 WSU Team Physicians: 6.4.2.1 Authority to screen, evaluate, and treat concussion in accordance with written concussion management plan. 6.4.2.2 Authority to diagnose concussion. 6.4.2.3 Authority to make any and all management/return-to-play decisions using best practice clinical decision making and in accordance with written concussion management plan. 6.4.2.4 Only healthcare provider able to give final medical clearance for return-to-play. 6.4.2.5 Authority to provide and approve any and all educational materials to student athletes, caregivers, and coaches. 6.4.2.6 Authority to designate other healthcare providers to make same decisions as above when deemed necessary (e.g. during away competition). 6.4.2.7 Authority to interpret ImPACT, BESS, and SAC testing. 6.4.3 WSU Athletic Trainers: 6.4.3.1 Authority to screen, evaluate, and treat concussion in accordance with written concussion management plan. 6.4.3.2 Authority to make the assessment of concussion. 6.4.3.3 Does not have authority to make return-to-play decisions unless directed by WSU team physician (or team physician designee). 6.4.3.4 Authority to provide any and all educational materials to student athletes, caregivers, and coaches. 6.4.3.5 Authority to perform and interpret BESS and SAC testing. 6.4.4 Consultants: 6.4.4.1 Neurology, neuropsychology, or any other consultant deemed appropriate by WSU team physicians may participate in the care of concussed student athletes in conjunction with WSU team physicians. 6.4.4.2 Consultant recommendations (including return-to-play) will be used as part of the decision making process, but may not be the sole basis of final concussion management decisions. 6.4.4.3 Neuropsychology will be consulted to interpret ImPACT tests as deemed necessary by WSU team physicians. 6.5 Medical History and Baseline Testing

-30-

6.5.1 Every new (first year, transfer, or return missionary) student-athlete at Weber State University must complete a detailed medical history as part of the pre-participation physical exam. Previous head injuries, brain injuries, and/or concussions must be documented in the medical history. The medical history will be reviewed by a staff athletic trainer and team physician at WSU. 6.5.2 The team physician at Weber State University will determine the participation status for every new (first year or transfer) student athlete. Medical clearance for participation, medical non-clearance for participation, or the need for additional consultation or testing, will be documented in writing on the student-athlete’s pre- participation physical exam by the team physician. 6.5.3 Every new (first year, transfer, or return missionary) student-athlete at Weber State University who are participating in those sports which have been identified as a contact or collision sport and/or who have had a previous history of concussions as identified by their health history will have a baseline neurocognitive test and baseline balance test performed as part of their athletic medical screening. Currently the department utilizes the IMPACT concussion management system for neurocognitive testing and the BESS test to assess balance. The sports which currently undergo baseline neurocognitive testing and baseline balance testing are as follows: Football, Men’s Basketball, Women’s Basketball, Cheerleading, Women’s Soccer, Women’s Softball, Women’s Volleyball, Track & Field hurdlers, and field event participants. 6.6 Recognition and Diagnosis of Concussion 6.6.1 Medical personnel (WSU Team Physician and/or Athletic Trainer) with training in the diagnosis, treatment and initial management of acute concussion must be “present” at all NCAA varsity competitions in the following contact/collision sports: Football, men’s and women’s basketball, women’s soccer, and pole vault. To be present means to be on site at the campus or arena of the competition. Medical personnel may be from either team, or may be independently contracted for the event. 6.6.2 Medical personnel (WSU Team Physician and/or Athletic Trainer) with training in the diagnosis, treatment and initial management of acute concussion must be “available” at all NCAA varsity practices in the following contact/collision sports: Football, men’s and women’s basketball, women’s soccer, and pole vault. To be available means that, at a minimum, medical personnel can be contacted at any time during the practice via telephone, messaging, email, beeper or other immediate communication means. Further, the case can be discussed through such communication, and immediate arrangements can be made for the athlete to be evaluated. 6.6.3 Student athletes who exhibit signs, symptoms, or behaviors consistent with a concussion, will be removed from practice or competition, by either a member of the coaching staff or sports medicine staff with concussion experience. If diagnosed with a concussion, the student athlete will be disallowed to return that day. If removed by a coach, the coach will refer the student-athlete to the sports medicine staff with concussion experience to be evaluated. 6.6.4 A student-athlete suspected of sustaining a concussion will be evaluated by the team’s athletic trainer with concussion experience, ASAP. Should the team physician not be present, the athletic trainer will notify the team physician ASAP in order to develop an evaluation and treatment plan. A Graded Symptom Check List will be performed at the time of the injury or when first reported and then serially thereafter (i.e. 5 min. intervals assessing immediate change in mental status, 2-3 hours post-injury, 24 hours, 48 hours, etc.). Immediate examination will also include the administration of the “BESS” (Balance Error Scoring System) test. 6.6.5 Follow-up ImPACT testing of the injured athlete will be performed 24-48 hours post injury. 6.6.6 A student-athlete suspected of sustaining a concussion will also be evaluated for a cervical spine injury, skull fracture, and internal bleeding during the initial evaluation. Any signs and symptoms suggesting these injuries will warrant an immediate activation of the Weber State University Athletics Department Emergency Action Plan. 6.6.7 The WSU Athletics Department Emergency Action Plan will be initiated for a student-athlete who suffers a concussion and presents with any of the following: Glasgow Coma Scale < 13; prolonged loss of consciousness; focal neurological deficit suggesting intracranial trauma, repetitive emesis, persistently diminished/worsening mental status, or significant injury to the spine. 6.6.8 Student-athletes that sustain a concussion outside of their sport will be managed in the same manner as those sustained during sport activity. 6.7 Management 6.7.1 The student-athlete will receive serial monitoring for deterioration. In the event that the student-athletes condition deteriorates, the athletic trainer will contact the team physician or activate the EAP as appropriate. 6.7.2 The WSU “Post Concussion Instruction Form” will be given to any student-athlete sent home after a head injury and to the parent/guardian or adult who is to monitor the student-athlete throughout the night. This form instructs the parent or adult to call the athletic trainer, 911, or seek medical attention at the closest emergency department if any of the following develop: Persistent vomiting, confusion or disturbed behavior, disturbance of vision (e.g. blurring or double vision), inappropriate drowsiness, severe headache, limb incoordination or weakness. The best guideline is to note symptoms that worsen, and behaviors that seem to represent a change in the student athlete. 6.7.3 The “Post-Concussion Instruction Form” also instructs the student athlete as to where and when to report to the athletic trainer/team physician for a follow-up assessment. 6.7.4 The medical provider will document the injury, immediate care, follow-up care, & physician referrals in the student- athletes personal medical file. 6.7.5 The student-athlete will be monitored for recurrence of symptoms both from physical exertion and also mental exertion, such as reading, phone texting, computer games, watching film, athletic meetings, working on a computer,

-31-

classroom work, or taking a test. Academic advisors will be notified of the student-athlete’s concussion, with permission for release of information from the student-athlete. 6.7.6 The following “Management and Return to Play Protocol” will be used for all concussions: 6.7.6.1 Time of Injury: Remove from activity, clinical evaluation, graded symptom check list, and BESS testing to be completed. Activate EMS or referral if necessary. 6.7.6.2 Post injury 2-3 hrs.: Graded Symptom Check List to be completed, activate EMS or referral if necessary. Post- Concussion Instructions given to parents/guardian/roommate. 6.7.6.3 Post injury 24 hrs.: Graded Symptom Check List to be completed, post-concussion ImPACT neurocognitive assessment to be completed, referral if necessary. 6.7.6.4 Daily: Graded Symptom Check List to be completed, referral if necessary. 6.7.6.5 Weekly: Clinical evaluation (Wed. Clinic) by a team physician until: (1) asymptomatic at rest, (2) the 4-step graduated exertional return to play protocol has been completed successfully, (3) and gradual return to cognitive activity has been completed successfully. 6.7.6.6 Once Athlete Becomes Asymptomatic at rest and with full exertion: 6.7.6.6.1 Determine where athlete is relative to baseline on the following measures: ImPACT Neurocognitive Assessment and BESS balance test. 6.7.6.7 Detailed explanation of the above “Graduated Exertional Return to Play Protocol”, 4 – Steps 6.7.6.7.1 If the measures listed above are at least 90% of baseline scores and the athlete remains asymptomatic for one additional day following these tests, the team physician can instruct the athletic trainer to begin a 4-step graduated exertional return to play (RTP) protocol (see below) with the athlete to assess for increasing signs and symptoms. Symptoms should be reassessed immediately following exertional activities. 6.7.6.7.2 If the athlete remains asymptomatic on the day following the first step(s) of the graduated exertional RTP protocol, the athlete will be reassessed, and continue with the next step(s) on the graduated exertional RTP protocol. 6.7.6.7.3 All scores on the assessments and/or exertional activities will be documented in the student-athlete’s medical file by the staff athletic trainer. 6.7.6.7.4 The Staff Athletic Trainer will share the scores on the assessments and/or exertional activities with the Team Physician. 6.7.6.7.5 4-Step Graduated Exertional Return to Play Protocol 6.7.6.7.6 This exertional protocol allows a gradual increase in volume and intensity during the return to play process. The athlete is monitored for any concussion-like signs or symptoms during and after each exertional activity. 6.7.6.7.7 The following steps are not ALL to be performed on the same day. In some cases, steps 1 and 2 or 2 and 3 may be completed on the same day, but typically will occur over multiple days. Steps 3 and 4 will each be performed on separate and subsequent days. 6.7.6.7.8 Exertion Step 1: 20-minute stationary bike ride (10-14 mph). 6.7.6.7.9 Exertion Step 2: Jog a mile w/15 sec. recovery after each lap and 10x40yards sprints, half speed 6.7.6.7.10 Exertion Step 3: 10–14 x 40 yard sprints w/10-12 sec rest after each. 6.7.6.7.11 Exertion Step 4: Unrestricted training and return to non-contact full participation practice (Red jersey). 6.7.6.7.12 Exertion Step 5: Return to competition (Has been cleared by team physician: 6.8.1) 6.8 Return to Play Procedures 6.8.1 Student-athletes will be permitted to return to play when cleared by the team physician. Clearance will also include being asymptomatic for at least five days at rest and with exercise as well as passing (return to baseline) the ImPACT and BESS tests. 6.8.2 Re-Evaluation by the Team Physician and CT or MRI is recommended when headache or other symptoms worsen or persist longer than one week. 6.8.3 Following a second concussion in the same season, return to play will be deferred until the athlete has had at least two weeks symptom-free at rest and with exercise. Clearance to play will also include being cleared by the team physician and passing the ImPACT test and BESS test. 6.8.4 Termination of the season is mandated by any abnormality on CT or MRI scan consistent with brain swelling, contusion, or other intracranial pathology, or is not cleared by the team physician for any other reason not mentioned. 6.8.5 If the student-athlete becomes symptomatic at any point during the return to play process, exertional activities will be discontinued until asymptomatic. Once asymptomatic, the athlete should then continue the 4-step graduated exertional return to play protocol. 6.8.6 No athlete can return to full activity or competitions until they are asymptomatic in limited, controlled, and full- noncontact practice/activities, AND cleared by the Team Physician. 6.9 Return to Cognitive Activity Procedures 6.9.1 The Athletics Health Care Administrator will act as the point person, working in conjunction with the Director of Student-Athlete Academic Services, in managing the return of the student athlete to cognitive activity. 6.9.2 While managing the return to cognitive activity, WSU Athletics with remain in compliance with ADAAA 6.9.3 Student-athlete will not be permitted to return to classroom activity on the same day as the concussion.

-32-

6.9.4 During the first 24 hours following a concussion, student athletes should avoid potential cognitive stressors such as schoolwork, video games, reading, texting, watching television, attending film sessions, and anything else that requires concentration and attention. 6.9.5 After the initial 24-hour recovery period, if the student athlete cannot tolerate 30 minutes of light cognitive activity, he/she should remain at home or in the residence hall. 6.9.6 Once the student athlete can tolerate 30-45 minutes of cognitive activity without return of symptoms, he/she should return to the classroom in a step-wise manner. Such return should include no more than 30-45 minutes of cognitive activity at one time, followed by at least 15 minutes of rest. 6.9.7 A letter verifying a concussion/head injury will be provided by a physician to assist academic faculty/staff with providing accommodations. The following statement is included in this correspondence: “This WSU student-athlete is currently being treated for a concussion. The treatment for this injury is rest (both physical and mental). It is my request that you please postpone any scheduled assignments, quizzes or tests for at least one week and provide an opportunity to make up this course work.” 6.9.8 It is recommended that the student athlete counsel with an athletic trainer on a daily basis as he/she increase his/her level of cognitive activity. A multi-disciplinary team will be utilized to make decisions on increased activity. This team will include the team physician, athletic trainer, and faculty athletic representative. Other members of this team may include: A faculty representative, coach, individual teachers and psychologist. 6.9.9 WSU Disability Services will be utilized in the event that recovering student athletes cannot be fully managed through scheduled modifications and academic accommodations.

Policy 7.0 Diabetes

Student athletes with type I diabetes should meet the following criteria before participation in an athletic or conditioning program is permitted: Knowledge, technical mastery, and consistent application of home blood sugar monitoring techniques. Achievement of reasonable blood sugar controle. Evidence of passing a recent screening for diabetic microvascular complications. Knowledge of preventive strategies needed to avoid hypoglycemia during and after exercise. Prior arrangements with the athletic trainer should be made to ensure emergency treatment of hypoglycemia. Glucose tablets and a Glucagon Emergency Kit must be carried by both athletic trainer and student athlete. The student athlete should also carry regular insulin for the treatment of hyperglycemia.

7.1 Hypoglycemia 7.1.2 If an student athlete’s blood sugar goes too low (< about 60 milligrams per deciliter mg/dl) he/she can have a low blood sugar reaction, called hypoglycemia. Hypoglycemia can come on fast and is considered to be an emergency. It needs prompt recognition and proper attention. The Certified Athletic Trainer and Coach must learn the symptoms of hypoglycemia and what to do about it. 7.2 Signs and Symptoms of Hypoglycemia · Shakiness or nervousness · Fatigue · Sweating · Pale skin color · Confusion, irritability or impatience · Sudden moodiness or behavior change, such as crying for no apparent reason · Clumsy or jerky movements · Tingling sensations around the mouth 7.3 Treatment The most important thing a diabetic can do during a reaction is to eat something to counteract the low blood sugar. - Hard candy equal to about five life savers - A regular- not diet- soft drink - Half a cup of juice - Glucose tablets (2) (Glucose tablets must be carried by both student athlete and ATC if a diabetic is on your team) **Never give food to a person with diabetes who is unconscious from hypoglycemia**

7.4 If the student athlete is unconscious or unable to eat the ATC should assist the student athlete in administering a Glucagaon Shot.(Glucagon Emergency Kits should be carried by both student athlete and ATC if a diabetic in on your team) Glucagon is a hormone that raises the level of glucose in the blood. The alpha cells of the pancreas, in areas called the islets of Langerhans, make glucagon when the body needs to put more sugar into the blood.

7.5 If the student athlete is unconscious or can’t eat and the athletic trainer is unable to assist in the administration of a Glucagon shot, call 911 for intravenous glucose.

7.6 Hyperglycemia

-33-

7.6.1 Hyperglycemia is the flip side of hypoglycemia. It occurs when the blood sugar is too high, and usually develops much more slowly. Student athletes may not experience any of the signs and symptoms listed below unless their blood sugar is extremely high (above 350). Untreated high blood sugar (hyperglycemia) can result in diabetic ketoacidosis (DKA) or hyperosmolar syndrome. These conditions can be fatal if not treated promptly. Hyperglycemia and worsening ketosis can result with insulin deficiency if exercise is started when blood glucose levels are higher than 250 to 300 mg/dl. With elevated blood glucose and urine ketones, exercise should be postponed until control improves. 7.7 Signs and Symptoms of Hyperglycemia · Extreme thirst · Frequent urination · Dehydration · Fatigue · Blurred vision · Vomiting · Agitation or confusion · Weakness · Rapid breathing · A sweet smell to the breath 7.8 Treatment - Immediately drink a large amount of non-caloric or low caloric fluid. - Take extra insulin (regular) every 3 hours until blood sugars are below 200 mg/dl - If nausea becomes severe, call team physician.

Policy 8.0 Athletic Injury Procedures

All athletic injuries should be reported to a member of the Weber State Athletic Training staff as soon as possible after the onset of injury. Failure to promptly report injuries may delay return to activity and/or effect secondary health insurance coverage.

8.1 Injury Treatments/Rehabilitation Student athletes may be required to undergo specific treatment in the athletic training facility in the event of injury. All treatments and rehabilitation will be directed by a certified athletic trainer with periodic consultation with team physicians. Athletes are expected to schedule treatments/rehabilitation around their class schedules and to pay close attention to the operating hours of the athletic training facility.

8.2 Practice/Competition limitations All decisions regarding practice and competition participation will be made jointly by the athletic trainers in conjunction with periodic physician consultations. It is our policy to avoid putting athletes into situations that are unsafe in relation to their injury. Priority is placed on student athlete safety. Daily communication between the athletic trainers, coaches and athletes is necessary to make appropriate decisions regarding athletic participation.

8.3 Physician Referrals/Consultation Physician referrals are a necessary component of the Weber State University athlete healthcare system. Decisions regarding physician referrals are made by the athletic training staff. An appointment will be scheduled by one of the athletic trainers if a physician referral is deemed necessary. Every effort is made to schedule appointments around practices, team meetings, and class schedules. Transportation to appointments may be either by the athletic training staff or athletes' personal vehicle.

8.4 Missed doctor's appointments An athlete missing a scheduled doctor’s appointment will be required to reschedule the appointment at his or her own convenience.

8.5 Second Opinions Athletes are welcome to get second opinions regarding medical issues. A member of the Weber State sports medicine staff must be informed of all appointments concerning second opinions. Insurance coverage may be denied if Weber State sports medicine staff has not been notified.

8.6 Prescription Medication Policy Team physicians may write prescriptions to athletes on a medically necessary basis. If prior arrangements have not been made, athletes will need to purchase these prescriptions on their own and submit receipts to the athletic training room for reimbursement. Athletes will not be reimbursed for medication that is for the treatment of non-athletic related injuries. The Weber State athletic training staff will not distribute any prescription medications.

8.7 Over the Counter Medication Policy

-34-

Over the counter medications will be dispensed as indicated by standing orders from our supervising Team Physicians to Weber State student-athletes. Over the counter medication (Tylenol, Aleve, Ibuprofen, cough suppressant, and decongestant) will be stocked and distributed by a member of the athletic training staff to athletes as needed. Over the counter medications are stored in a common key access cabinet in the athletic training facility.

8.8 Dental/Vision policies and procedures

Dental or eye injuries resulting from participation in intercollegiate athletics at Weber State University are covered under the athletic department secondary insurance policy. Appropriate arrangements will be made with dentists or ophthalmologists as needed. Check-ups for the eyes or dental work is to be paid for by the athlete. Spare contact lenses should be given to the athletic training staff if the student athlete uses them or in the event contacts are lost during competition.

Policy 9.0 Athletic Injury Rehabilitation Procedures

9.1 General Protocol for the Care and Rehabilitation of Athletic Injuries:

Setting Therapeutic Goals o Long - range goals should encompass several short-range goals Continual Evaluation o The SAID (specific adaptation to imposed demands) principle requires both an accurate initial evaluation and daily re-evaluation to determine the athlete’s response. Functional Progression o Should progress from the easiest of activities to full sports participation (PRE Progressive resistive exercise) Early Exercise o Early exercise speeds healing o Lack of exercise may result in permanent disability o Caution must be observed Rate of Reconditioning o Redevelopment is much quicker than development o Much of the strength lost after injury is the result of pain-induced inhibition Pain Free o All exercises should be pain free o Exercises should not cause swelling o Exercises should not cause residual pain Biofeedback o Measure athlete’s performance in some way and then tell the athlete what his Scores were. Athlete’s Health Comes First o As long as the athlete’s health is the uppermost concern, rehabilitation should proceed as quickly as possible.

9.2 10 Phase Protocol for the care and Rehabilitation of Athletic Injuries:

Phase 1: Structural Integrity o First priority is that anatomical structures are intact § Injury or Illness my require: • Surgery • Immobilization • Rest Phase 2: Pain - Free Joints and Muscles o The following are techniques and practices that should be utilized to diminish pain: § Immobilization § Therapeutic modalities § Cryotherapy § Graded exercise (quad sets, isometric contractions..) Phase 3: Joint Flexibility o Decreased joint flexibility results from: § Muscle spasm, pain (Therapeutic exercise with cold) § Connective tissue adhesions (Therapeutic exercise with heat) o When 80% of flexibility is restored rehabilitation emphasis moves to the development of muscular strength.

-35-

Phase 4: Muscular Strength o Must perform a progressive resistive exercise on a regular basis. (DAPRE) o Each side of the body should be worked independently. o Once strength in the injured side is 90% of the non-injured side, emphasis moves to the development of muscular endurance. Phase 5: Muscular Endurance o The following, or similar to, should be utilize in the development of muscular endurance o Stationary bike o Running when tolerated (jog 400 meters first day and increase by 400 meters each 1 or 2 days) o When athlete can run equivalent to 1 mile, emphasis should move to next phase Phase 6: Muscular Speed o The following, or similar to, should be utilize in the development of muscular speed § High intense stationary bike § Cybex

Phase 7: Muscular Power o The following, or similar to, should be utilize in the development of muscular power § Isokinetic devices § High- speed resistive work Phase 8: Skill Patterns o Participation in team drills at 2 speed o Sport-specific skill patterns Phase 9: Agility o Participation in team drills at 3/4 speed to full speed o Skill patterns are performed quickly and speedily Phase 10: Cardiovascular Endurance o Develop creative ways to maintain cardiovascular endurance throughout rehab.

Efficacy for Therapeutic Modalities in Rehabilitation of Athletic Injuries

Intact Joints/ Pain-Free Flexibility Strength Endurance Speed Skill Cardio Muscle Joints/Muscles Cold Pack 1 2 Ice Massage 1 2 Cold Bath 1 2 Hot Whirlpool 1 3 2 Hot Pack 1 3 2 Paraffin bath 1 3 2 Contrast bath 1 3 2 Ultrasound 1 3 3 Diathermy 1 3 Low Volt MS 1 2/3 2/3 High Volt MS 2 1 Exercise Passive 2 1 Assistive 2 3 Active Ex. ROM 2 2 3 jogging 3 3 1 1 1 Sprinting 2 3 2 1 Agility drills 2 3 2 1 1 2 Team drills 2 3 2 2 1 2 Practice 2 3 2 2 1 2 Resistive Ex. Manual 2 Isometric 2 Isotonic Ex. Free weights 1 2 2 3 3 Machine weights 1 2 2 3 Variable resistance 2 1 2 2 3 Isokinetic 1 2 1 3

1 – Modality of choice 2 – Not the modality of choice but is moderately effective in accomplishing rehabilitation emphasis. 3 – Can have some but limited effect in accomplishing rehabilitation emphasis.

-36-

Policy 10.0 Staphylococcal Infections

This information is provided to assist student athletes in the control and prevention of staphylococcal (commonly called staph) infections. These infections usually are easy to treat with inexpensive, well-tolerated antibiotics. However, some staph bacteria have developed resistance; that is, the antibiotics can no longer kill the bacteria. Although antibiotic-resistant infections pose a significant health threat, the following measures are effective against many other infectious diseases.

10.1 What is a Staphylococcal Infection ? Staphylococcus aureus commonly causes boils and soft-tissue infections as well as more serious conditions such as pneumonia or bloodstream infections. According to the Centers for Disease Control and Prevention (CDC), twenty to thirty- five percent of adults and children in the United States are colonized with staph bacteria but do not cause illness. Staphylococcus aureus colonization usually occurs in the armpit, groin, genital area, and, most frequently, the inside of the nose. Most infections occur through direct physical contact of the staph bacteria with a break in the skin (cut or scrape) or during contact with inanimate objects (such as clothing, bed linens, or furniture) soiled with wound drainage. Your hands must be clean before you touch your eyes, nose, mouth, or any cuts or scrapes on the skin. The bacterium is not carried through the air and is not found in dirt or mud.

10.2 Strategies to Prevent Staphylococcal Infections All HAND WASHING IS THE SINGLE MOST IMPORTANT BEHAVIOR IN PREVENTING INFECTIOUS DISEASE The proper way to wash your hands: 1. Use warm water. 2. Wet your hands and wrists. 3. Using a bar or liquid soap. 4. Work soap into a lather and wash between fingers, up to wrists, and under fingernails for at least 15 seconds. 5. Dry, using a clean cloth towel or paper towel. 6. Use alcohol-based hand sanitizers to wash hands immediately if they come in contact with any body fluid at the playing field or other places where hand-washing facilities are not available. Wash your hands as described above: 1. After sneezing, blowing, or touching your nose. 2. Before and after close contact or using the toilet. 3. Before leaving the athletic area.

10.3 Other Precautions 1. Keep your hands away from your nose and groin. 2. Do not share towels, soap, lotion or other personal care items, even on the sidelines at games. 3. Shower with soap and water as soon as possible after direct contact sports 4. Dry using a clean, dry towel. 5. Use a moisturizing lotion to prevent dry, cracked skin. 6. Prewash or rinse with plain water items that have been grossly contaminated with body fluids. 7. Wash your towels, uniforms, scrimmage shirts, and any other laundry in hot water and ordinary detergent and dry on the hottest possible cycle. 8. Inform your parents of these precautions if laundry is sent home. 9. More specific directions may be provided by your athletic trainer or coach.

10.4 How to Care for Draining Wounds MRSA may be more difficult to treat. However, treatment is usually successful after prompt, appropriate evaluation by a doctor or clinic and when the correct antibiotic(s) (if indicated) is prescribed. Other types of treatments may be indicated.

WITH YOUR PHYSICIAN

A physician or advanced practitioner should examine the wound. A culture and susceptibility test should be performed to determine what bacteria you have and what antibiotic would be the most effective with the fewest side effects. If the practitioner determines you do not have a bacterial infection, you will not receive an antibiotic. Antibiotics are not effective against non-bacterial infections. 1. Take all medication even after the infection seems to have healed. 2. If a topical ointment is prescribed, apply as directed. 3. Follow all other directions the physician/practitioner gives you. 4. Inform the physician/practitioner if you are not responding to treatment.

HOW TO TAKE CARE OF WOUNDS AT HOME

-37-

1. Avoid direct contact with others until the wound is no longer draining and you have been instructed by your physician to resume your usual activities. 2. Wash your hands frequently, especially before and after changing band-aids, bandages, or wound dressings. 3. Keep the wound covered. The dressing must be changed at least twice a day; or, more frequently, if drainage is apparent. 4. All disposable materials that come into contact with the wound (including dressings or bandages) need to be placed in a separate plastic bag and closed before being disposed of in the household trash. Wash your hands after removing and disposing of the soiled dressing. 5. Use isopropyl alcohol (available at pharmacies or grocery stores) to disinfect reusable materials, such as scissors or tweezers after each use. 6. All items that come in contact with the wound must be disinfected with a fresh (prepared daily) mix of one tablespoon of household bleach to one quart of water or a phenol-containing product such as Lysol¨ or Pine-sol¨. Use a phenol-containing spray to disinfect any cloth or upholstered surface. Other commercially available products may be appropriate. 7. Have a designated chair or area for sitting. It should have a hard surface or an easily cleaned plastic or similar cover for easy disinfection. No one else should sit there until the wound has healed completely. 8. Utensils and dishes should be washed in the usual manner with soap and hot water or using a standard home dishwasher. 9. Carry laundry away from the body in a plastic or other lined bag that will not allow wet articles to drain through. 10. Handle and launder all clothing, towels, and linens that come in contact with the wound separately from those of other members of the household. Use a separate hamper. 11. Articles that come in contact with the wound should be washed in hot water with the usual detergent. 12. Dry clothes thoroughly using the hottest setting. 13. Towels and linens should be changed daily. 14. Do not share ointments or antibiotics.

HOW TO TAKE CARE OF WOUNDS AT SCHOOL

1. Follow any instructions that your athletic trainer, coach, or school nurse give you regarding direct contact with other persons at school. 2. Carry and use an alcohol-based hand sanitizer when soap and water are not available. 3. Wash hands immediately after contact with the wound. 4. Do not take antibiotics to prevent an infection.

-38-