Health & Safety

Concussions
Sudden Cardiac Arrest Syndrome
PEDs
MRSA
H1N1
Beat the Heat
Hydration
Southwest Sports Wellness Foundation
Health & Saftey Committee

Concussions

Nationwide data continues to show that many catastrophic head injuries are a direct result of injured athletes returning to play too soon, not having fully recovered from the first head injury. Additionally, the Centers for Disease Control reports that approximately 3 million sports and recreational concussion occur every year.

California law mandates that all coaches must receive training on concussions. The training may be fulfilled through the free, online course available through the National Federation of State High School Associations (NFHS).

Complete this 20-minute online class for FREE from the NFHS and the CIF.
Coaches should download and print their certificate at the completion of the course.

Additionally, California law mandates that all CIF member schools must comply with the following: On a yearly basis, a concussion and head injury information sheet shall be signed and returned by the athlete and the athlete's parent or guardian before the athlete's initiating practice or competition.

Below is the document from the Centers for Disease Control and Prevention (CDC) that schools/districts may use to meet this mandate which informs parents and students on concussion signs and symptoms.

NEW Concussion Information Sheet
This form is recommended for use by the CIF Sports Medicine Advisory Committee (SMAC)

The CIF Concussion Information Sheet is recommended for schools to use to comply with CIF Bylaw 503.H. – Concussion Protocol and California State Law AB 25 (Education Code § 49475).

Recent changes to California law (A.B. 2127) also require that the schools take additional measures to reduce risks and minimize injuries for concussed athletes.

NEW CIF Acute Concussion Notification Form for Parents/ Guardians
This form is recommended for use by the CIF Sports Medicine Advisory Committee (SMAC)

The CIF Acute Concussion Notification Form for Parents/Guardians is the recommended form for schools to use in communicating with parents/guardians when a student-athlete displays signs and symptoms of concussion.

RETURN TO LEARN

These three (3) documents (below) are to assist the concussed student to “return to the classroom and learning environment” in a scientific manner regarding brain activity.

NEW Physician Letter to Schools Form
This form is recommended for use by the CIF Sports Medicine Advisory Committee (SMAC)

The Physician Letter to Schools Form is recommended for physicians to use when communicating with school personnel and parents/guardians.

NEW CIF Concussion Return to Learn (RTL) Protocol Form
This form is recommended for use by the CIF Sports Medicine Advisory Committee (SMAC)

The CIF Concussion Return to Learn (RTL) Protocol Form is recommended for use by all parties involved with returning a student-athlete to the classroom.

NEW CIF Physician (MD/DO) Recommended School Accommodations Following Concussion Form
This form is recommended for use by the CIF Sports Medicine Advisory Committee (SMAC)

The CIF Physician (MD/DO) Recommended School Accommodations Following Concussion Form is recommended for use by all parties involved with returning a student-athlete to the classroom.

RETURN TO PRACTICE AND PLAY
Medical science and concussion care experts have found that a concussed athlete must take a gradual and progressive, stage by stage, step by step return to practice under medical supervision to minimize risks and allow the brain to properly recover. A.B. 2127 and CIF Bylaws mandated a MINIMUM timeline, but medical experts recognize that many adolescent concussion patients may take much longer to recover. Always be cautious as returning to practice and play too quickly may have catastrophic consequences.

NEW CIF Concussion Return to Play (RTP) Protocol
This form is recommended for use by the CIF Sports Medicine Advisory Committee (SMAC)

The CIF Concussion Return to Play Protocol Form is recommended for use by all parties involved with returning a student-athlete to play.

NEW CIF Grade Concussion Symptom Checklist
This form is recommended for use by the CIF Sports Medicine Advisory Committee (SMAC)

The CIF Graded Concussion Symptom Checklist Form is recommended for parents/guardians and student-athletes to use when communicating signs and symptoms of a concussion to their physician. This form should be completed as a baseline at the beginning of the season and also used after a suspected concussion as a checklist to record daily symptoms.

Additional Resources:

Play It Safer
NFHS SMAC Position Statements Soft Helmets
Coaches Resources
Licensed Health Care Providers Resources
School Resources
Students and Parent/ Guardian Resources

Complete this 20-minute online class for FREE from the NFHS and the CIF.
Coaches should download and print their certificate at the completion of the course.

What Is Sudden Cardiac Arrest?
Sudden Cardiac Arrest (SCA) is not a heart attack. It’s an abnormality in the heart’s electrical system that abruptly stops the heartbeat. It's caused by an undetected congenital or genetic heart condition.

First Symptom May Be Death
Possible Warning Signs: Unexplained fainting, shortness of breath, lightheadedness, chest pain, heart palpitations, family history of SCA or unexplained sudden death under the age of 50.

1 Youth Athlete Dies Every 3 Days in the United States
SCA is 60% more likely to occur during exercise or sports activity, so athletes are at greater risk. SCA is also the leading cause of death on school campuses.

Time Critical
If not properly treated within minutes, SCA is fatal in 92% of cases.

Are there warning signs?Although SCA happens unexpectedly, some people may have signs or symptoms, such as:

dizziness
lightheadedness
shortness of breath
difficulty breathing
racing or fluttering heartbeat (palpitations)
syncope (fainting)
fatigue (extreme tiredness)
weakness
nausea
chest pains

These symptoms can be unclear and confusing in athletes. Often, people confuse these warning signs with physical exhaustion. SCA can be prevented if the underlying causes can be diagnosed and treated.
Resources
NFHS Sudden Cardiac Arrest Course (Free)
SCA Flyer/ SCA Flyer (Spanish)
SCA Fact Sheet / SCA Fact Sheet (Spanish)
SCA Risks and Symptoms
SCA Frequently Asked Questions
Cardiac Chain of Survival
SCA Testimonials
SCA Parent/Student Review Form / Spanish Version
A Parents Guide to Sudden Cardiac Arrest (Video)
Informational Videos
Eric Paredes Save a Life Foundation

Performance Enhancement Drugs (PEDs)

What to do if you suspect drug use

Remember you are not alone, there is plenty of help.
Document the specific behaviors/signs that have made you suspect use.
Talk with the person about your specific concerns.
Listen to the person.
Let the person know of your expectations.
Let the person know you are willing to help them meet these expectations.
Hold the person and yourself accountable, follow through and don't enable sickness.

INFORMATION ON STEROIDS

National Institute on Drug Abuse - A great resource to find information about physical and psychological effects of anabolic steroid use.
Kids Health for Parents - Information you should know about steroids.
Anabolic Steroid Abuse - Resource for information on abuse of steroids.
The Efrain Anthony Marrero Foundation - Tells Efrain's story and explains the risks and signs of steroid use.
Taylor Hooton Foundation - The foundation's primary objective is to raise awareness among the general population about the dangers of steroid abuse.

MRSA

MRSA (methicillin-resistant staph aureus) is a type of staph infection that is resistant to many common antibiotics and, in cases where treatment is needed, can be very difficult to treat. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics, but occasionally serious infections require treatment. In the last few years, there have been a number of cases where these bacteria have spread among members of sports teams. Recently, this issue is making headlines as MRSA can have serious and deadly ramifications if not dealt with immediately.

MRSA Alert for Student/ Athletes and Parents
MRSA Alert for Coaches

Resources
Skin Infections and MRSA Information- These documents from the California Department of Public Health (CDPH) were designed to educate and alleviate fears generated by staph reports.

NFHS Position Statement: Skin Infections and Guidelines

Center for Disease Control - Print downloadable posters

H1N1

H1N1November 4, 2009 - The California Interscholastic Federation (State CIF) has received several inquiries related to the H1N1 Virus (Swine Flu) and its potential impact on upcoming State CIF Championships.

While we recognize the desire of schools and communities to have students participating in these events, the CIF places

the safety and health of everyone involved – both participants and spectators – as our top priority. Toward that end, the State CIF Executive Committee has requested that staff distribute the following policy regarding the H1N1 Virus (Swine Flu) and State CIF State Championships.

TEAM SPORTS

Teams from schools that are closed due to the H1N1 Virus (Swine Flu) will not be allowed to participate in State CIF Championships (including regional play) until the school has been re‐opened and classes resume (i.e. a school closed on Friday would not be considered re‐opened until classes resume on Monday). In an effort to provide a participation opportunity for schools in this situation, the State CIF will allow a State CIF playoff game in a team sport to be conducted later than its originally scheduled date on the bracket, provided that the contest is played prior to the next round of play. If a contest is not able to be completed within these parameters, the contest will be considered a forfeit by the school closed due to the H1N1 Virus (Swine Flu) and the other school’s team will advance in the bracket.

The State CIF Sports Medicine Committee has advised that under no circumstances should a school participate in more than two football games within any eight-day period (bylaw 1905). The potential risk to the health and safety of participants causes serious concerns for the Committee.

INDIVIDUAL SPORTS

Students of schools that are closed due to the H1N1 Virus (Swine Flu) will not be allowed to participate in high school athletics until the school has been re‐opened and classes resume (i.e. a school closed on Friday would not be considered re‐opened until classes resume on Monday). Due to the high number of individuals involved in these events, it is simply not possible to move and/or reschedule individual sport state championships on such short notice.

It is strongly suggested that sections, leagues and schools adopt this policy, or a similar one, in advance of facing these types of situations. The State CIF encourages schools and leagues to work together to balance the desire to have contests played while keeping the health and safety of participants and spectators at the forefront.

For the latest information on H1N1 please go to the California Department of Public Health web site: http://www.cdph.ca.gov/

Beat the Heat

Exercise produces heat within the body and can increase the player's body temperature. Add to this a hot or humid day and any barriers to heat loss such as padding and equipment, and the temperature of the individual can become dangerously high. There are several steps which can be taken to prevent heat illness from occurring:

ADEQUATE HYDRATION

The athlete should arrive at practice well-hydrated to reduce the risk of dehydration.
Water or sports drinks should be readily available to athletes during practice and should be served ideally chilled in containers that allow adequate volumes of fluid to be ingested.
Water breaks should be given at least every 30-45 minutes and should be long enough to allow athletes to ingest adequate volumes of fluid.
Athletes should be instructed to continue fluid replacement in between practice sessions.

GRADUAL ACCLIMATIZATION

Intensity and duration of exercise should be gradually increased over a period of 7-14 days to give athletes’ time to build fitness levels and become accustomed to practicing in the heat.
Protective equipment should be introduced in phases (start with helmet, progress to helmet and shoulder pads, and finally fully uniform).

HYDRATION STATUS RECORD KEEPING

Athletes should weigh-in before and after practice, ideally in dry undergarments in their to check hydration status.
The amount of fluid lost should be replaced by the next session of activity. An athlete should drink approximately 16 oz of fluid for each kilogram of fluid lost (1 kg = 2.2 lbs).
The color of the urine can provide a quick guess at how hydrated the athlete. If the urine is dark like apple juice means the athlete is dehydrated. If the urine is light like lemonade in color means the athlete seems adequately hydrated.

ADDITIONAL PREVENTION MEASURES

Appropriate medical coverage during exercise.
The use of light weight synthetic clothing which aids heat loss.
Athletes should wear light colored clothing.
Well-balanced diet which aids in replacing lost electrolytes.
Avoid drinks containing stimulants such as ephedrine or high doses of caffeine.
Alteration of practice plans in extreme environmental conditions.
Adequate rest breaks in the shade.
Allow athletes to remove unnecessary equipment during rest breaks.
Athletes with febrile or gastrointestinal illnesses should not be allowed to participate until recovered.

RESOURCES

Prevention of Heat Illness
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CIF Position Statement & Recommendations
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NFHS Position on Heat Illness
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ID and Treatment of Heat Illness
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Facts About Heat Stress
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Hydration and Prevention

Adequate hydration is necessary for all student-athletes, especially to prevent heat illness from occurring. Here are the suggested steps to take for proper hydration:

The athlete should arrive at practice well-hydrated to reduce the risk of dehydration.
Water or sports drinks should be readily available to athletes during practice and should be served, ideally chilled, in containers that allow adequate volumes of fluid to be ingested.
Water breaks should be given at least every 30-45 minutes and should be long enough to allow athletes to ingest adequate volumes of fluid.
Athletes should be instructed to continue fluid replacement in between practice sessions

Hydration information from the Sports Library of the Gatorade Sports Science Institute

﻿Concussions﻿

Performance Enhancement Drugs (PEDs)

MRSA

H1N1

Beat the Heat

Hydration and Prevention

Concussions