Section 05 - Safety Guidelines

5.1 CURRENT FIRST AID CARD

5.1.0. All coaches must obtain and maintain a current first aid card or successfully complete an equivalent course that is approved by the Athletic/Activity Director. This requirement applies to all coaches, paid or volunteer.

5.1.1 During a sports season, any coach that does not hold a current First Aid/CPR card, which is valid for the entire season, will not be allowed to supervise or coach unless under the direct supervision of a coach with proper first aid/CPR certification.

5.1.2. Special assignment pay specified in the supplemental coaching contract is paid in accordance with the regulations and requirements of the district as contained in the policy and procedures book. It is an expectation of state and school board policies that coaches hold and maintain a current first aid and CPR card.

5.2 ACCIDENT & INSURANCE

5.2.0. ACCIDENTS

FIRST AID

• All coaching staff members must be able to handle minor injuries through first aid training.

5.2.1 EMERGENCIES

• When a serious injury occurs that requires immediate medical attention, the coach in charge must take appropriate first aid measures (with special attention to the Prevention and Care. factors in the following section of this manual).

If a physician, emergency medical technician (EMT) or other medical professional is present, his/her assistance shall be requested.

Call 911 if additional emergency medical assistance is required.

Note: All coaches are required to have WVSD Emergency Medical Information and Authorization forms for every student athlete on their team eligibility list at all games and practices.

5.2.2 SERIOUS INJURY

• When a serious injury occurs, the athlete shall be advised to see his/her medical provider.

• Coaches shall not designate a specific physician or clinic, unless directly requested to do so by the parent or guardian.

• The athlete must provide a written release from his/her medical provider before they may return to any sports activity.

5.2.3. REPORTING

Injuries are to be reported to the Principal/Designee & Athletic Trainer (HS) by the coach(es)

A WVSD Accident Report Form must be completed and turned in within 24 hours.

If the athlete is enrolled in the WVSD Student Accident Insurance Program, he/she shall be given a claim form and be advised to take home to parents.

INSURANCE

AS PER WEST VALLEY SCHOOL BOARD POLICY:

5.2.4.0 All athletes must have a parent or guardian signature on their Athletic/Activity Registration Form, indicating one of the following:

5.2.4.1 The athlete is currently enrolled in the WVSD Accident Insurance Program, or

5.2.4.2. The athlete is currently covered by daily insurance that is equivalent or better than the requirements specified on the Athletic/Activity Registration Form.

EMERGENCY NUMBERS

5.3.0 Ambulance/Fire Department/Police Department/Sheriff..................911

A COACH’S SAFETY DUTIES

5.4.0 DOCTOR/COACH RELATIONS

Except where emergency situations dictate otherwise, coaches are to refer problems indicating medical attention to the athlete’s family physician (as recorded on his/her Athletic/Activity Registration Form).

5.4.1 SAFEGUARDING THE HEALTH OF THE ATHLETE

Participation in WVSD Athletic/Activities is a privilege involving both responsibilities and rights. The athlete’s responsibilities are to play fair, to give his best, to keep in training, and to conduct himself with credit to his sport and school. In turn he has the right to optimal protection against injury as this may be assured through good conditioning and technical instruction, proper regulation and conditions of play, and adequate health supervision.

Periodic evaluation of each of these factors will help assure a safe and healthful experience for players. The checklist below contains the kinds of questions to be answered in such an appraisal.

5.4.2 PROPER CONDITIONING - helps to prevent injuries by hardening the body and increasing

resistance to fatigue.

5.4.3.1 Are prospective players given directions and activities for preseason conditioning?

5.4.3.2 Is there a minimum of two weeks of practice before the first game or contest?

5.4.3.3 Is each player required to warm-up thoroughly prior to participation?

5.4.3.4 Are substitutions made without hesitation when players evidence disability?

5.4.3 CAREFUL COACHING - leads to skillful performance, which lowers the incidence of

injuries.

5.4.4.1. Is emphasis given to safety in teaching techniques, elements of play?

Are injuries carefully analyzed to determine causes and to suggest preventative programs?

5.3.4.3. Are tactics discouraged that may increase the hazards and thus the incidence of injuries?

5.3.4.4. Are practice periods carefully planned and of reasonable duration?

5.4.4. GOOD OFFICIATING - promotes enjoyment of the game as well as the protection of the players.

5.4.5.0 Are players as well as coaches thoroughly schooled in the rules of the game?

5.4.5.1 Are rules and regulations strictly enforced in practice periods and well game?

5.4.5.2. Are officials employed who are qualified both emotionally and technically for their responsibilities?

RIGHT EQUIPMENT AND FACILITIES - serve a unique purpose in protection of players.

5.4.6.0. Is the best protective equipment provided for contact sports?

5.4.6.1. Is careful attention given to proper fitting and adjustment of equipment?

5.4.6.2. Is equipment properly maintained; worn and outmoded items discarded?

5.4.6.3. Are proper areas for play provided and carefully maintained?

5.4.6. ADEQUATE MEDICAL CARE is a necessity in the prevention and control of Athletic/Activity injuries.

5.4.7.0. Is there a thorough pre-season health history & medical exam?

5.4.7.1. Is careful attention given to proper fitting, adjustment of equipment?

5.4.7.2. Does the physician make the decision as to whether an athlete shall return to play following injury during games?

5.4.7.3. Is authority from a physician required before an athlete can return to practice after being out of play due to injury?

5.4.7.4. Is the care given athlete by coach or trainer limited to first aid and medically prescribed services?

HOT WEATHER HINTS

5.5.0. HOT WEATHER HINTS

Fredrick O. Mueller, Ph.D.

University of North Carolina at Chapel Hill

Dick Schindler

National Federation of State High School Associations

Early fall football practice frequently is conducted in very warm and highly humid weather in many parts of the United States. Under such conditions the athlete is subject to:

Heat Cramps - painful spasms of skeletal muscle, most common of the calf muscle, caused by depletions of water and salt due to sweating.

Heat Fatigue - feeling of weakness and tiredness caused by depletions of water and salt due to sweating.

Heat Exhaustion - characterized by extreme weakness, exhaustion, headache, dizziness, profuse sweating and sometimes unconsciousness caused by extreme depletion of water and salt. Key features that are different in heat exhaustion from heat stroke are sweating from skin and normal body temperature.

Heat Stroke - a true medical emergency caused by overheating from a breakdown of the sweating mechanism. May occur suddenly without being preceded by any of the other clinical signs. The individual is usually unconscious and has a hot, dry skin with rising body temperature.

It is felt that the above heat stress problems can be controlled provided certain precautions are taken. The following practices and precautions are recommended:

1. Each athlete shall have a physical examination with a medical history when first entering a program and an annual health history update. History of previous heat illness and type of training activities before organized practice begins shall be included.

It is clear that top physical performance can only be achieved by an athlete who is in top physical condition. Lack of physical fitness impairs the performance of an athlete who participates in high temperatures. Coaches shall know the physical condition of their athletes and set practice schedules accordingly.

Along with physical conditioning, the factor of acclimatization is the process of becoming adjusted to heat and it is essential to provide for gradual acclimation to hot weather activities. It is necessary for an athlete to exercise in the heat if he is to become acclimatized to it. It is suggested that a graduated physical conditioning program be used and that acclimatization can be expected to take place over a period of a week. Final stages of acclimation to heat are marked by increased sweat loss and reduced salt concentration in the sweat.

The old idea that water shall be withheld from athletes during workouts has no scientific foundation. The most important safeguard to the health of the athlete is the replacement of water. Water must be in the field and readily available to the athlete at all times. It is recommended that a 10-minute water break be scheduled for every half hour of heavy exercise in the heat. Athletes shall rest in a shaded area during the break. Water shall be available in unlimited quantities.

Salt shall be replaced daily. Extra salting of the athlete’s food will accomplish this purpose. Salt tablets shall not be taken by athletes engaged in physical activity. Attention must be directed to replacing water.

6. Know both the temperature and humidity. The greater the humidity, the more difficult it is for the body to cool itself.

7. Cooling by evaporation is proportional to the area of skin exposed. In extremely hot

and humid weather reduce the amount of clothing covering the body as much as

possible. Never use rubberized clothing.

8. Athletes should weigh each day before and after practice and weight charts checked.

Generally 3 percent weight loss through sweating is safe and a 5 percent loss is in the danger zone.

9. Watch athletes carefully for signs of trouble, particularly athletes who lose much

weight, overweight athletes and the eager athlete who constantly competes at his

capacity. Some trouble signs are nausea, incoherence, fatigue, weakness, vomiting,

cramps, weak rapid pulse, visual disturbance and unsteadiness.

10. Teams that encounter hot weather during the season, through travel or following an

unseasonable cool period, shall be physically fit but will not be environmentally fit.

Coaches in this situation shall follow the above recommendations and substitute more frequently during games.

11. Know what to do in case of emergency. Be familiar with immediate first aid practice and prearranged procedures for obtaining medical care, including ambulance service.

Heat Stroke - THIS IS A MEDICAL EMERGENCY. DELAY COULD BE FATAL. Immediately cool the body (immersing in cold water, spray with cool water, or using any other means available for immediate cooling) while awaiting transfer to a hospital.

Heat Exhaustion - OBTAIN MEDICAL CARE AT ONCE. Withdraw individual from further activity and give fluids by mouth if athlete is able to swallow. Place athlete in shade and keep cool while awaiting transfer to hospital.

Summary: The main problem associated with exercising in hot weather is water loss through sweating. Water loss is best replaced by allowing the athlete to drink as much water as he likes, whenever he wishes. The small amount of salt lost in sweat is adequately replaced by salting food to individual taste at mealtime.

REDUCING HEAD AND NECK INJURIES IN FOOTBALL

Frederick O. Mueller

From WIAA

Head and neck injuries in football have been dramatically reduced since the late 1960’s. Several suggestions for continued reduction are as follows:

Pre-season physical exams for all participants - Identify during physical exam those athletes with a history of previous head or neck injuries. If the physician has any question about the athlete’s readiness to participate, the athlete shall not be allowed to play.

A physician to be present at all times. If it is not possible for a physician to be present at all games and practice sessions, emergency measures must be provided. The total staff shall be organized in that each person will know what to do in case of a head or neck injury in game or practice. Have a plan ready and your staff prepared to implement that plan. Prevention of further injury is the main objective.

Athletes must be given proper conditioning exercises, which will strengthen their necks so that participants will be able to hold their necks firmly erect when making contact. Strong neck muscles may help prevent neck injuries.

Coaches shall drill the athletes in proper execution of the fundamentals of football skills, particularly blocking and tackling. KEEP THE HEAD OUT OF FOOTBALL.

Coaches and officials shall discourage the players from using their heads as battering rams. The rules prohibiting spearing shall be enforced in practice and in games. Players shall be taught to respect the helmet as a protective device and that the helmet shall not be used as a weapon.

All coaches, physicians and trainers shall take special care to see that the players’ equipment is properly fitted, particularly the helmet.

Strict enforcement of the rules of the game by both coaches and officials will help reduce serious injuries.

When a player has experienced or shown signs of head trauma (loss of consciousness, visual disturbances, headache, inability to walk correctly, obvious disorientation, memory loss) he shall receive immediate medical attention and shall not be allowed to return to practice or game without permission from the proper medical authorities.

THE UNCONSCIOUS ATHLETE

A comment by the National Federation of State High School Associations and the Committee on the Medical Aspects of Sports of the American Medical Association.

The common definition of first aid is:

The immediate emergency care of injury and/or illness until medical attention can be obtained. This is especially significant with regard to the player rendered unconscious during an Athletic/Activity contest or practice.

Medical attention shall be immediately available, with a physician present or readily available at the games and during practice sessions. This requires that plans be developed so that a physician can be reached quickly by phone. The unconscious player can pose a serious problem, and the physician, the coach and the Athletic/Activity trainer must realize the importance of prompt and proper care.

There are a number of conditions that may cause unconsciousness. Some of these conditions and recommendations for care are listed below:

5.7.0 HEAT STROKE - Collapses with dry, warm skin: Indicates sweating mechanism failure and rising body temperature. THIS IS AN EMERGENCY; DELAY COULD BE FATAL. Immediately cool athlete by the most expedient means (immersion in cool water is the best method). Obtain medical care at once. Player shall not return to participation without consent of a physician.

HEAT EXHAUSTION - Weakness, with profuse sweating indicates a state of shock due to the depletion of salt and water. Obtain medical care at once. Player shall not return to participation without consent of a physician.

5.7.2. IMPACT BLOW TO THE SOLAR PLEXUS - Rest athlete on back and moisten face with cool water. Loosen clothing around waist and chest. Do nothing else except obtain medical care if needed. Player may return to participation if further medical care is not indicated.

5.7.3 CONCUSSIONS/BLOWS TO THE HEAD- Not all blows to the head will lead to a state of unconsciousness. Washington State Law and information regarding guidelines/care for concussions follows:

5.8 CONCUSSIONS/HEAD INJURY LAW

Policies for the management of concussion and head injury in youth sports.

AN ACT Relating to requiring the adoption of policies for the management of concussion and head injury in youth sports; amending RCW 4.24.660 and adding a new section to chapter 28A.600 RCW.

Each school district's board of directors shall work in concert with the Washington Interscholastic Activities Association (WIAA) to develop the guidelines and other pertinent information and forms to inform and educate coaches, youth athletes, and their parent(s)/guardian(s) of the nature and risk of concussion and head injury including continuing to play after concussion or head injury. On a yearly basis, concussion/head injury information must be reviewed by athlete and parent, and their understanding of such is indicated with signatures on the activities clearance form.

A youth athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time.

A youth athlete who has been removed from play may not return to play until the athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussion and receives written clearance to return to play from that health care provider.

What is needed to be in compliance?

WIAA MEMBER SCHOOLS:

Adopt policies for the management of concussion and head injuries in youth sports.

Shall ensure that all coaches (paid or volunteer) are educated in the nature and risk of concussion or head injury prior to the first practice/competition. This education shall include signs and symptoms of concussion/brain injury. This education is available at no charge to coaches via the sports specific WIAA online rules clinics.

Shall annually require all athletes and the parent(s)/guardian(s) of those athletes to sign and return an information sheet relating to the nature and risk of concussion or head injury. This information sheet shall include the signs and symptoms of concussion/brain injury.

Shall ensure that any athlete showing signs or symptoms of concussion/brain injury is removed from participation immediately, and not allowed to return to play until they have written clearance from a licensed health care provider trained in the evaluation and management of concussion/brain injury.

Shall require all non-profit youth sports groups utilizing school facilities to provide a statement of compliance with the policies for the management of concussion and head injury. This statement of compliance shall be returned to the school district prior to the group’s first practice/competition.

COACHES:

Shall be educated as to the nature and risk of concussion and head injuries including continuing to play after concussion or head injury. This education shall include signs and symptoms of concussion/brain injury. This education is available at no charge to coaches via the sports specific WIAA online rules clinics. Coaches shall educate their athletes on the signs and symptoms of concussion and encourage athletes to notify a coach if they or a teammate exhibits those signs or symptoms.

Shall immediately remove from participation/competition any athlete who is suspected of sustaining a concussion or head injury.

Shall not allow an athlete who has been removed from play because of a suspected concussion/brain injury to return to play until the athlete has received written clearance from a licensed health care provider trained in the evaluation and management of brain injuries.

WHAT IS A CONCUSSION?

A concussion is an injury that changes how the cells in the brain normally work. A concussion is caused by a blow to the head or body that causes the brain to move rapidly inside the skull. Even or what seems to be a mild bump or blow to the head can be serious. Concussions can also result from a fall or from players colliding with each other or with obstacles, such as a goalpost.

The potential for concussions is greatest in athletic environments where collisions are common.1 Concussions can occur, however, in any organized or unorganized sport or recreational activity. As many as 3.8 million sports- and recreation-related concussions occur in the United States each year.2

RECOGNIZING A POSSIBLE CONCUSSION

To help recognize a concussion, you should watch for the following two things among your athletes:

A forceful blow to the head or body that results in rapid movement of the head.

-and-

Any change in the athlete’s behavior, thinking, or physical functioning. (See the signs and symptoms)

SIGNS AND SYMPTOMS

Signs observed by coaching staff

Appears dazed or stunned

Is confused about assignment or position

Forgets sports plays

Is unsure of game, score, or opponent

Moves clumsily

Answers questions slowly

Loses consciousness (even briefly)

Shows behavior or personality changes

Can’t recall events prior to hit or fall

Can’t recall events after hit or fall

Symptoms Reported By Athlete

Headache or “pressure” in head

Nausea or vomiting

Balance problems or dizziness

Double or blurry vision

Sensitivity to light

Sensitivity to noise

Feeling sluggish, hazy, foggy, or groggy

Concentration or memory problems

Confusion

Does not “feel right”

Adapted from Lovell et al. 2004

Athletes who experience any of these signs or symptoms after a bump or blow to the head should be kept from play until given permission to return to play by a health care professional with experience in evaluating for concussion. Signs and symptoms of concussion can last from several minutes to days, weeks, months, or even longer in some cases.

Remember, you can’t see a concussion and some athletes may not experience and/or report symptoms until hours or days after the injury. If you have any suspicion that your athlete has a concussion, you should keep the athlete out of the game or practice.

PREVENTION AND PREPARATION

As a coach, you can play a key role in preventing concussions and responding to them properly when they occur. Here are some steps you can take to ensure the best outcome for your athletes and the team:

Educate athletes and parents about concussion. Talk with athletes and their parents about the dangers and potential long-term consequences of concussion. For more information on long-term effects of concussion, view the following online video clip: http://www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.htm#Video. Explain your concerns about concussion and your expectations of safe play to athletes, parents, and assistant coaches. Pass out the concussion fact sheets for athletes and for parents at the beginning of the season and again if a concussion occurs.

Insist that safety comes first.

Teach athletes safe playing techniques and encourage them to follow the rules of play.

Encourage athletes to practice good sportsmanship at all times.

Make sure athletes wear the right protective equipment for their activity (such as helmets, padding, shin guards, and eye and mouth guards). Protective equipment should fit properly, be well maintained, and be worn consistently and correctly.

Review the athlete fact sheet with your team to help them recognize the signs and symptoms of a concussion.

Check with your youth sports league or administrator about concussion policies. Concussion policy statements can be developed to include the league’s commitment to safety, a brief description of concussion, and information on when athletes can safely return to play following a concussion (i.e., an athlete with known or suspected concussion should be kept from play until evaluated and given permission to return by a health care professional). Parents and athletes should sign the concussion policy statement at the beginning of the sports season.

Teach athletes and parents that it’s not smart to play with a concussion. Sometimes players and parents wrongly believe that it shows strength and courage to play injured. Discourage others from pressuring injured athletes to play. Don’t let athletes persuade you that they’re “just fine” after they have sustained any bump or blow to the head. Ask if players have ever had a concussion.

Prevent long-term problems. A repeat concussion that occurs before the brain recovers from the first -usually within a short period of time (hours, days, or weeks) - can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in brain swelling, permanent brain damage, and even death. This more serious condition is called second impact syndrome.4, 5 Keep athletes with known or suspected concussion from play until they have been evaluated and given permission to return to play by a health care professional with experience in evaluating for concussion. Remind your athletes: “It’s better to miss one game than the whole season.”

WHAT SHOULD A COACH DO WHEN A CONCUSSION IS SUSPECTED?

Remove the athlete from play. Look for the signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head. Athletes who experience signs or symptoms of concussion should not be allowed to return to play. When in doubt, keep the athlete out of play.

Ensure that the athlete is evaluated right away by an appropriate health care professional. Do not try to judge the severity of the injury yourself. Health care professionals have a number of methods that they can use to assess the severity of concussions. As a coach, recording the following information can help health care professionals in assessing the athlete after the injury:

Cause of the injury and force of the hit or blow to the head

Any loss of consciousness (passed out/knocked out) and if so, for how long

Any memory loss immediately following the injury

Any seizures immediately following the injury

Number of previous concussions (if any)

Inform the athlete’s parents or guardians about the possible concussion and give them the fact sheet on concussion. Make sure they know that the athlete should be seen by a health care professional experienced in evaluating for concussion

Allow the athlete to return to play only with permission from a health care professional with experience in evaluating for concussion. A repeat concussion that occurs before the brain recovers from the first can slow recovery or increase the likelihood of having long-term problems. Prevent common long-term problems and the rare second impact syndrome by delaying the athlete’s return to the activity until the player receives appropriate medical evaluation and approval for return to play.

If you think your athlete has sustained a concussion

take him/her out of play, and

seek the advice of a health care professional experienced in evaluating for concussion.

5.9 MOVING THE INJURED ATHLETE

National Federation/American Medical Association

STOP: Stop play immediately at indication of injury

LOOK: Look for obvious deformity or other deviation from normal

LISTEN: Listen to the athlete’s complaint

ACT: Move athlete only after serious injury is ruled out

The first aid chart for Athletic/Activity injuries thus places action last among the four initial steps of first aid to protect the athlete at the time of injury.

Serious injuries occur in sports as in other activities in life. The advantage of participating in supervised sports is that these injuries can be anticipated and appropriate safeguarding measures taken. First aid procedure and equipment can be prearranged. Student managers as well as coaches, trainers and other faculty members connected with sports shall be well grounded in correct first aid procedures, especially proper methods of moving the injured player. Improper or careless methods can increase the severity of the injury and may even cause disability or death.

A physician hopefully is present at Athletic/Activity contests such as football, where the risk of injury is obvious. One of the responsibilities of the attending physician is to supervise the transportation of an injured athlete when this is necessary. However, such a provision is no assurance against problems, because serious injuries can occur: 1) in practice when a physician may not be immediately at hand, and 2) in sports that are not so hazardous to require the regular attendance of a physician. In such instances, it may be necessary to move the injured athlete in accordance with sound principles, although it would be preferable to do so only on a physician’s instructions:

PRINCIPLE ONE: Avoid being hurried into moving the athlete who has been hurt. Meriting re-emphasis is the admonition that to protect the athlete at the time of injury move him only after serious injury is ruled out. Few injuries in sports require breakneck speed in removal of the player; the game officials will respect the judgment and caution of responsible personnel.

PRINCIPLE TWO: Obtain medical supervision before moving an athlete with a suspected neck or spinal injury. An athlete’s inability to move or feel an extremity, even if momentary, is sufficient cause

for the first aider to be determined in his conservatism. Moving a player with such an injury can cause further damage and result in permanent disability, if not death. The game can wait.

PRINCIPLE THREE: Have near at had for ready use: 1) a stretcher or backboard with sand bags; 2) a telephone; 3) a safe means of transportation to the nearest hospital. The stretcher may be in conflict with the heroic stoicism an injured player mistakenly wants to display. But with any serious injury, attempting to walk or run off the field may be sufficiently aggravating to delay unnecessarily the effective return of that athlete to competition.

In the case of a concussive head injury, the recumbent position is a wise precaution against aggravation of possible internal bleeding before medical care can be reached. The immediate availability of a vehicle for rapid transit can be a lifesaver. Rapid communication with an assigned physician is frequently necessary.

PRINCIPLE FOUR: If the player can be moved, support the injured joint or limb. If in the lower extremity, avoid weight bearing. An assistant of 140 pounds is little help in this regard when helping a limping 200-pound player away from the zone of action. If the upper extremity is involved, giving support against gravity will bring the player to medical care with the least pain and risk.

PRINCIPLE FIVE: If the player is to be moved, move him away from the proximity of the crowd. An emergency medical station near but not at the site of the action will minimize the natural tendencies of the player to attempt unauthorized return to play. Equally important it will give the physician the opportunity to make a quiet, unrushed initial evaluation of the severity of the injury.

PRINCIPLE SIX: Post conspicuously and have understood by all the supervisory personnel, the step-by-step directions for emergency first aid procedures. The physician closest to the school’s sports program can help develop the best practical plan for fitting the community’s resources to the supervisory coverage of games and practices.

5.10 RECOGNITION OF A DRUG USER

From “For Coaches Only: A booklet by the DEA of the U.S. Department of Justice”.

Spotting a drug user or abuser can be a difficult and complicated task for a coach or Athletic/Activity trainer. Some of the changes that may be seen in an athlete using drugs resemble symptoms of severe personal or emotional problems. It is imperative to treat the athlete as an individual and to talk to him privately about the nature of his problem. Here’s an outline of things to look for:

• Decrease in motivation

• Change in personality or behavioral patterns

• Withdrawal from companionship

• Decline in performance, both physically and academically

• Frequent missing of classes, especially physical activity classes

• Inability to coordinate (standing or walking)

• Poor personal hygiene and grooming

• Muddled speech

• Impaired judgment

• Restlessness, jittery

• Muscular twitches, tremor of hands

• Heavy sweating, bad breath, nervousness (amphetamine abuse)

• Red eyes, listlessness, increased appetite with special craving for sweets (marijuana abuse)

WHAT THE COACH CAN DO

Successful programs have shown that doing simple things, like the following, are highly effective:

Call your captains together and talk about alcohol and other drug abuse.

Open a dialogue with all your athletes on alcohol and other drug abuse.

Get your athletes to use peer pressure on teammates to refrain from the use of alcohol and drugs.

Enforce all training rules and regulations.

Advise athletes of the legal penalties associated with drug and alcohol use and sale.

Know the symptoms of alcohol/drug use - recognize the signs.

Have a definite plan for dealing with drug and alcohol use by your athlete(s).

Set a conference with parents for cosigning training rule pledge cards.

Check on athletes. Call them and let them know you care.

Investigate any violations and confront the athlete immediately.

Take immediate action when you overhear party plans involving drugs and alcohol.

Confront the athlete immediately when you smell alcohol or some form of tobacco.

Develop alternative activities for athletes.

YOU, THE COACH, shall set a good example for your athletes at all times.

PERFORMANCE ENHANCING DRUGS

Performance-enhancing drugs and supplements are used to boost athletic performance, ward off fatigue and enhance physical appearance. They're also taken to increase muscle mass and strength. But they can cause serious harm. Here's a look at some of the substances your son or daughter might be using.

Creatine. Creatine is a naturally occurring compound in the body that is also sold as an over-the-counter supplement. It's primarily used to enhance recovery after a workout and increase muscle mass and strength. Creatine is popular with athletes who participate in sports in which short bursts of power are required. Examples include football, gymnastics, hockey and wrestling. Side effects include weight gain, nausea and muscle cramps. High doses of creatine have the potential to harm the kidneys.

Anabolic steroids. Anabolic steroids are synthetic versions of testosterone. They build muscle and increase strength, and are particularly popular with bodybuilders and football players. Anabolic steroids can halt bone growth and result in a permanently short stature, so they're particularly dangerous for still-growing adolescents. Steroids can also damage the heart and liver.

Steroid precursors. Steroid precursors, such as androstenedione ("andro") and dehydroepiandrosterone (DHEA), are substances that the body converts into anabolic steroids. They are used to increase muscle mass.

The Anabolic Steroid Control Act of 2004 made most steroid precursors illegal without a prescription. DHEA is the only one that is still available in over-the-counter preparations. Side effects of steroid precursors are similar to those for steroids.

Teens tend to deny their mortality and take risks that more mature people wouldn't consider. Here are some reasons teen athletes might consider taking performance-enhancing drugs.

Pressure from parents or peers

A desire to gain muscle mass

A desire to be stronger

A negative body image

A tendency to compare their appearance with others', particularly those who use steroids

What you can do

Today’s student athletes are under considerable pressure to succeed. And besides the pressure from coaches, parents and peers, teens place a lot of pressure on themselves. Not surprisingly, the pressure may contribute to the lure of performance-enhancing drugs and supplements.

If you're concerned that your athlete(s) may be using performance-enhancing drugs or supplements, here's what you can do:

Be clear about your expectations as a coach. Tell your team that unless the long-term effects of performance-enhancing drugs on young athletes are known to be safe, you expect him or her to avoid them. Set rules. Teach your team that short-term gains can lead to long-term problems.

Discuss ethics and proper training. Athletes should compete fairly. Remind your athletes that using a performance-enhancing drug is cheating, but even more importantly, could lead to serious health problems or even death. Another key message is that a balanced diet and rigorous training are the true keys to athletic performance. Encourage your team to feel good about their drug-free sports performance.

Talk with your parents/supporters. Let the parents know you've talked with your team and that you don't approve of performance-enhancing drugs.

Monitor for signs of drug use. Signs your athlete(s) may be taking anabolic steroids include increased acne and male-pattern baldness. If your female athlete(s) takes anabolic steroids, she may develop male characteristics, such as a deep voice or dark facial hair. Teens who take anabolic steroids may seem unusually moody and have angry outbursts known as 'roid rage.

All children have health education in school. But ultimately it's up to you to talk with your athletes about performance-enhancing drugs. Remember — teens are smart, they ask tough questions, and they tend to deny risks to their health. So do your best to convey the message that performance-enhancing drugs are risky business.

Excerpt from Mayo Foundation for Medical Education and Research

5.11 INFECTIOUS DISEASE CONTROL GUIDE FOR SCHOOL STAFF

GUIDELINES FOR HANDLING BODY FLUIDS IN SCHOOLS

CONSIDERATIONS FOR PHYSICAL EDUCATION AND ATHLETIC/ ACTIVITIES

The following concepts shall be applied as general safety precautions against the transmission of disease. No distinction is made between body fluids from students with a known disease or those from students without symptoms or with an undiagnosed disease.

5.11.0. RESPONSIBILITY

The coach in charge is responsible for seeing that these procedures are carried out and that the supplies are available.

5.11.1. SUPPLIES NEEDED

Spray bottle with plain water

Spray bottle with 1 part household bleach to 10 parts water (solution made up each day)

Spray bottle with bactisol

Disposable towels

Gauze pads

Gloves

Plastic bags for disposal of contaminated items

5.11.2. CARE OF HANDS

Direct contact with body fluids shall be avoided whenever possible. All personnel dealing with students in a situation where contact with body fluids is possible, especially blood, disposable gloves shall be worn.

Instances where contact with body fluids is unanticipated, hands and other affected areas shall be washed with soap and running water for 10 seconds immediately after direct contact has ceased. Hands shall also be washed after removing gloves.

5.11.3. CARE OF GLOVES AND OTHER DISPOSABLE ITEMS

Used gloves shall be removed inside out and disposed of in a plastic bag or lined trash can. Used tissues, diapers and paper towels shall also be placed in a plastic bag or plastic-lined waste can for disposal.

5.11.4. CARE OF CLOTHING AND NON-DISPOSIBLE ITEMS

Non-disposable items (towels, clothing, etc.) that have been in contact with body fluids shall be handled only by wearing plastic gloves and shall immediately be rinsed and placed in a plastic bag. As soon as possible, these items shall be washed separately in soap and water. If material is bleachable, add ½ cup of household bleach to the wash cycle. If the material is not colorfast, add ½ non-Clorox bleach (e.g. Clorox II, Borateem) to the wash cycle. Student clothing shall be sent home in a plastic bag with laundry instructions.

During an Athletic/Activity event, blood spots on the uniform shall be sprayed with the same solution, then sprayed again with plain water to minimize the bleaching action on the uniform. Remember to wear gloves and dispose as indicated above.

5.11.5. CARE OF THE INJURY

If an athlete sustains a minor bleeding injury, the event shall be stopped and the bleeding stemmed using a fresh, disposable towel, gauze or similar equipment. By using a spray bottle, any blood on the mat, opponent, the official(s) or other people shall be wiped off on a disposable paper towel sprayed with a 1:10 solution of laundry bleach in water.

5.11.6. CARE OF EQUIPMENT/DISINFECTION OF MATS AND OTHER ATHLETIC/ ACTIVITY EQUIPMENT

In order to provide a safe learning environment, all gymnastics and wrestling mats shall be cleaned/disinfected at the conclusion of each days use. If an incident occurs where blood or saliva has contaminated the surface, cleaning and disinfecting (with gloves on) shall take place prior to allowing activity to continue. Bacisol or a solution of one part bleach diluted with ten parts water are effective disinfecting agents.

In addition to mats, attention needs to be given to any other surface or equipment that might become soiled by body fluids.

5.12 COMMUNICABLE DISEASE PRECAUTIONS

While the risk of one athlete infecting another with HIV/AIDS during competition is close to nonexistent, there is greater risk that other blood-borne infectious diseases can be transmitted. For example, Hepatitis B can be present in blood as well as other body fluids. Precautions for reducing the potential for transmission of these infectious agents shall include, but are not limited to, the following:

1. Routine use of gloves or other precautions to prevent skin and mucous membrane exposure when contact with blood or other body fluids is anticipated.

2. Immediately wash hands and other skin surfaces if contaminated (in contact) with blood or body fluids. Wash hands immediately after removing gloves.

3. The bloodied portion of the uniform must be properly disinfected or the uniform changed before the athlete may participate.

4. Clean all blood-contaminated surfaces and equipment with a solution made from 1:10 dilution of household bleach or other disinfectant before competition resumes. (Use new mixture for each event. Discard after each event.)

5. Practice proper disposal procedures to prevent injuries caused by needles, scalpels and other sharp instruments or devices.

6. Although saliva has not been implicated in HIV transmission, to minimize the need for emergency direct mouth-to-mouth resuscitation, mouthpieces, resuscitation bags or other ventilation devices shall be available for use.

7. Athletic/Activity trainers/coaches with bleeding or oozing skin conditions shall refrain from all direct Athletic/Activity care until the condition resolves.

8. Contaminated towels shall be properly disposed of or disinfected.

9. Follow acceptable guidelines in the immediate control of bleeding and when handling bloody dressings, mouth guards and other articles containing body fluids.

10 Refer to specific sport rules for additional information.