Clarksville panthers

1. Clarksville panthers Heat Information

2. Hydration Video http://www.nfhslearn.com/flash/Gatorade_demo_v3_stream.aspx

3. Exertional Heat Illness • Heat illness is inherent to physical activity and its occurrence increases with rising ambient temperature and relative humidity. • Potential Signs and Symptoms to Recognize: • Heat (Muscle) Cramps 5. Lightheadedness • Fatigue 6. Dizziness • Profuse or NOT Sweating 7. Nausea/Vomiting • Confusion • If an athlete is displaying any of these signs or symptoms remove from participation immediately. Begin to cool & rehydrate as quickly as possible and DO NOT let the athlete return to participation.

4. Symptoms of Heat Illness Heat (muscle) Cramps: Exercise-associated muscle (heat) cramps represent a condition that presents during or after intense exercise sessions as an acute, painful, involuntary muscle contraction. Proposed causes include fluid deficiencies (dehydration), electrolyte imbalances, neuromuscular fatigue or any combination of these factors.

5. Treatment: • Try to rehydrate orally, preferably with electrolyte solution • Apply ICE to the affected area • Encourage athlete to counter contract opposing muscle group • Light stretching or massage is permissible • If cramps do not subside or if the athlete is vomiting; the athlete may need I.V. fluids

6. Heat Syncope - Orthostatic Dizziness: • May occur when a person is exposed to high environmental temperatures. Usually occurs within the first five days of acclimatization, before blood volume expands. • Treatment: • Remove athlete from participation to a cooler place • Try to rehydrate orally; preferably use electrolyte solution • Monitor vital signs and cognitive status

7. Heat exhaustion or heat stroke • Treatment: • Activate EAP and call 911 • Remove equipment and clothing • Remove athlete from participation to an air conditioned space if available • Begin aggressive cooling (ice packs, cold shower, cold water immersion) • Try to rehydrate orally • Monitor vital signs and cognitive status

8. Preventing Heat Injuries • Acclimatization is a must • If possible, arrange training for the coolest part of the day or go indoors. • Rest in the shade during breaks. Remove excess clothing; take advantage of wind, fans or cooling devices to cool.

9. Preventing Heat Injuries • Use minimal, loose-fitting clothing made from natural fibers to promote heat loss. • Ensure players are fully hydrated prior to participation. 16-20 oz of fluid, 2 hours before and at least 8-10 oz every 15 minutes during is a must. • Drink properly formulated sports drinks to delay onset of fatigue during exercise and to provide carbohydrates. Especially important as muscles favor carbohydrate metabolism in warm conditions.

10. Heat Index Calculator • http://www.osaa.org/heatindex/

11. Heat Index Levels and Guidelines Under 95° Heat Index • All Sports • Provide ample amounts of water. This means that water should always be available and athletes should be able to take in as much water as they desire • Optional water breaks every 30 minutes for 10 minutes in duration • Watch/monitor athletes for necessary action • Check and record Heat Index during each break and make necessary modifications 95°- 99° Heat Index • All Sports • Provide ample amounts of water. This means that water should always be available and athletes should be able to take in as much water as they desire • Mandatory water breaks every 30 minutes for 10 minutes in duration • Watch/monitor athletes for necessary action • Check and record Heat Index during each break and make necessary modifications • Contact sports and activities with additional equipment • Helmets and other possible equipment removed if not involved in contact 100°- 104° Heat Index • All Sports • Provide ample amounts of water. This means that water should always be available and athletes should be able to take in as much water as they desire. • Mandatory water breaks every 30 minutes for 10 minutes in duration • Watch/monitor athletes for necessary action • Check and record Heat Index during each break and make necessary modifications • Alter uniform by removing items if possible • Allow for changes to dry t-shirts and shorts • Reduce time of outside activity • Contact sports and activities with additional equipment • Helmets and other possible equipment removed if not involved in contact or necessary for safety

12. Heat Index Levels and Guidelines Above 104° Heat Index • All Sports • Limit outside activity in practice and/or play. • Watch/monitor athletes for necessary action • Check and record Heat Index during each break and make necessary modifications. • Inside practices are limited to the following: • Walk-throughs • Weight training • Meetings • Provide ample amounts of water. This means that water should always be available and athletes should be able to take in as much water as they desire. • Mandatory water breaks every 20 minutes in a shaded area • Contact sports will conduct practice in helmets and shoulder pads with the option to remove one or both pieces of equipment as conditions change.

13. Wet Bulb Categories (Inside)

14. WBGT Guidelines according to Categories or Flags (Inside) • No limits, suggested breaks for hydration every 30 minutes depending on exertion. • No limits, must hydrate every 30 minutes and at least a 5 minute break in shade with fans. • Limit strenuous activities to a maximum of 20 minutes, hydration and cool down break in shade for at least 5 minutes. • Limit strenuous activities to 20 minutes, hydration and cool down break in shade for 10 minutes. • Limit strenuous activities to 15 minutes, hydration and cool down break in shade for 10 minutes. Walk-throughs, weight training, and meetings are suggested if conditions continue to worsen.

15. We will follow the recommendations of AATA • Hydration breaks at least every 30 minutes followed by the recommended cool down • Equipment worn for practices will be adjusted according to Heat Index guidelines which will be monitored every break period. • Canopies, fans/misters, water coolers, Gatorade, and ice towels will be located adjacent to the shaded area, all hydration and cool down breaks will be taken there or in other shaded areas

16. Fluid Replacement • During practice make fluids readily available. Every 15 minutes athletes should consume 7 to 10 oz of fluids. (DO NOT DENY WATER BREAKS) Remember to calculate your rest/break sessions based on temperature to humidity forecast. Provide some sort of shade to allow the athletes to get out of direct sun exposure. • Post-exercise hydration should aim to correct any fluid loss accumulated during the practice or event. Ideally completed within 2 hours, rehydration should contain water to restore hydration status, carbohydrates to replenish glycogen stores, and electrolytes to speed rehydration.

17. How to Determine Dehydration • Urine Color: • Urine color of a well hydrated individual should be clear to slightly tinted. If the urine output is the color of “Apple Juice”, the individual is dehydrated and should be rehydrated before participating.

18. AM I HYDRATED? - Urine Color Chart

19. How to Determine Dehydration • Weight Loss: • Weigh athletes prior to first practice. (DO NOT go by weight listed on the athletes’ pre-participation physical) • Weigh athletes pre- and post-practice. • +1 to -1 percent of total body wt. loss = Well Hydrated • **-1 to -3 percent of total body wt. loss = Minimal If an athlete has not recovered to less than -3% total body weight, he is held out until he makes weight. 3. -3 to -5 percent of total body wt. loss = Significant Notify Parents of potential hazards • > 5 percent of total body wt. loss = Serious Dehydration Notify Parents and suggest taking to ER for IV fluids

20. Implement a Hydration Protocol • Educate athletes AND parents on effects of dehydration on physical performance. • Inform athletes on how to monitor hydration status. • Convince athletes to participate in hydration protocols based on sweat rate, drinking preferences, and personal responses to different fluid quantities. • Encourage coaches to mandate rehydration during practices and competitions, just as required other drills and conditioning activities.

21. Implement a Hydration Protocol • ID at risk heavy sweaters • Have scale accessible to weigh before and after practices, alert athlete and or parent if an unusual amount of weight loss. • Provide optimal oral rehydration solution (water, sport drinks, & electrolytes) before, during, and after exercise. • Implement hydration protocol during all practices and games, and adapt as needed. • Finally, encourage event scheduling and rule modifications to minimize the risks associated with exercise in the heat

22. Why Is Treatment So Critical? • The Golden Hour? • The Golden ½ Hour – the first 30 minutes of heat illness are the most crucial for treatment!

23. Cold Water Immersion Cooling Guidelines • Prepare ice water immersion • On the field or in a tent, half-fill tub or wading pool with water and ice (before use, check water source to see how quickly tub fills). • Stock tank can be filled with ice and cold water before an event or have tub half-filled with water and coolers of ice next to tub to prevent keeping tub cold throughout the day. • Ice should cover the surface of the water • If the athlete collapses near an athletic training room, a whirlpool tub or cold shower may be used.

24. Total body coverage • Cover as much of the body as possible with ice water while cooling • If full body coverage is not possible, cover the torso as much as possible • Keep the athlete’s head and neck above water, an assistant may hold the victim under the armpits with towel or sheet wrapped across the chest and under the arms. • Place an ice/wet towel over head and neck while body is being cooled in tub • Use a water temperature below 60ºF

25. Vigorously circulate waterDuring cooling, water should be continuously circulated or stirred to improve the water-to-skin temperature gradient, which optimizes cooling. Have an assistant stir the water during cooling.

26. Continue medical assessment • Vital signs should be monitored at regular intervals. • It may be helpful for an assistant to stand nearby in case the athlete becomes combative. • Other assistants may be needed to lift or roll the athlete if vomiting occurs.

27. Cooling duration • Continue cooling until the patient’s rectal temperature lowers to 39ºC (102ºF) • If rectal temperature cannot be measured and cold water immersion is administered, cool for 10-15 minutes and then transport to a medical facility (1°F/3 minutes) • If rectal thermometer is not being used because of lack of proper medical help, remove from water after shivering begins, a natural reaction of the body to warm itself • Patient transfer • Remove the patient from the immersion tub only after rectal temperature reaches 39ºC (102ºF) and then transfer to the nearest medical facility via EMS as quickly as possible

28. Cold Water Immersion

29. AAA Recommendations Football Pre‐season Regulations 1. Football practice may begin on Monday of week #5. 2. Schools cannot have consecutive days of “two‐a‐day” practices. 3. Three days of conditioning with only football helmets and shorts are mandatory before full pads are worn. 4. Thursday of week #5 is the first permissible practice with full equipment.(August 4)

30. AAA Recommendations 5. Student athletes shall not engage in more than three hours of practice activities on those days during which one practice is conducted. 6. Student athletes shall not engage in more than five hours of practice activities on those days when more than one practice is conducted. 7. The maximum length of any single practice session is three hours. 8. On days when more than one practice is conducted, there shall be, at a minimum, one hour of rest/recovery time between the end of one practice and the beginning of the next practice.

31. AAA RecommendationsWhen determining how to count time spent as “practice activities” please consult the followingchart: No activities (including meetings, weight training, and film study) can occur during the one hour rest/recovery time between the end of one practice and the beginning of the next practice (on days when more than one practice is scheduled). This time is exclusively for students to rest/recover for the following practice session.

32. Things we will do • Weigh in and out • Weigh in before and after practice and chart to keep records for coaching staff and athlete • Water breaks • every 15 – 20 minutes in shade, depending on weather and intensity of practice • Cold water emersion after practice • After practice wading pools are setup up with water and ice for athletes to cool down their core temperature • This aids in healing of leg muscles and alleviates cramping later

33. Things we will do • Water available at all times during practice • Water bottles will be available to all groups for drinks between reps or plays • Heat Index Calculator • Take readings every water break and adjust schedule and equipment as indicated by reading and chart • Gatorade after practice • 10 gallons mixed for athletes after practice

34. Things we will do • Have parent meetings for necessary activities. We will disseminate information we have to parents on, proper hydration, nutrition, and rest. Let them know the protocols that we are using are accepted and safe for their athletes. • R:\Athletic EAP\Hydration Campaign - Printed Information.pdf

35. Things we will do • Have canopies, misters, tents, and fans set up for a break area • We will have water and Gatorade available at all breaks • Athletes will take off shoulder pads and helmets during water and cool down breaks to aid in getting core temps down • Have cold water emersion tank at break station with water in it and ice ready if needed

36. Supplemental Instruction Plan • We will be having a Supplemental Instruction Program (SIP) this year for students who do not have a 2.0 or higher grade point average. • I will be having meetings with the parents of those students who qualify. • Monday and Wednesday from 3:30-5:10 • Two tardies of up to 5 minutes will be allowed. • Must remain in SIP for an additional 20 minutes • During semester student is enrolled: (Immediate Suspension) • No unexcused absences • No out of school suspension • No criminal convictions

37. Supplemental Instruction Plan • Maintain Eligibility • Pass 4 academic courses and earn a minimum of 2.0 GPA (Out of SIP) • Pass 4 Academic courses and show improvement of at least one tenth of one point in his/her GPA after first semester of SIP. Student is in SIP for the next semester but must make a 2.0 to remain eligible. • The rule restricts a student to a maximum of two consecutive semesters in the SIP any time a student’s GPA falls below a 2.0 for the previous semester.

38. AAA Concussion Guidelines and Procedures The Arkansas Activities Association Board of Directors has adopted the following guidelines for dealing with a concussed student athlete: • 1. No athlete should return to play or practice on the same day of a concussion. • 2. Any athlete suspected of having a concussion should be evaluated by an appropriate health-care professional that day (MD, DO, Nurse Practitioner, Certified Athletic Trainer, or Physician Assistant). • 3. Any athlete with a concussion should be medically cleared by an appropriate health-care professional prior to resuming participation in any practice or competition. • 4. After medical clearance, return to play should follow a step-wise protocol with provisions for delayed return to play based upon the return of any signs or symptoms. • Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health-care professional.

39. AAA Concussion Guidelines and Procedures Behavior or signs observed indicative of a possible concussion: • Loss of consciousness • Appears dazed or stunned • Appears confused • Forgets plays • Unsure of game, score or opponent • Moves clumsily • Answers questions slowly • Shows behavior or personality changes • Cannot recall events prior to or after the injury Symptoms reported by a player indicative of a possible concussion: • Headache • Nausea • Balance problems or dizziness • Double or fuzzy vision • Sensitivity to light or noise • Feeling sluggish • Feeling foggy or groggy • Concentration or memory problems • Confusion

40. MRSA Guidelines • Athletes MUST wash their hands prior to any athletic participation. • Athletes should have all cuts and scrapes covered prior to participation. After participation clean the wound and recover. • DO NOT allow athletes to share water bottles, towels, razors, or athletic equipment. (use cups disposable drinks, individual towels or disposable towels, and make sure athletes are wearing the equipment that was issued to them. • Make alcohol based hand sanitizer available during practice and games. • Athletes MUST take showers after practice and games. • Disinfect ALL balls used in practice or games by spraying with Lysol. • Clean locker rooms, meeting areas, in-door workout facilities, courts, and cheerleading mats weekly with an FDA approved solution that targets MRSA (wrestling mats should be cleaned daily) • If you have turf in your indoor facility check with manufacturer to see which disinfectants are recommended. • Wash all soft good items daily (towels, practice gear, etc.) • Specific equipment for each sport should be cleaned weekly (volleyball knee pads, football equipment, catcher’s gear, etc. • Weight rooms should be equipped with disinfecting wipes and hand sanitizer (wipe down weights after each use, encourage athletes to clean hands, cover and tears on weight benches, athletes should wear shirts while working out) • Any athlete with signs and symptoms of an infection should be isolated from the rest of the team immediately and referred to a licensed health care professional, such as a school nurse, certified athletic trainer, or physician