Download 2014-2015 Policies and Procedures Manual Brevard College 2014-2015 Policies and Procedures Manual

Brevard College 2014-2015 Policies and Procedures Manual
2014-2015 Policies and
Procedures Manual
Brevard College 2014-2015 Policies and Procedures Manual
TABLE OF CONTENTS
Sports Medicine Team.....................................................................................................................2
Medical Documentation and Physicals............................................................................................4
Prescription and Over the Counter Medication Management........................................................10
ADD/ADHD Medication...............................................................................................................13
Alcohol, Tobacco, and Other Drug Education Guidelines............................................................15
Event Coverage..............................................................................................................................16
Lightning Safety.............................................................................................................................19
Cold Stress and Cold Exposure Policy..........................................................................................21
Prevention of Heat Illness..............................................................................................................25
Brachial Plexus Injuries.................................................................................................................28
Concussion Management...............................................................................................................30
Skin Infection Management...........................................................................................................35
Asthma Management.....................................................................................................................39
Sickle Cell Trait Management.......................................................................................................43
Disordered Eating Management....................................................................................................46
Participation by the Student-Athlete with Impairment..................................................................51
Mental Health Interventions..........................................................................................................53
The Pregnant and Parenting Student-Athlete................................................................................56
Use of the Head as a Weapon in Football and Other Contact Sports............................................59
References.....................................................................................................................................60
Appendix 1: Emergency Action Plan............................................................................................61
Appendix 2: Substance Abuse Education and Drug Testing.........................................................93
Appendix 3: Discontinuance of Brace/DME AMA Form...........................................................108
Appendix 4: Return to Play AMA Form......................................................................................110
Appendix 5: Post-Participation Release Form.............................................................................112
Appendix 6: Student Patient Privacy Contract............................................................................114
Appendix 7: Parent-Guardian Notice of Injury, Insurance Coverage Letter...............................115
Appendix 8: ACL Return-to-Play Criteria Policy.......................................................................118
Brevard College 2014-2015 Policies and Procedures Manual
ROLES OF BREVARD COLLEGE SPORTS MEDICINE TEAM
POLICY
Brevard College is obligated to provide health care that puts the safety and well being of the
student-athlete first. The athletics department works in conjunction with the sports medicine
department to create a qualified interdisciplinary health care team; this team consists of athletic
trainers and team physicians.
Brevard College has designated a qualified health care provider who is in charge of the
coordination, monitoring, and evaluation of how well the health care is delivered; this both
practice and competition coverage. At no point in the process of creating a health care team will
a coach have any input as to who is hired and/or fired in a specific position.
PROCEDURES
Health Care Providers
The Athletics Health Care Providers at Brevard College
• Team Physician
• The team physician should be a medical doctor (MD) or osteopathic physician
(DO) who is in good standing with the medical board of the state where the
school is located.
• It is the duty of the team physician to integrate medical expertise with the athletic
trainers, medical consultants, and other health care professionals.
• Ultimately, it is up to the team physician as to whether or not a student-athlete is
cleared to play to Brevard College Athletics.
• Athletic Trainers
• In order for the athletic program to run smoothly, there needs to be enough
athletic trainers to cover all practices and/or games.
• Athletic trainers provide health care services both clinical and sideline care.
• Each athletic trainer is certified by the Board of Certification as well as being
licensed by North Carolina’s Board of Athletic Training.
Day to Day Operations
Responsibilities of the Sports Medicine Team include but are not limited to:
• Medical Services
• Injury evaluation and treatment
• Injury rehabilitation and reconditioning
• After hours/on-call consultation and injury/illness management
• Outside medical provider services
• Team Physician services
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Brevard College 2014-2015 Policies and Procedures Manual
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•
•
• Concussion pre-injury baseline testing
• Concussion Management
• Championships/tournament event coverage
• Visiting team services
Risk Minimization
• Mental health counseling referrals
• Create/maintain appropriate medical referral system
• Appropriate use of preventive and post-injury taping, bracing, and padding
• Protective equipment selection, fitting, and use
• Make appropriate play/no play decisions
• Infection control
• Practice/event coverage
• Knowledge of and recommendations for institutional and governing body drug
testing
Organization and Administration
• Budgeting
• Electronic medical record management
• Pre-participation examination (PPE)/medical history
• Emergency action plans
• Insurance claims management
• Drug use prevention
• Inventory management
Fiscal Management
• Insurance premiums
• Staffing and workload management
• Medical services
• Budget management
• Fundraising
• Academic success
• Contracts
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Brevard College 2014-2015 Policies and Procedures Manual
MEDICAL DOCUMENTATION AND PHYSICALS
POLICY
Brevard College student-athletes are to report all injuries and illnesses affecting their physical or
mental health status to one of the staff athletic trainers as soon as possible. Injuries and illness
occurring during the off-season should be reported as well.
The Brevard College Sports Medicine Department will keep a record of all injuries, illnesses,
and surgical procedures along with daily injury records and daily treatment records using
SportsWareOnLine™, the injury tracking software utilized by all Brevard College Sports
Medicine Staff Members. All medical records will be secured under double-locked conditions,
and all computer records will be password protected. All the information gathered and kept
private by the Sports Medicine Department is highly confidential and is protected by the Health
Insurance Portability and Accountability Act (HIPAA). A student-athlete must sign a waiver for
release of any information to any family member, media source, health care professionals, and/or
professional scout.
All new student-athletes participating on Brevard College Athletics teams must have a preparticipation physical exam, before they can participate with his/her team; returners are required
to fill out an updated medical questionnaire with vital sign assessment. The purpose of the
physical is to identify any pre-existing conditions that could put the student-athlete at risk during
practice or competition. The physician will determine the extent of the physical exam and if any
follow-up medical testing is necessary.
PROCEDURE
Athletic Training Reports
The Brevard College athletic training staff documents all initial evaluations, treatments, daily
progress notes, and rehabilitation sessions using SportsWareOnLine™ and appropriate forms.
• Injury/Illness report
• Reports are written for any student-athlete sustaining an injury or reporting an
illness that affects their participation status for that day.
• All injuries/illnesses are recorded in SportsWareOnLine™.
• Reports are documented in SportsWareOnLine™ by selecting the studentathlete’s name, clicking on the injury icon (located on the top of the page),
followed by clicking on the “Add” link (located on the top left side of the page).
• Treatment Record
• Treatments are logged for any student-athlete every time they receive treatment
for a documented injury/illness.
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Brevard College 2014-2015 Policies and Procedures Manual
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•
•
•
All treatments are recorded in SportsWareOnLine™.
Documented on SportsWareOnLine™ by selecting the student-athlete’s name,
clicking on the treatment icon (located on the top of the page), followed by
clicking on the “Add” link (located on the top left side of the page).
• You may then select any entry under “Existing Injuries” for treatment on an
existing injury or you may select “No Specific Injury” for treatment when no
specific injury is applicable.
• When documenting a reoccurring treatment for a specific injury on a studentathlete, select the student-athlete’s name, click on the treatment icon, select the
treatment that you are duplicating, and then click on the “Duplicate” link (located
on the top left side of the screen).
Progress Note
• Written a minimum of one time per week for any student-athlete receiving
treatment continuously for the same injury.
• Written for any change in status.
• Written in SOAP note format.
• All progress notes are to be recorded on SportsWareOnLine™.
• Documented on SportsWareOnLine™ by selecting the student-athlete’s name,
clicking on the injury icon (located on the top of the page), and then clicking
on the “Update” tab (located on the top left side of the page). Progress notes
are then recorded under the “Notes” tab (located at the top of the page). The
date and time is recorded at the beginning of each note.
Rehabilitation Chart
• Written for student-athletes on a long term rehabilitation program.
• Daily exercises are recorded.
• Scanned and attached to student-athlete’s injury record when completed.
• All rehabilitation charts are to be recorded on SportsWareOnLine™.
• Attached to SportsWareOnLine™ by selecting the student-athlete’s name,
clicking on the injury icon (located on the top of the page), and then clicking on
the “Update” tab (located on the top left side of the page). Rehabilitation charts
are then attached under the “Attachments” tab (located on the top of the page)
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Brevard College 2014-2015 Policies and Procedures Manual
Physician Reports
• Team Physician Referrals
• The ATC will determine if the student-athlete needs to see a team Physician. The
ATC will then schedule the student-athlete to be seen either in the Athletic
Training Room or the Physician’s office (on a case by case basis).
• The ATC should then begin a Physician Referral Form on SportsWareOnLine™.
• After the appointment has taken place and the Physician’s Report has been
received, it will be scanned and attached to the student-athlete’s injury record on
SportsWareOnLine™.
• Attached to SportsWareOnLine™ by selecting the student-athlete’s name,
clicking on the injury icon (located on the top of the page), and then clicking on
the “Update” tab (located on the top left side of the page). Physician’s reports are
then attached under the “Attachments” tab (located on the top of the page).
• Other Medical Documentation (i.e., Doctor’s Notes, MRI Reports, etc.)
• All medical documentation concerning any injury or illness that effects the
student-athlete’s participation in his or her sport should be submitted to the Sports
Medicine Department, where it will then be scanned and attached to the studentathlete’s injury record.
• Any document that is scanned is saved and named using the following format:
 Last Name, First Name; Date of Document (mm/dd/yy); Type of
Document (i.e., Doctor’s Notes, MRI Report, etc.).
• Attached to SportsWareOnLine™ by selecting the student-athlete’s name, clicking on the
injury icon (located on the top of the page), and then clicking on the “Update” tab
(located on the top left side of the page). Medical documents are then attached under the
“Attachments” tab (located on the top of the page).
Surgery Reports/Documents
• Any student-athlete that has had a prior surgery before attending and/or while enrolled at
Brevard College must submit all of the test results, imaging, and surgery reports
pertaining to the specific procedure to the Brevard College Sports Medicine Department.
The documentation will then be scanned and attached to the student-athlete’s surgery file
on SportsWareOnLine™.
• A surgery file is created in the SportsWareOnLine™ software by selecting the athlete’s
name, choosing the surgery icon located at the top of the page, and then clicking on the
“Add” link located on the top left side of the page.
• You may then select any entry under “Existing Injuries” for surgery that was performed
on an existing injury or you may select “No Specific Injury” for surgery that was
performed when no specific injury is applicable.
• All medical documentation pertaining to this particular surgery will then be attached to
this file. A new surgery file will be created, if necessary, for multiple surgeries.
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Brevard College 2014-2015 Policies and Procedures Manual
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•
Surgery documents are important to the Sports Medicine Department in order to provide
the best possible care to the student-athlete, as well as aiding in the process of obtaining a
Medical Hardship Waiver in certain cases. It is the responsibility of the studentathlete to submit all medical documentation concerning any injury/illness that may
affect the student-athlete’s participation status in his or her sport.
There are two different types of waivers that an athlete can receive: a hardship waiver or
an extension waiver.
• A hardship waiver deals with a student-athlete’s seasons of competition and may
only be granted if a student-athlete has competed and used on of the four season
of competition.
• Objective documentation containing these key three elements must be
included in the documentation:
• Contemporaneous diagnosis of injury/illness.
• Acknowledgement that the injury/illness is incapacitating.
• Length of incapacitation.
• An extension waiver deals with time on a student-athlete’s eligibility clock and
may be granted if, within a student-athlete’s period of eligibility (five years or ten
semesters), he or she has been denied more than one participation opportunity for
reasons beyond the student-athlete’s and the institution’s control.
Medication
• All prescription medications taken by a student-athlete are to be recorded on
SportsWareOnLine™.
• Documentation of prescription medications are completed by selecting the studentathlete’s name, clicking on the medication icon (located at the top of the page), and then
clicking on the “Add” tab (located on the top left side of the screen).
• You may then select any entry under “Existing Injuries” for medication that was
prescribed for an existing injury or you may select “No Specific Injury” for medication
that was prescribed when no specific injury is applicable.
• It is the responsibility of the student-athlete to inform the Sports Medicine
Department if he or she is taken a prescribed medication or if any changes occur
concerning the prescription (i.e., dosage, etc.).
• This information is important, especially pertaining to medication prescribed for
Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD)
because medication for these conditions are on the NCAA banned substance list will
result in a failed drug test if the student-athlete and Brevard College do not have the
proper documentation regarding the student-athlete’s use of these medications.
• Please refer to the Brevard College Sports Medicine Policies and Procedures:
ADD/ADHD Management Policy for further information regarding ADD and ADHD.
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Brevard College 2014-2015 Policies and Procedures Manual
Student-Athlete Health History and Physical Examination
• Pre-Participation Physical Examinations
• It is the Coaching Staff’s responsibility to ensure that all student-athletes have
their physicals prior to the beginning of athletic participation.
• The Coaching Staff and Sports Medicine Department will work together in the
off-season to come up with a team’s scheduled time for on-site physical’s
performed by Brevard College Team Physicians.
• These scheduled dates and times will be prior to the first date of any scheduled
practice for the academic school year. Coaches will also notify the Staff Certified
Athletic Trainers of any student-athletes who join the team after the season
begins.
• These student-athletes will not be allowed to participate until all Brevard College
Athletic Department pre-participation requirements are met. Only physicals
administered by Brevard College Team Physicians will be acceptable for
clearance of participation.
• New and Transfer Student-Athlete Pre-Participation Physical
• New and transfer athletes must complete a “New Athlete Medical History Form”
as part of required paperwork on SportsWareOnLine™.
• Returning Student-Athlete Pre-Participation Physical
• Returning student-athletes must complete a “Yearly Medical History
Questionnaire Form” and take blood pressure and pulse.
• If the student-athlete has had a significant injury or illness since their last
physical, they must have a full pre-participation physical completed by a Brevard
College Team Physician for clearance.
• All student-athletes will be given the opportunity for a complete physical if they
so choose.
• Post-Participation Physical Examinations
• Non-returning student-athletes must complete a “Post Physical Form” on
SportsWareOnLine™.
• In order to ensure the health of a student-athlete before leaving Brevard College,
the student- athlete is required to complete an “Exit Physical Form” when their
athletic career is over.
• The exit physical form will determine the student-athlete’s health status and allow
the student-athlete to disclose on-going athletically-related injuries that may need
to be addressed before leaving.
• The Prospective Student-Athlete (Tryout)
• A student who would like to try out for a varsity team must initiate the process by
meeting with the compliance coordinator and obtaining a try-out form; this form
outlines the terms of the try-out and to ensure that they are eligible for
participation.
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Brevard College 2014-2015 Policies and Procedures Manual
•
•
Once the student has received clearance for participation, the student must
provide the coach with proof of a passed medical physical, examined within the
last 6 months, sickle cell status form and a copy of his or her primary insurance
card (front and back).
Once the athlete receives a physical and turns it into their coach, the athletic
trainer will review it to make sure the athlete has been cleared and no further tests
or examinations have been ordered.
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Brevard College 2014-2015 Policies and Procedures Manual
PRESCRIPTION AND OVER THE COUNTER MEDICATION MANAGEMENT
POLICY
This policy should be followed for any student-athlete who requires medical attention due to
illness or injury. OTC medication may be administered by Licensed and Certified Athletic
Trainers and Physicians only. Prescription medications may be administered by a Licensed
Physician only. The purpose of this policy is to prevent the spread of disease and serve the
population in which we cover by providing Physician directed OTC medication therapy.
PROCEDURES
Over The Counter and Prescription Medication Administration
Over the Counter (OTC) medication is provided to Brevard College student-athletes on a case by
case basis by a member of the Sports Medicine department. The use of OTC medications is
approved by a team physician(s) and follows federal and state laws. Only single doses of OTC
medication will be provided. Prescription medications will be provided for student-athletes for
conditions related to sports participation as determined by the team physician(s). The Team
Physician or an Athletic Training Staff Member must approve the purchase of the medication.
The Sports Medicine Department will try to offset prescription costs by filing claims to the
student-athlete’s primary insurance carrier. The Sports Medicine Department follows all
recommendations made by the NCAA regarding prescription medication to include, but not
limited to the following:
• Drug-dispensing practices are subject to and should be in compliance with all state,
federal, and Drug Enforcement Agency (DEA) regulations. This includes appropriate
packaging, labeling, counseling and education, record keeping, and accountability for all
drugs dispensed.
• Certified athletic trainers cannot be assigned duties that can only be performed by a
physician or pharmacist. A team physician cannot delegate diagnosis, prescription-drug
control or prescription-dispensing duties to athletic trainers.
• All prescription and OTC medications are stored in designated areas that assure proper
environmental (dry with temperatures between 59 and 86 degrees Fahrenheit) and
security conditions.
• All drug stocks should be examined at regular intervals for removal of any outdated,
deteriorated, or recalled medications.
• All emergency and travel kits containing prescription and OTC drugs should be routinely
inspected for drug quality and security.
• Individuals receiving medication should be properly informed about what they are taking
and how they should take it. Drug allergies, chronic medical conditions, and concurrent
medication use should be documented in the student-athlete’s medical record and readily
retrievable.
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Brevard College 2014-2015 Policies and Procedures Manual
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Follow-up should be performed to be sure student-athletes are complying with the drug
regimen and to ensure that drug therapy is effective. This procedure is performed
through record keeping in the student-athlete’s medical file.
• Any medications on the NCAA Banned Substance List will be prohibited.
• If any student-athlete does not show improvement while taking OTC medication,
arrangements will be made for evaluation by a Team Physician.
Medication Tracking and Storage
• All OTC medication is maintained in locked offices and/or cabinets that provide
sufficient safe, dry, well ventilated storage that is temperature controlled and free from
dust, insects, rodents and contamination.
• The medication is in the possession of an Athletic Training Staff Member and Team
Physicians.
• Prescription medications are recorded in the student-athlete’s electronic medical record.
• Purchase of OTC and prescription medications will be conducted within the rules of
procurement as set by the state of North Carolina and Brevard College.
• Team Physicians will issue written prescriptions for prescription medication in the name
of the student-athlete, who will then proceed to the pharmacy of his or her choice to
obtain medication at their own expense.
The Student-Athlete with Asthma
• It is the responsibility of the student-athlete to make certain that his or her rescue inhaler
is present for all practices, games, and strength and conditioning sessions, as well as at all
informal summer workouts.
• During practices and games, the Sports Medicine Staff may hold the inhaler for the
student-athlete in their medical kit at his or her request.
• Exceptions to this will be made when the student-athlete is outside the physical or
visual confines of the Sports Medicine Staff.
• In such sports, affected student-athletes will be responsible for carrying their
rescue inhaler.
• The Sports Medicine Department will not be responsible for the cost of asthma
medications.
Anaphylactic Shock and the use of an EpiPen
• EpiPen® (epinephrine) 0.3 mg and EpiPen Jr® (epinephrine) 0.15 mg Auto-Injectors are
for the emergency treatment of life-threatening allergic reactions (anaphylaxis) caused by
allergens, exercise, or unknown triggers and for people who are at increased risk for these
reactions.
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Brevard College 2014-2015 Policies and Procedures Manual
•
It is the responsibility of the student-athlete to make certain that his or her EpiPen is
present for all practices, games, and strength and conditioning sessions, as well as at all
informal summer workouts.
• During practices and games, the Sports Medicine Staff may hold the EpiPen for the
student-athlete in their medical kit at his or her request.
• Exceptions to this will be made when the student-athlete is outside the physical or
visual confines of the Sports Medicine Staff.
• In such sports, affected student-athletes will be responsible for carrying their
EpiPen.
The Sports Medicine Department will not be responsible for the cost of epinephrine medications.
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Brevard College 2014-2015 Policies and Procedures Manual
ADD/ADHD MEDICATION
POLICY
Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are two
conditions that affect a number of Brevard College student-athletes. The prescribed medications
to control ADD/ADHD are on the “NCAA Banned Substance” list and will result in a positive
drug test for a banned substance. The student-athlete and Brevard College must provide proper
documentation regarding the student’s use of these medications to explain why a student-athlete
tested positive for a banned substance. If the parent and/or student-athlete have any questions,
please refer to the NCAA Medical Exceptions Policy regarding obtaining an exception for the
use of ADD/ADHD medication.
PROCEDURES
New Student-Athletes
• The following documents must be on file before a student-athlete is allowed to participate
in intercollegiate athletic practices, conditioning or competition at Brevard College.
• Required Documents
• Completed Brevard College ADD/ADHD Medication Usage and
Documentation Policy upon matriculation (first year) into Brevard College
• Documentation from the student-athlete’s prescribing physician, including
a comprehensive clinical evaluation, recorded observations, results from
ADHD rating scales, physical exam, lab work, previous treatment for
ADHD, the diagnosis and recommended treatment for the student-athlete
using ADHD stimulant medication. The physician can provide
documentation of the above either with a cover letter and attachments
(recommended) or provide the actual medical record.
• A copy of the student-athlete’s most recent prescription for the medication
to be turned into the Sports Medicine Department with each new
prescription
• Physician Exam
• A follow up medical exam must be performed and cover letter provided annually
to the Sports Medicine Department; this information can be found in the Sample
Letter in the Brevard College ADD/ADHD Medical Documentation Packet
Returning Student Athletes
• Returning student-athletes must also submit the following documents annually in order to
remain eligible to participate in intercollegiate athletic practices, conditioning or
competition at Brevard College.
• Required Documents
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Annual letter from the prescribing physician following an annual follow-up
examination (see Sample Letter in the Brevard College ADD/ADHD
Documentation Packet)
A copy of the student-athletes most recent prescription for the medication (to be turned into the
Sports Medicine Department with each new prescription)
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Brevard College 2014-2015 Policies and Procedures Manual
ALCOHOL, TOBACCO, AND OTHERDRUG EDUCATION GUIDELINES
POLICY
The NCAA mandates that the Brevard College athletics director or an employee designated by
the athletics director must educate and review the list of banned drug classes with the studentathletes for that school year. These athletic administrators are encouraged to participate in
different drug education sessions.
PROCEDURE
•
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•
•
•
•
•
•
Develop a written policy on alcohol, tobacco, marijuana, opiate, and other drug use.
Make sure to include statements on recruitment activities, drug testing, disclosure of all
medications and supplement, discipline, and counseling or treatment options.
Review the NCAA, conference, and institutional drug-testing program policies and
update handbook materials accordingly.
Include the NCAA list of banned drug classes and NCAA written policies in the studentathlete handbook
Identify NCAA, conference, and institutional rules regarding the use of street drugs,
performance-enhancing substances, and nutritional supplements, and consequences for
breaking the rules.
Warn athlete that the ingredients of any dietary supplement need to be reviewed with an
athletic trainer and/or strength & conditioning coach; banned substances may be
included, and the student-athlete could inadvertently test positive for a banned substance.
Before reporting to campus for pre-season practice
• Send out the NCAA list of banned drug classes, the dietary supplement warning
and Resource Exchange Center (REC) information to all returning and incoming
student-athletes.
Orientation at the start of each academic term
• Ensure that student-athletes sign NCAA compliance forms
• Provide student-athlete with a copy of the written drug policies as outlined prior.
• Explain all relevant drug policies:
 Banned drug classes
 Drug testing policies for NCAA, conference, and institution
 Risks of using dietary supplements without knowing all of the ingredients
and as to whether or not they are banned.
• Repeat all relevant information during team meetings
Continue to remind and educate coaches and student-athletes about the guidelines for
drug use.
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Brevard College 2014-2015 Policies and Procedures Manual
EVENT COVERAGE
POLICY
It is the goal of the Sports Medicine Staff at Brevard College to cover every practice, game, and
conditioning session that is feasibly possible; however, due to the number of sports and the yearround nature of collegiate athletics, there are times where it is simply not possible to have
someone at all of the events. In such cases, precedence will be given to the in-season sports over
the out-of-season sports, then contact or high risk sports over the non-contact or low risk sports.
Below is a matrix of which sports will have precedence during each season regarding sports
medicine coverage.
PROCEDURE
Captains’ Practices (Open Gyms, Free Play, etc.)
• Captain’s practices are practices that occur without the presence of a coach and are
organized by the student-athletes only.
• These practices will not be covered by a member of the Brevard College Sports Medicine
Staff.
• If an athletic injury or accident occurs during these practices, the student-athlete should
report to the Athletic Training Room.
• Please refer to the Brevard College Sports Medicine Emergency Action Plan for further
information concerning emergency situations.
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Coverage Matrix
FALL
SPORTS MEDICINE COVERAGE
Risk
Team
Practice
Individuals
Home
Events
Away
Events
High
Yes
ATR
Yes
Yes
Soccer, Men
Moderate
Yes
ATR
Yes
TBD
Soccer, Women
Moderate
Yes
ATR
Yes
TBD
Basketball, Men
Moderate
ATR
ATR
Yes
TBD
Basketball,
Women
Moderate
ATR
ATR
Yes
TBD
High
ATR
ATR
Yes
TBD
Lacrosse,
Women
Moderate
ATR
ATR
Yes
TBD
Baseball
Moderate
ATR
No
N/A
N/A
Softball
Moderate
ATR
No
N/A
N/A
Volleyball
Low
ATR
ATR
Yes
No
Track and Field
Low
No
No
N/A
N/A
Cross Country
Low
ATR
No
Yes
No
Tennis
Low
No
No
Yes
No
Golf
Low
No
No
No
No
Cheer/Dance
Low
No
No
N/A
No
Football
Lacrosse, Men
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Brevard College 2014-2015 Policies and Procedures Manual
SPRING
SPORTS MEDICINE COVERAGE
Risk
Team
Practice
Individuals
Home
Events
Away
Events
High
Yes
ATR
Yes
N/A
Soccer, Men
Moderate
ATR
ATR
Yes
TBD
Soccer, Women
Moderate
ATR
ATR
Yes
TBD
Basketball, Men
Moderate
ATR
ATR
Yes
TBD
Basketball,
Women
Moderate
ATR
ATR
Yes
TBD
High
Yes
ATR
Yes
TBD
Lacrosse,
Women
Moderate
Yes
ATR
Yes
TBD
Baseball
Moderate
ATR
ATR
Yes
TBD
Softball
Moderate
ATR
ATR
Yes
TBD
Volleyball
Low
ATR
ATR
N/A
N/A
Track and Field
Low
ATR
ATR
N/A
No
Cross Country
Low
N/A
N/A
N/A
N/A
Tennis
Low
ATR
ATR
Yes
No
Golf
Low
No
No
No
No
Cheer/Dance
Low
No
No
No
No
Football
Lacrosse, Men
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Brevard College 2014-2015 Policies and Procedures Manual
LIGHTNING SAFETY
South Atlantic Conference Lightning Policy
“Lightning is the most consistent and significant weather hazard that may affect intercollegiate
athletics. Within the United States, the National Oceanographic and Atmospheric
Administration (NOAA) estimated those 60-70 fatalities and about 10 times as many injuries
occur from lightning strikes each year. While the probability of being struck by lightning is low,
the odds are significantly greater when a storm is in the area and the proper safety precautions
are not followed.”
Excerpt from the NCAA Guide Line (1d Lightning Safety) from the Sports Medicine Handbook,
2012-13, pages 13-15.
Chain of Command
• The responsibility of removing athletes from tournament play due to the threat of
lightning and/or severe weather lies with the SAC Administrator in-charge and/or the
host-site administrator in-charge of that particular sport/activity.
• The host site staff athletic trainer(s) and/or host-site administrator present or their
designee(s) will monitor the weather and advise the attending SAC Administrator,
officials/umpires and coaches on the situation as deemed necessary.
• Once the ruling is made to halt play and remove the athletes from the area of play is
deemed necessary by the event administrators due to the threat of severe
weather/lightning; the official/referee or umpire in charge will be notified to suspend
such play and the coaches must get their players as quickly as possible to a designated
safe zone.
• The host-site administrator is responsible for alerting and informing the spectators to seek
safe shelter in the event of severe weather/lightning.
• This policy should be reviewed by the Tournament Committee, officials, and host athletic
trainer(s) prior to the first outdoor activity of each tournament.
Means of Monitoring the Weather
• The host site staff athletic trainer(s) and/or host-site administrator present will monitor
the weather and advise the officials/umpires and coaches on the situation as deemed
necessary.
• The use of commercial, real time lightning detection service (ex. Telvent DTN Weather
Sentry Service – Schneider Electric) if available at the host-site, should be used for
severe weather including lightning notification for use during practices and competition.
• Flash-to-Bang Count: The number of seconds which pass between a lightning strike
(flash) and the following sound of thunder (bang). The number of seconds between the
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flash and the bang are divided by 5 – with the resulting number approximating in distance
(miles) from the practice/game area to the lightning strike (flash).
Computer real-time weather monitoring (weather channel, National Weather Service and
local Doppler Radar reports) are utilized whenever possible as an adjunct for information
to aid in the decision making process
When the danger or threat of severe weather/lightning becomes apparent at the outdoor
venues – the attending athletic training staff and/or host-site administrator present will
notify the attending SAC Administrator, officials/umpires and coaches that play must be
suspended.
The coaches, officials and athletes must immediately leave the playing area and seek the
designated safe zones for shelter.
Safe Locations from Lightning Hazards
• Any fully enclosed substantial building; ideally with plumbing and electrical wiring and
telephone services which is “grounding” the building. (ex. Field houses, locker rooms,
gymnasiums, school buildings etc.)
• If a substantial building is NOT available, a fully enclosed vehicle such as a team bus or
van with a metal roof and the windows completely enclosed is a reasonable alternative.
• Cellular or cordless phones should be used to summon help during a thunderstorm as they
are a safer alternative to land-line telephones.
• UNSAFE LOCATIONS from lightning hazards
• Small open structures such a rain or picnic shelters, batting cages, bleachers,
video-filming towers, open press boxes, dugouts, gazebos, open air or portable
concession stands, or athletic storage sheds should be avoided during
thunderstorms.
• Convertible vehicles, bleachers and golf carts do not provide a high level of
protection and cannot be considered safe from lightning and must not be utilized.
• Locker-room shower areas, sinks, swimming pool areas (indoor/outdoor), landline telephones and electric appliances are also unsafe due to the possible contact
with current carrying conduction.
If no Safe Location is Available (Last Resort)
• Find a thick grove of small trees surrounded by taller trees or a dry ditch.
• Stay away from the tallest trees or objects (ex. light poles/flag poles), metal objects (ex.
fences or bleachers), individual trees, standing pools of water, air conditioning units and
open fields.
• Assume a crouched position on the ground with only the balls of your feet touching the
ground, head lowered and cover your ears. DO NOT lie flat!!
• A person who feels his or her hair stand on end or skin tingle should immediately assume
the position noted above.
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Suspension and Resumption of Athletic Activity
• Commercial real-time lightning detection service notification—if available—should
provide lightning strike messages as follows: Advisory message(s) at 30 miles, Caution
message(s) at 15 miles and a Warning message(s) at 8 miles. When the Warning
message is alerted or displayed, play must be immediately suspended and all coaches,
officials, athletes and spectators must seek immediate shelter.
• Suspension of athletic activity should occur when lightning is at or within 8 miles or the
Flash to Bang Count is 30 seconds or less.
• Flash to Bang Count used in conjunction with the commercial, real-time lightning
detection service and local weather reports enable a sound decision to be made.
• Resumption of activity should not occur until 30 minutes after the last lightning flash is
seen and after the last sound of thunder is heard or commercial, real time lightning
detection service sends an “All Clear” signal.
Obligation to Warn
• According to a basic principle of tort law, an individual has a duty to warn others of
dangers that may or may not be obvious to a guest of that person.
• A public address message should be given warning spectators attending events if
lightning/severe weather activity becomes an imminent danger in the immediate area.
• Lightning safety information and tips should be published in game programs and media
guides whenever possible.
• There must be a means of preventing spectators and participants from re-entering the
outdoor venue when the event is suspended until the “All Clear” is given.
Pre-Hospital Care of Lightning Strike Victims
• Activate the local emergency management system (911).
• Lightning strike victims do not carry a charge and are safe to touch/assess.
• Make sure the scene is safe, if needed it may be necessary to move victim to safe
location.
• Provide CPR, Airway management, Oxygen administration, AED application as needed
per primary survey.
• Secondary survey should include evaluating and treating for common injuries from
lightning strikes: hypothermia, shock, fractures, burns and concussion.
Weather Terms Defined by the National Weather Service
• WATCH – issued when the risk of hazardous weather is significantly increased but its
presence, location or timing is unclear.
• WARNING – issued when hazardous weather occurring is imminent, threatening or has a
high probability of occurring.
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COLD STRESS AND COLD EXPOSURE POLICY
POLICY
The Brevard College Sports Medicine Department uses the Position Statement created by The
National Athletic Trainers’ Association (NATA) in 2008, stating that “injuries from cold
exposure are due to a combination of low air or water temperatures and the influence of wind on
the body’s ability to maintain a normal core temperature, due to localized exposure of the
extremities to cold air or surface.”
PROCEDURE
Common cold injuries
• Frostbite
• Usually a localized response to a cold, dry environment; moisture can exacerbate
the condition.
• It appears in three distinct phases: frostnip, mild frostbite, and deep frostbite
 Frostnip is a precursor to frostbite and usually occurs when she skin comes
in contact with a cold surface. The skin usually loses sensation.
 Frostbite occurs when the tissue actually begins to freeze; in extreme
conditions frostbite can happen very quickly.
 Some signs and symptoms of frostbite include:
• Edema.
• Redness or mottled gray skin.
• Transient tingling and burning.
 In severe cases of frostbite, permanent numbness, chronic pain, cold
sensitivity, and sensory loss can last for years or permanently.
• Hypothermia
• Hypothermia begins to set with the core temperature drops below 95oF (35oC).
• An individual will begin to exhibit these signs/symptoms when they start to suffer
from hypothermia:
 Clumsiness or loss of finger dexterity.
 Confusion or memory loss.
 Drop in heart rate.
 Stress on the renal system.
 Hyperventilation.
• When wind speed begins to interact with wetness whether it is from sweat, rain,
snow, or immersion, hypothermia can occur on days of 30o-50oF day from a
combination of the wetness and the wind chill.
• Chilblain and Immersion (Trench) Foot
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A nonfreezing cold injury that normally happens then an extremity gets wet and is
then out in a cold environment for a long period of time.
This injury is commonly seen in endurance and alpine events, as well as team
sports where there is a greater chance for exposure to cold and wet environments.
How to help control and/or prevent cold injuries
• The sports medicine staff, coaches, and student-athletes should:
• Be educated in the recognition and treatment of cold stress and cold exposure.
• Wear proper layered clothing around the core, including:
 Pants and sleeves designed to insulate and break the wind.
 Gloves, ear, and face protection.
 Socks that help wick away moisture.
• Recognize environmental and non-environmental factors that help contribute to
cold stress:
 Wind chill.
 Previous cold weather injury.
 Race.
 Geological origin.
 Ambient temperature.
 Use of medications.
 Clothing, attire, fatigue, hydration, age, activity level, body
size/composition, aerobic fitness level, acclimatization, and low caloric
intake.
Cold temperature practice/game guidelines
• Brevard College has strict guidelines as to when practice/games should be modified due
to weather conditions
• 30oF and below: understand that the conditions are correct for cold injury is
possible, and notify coaches of this risk.
• 25oF and below: additional clothing should be worn and extremities should be
covered.
• 15oF and below: activity should be limited to 45 minutes outdoors, and 15
minutes of a warming period.
• 0oF and below: outdoor activities will not occur.
• These guidelines have been developed with the help of the NATA position statement on
environmental cold injuries.
Environmental Conditions
• Wind Chill
• Increasing wind speeds can cause a low temperature to feel much colder; when
the wind chill reaches -18oF, outdoor activity will be stopped.
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A wind chill advisory is issued by the National Weather Service when the wind
chill reaches a life threatening level.
Blizzard Warning
• The National Weather service issues a blizzard warning for winter storms with
frequent winds reaching 35 miles per higher.
• These wind speeds can cause considerable snow fall and wind gusts that can
reduce visibility to one quarter of a mile or less.
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PREVENTION OF HEAT ILLNESS
POLICY
The National Athletic Trainer’s Association (NATA), in 2002, published its Heat Illness position
statement. It states that athletic participation in hot and/or humid climates increases the
likelihood of student-athletes suffering from a heat illness. The Brevard College Sports
Medicine Department follows the NATA’s position statement and guidelines in providing
surveillance and education necessary to assist in the prevention and treatment of heat-related
problems.
PROCEDURE
Prevention
• All student-athletes must complete a physical examination with heat illness and heat
related questions prior to the first pre-season practice.
• It may take a period of seven to ten days to adjust to hot and/or humid environmental
conditions. This accommodating should occur during the off-season, but coaches need to
be accommodating the first week of pre-season to assure all student-athletes have a
chance to adjust physiologically.
• As protective gear could interfere with sweat evaporation, frequent breaks should be
given so that gear and clothing can be loosened to allow heat loss. Clothing should be
light in color, cotton-blend, and loose fitting. Time for changing of wet clothes will be
allowed.
• Proper hydration, including the use of electrolyte drinks (ex. Gatorade), is recommended
before, during, and after practice:
• A minimum of 20oz of water or an electrolyte drink is recommended 2-3 hours
before activity.
• A minimum of 10oz is again recommended 10-20 minutes prior to activity.
• A minimum of 10oz is recommended every 10-15 minutes during exercise.
• At least 20oz of electrolyte drink and/or water should be ingested per pound of
weight loss following activity.
• An unlimited access of water will be provided.
• During periods of heat stress, a member of the Sports Medicine Staff will measure the
heat index using MxVision WeatherSentry Online® and notify the rest of the Sports
Medicine Staff and Coaches if any dangerous conditions are imminent.
• A member of the Brevard College Sports Medicine Staff (i.e., Certified Athletic Trainer
or Team Physician) shall be empowered to have the unchallengeable authority to cancel
or modify a practice or workout for health and safety reasons (i.e., environmental
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changes), as he or she deems appropriate. Please see the Brevard College Sport Medicine
Emergency Action Plan: Policy and Procedures.
Prescription and over-the-counter medications or nutritional supplements may increase
the risk of heat illness. Be sure to check with the Sports Medicine Staff.
Sickle Cell Trait (SCT), an inheritance of an abnormal gene which can cause deformation
of the red blood cells, has been associated with exertional rhabdomyolysis, renal failure,
as well as death and complicating factors include extreme exertion, increased heat,
altitude, and dehydration. Please see the Brevard College Sports Medicine Policy and
Procedures: Sickle Cell for further information.
Education
• Inform student-athletes of signs and symptoms of heat illness, such as cessation of
sweating, weakness, cramping, rapid and weak pulse, pale or flushed skin,
excessive fatigue, nausea, unsteadiness, disturbance of vision, and incoherence.
Please see Types of Heat Illnesses chart for further information.
• Inform student-athletes to notify their Athletic Trainer or Coach immediately if
they or another teammate are having symptoms
• There will be a pre-season discussion to each team from their Athletic Trainer on
the prevention techniques for heat illness and heat related problems
On warm weather days (>70° F) during the pre-season training sessions, body weights
may be taken (if appropriate) and recorded before and after each practice to monitor
water loss. Student-athletes losing 3% of their body weight or greater during one practice
(greater than 5% over a 2-day period), may not return to practice until they are properly
rehydrated.
Treatment
• Remove student-athlete from participation and, if possible, move to cooler or shaded
area.
• Remove wet t-shirt and begin to cool body down with cold wet towels; if possible, apply
ice bags to as much of the body as possible, especially the major vessels in the armpit,
groin, and neck.
• Continue to replace fluids at a regular rate (up to 20oz/lb. body weight loss).
• Temperature, pulse, respiration, and blood pressure will be taken regularly and recorded
until symptoms resolve.
• Once a student-athlete has had a heat illness, he or she may not return to participation that
day. A physician must provide written approval for return on subsequent day(s).
• If problems persist or they become worse, this is a medical emergency and the
Emergency Action Plan (EAP) should be initiated (Please see the Brevard College
Emergency Action Plan: Heat Illness Protocol).
Return-to-Play
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After a heat illness episode (depending on the severity) has occurred, there may be
physiological changes, such as heat tolerance, that are temporarily, and occasionally,
permanently compromised. Long-term complications and morbidity are directly related to
the time that the core body temperature remained above the critical threshold.
To safely return a student-athlete to full participation following a heat illness episode, a
specific return-to-play strategy should be implemented. The following guidelines are
recommended:
• Physician clearance prior to return to physical activity. The student-athlete
must be asymptomatic.
• The length of recovery time is primarily dictated by the severity of the
incident.
• The student-athlete should begin a gradual return-to-play protocol in which
they are under the direct supervision of a Staff Athletic Trainer or Physician.
The type and length of the return-to-play protocol may vary among student-athletes, but a
general program should include:
• Easy-to-moderate exercise in a climate-controlled environment for several
days, followed by strenuous exercise in a climate-controlled environment for
several days.
• Easy-to-moderate exercise in the heat for several days, followed by strenuous
exercise in the heat for several days.
• If applicable to the student-athlete’s sport: easy-to-moderate exercise in the
heat with equipment for several days, followed by strenuous exercise in the
heat with equipment for several days.
As this policy is only a general guideline to heat illness and heat related illnesses, it is up
to the discretion of the Athletic Trainer or Team Physician to make decisions regarding
the immediate treatment and care of the student-athlete. Ultimately, it is the Team
Athletic Trainer and Physician on follow-up care and return to sport participation.
Please see the Brevard College Emergency Action Plan: Heat Illness Protocol.
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BRACHIAL PLEXUS INJURIES
POLICY
A brachial plexus injury is better known as a “stinger” or “burner” due to the pain that is felt
when a brachial plexus injury occurs. While a brachial plexus injury can be painful and cause
some loss of function, an injury sustained to the spinal cord is more serious, and should be ruled
out before diagnosing a burner. This injury is mainly seen in football. Statistics show that
almost seventy percent of stinger injuries occur in football; brachial plexus injuries have also
been seen in basketball, ice hockey, wrestling, and some field events in track.
Mechanism of Injury
Stingers normally happen when there is a stretch placed on the plexus or a pinch at the nerve root
from the vertebrae that protect the spinal cord. The direct contact to the neck can also cause a
bruising to occur over the brachial plexus. Improper blocking or tackling techniques can cause a
stinger; contact sport student-athletes should be warned about what can happen when they do not
use proper technique in their respective sport..
Symptoms and Treatment
When a student-athlete suffers a suspected stinger/burner, they will complain of a “stinging or
burning” sensation that can run all the way down their arm and possibly to the fingers. The
student-athlete may feel like their entire arm is numb and unable to lift or move it; these
symptoms are usually transient and the student athlete will regain normal feeling and/or strength
in the effected arm. In some cases, a severe burner/stinger can cause the symptoms to last for
weeks due to the slow healing nature of nerve tissue, but as with the minor burners/stingers, the
student-athlete will regain full use of their arm and hand.
When a student-athlete suffers a stinger/burner and the signs and symptoms resolve within a few
seconds to minutes and the individual is not having any neck pain and/or limited range of motion
at their neck and signs of shoulder subluxation/dislocation, they can return to play immediately.
The student-athlete needs to be monitored for the next few days for stinger/burner
signs/symptoms. If these signs/symptoms take longer to resolve, the student-athlete may need to
be evaluated for cervical disk rupture, acromioclavicular separation, or shoulder
subluxation/dislocation. If the injury is severe enough and there are bilateral symptoms, the
spinal cord could be traumatized resulting in transient quadriplegia; these athletes need to be
immobilized and transported to a medical facility to be evaluated and monitored.
Student-athletes who suffer one stinger are prone to having repeat stingers; studies show that 87
percent of student-athletes how have a stinger will have at least one more. These individuals
need to be monitored because of the risk of permanent injury due to the high number of stingers
that can occur with these student-athletes. The most important thing to make sure a student-
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athlete suffering recurrent stingers/burners is to report all symptoms, especially if their strength
and sense of feeling is compromised; if these continue to worsen, they need to be reevaluated
immediately.
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CONCUSSION MANAGEMENT
POLICY (Updated 8.6.13)
The purpose of this policy is to establish the manner in which to manage sports related head
injuries and return to play considerations. A concussion is defined as “a complex
pathophysiological process affecting the brain, induced by traumatic biomechanical forces”.
Included are recommendations for the progression of a student-athlete to full participation and
disqualification criteria from participation at Brevard College.
PROCEDURE
Evaluation
• The Brevard College Sports Medicine Team should approach the evaluation of sports
related head injuries with a systematic and collaborative approach.
• On Field Assessment
• Check for responsiveness.
• If not responsive, assess ABC’s.
• Assume C-spine injury.
• Ammonia capsules should NOT be used.
• Rule out C-spine injury.
• Rule out cranial and facial fractures.
• Check for cerebral spinal fluid.
• Ask for mechanism of injury.
• Check for mobility.
• If mobile, assist student-athlete off playing surface.
• When it is determined that the situation in not a medical emergency, a proper sideline
assessment should take place.
• Sideline Assessment
• History
• SCAT 2 Card or Pocket SCAT 2 (Concussion Vital Signs©)
• Symptoms.
• Memory.
• Balance.
• Cranial Nerves 1-12.
• Pupil Response.
• Pupils are equal and reactive to light (PEARL).
• Nystagmus or “dancing eyes.”
• Battle Sign.
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• Recheck for cerebro-spinal fluid.
The injured student-athlete should be closely monitored on the sideline. Serial
assessments should follow on the sideline every 5 minutes until symptoms stabilize.
All findings should be recorded to compare with follow-up assessments; at the conclusion
of play the student-athlete should be escorted to the Athletic Training Room by the
Athletic Trainer where a follow up assessment should be performed.
The evaluation should be a more thorough examination than the on field but should
include the same tests performed to compare objective findings. In addition, a Sport
Concussion Assessment Tool 2 (SCAT 2) should be administered and any deficits should
be noted. All symptoms should be recorded on Concussion Vital Signs© and completed
at every 24 hour assessment. Brevard College Take Home Instructions should be given
to the party that will be monitoring the student-athlete over the next 24 hours (i.e. parents,
roommate).
Verbal communication should take place between that party and the Athletic Trainer to
make sure they understand the instructions and who to contact in an emergency. If a
responsible party is not going to be with the student-athlete at all times over night, then
the student-athlete should be admitted to the hospital to ensure the student-athlete’s
safety.
An email or phone call should be sent to the Head Athletic Trainer by the responsible
Athletic Trainer informing of the concussion and any limitations to be shared with the
Student Intervention Team (SIT). The student-athlete should be instructed to report to
the Athletic Training Room prior to class the following morning. A final Concussion
Vital Signs© Test should be performed prior to introducing the student-athlete back to
athletic activity to rule out neurological deficits if not within normal limits.
Pharmacologic Management
• Brevard College recognizes that there are no evidence-based pharmacologic treatment
options for a student-athlete with a concussion.
• The Brevard College Sports Medicine Staff recommends acetaminophen is used as
directed for the first 24 hours to manage symptoms.
• The student-athlete is strongly encouraged to not use medications containing aspirin or
non-steroidal anti-inflammatories.
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Referral
• The Brevard College Athletic Training Staff has the ultimate authority to refer a studentathlete to a member of the Brevard College Sports Medicine Team for any concerns
regarding concussion signs and/or symptoms.
• Following a proper assessment any of the following criteria are deemed a medical
emergency:
• Deterioration of neurologic function.
• Decreasing level of consciousness.
• Decrease or irregular respirations.
• Any sign or symptoms of injury, spine or skull fracture, bleeding.
• Unequal, dilated, or unreactive pupils.
• Mental status change.
• The following criteria indicate a physician should be notified the day of injury. The list
includes medical emergency signs and symptoms so adhere to the above guidelines to
manage the sport related head injury.
• Loss of consciousness on the field.
• Amnesia lasting longer than 15 minutes.
• Deterioration of neurologic function.
• Decreasing level of consciousness.
• Decrease or irregular respirations.
• Increase in blood pressure.
• Unequal, dilated, or unreactive pupils.
• Cranial nerve deficits.
• Signs or symptoms of associating injuries, spine or skull fracture, or bleeding.
• Mental status change.
• Seizure.
• Prolonged severe vomiting.
• Motor deficits.
• Sensory deficits.
• Balance deficits.
• Post-concussion signs and symptoms worsen.
• Additional severe post-concussion signs or symptoms.
• Student-athlete is still experiencing moderate to severe symptoms after the game.
• Next Day Physician Referral
• Increase in post-concussion symptoms.
• Post-concussion symptoms worsen.
• Post-concussion symptoms interfere with daily activities.
• Delayed Referral
• Student-athlete’s symptoms not improving 3 days from the injury date.
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Increase in post-concussion symptoms or symptoms worsen.
Post-concussion symptoms begin to interfere with daily activities.
Coach Role in Sport Related Head Injury
• The NCAA mandates that the healthcare provider should have the unchallengeable
authority to make a participation status. At no time should a coach, administrator, or any
other Brevard College representative interfere with an on field assessment.
• The coach may approach the injured student-athlete with the Athletic Trainer to assist
with any needs. If other players or bystanders are approaching the scene, the coach then
acts as crowd control. The game day supervisor assists with crowd control in the stands
and keeps emergency exits clear for transport.
Return to Play Criteria
• The return to play decision is one of the most important factors when managing sports
related head injuries. The Brevard College Sports Medicine Staff should be very cautious
not to return a student-athlete to activity too soon. Brevard College takes a strong stand
to be committed to eliminate second impact syndrome in our student-athletes.
• When beginning a progression to return to full participation, the process should be slow
to ensure proper healing.
• Each step in the Post-Concussion Clearance Form including an exercise test must be
fulfilled and the student-athlete must be within 5% of their baseline scores on the
Concussion Vital Signs© Test before beginning the Return-To-Play Progression.
• The exercise test will consist of a minimum of: 5 minutes running @ 50% max effort, 30
seconds push-ups, 30 seconds up-downs, and 3 minutes running @ 100% max effort.
Once the student-athlete has been symptom free 24 hours, the will student-athlete will be
tested for any balance and/or
• The following gradual return to play steps can be followed after passing the exercise test
and the Concussion Vital Sign test within 5% of their baseline:
• Light aerobic exercise, no resistance training.
• Sports specific exercise without training.
• Non-contact training drills.
• Full contact training drills.
• Game play.
• All steps cannot be performed on the same day but do not have to be performed on five
separate days.
• The history and severity of concussion should be considered during the progression to
return to participation activities.
• The student-athlete will only return to full participation when the Brevard College Post
Concussion Clearance Form signed by a Team Physician or Athletic Trainer.
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•
The student-athlete’s Athletic Trainer will notify the Head Athletic Trainer of the status
of the student-athlete and any considerations for the Student Intervention Team (SIT).
Baseline Testing
• The following sports will be baseline tested: Football, Men’s Basketball, Women’s
Basketball, Men’s Soccer, Women’s Soccer, Baseball, Softball, Cheerleading,
Volleyball, Men’s Lacrosse, and Women’s Lacrosse.
• The baseline testing will consist of a Balance Error Scoring System (BESS) test and a
Concussion Vital Signs© Test.
• The purpose for baseline testing is to compare data collected during concussion
assessments and ensure student-athletes are returning to participation safely.
• Baseline testing will be performed before student-athletes participate in activity.
Disqualification Criteria
• Game Day
• Any student-athlete exhibiting signs or symptoms of a concussion will be
removed from play and not allowed to re-enter the competition or practice that
day
• Season
• After a student-athlete suffers 3 documented concussions in the same season they
will be removed from participation as a Brevard College student-athlete.
• The student-athlete must receive clearance from a Brevard College Team
Physician to participate in the following season
• Career
• The decision to disqualify a student-athlete’s career should be made by
conference with the student-athlete, Athletic Trainer, and Physician.
• The student-athlete’s concussion history, physical exam, brain images, healing
time between concussions, sport, and current neurological status will be
considered in making an informed decision.
Away Game Protocol
• The Athletic Trainer will apply the same evaluation and referral criteria used for home
completion to a sports related head injury sustained during an away completion.
• The coach is instructed to call the assigned Athletic Trainer immediately so proper follow
up is performed and the correct parties are notified.
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SKIN INFECTION MANAGEMENT
POLICY
The Brevard College Sports Medicine Department strives to prevent and protect all coaches,
administrators, and student-athletes from infectious diseases such as the Hepatitis B virus
(HBV), Human Immunodeficiency Virus (HIV), and community-acquired methicillin-resistant
Staphylococcus Aureus (MRSA). This policy explains all of the precautions taken to help
protect the Brevard College Athletics Department from risk of infection; knowledge and
awareness of appropriate preventative strategies are essential to all individuals.
PROCEDURE
Background
• Blood-borne pathogens
• Blood-borne pathogens are disease-causing microorganism that can be potentially
transmitted through blood contact.
• The blood-borne pathogens of concern include but are not limited to the Hepatitis
B virus (HBV) and Human Immunodeficiency Virus (HIV). Infections from
these viruses have increased throughout the last decade among all portions of the
general population
• The particular blood-borne pathogen HBV and HIV are transmitted through
sexual contact, direct contact with infected blood or blood components, and from
mother to baby during pregnancy.
• Behaviors such as body piercing and tattoos may place student-athletes at some
increased risk for contracting HBV, HIV, or Hepatitis C.
• MRSA
• Staphylococcal Aureus, often referred to as “staph,” is a bacterium commonly
carried on the skin or in the nose of healthy people.
• The Staphylococcal Aureus bacteria can cause an infection that can become
serious if not handled correctly. Most infections are minor, typically presenting
as skin and soft tissue infection; the first sign of the infection is a pustule or boil
that can be mistaken as a spider bite.
• Without proper referral and care, more serious infections can cause pneumonia, or
bloodstream infections. In the past, serious infections were treated with
antibiotics, but antibiotic treatment of these infections has changed recently; these
drug-resistant bacteria are called methicillin-resistant Staphylococcal Aureus, or
MRSA.
• The staphylococcus bacteria, including MRSA, is spread by having direct contact
with the infected individual and/or indirect contact by touching objects
contaminated by an individual with MRSA.
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•
Athletes are at-higher risk due to presence of open wounds, poor hygiene
practices, close physical contact, and the sharing of towels and equipment.
Prevention
• It is the policy of the Brevard College Sports Medicine Department to adhere to all
recommendations by the Occupational Safety and Health Administration (OSHA)
regarding universal precautions.
• OSHA standards for Blood-borne Pathogens (Standard #29 CFR 1910.1030) and
Hazard Communication.
• Care of the Athlete
• All personnel involved in sports who care for injured or bleeding student-athletes
should be properly trained in first aid and standard precautions
• Pre-event preparation includes proper care for wounds, abrasions or cuts that may
serve as a source of bleeding or a port of entry for blood-borne pathogens. These
wounds should be covered with an occlusive dressing that will withstand the
demands of competition.
• Participants with active bleeding should be removed from the event as is standard
practice. Return to play is determined by appropriate medical staff personnel
and/or sports officials.
• When a student-athlete is bleeding, the bleeding must be stopped and the open
wound covered with a dressing sturdy enough to withstand the demands of
activity before the student-athlete may continue participation in practice or
competition.
• Personnel managing an acute blood exposure must follow the guidelines for
standard precaution. Gloves and other PPE, if necessary, should be worn during
direct contact with blood or other bodily fluids.
• If blood and/or bodily fluid is transferred from an injured or bleeding studentathlete to the intact skin of another athlete, the event must be stopped, the skin
cleaned with antimicrobial wipes to remove gross contaminate, and the athlete
instructed to wash with soap and water as soon as possible.
Care of Environment
• All individuals responsible for cleaning and disinfection of blood spills or other
potentially infectious materials (OPIM) should be properly trained on procedures and the
use of standard precautions.
• Personal Protective Equipment (PPE) [gloves, goggles, mask, and fluid-resistant gown if
chance of splash or splatter] is available to all athletic training staff. Gloves are readily
available in all treatment areas of the athletic training room and in all medical kits.
Gloves are required to be worn by all athletic training staff whenever there is reasonable
risk of contact with contaminants.
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Waste Disposal
• Any needles, syringes or scalpels should be carefully disposed of in an appropriately
labeled “sharps” container.
• Biohazard bags and waste containers are disposed of in accordance with OSHA
guidelines. All contaminated materials other than sharps and laundry are place in these
bags.
• Contaminated laundry should be placed in a sealed, red, biohazard bag and placed in the
laundry container.
• Biohazard wasted bags will be disposed as needed. Please call 1-800-662-0088 for
collection.
• Cleaning
• All treatment tables and equipment coming in direct contact with student-athletes
are disinfected daily.
• Any items contaminated with bodily fluids are disinfected immediately. Spray the
surface with a freshly prepared bleach solution diluted 1:100.
• Whirlpools are cleaned on a daily basis, or as needed with a disinfectant. No open
skin lesions are allowed in the whirlpools.
• Coolers, water bottles, pitchers, etc…must be cleaned and disinfected after every
session using household dishwashing detergent or other appropriate cleaner. Store
water bottles upside down in their carrier and place the carriers in the designated
area. Coolers should be towel dried.
• Cloth towels should only be used on a single patient and should be laundered
following every use; hydrocollator covers should be laundered every Friday
and/or following a possible contamination.
• Soft durable medical equipment (pads, braces, walking boot liners, etc…) must be
laundered upon return to the athletic training facility before being returned to
inventory and/or administered to another student athlete.
• Management of student-athlete’s participation
• Student-athlete with HBV
• If a student-athlete develops an acute HBV illness, the individual will be withheld
from contact sports until it is established that the student-athlete is not contagious.
• Student-athletes in such sports who develop chronic HBV infections may be
removed from competition indefinitely, due to the small but realistic risk of
transmitting HBV to other student-athletes.
• Student-athlete with HIV
• If a student-athlete is suspected of being HIV positive, the student-athlete will be
asked to voluntarily take an HIV test and to sign a written consent form allowing
identified members of the sports medicine staff access to the results.
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•
•
If the test is positive, a meeting will be initiated between the student-athlete, the
student-athlete’s personal physician, team physician, director of athletic
department and head athletic trainer.
• The meeting will cover a written document providing the names of any
individual(s) whom will be informed of the student-athlete’s status, a schedule of
monitoring the student-athlete’s health status, a written document for identifying
criteria for medical disqualification if the student-athlete’s physical condition
becomes compromised and other topics deemed necessary by the members of the
meeting.
Student-athlete with MRSA
• A student-athlete suspected of having a MRSA infection will be referred to a team
physician or other local provider for follow-up care and proper treatment.
• An athlete confirmed to have MRSA cannot engage in contact athletic activity
until proven infection free from a team physician.
• Communal areas, including the weight rooms and athletic training room, need to
be sanitized after every patient use.
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ASTHMA MANAGEMENT
POLICY
Asthma Introduction
Asthma is a disorder of the airway characterized by chronic hyper-responsiveness of the bronchi.
According to the CDC, 24.6 million Americans (8.2%) suffered from asthma in 2009. In 2007,
the World Health Organization reported that 300 million people suffered from asthma
worldwide, and 250 thousand deaths had been attributed to asthma. Although the exact causes of
asthma are unknown, several factors, including exercise, may induce an asthma attack. The
majority of patients with asthma and patients with allergies will have exercise-induced
bronchospasm (EIB). EIB usually occurs during or minutes after vigorous activity, reaches its
peak 5-10 minutes after stopping the activity, and usually resolves in another 20-30 minutes.
The Brevard College Department of Athletics aligns itself with the position statement published
by the National Athletic Trainer’s Association (NATA) in 2005 in regards to the identification,
treatment, and follow-up care of student-athletes with asthma.
Asthma Medications
Depending on the severity of asthma, medications can be taken on an as-needed basis (PRN) or
regularly to prevent or decrease breathing difficulty. Most of the medications fall into two major
groups: quick relief medications and long-term control medications.
•
•
Quick relief medications are used to treat asthma symptoms or an asthma episode
• The most common quick relief medications are the short-acting beta-agonists that
relieve asthma symptoms by relaxing the smooth muscles around the airways.
• Common beta-agonists include Proventil and Ventonlin (albuterol), Maxair
(pirbuterol), and Alupent (metaproterenol). Atrovent (ipatroprium), an
anticholinergic, is a quick relief medication that opens the airways by blocking
reflexes through nerves that control the smooth muscle around the airways.
• Steroid pills and syrups, such as Deltasone (prednisone), Medrol
(methylprednisolone), and Prelone or Pediapred (predmosolone) are very
effective at reducing swelling and mucus production in the airways; however,
these medications take 24-72 hours to take effect.
Long-term control medications are used daily to maintain control of asthma and prevent
asthma symptoms.
• Intal (cromolyn sodium) and Tilade (nedocromil) are long-term control
medications which help prevent swelling in the airways.
• Inhaled steroids are also long-term control medications. In addition to preventing
swelling, they also reduce swelling inside the airways and may decrease mucus
production.
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•
•
•
•
Common inhaled steroids include, Vanceril, Vanceril DS, Beclovent, and
Beclovent DS (beclomethasone), Azmacort (triamcinolone), Aerobid
(flunisolide), Flovent (fluticasone), and Pulmicort (budesonide).
Leukotriene modifiers are new long-term control medications. They may reduce
swelling inside the airways and relax smooth muscles around airways. Common
leukotriene modifiers include:
• Accolate (zafirlukate)
• Zyflo (zileuton)
• Singulair (monteleukast).
Another long-term control medication, Theophylline, relaxes the smooth muscle
around the airways. Common theophyllines in oral form include:
• Theo-Dur
• Slo-Bid
• Uniphyl
• UniDur
Serevent (salmeterol) in inhaler form is also a long-term control medication. As a
long-acting betaantagonist, it opens the airways in the lungs by relaxing smooth
muscle around the airways.
Inhaled Medications
Metered-dose inhaler (MDI) help deliver inhaled medication directly to the lungs; MDIs have a
“spacer,” which holds the medication in its chamber long enough for the patient to inhale it in
one or two deep breaths. The most common inhaled medications are delivered by the MDI, with
or without the spacer. It is important that the MDI is correctly to receive the full dosage of the
medication. If the inhaler is not used correctly, most of the medicine will end up on the patient’s
tongue, the back of their throat, or in the air. The spacer helps to hold the medication in its
chamber long enough for the patient to inhale it in one or two deep breaths; this eliminates the
possibility of inadequate medicine delivery from poor patient technique.
Signs and Symptoms
• Chest tightness.
• Coughing.
• Prolonged shortness of breath (dyspnea).
• Wheezing (especially after exercise bouts).
• Performance affected by breathing difficulty.
• Use of accessory muscles to breathe
• Dyspnea when exposed to allergens or irritants
• Exercise-induced symptoms
• A well-conditioned athlete who had trouble completing tasks
• Family history of asthma
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•
Personal history of atopic dermatitis/eczema or hay fever
PROCEDURE
The Brevard College Sports Medicine strives to have all student-athletes with asthma participate
in varsity sports to the best of their abilities without interference by their asthma or medication’s
side effects. The athletes will be screened during their pre-participation physical exam for any
signs and/or symptoms of related to asthma.
It is the responsibility of the student-athlete to have their rescue inhaler with them for all
practices, games, and strength and conditioning sessions, as well as at all informal summer
workouts. During practices and games, the athletic training staff may hold the inhaler for the
student-athlete in their medical kit at the request of the student-athlete.
If during activity, the student-athlete uses his or her rescue inhaler for more than two episodes,
excluding the pre-practice dose, the student-athlete will be removed from activity for that day. If
this occurs more than three times in one week, the student-athlete will be referred to a team
physician for reassessment; the team physician and an asthma specialist will decide upon
appropriate medical management of the student athlete’s asthma and their level of participation.
In order to achieve adequate asthma management, communication between the student-athlete,
Staff Certified Athletic Trainer, and Team Physician is imperative. The Sports Medicine
Department is not responsible for the cost of asthma medications.
Using the MDI
• The Brevard College Sports Medicine staff may assist a student-athlete in the use of a
prescribe MDI as follows:
• Remove the cap from MDI and hold the inhaler upright.
• Shake the inhaler.
• Tilt the head back slightly and then patient breathe out.
• Open mouth with inhaler 1-2 inches away (or mouth to spacer mouthpiece if a spacer is
available).
• Press down on the inhaler to release the medication as patient starts to breathe in slowly.
• Breathe in slowly for 3-5 seconds.
• Patient hold breath for 10 seconds to allow the medication to reach deeply into the lungs
• Repeat puffs as prescribed; waiting 1 minute between buffs may permit the 2nd puff to go
deeper into the lungs.
Basic Life Support Treatment for Severe Asthma
• Patients who have progressed to severe asthma experience a combination of the
following: shortness of breath (>30 respiration/min.), mental status changes (anxious,
confused, combative, and/or drowsy), inability to speak in sentences, sweaty and unable
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•
•
•
•
•
•
to lie down. If the patient is not responding to or is unable to properly use their MDI, the
sports medicine staff should:
Call for EMS (if not on-site or in-route).
Maintain a patent airway.
Suction any secretions.
Administer oxygen therapy at 15 liters/minute with non-rebreather device.
Be prepared to assist ventilation with positive ventilation with bag-valve-mask.
Administer epinephrine by a prescribe auto-injector (refer to Epi-Pen Policies and
Procedures).
Initiate early emergency transport.
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SICKLE CELL TRAIT MANAGEMENT
POLICY
The Brevard College Sports Medicine Department is mandating that all student-athletes show
proof of a prior test or sign a waiver releasing Brevard College.
According to the “National Athletic Trainers’ Association Consensus Statement: Sickle Cell
Trait and the Athlete,” Sickle Cell Trait (SCT) is a recessive genetic trait that has been linked to
red blood cells changing from round to quarter-moon sickle shape during high intensity
workouts. The life-threatening breakdown of blood starved muscle from the incorrect shape of
the red blood cell from sickling can begin 2-3 minutes after any all-out exertion. The risk of
Ischemic Rhabdomyolysis increases with extreme exertion, increased heat, dehydration, high
altitude and/or asthma. People at high risk for having Sickle Cell Trait are those with ancestors
who are of African, South or Central American, the Caribbean, Mediterranean, Indian, and Saudi
Arabian descent.
All student-athletes participating in any Brevard College sport must have a Sickle Cell Trait test
performed before the start of athletic participation, verification of the completed test, and the
results of the test. The student-athlete has the choice to sign a written release declining the
option to be tested for Sickle Cell Trait. Brevard College complies with the NCAA and their
requirement for all NCAA student-athletes to be tested or sign the written waiver. The studentathlete acknowledges that upon signing the waiver, they have released Brevard College, its
officers, employees, athletics and sports medicine department(s), team physician(s), and any
other individuals involved in intercollegiate athletics at Brevard College from any
responsibilities pertaining to Sickle Cell Trait. These responsibilities include, but are not limited
to, medical bills and/or insurance claims, damages, court costs, or any other causes of action that
is the result of non-compliance with the Sickle Cell Trait testing policy.
PROCEDURE
Sickle Cell Screening
• All athletes will be screened for Sickle Cell Trait, and any positive results will be
managed with the following steps:
• The results of the Sickle Cell Trait test will communicated to the following people:
•
The student-athlete.
•
The student-athlete’s parent/guardian if they are a minor, or if the studentathlete requests that they be notified.
•
Staff athletic trainers and team physician(s).
•
The student-athlete’s respective coaches.
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•
Appropriate precautions for athletes with sickle cell trait will require a combined effort
involving the student-athlete, coaches, and athletic training staff.
Precautions
• There is no contraindication to participation in sport for the athlete with Sickle Cell Trait.
• The student-athlete should gradually increase the duration and intensity of training
sessions to allow for longer periods of rest and recovery from repetitive high speed
sprints and/or interval training.
• The student-athlete should be allowed extended recovery periods between repetitions
since this type of conditioning poses special risk to athletes with Sickle Cell Trait.
• Athletes with sickle cell trait should be excluded from participation in performance tests
such as mile runs, serial sprints, etc., as several deaths have occurred from participation
in this setting.
• Activity should be stopped with onset of symptoms of any of these symptoms:
• Muscle cramping, weakness, or tenderness.
• Severe pain.
• Shallow, rapid breaths.
• Ambient heat stress, dehydration, asthma, illness, and altitude predispose the athlete with
sickle trait to an onset of crisis in physical exertion; a student-athlete is encouraged to
take the following precautions:
• Adjust work/rest cycles during heat stress
• Emphasize hydration
• Control asthma symptoms (if applicable).
• Avoid workouts if the student-athlete with sickle trait is ill
• The student-athlete with Sickle Cell Trait who has not experienced athletic events
at a high altitude should be closely monitored. The student-athlete’s training must
be modified, and supplemental oxygen must be available at competitions.
• Educate to create an environment that encourages student-athletes with sickle cell
trait to report any signs or symptoms such as fatigue, difficulty breathing, leg or
low back pain or cramping. A student-athlete with sickle cell trait should be
assumed to be sickling.
Emergency Medical Care
• Brevard College has an appropriate Emergency Action Plan in place and the appropriate
emergency equipment for all practices and competitions to handle any Sickle Cell Trait
crisis.
• A sickling collapse is a medical emergency, and the following steps need to be taken to
handle the situation
• Check ABCs (Airway, Breathing, Circulation)
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•
•
Administer high-flow oxygen, 15 lpm (if available), with a non-rebreather face
mask.
• Cool the athlete, if necessary.
• Begin CPR if vital signs begin to decline.
Inform the emergency medical staff (EMTs/Paramedics, ER nurses and physicians) of the
possibility of explosive rhabdomyolysis and/or grave metabolic complications.
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DISORDERED EATING MANAGEMENT
POLICY
The use of extreme weight-control measures puts Brevard College student athletes at high risk of
injury and health problems, as well as triggering behavior associated with disordered eating.
40% of NCAA schools have reported at least one case of anorexia or bulimia in their athletics
program.
Brevard College is committed to an atmosphere of positive thinking and acting; any abusive
behavior by any of its staff will not be condoned, especially regarding the mental health and
wellness of a student-athlete. The following is our policy on how to identify disordered eating,
work with a student-athlete who is exhibiting the signs and/or symptoms of disordered eating,
and how to refer the student-athlete to the proper health care provider.
PROCEDURE
Disordered Eating Behaviors and Consequences
• When athletes place themselves in situations where their body weight and body
composition become their main focus, they put themselves at risk of starting a pattern of
disordered eating.
• Mental Illnesses associated with disordered eating
• Anorexia Nervosa
• Anorexia nervosa is a psychiatric illness that primarily strikes female
patients and is associated with the highest mortality rate of any mental
disorder.
• An individual suffering with anorexia will often times be debilitated by
their disease; there is an intense fear of gaining weight, and the individual
will take diet and exercise to extreme levels in order to stay thin.
• Malnutrition is a side effect associated with anorexia due to not eating,
and can lead to cardiovascular and gastrointestinal organ failure as well as
a condition in female athletes, known as the Female Athlete Triad.
• The first part of the Female Athlete Triad is known as
Amenorrhea, which is when the female student-athlete’s menstrual
cycle no longer occurs, an ovulation may occur infrequently or not
happen at all.
• The next portion of the Female Athlete Triad is in infertility, but
this effect can be reversed.
• The last consequence is bone demineralization, which can over
time lead to osteoporosis.
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•
•
Osteoporosis is weakening of the bone and loss of bone
density due to the lack of estrogen.
• Female athletes are at risk for fractures later in life due to
the weakened bones from the lack of estrogen in the body.
• Along with dieting, individuals suffering with anorexia will use self
induced vomiting, laxative abuse, diuretics, and enemas to keep their
weight low.
Bulimia Nervosa
• An individual suffering from Bulimia Nervosa is normally a female who
participates in gymnastics, track and field, and/or dancing. This is not
always the case though; wrestlers and male gymnasts often develop
Bulimia due to the nature of their sport.
• Bulimic athletes are white, affluent, perfectionists who are overly obedient
and compliant to instructions from a parent and/or coach.
• He/she does well in school, has many friends, and successful in their
chosen sport.
• The athlete suffering from Bulimia goes through a purge-binge-purge
pattern, where they starve themselves in order to get ready for a
competition, binge eat uncontrollably, and then purge themselves of all of
the excess food they have eaten.
• This cycle of binging and purging can cause the stomach to rupture, throw
off normal heart rhythm, and liver damage.
• Stomach acid from vomiting to purge them of the food can cause tooth
decay as well.
Ways to help an athlete cope with disordered eating patterns
• Proper Nutrition Education
• Nutrients
• Carbohydrates
• During a non-training day, the average individual needs 6 to 10
grams of carbohydrates per kilogram of body weight.
• As training levels increase, a student-athlete may in excess of 10
grams of carbohydrates per kilogram of body weight.
• Athletes should also try to consume 1 to 1.5 grams of
carbohydrates per kilogram of body weight immediately
following workouts to help replenish glycogen stores.
• Protein
• The typical individual who is not involved in intercollegiate
athletics needs about 0.8 grams of protein per kilogram of
body weight.
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•
•
•
Fat
•
•
•
Endurance athletes should have approximately 1.2-1.4
grams of protein per kilogram of body weight, and
.strength-training student-athletes should consume 1.6 to
1.7 grams of protein per kilogram of body weight.
If a student athlete consumes a well balanced meal, there is
no need for nutritional supplements.
Fat is an important source of essential fatty acids and
carrier for fat soluble vitamins necessary for optimal
physiological immune function.
Dietary fat intake is suggested to be from 20 to 35 percent
of total daily caloric intake.
• Hydration
• Fluids containing electrolytes and carbohydrates are a good source
of fuel and rehydration for exercise lasting longer than 60 minutes.
Educate athletes about Body Composition
• To most athletes, having high lean muscle mass to fat mass ratio is an important
part of their “success” on the field.
• Student-athletes need to be aware of optimal body composition for both their
body as well as for their specific sport; there is no single ideal body composition
for all student-athletes in all sports.
• Having a lower muscle to fat mass ratio is important to some athletes, such as
offensive and defensive lineman in football and heavyweight wrestlers.
• Concerns with Body Composition
• Improper ways to control body weight and composition
• There are certain sports that have strong links between body
weight and performance.
• Sports that are focused on a specific weight class
(wrestling, rowing).
• Sports where a lower body weight helps increase
performance (long distance running).
• Athletic competitions where the uniforms are contour-revealing
(volleyball, track and field, swimming and diving).
• Sports with subjective judging related to “aesthetics”
(gymnastics, diving).
• Since the coaches of these sports put such an emphasis on body
composition, the control of body and body composition must be realistic,
or the athlete is at serious risk of compromising their health and playing
status.
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•
Seeking an Arbitrarily low level of Body Fat
• When an athlete selects a level of body fat that may or may not be
too low for them can become sick easier, increase the frequency of
injury and how long they miss due to that injury and/or reduce
performance.
• Body composition values fall into a continuum, and studentathletes want to be in a healthy range, not too far on one end or the
other.
• Using Weight as a Marker of Body Composition
• A student-athlete who has increased resistance training to improve
strength may also have a higher weight, which is likely due to an
increase in muscle mass.
• Weight can be a misused measure of body composition, and can
detract from the purpose of body composition assessment.
• Comparing Body Composition Values with other Athletes
• Body composition data should be kept confidential in explained in
detail as to specific factors that lead to body composition values.
• Ways to properly handle body composition measurement:
• Monitor and take body composition values one athlete at a
time.
• Give student-athletes a desired range for fat and/or muscle
mass.
• Increase the focus on muscle mass and how that can cause
weight gain without accumulation of fat mass.
• Frequency of Body Composition Assessment
• Real body composition changes with values that show significant
change take time; taking body composition measurements once to
twice a year is more than enough for the student-athlete.
• There are certain circumstances where taking body composition
measurements more often is appropriate. An athlete whose
condition is being monitored by a physician may require body
composition tests on a regular basis.
• There are legitimate reasons for body composition measurements to be
taken, but this is a sensitive issue for some athletes and their fears and/or
worries need to be addressed. The student-athlete should not feel forced
or obligated to undergo body composition or weight measurement.
Mental and physical health should not be sacrificed or compromised in
order to increase athletic performance.
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Develop a support system
• Disordered eating is usually caused by other factors outside of athletics; more often than
not, it is found that these emotional problems have developed long before arriving at their
institution.
• There is no one single individual who is qualified to handle a case of disordered eating;
therefore is a support system set up for Brevard College student-athletes that will
approach and handle each situation on a case to case basis.
• If a coach, athletic trainer, administrator, and/or a teammate suspects a studentathlete is showing signs of disordered eating, the process of treatment needs to
begin immediately.
• If disordered eating behavior is discovered in process, the student-athlete will be
referred to the counseling center or proper individual immediately to avoid bodily
harm done to themself and/or others.
• If there is a psychological crisis discovered after the counseling center is closed,
campus security should be contacted at (828) 577-9590.
• Once the student-athlete is placed in the care of a mental health specialist, all parties
involved will be updated on the health status, both physically and mentally, to create a
plan to return to athletic competition.
• It is important to remember that in a situation that is confidential in nature like this one,
all information discussed is held in privacy between the student-athlete and counselor. It
is up to the student-athlete to decide whether or not the athletic trainer(s) and/or coaches
can know about anything discussed in the counseling sessions.
• The student-athlete will be allowed to return to play after the entire sports medicine
decides that they are both physically and mentally compete in athletic competition.
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Brevard College 2014-2015 Policies and Procedures Manual
PARTICIPATION BY THE STUDENT-ATHLETE WITH IMPAIRMENT
POLICY
A student-athlete with impairment, physical or mental, should be given every chance to
participate if they have the necessary skills to succeed in their sport. A student-athlete will be
excluded from participation from their sport only if it the impairment puts the student-athlete at
an increased risk of injury than their non-impaired counterpart; this decision is a joint decision
by the athletics and sports medicine department, and is not taken lightly.
Recently, there have been decisions handed down from higher courts that have ruled in favor
with a university’s right to exclude an athlete due to impairment, which are in place to protect the
student-athlete from physical and/or mental harm. If the student-athlete is not qualified because
of something not related to their impairment, the athletics department should try to find the
appropriate recreational program(s) to suit the student-athlete’s needs.
PROCEDURE
Participation Concerns
When deciding as to whether or not a student-athlete with impairment can participate in varsity
athletics, the athletics and sports medicine departments should use these guidelines:
• Read any documents containing pertinent information published by respected individuals
in the field.
• The current health status of the student-athlete.
• The amount of physical and mental stress that will be placed on the student athlete.
• What kind of protective equipment that the student athlete can wear during competition
to aid in the participation of the sport.
• The ability of the student-athlete and/or parent or guardian to understand the inherent
risks of participating in a sport with impairment.
Organ Absence or Lack of Functionality by Paired Organs
There are certain things needed to be considered when deciding as to whether or not a studentwith a missing paired organ (testicle, ovary, kidney, eye) can participate in intercollegiate
athletics. The factors include:
• The quality and function of the remaining organ.
• The probability of injury to the remaining organ.
• The availability of current protective equipment and the likely effectiveness of such
equipment to prevent injury to the remaining organ.
Medical Release
If it is found that a student-athlete is medically cleared to participate in intercollegiate athletics, it
is highly recommended that the student-athlete sign a waiver of liability drafted by a legal
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counsel to release Brevard College from any and all liability from injury or death from
participating in intercollegiate athletics. The legal document needs to be signed by the studentathlete, his or her parents/guardians, the team physician, a representative of the institution’s
athletics department, and the institution’s legal counsel. This document will act as evidence that
the student-athlete understands the inherent risk of participating in intercollegiate athletics with
impairment; this document may not completely release the institution from legal liability for
injury to the student-athlete.
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MENTAL HEALTH INTERVENTIONS
POLICY
The student-athlete is not immune to mental health issues; college is a time of change in a
student’s life and with the added pressure of intercollegiate athletics, a student-athlete is at
greater risk for mental health issues. Members of the Brevard College Athletics and Sports
Medicine Departments spend a large portion of the student-athlete’s day together and they feel
that they can confide in these individuals; these staff members need to be able to identify
problem behaviors and how/where the student-athletes can be referred for mental health
counseling.
PROCEDURE
Problem Behaviors to Monitor and Possible Trigger Events
• Students who are suffering from mental health may exhibit some of these behaviors that
can be abnormal for their personality:
• Change in eating and sleeping habits.
• Unexplained weight gain/loss.
• Drug and/or alcohol abuse.
• Withdrawing from social contact.
• Gambling issues.
• Decreased interest in activities that have been enjoyable, or taking up risky
behavior.
• Talking about death, dying, or “going away.”
• Loss of emotion, or sudden changes of emotion within a short period of time.
• Problems concentrating, focusing, or remembering.
• Frequent complaints of fatigue, illness, or being injured that prevent participation.
• Unexplained wounds or deliberate self-harm.
• Becoming more irritable or problems managing anger.
• These behaviors often are triggered by one certain event, or in conjunction with one
another.
• Poor performance, either real or perceived
• Conflicts with coaches or teammates.
• A debilitating injury or illness, resulting in a loss of playing time or surgery.
• Concussions.
• Class issues – schedule, grades, amount of work.
• Lack of playing time.
• Family and relationship issues.
• Changes in importance of sport, expectation by self/parent, role of sport in life.
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•
•
•
•
•
•
•
•
Violence, being assaulted, a victim of domestic violence, automobile accidents, or
merely witnessing a personality injury or assault on a family member, friend, or
teammate.
Adapting to college life.
Death of a loved one or close friend.
Alcohol or drug abuse.
Significant dieting or weight loss.
History of physical or sexual abuse.
Gambling issues.
Post-traumatic stress disorder (PTSD) for combat veterans who are now enrolled
in college and participating in intercollegiate athletics.
Who to contact at Brevard College concerning counseling and in case of a Mental Health
Crisis
• The Stamey Wellness Center offers 50 minute counseling sessions Monday-Friday from
9:30am-5:00pm
• Topics covered include, individual counseling, and emergency crisis counseling.
• Stamey Wellness Center will refer on to the proper community resources for
support groups and other treatment programs
• All counseling services are free of charge to Brevard College students.
• In case of an after-hours emergency, Campus Security should be contacted at (828) 5779590.
Confidentiality, ways to Support a Student-Athlete, and Decision to be Treated
• Unless a student-athlete has violated a code of conduct or team rule, the administration
cannot force them to seek mental health treatment.
• The Athletics staff should encourage the student athlete, and create a supportive
environment.
• The student-athlete’s privacy must be respected at all times; nothing in the counseling
sessions can be shared with anyone unless either: the student-athlete allows discussion of
the subject, or there is a risk of self-harm.
• It is imperative that the student-athlete’s decision to seek treatment is through a support
system with the Athletics and Sports Medicine Department. Here are ways that a
supportive environment can be fostered and created:
• Express confidence in the mental health professional.
• Be concrete about what counseling is and how it could help.
• Offer to accompany the student-athlete to the initial appointment.
• Offer to make the appointment, or have the student-athlete make the appointment.
• Emphasize the confidentiality of medical care and referral process.
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Approaching the Student-Athlete with a Potential Mental Health Issue
• When confronting a student-athlete who may have a mental illness, it is best to be
empathetic and identify with them as a person, not a student-athlete.
• Take the coach/athlete part out of the relationship. Empathy and encouragement are very
important to creating an atmosphere that will put the student-athlete at ease.
• These are possible questions that might help the student-athlete open up and begin a
productive dialogue between coach and student-athlete:
• “How are things going for you?”
• “Tell me what is going on.”
• “You don’t seem to be yourself lately, and I am concerned for you. Can you tell
me what is going on, or is there something I need to know why this incident
happened?”
• “Tell me how those cuts got there.”
• “Maybe you should talk to someone about this issue who knows more about this
subject than me; let me help you.”
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THE PREGNANT AND PARENTING STUDENT-ATHLETE
POLICY
The Brevard College Athletic Department recognizes that with the increasing numbers of women
participating in collegiate sports, there is a chance that more women may become pregnant while
playing intercollegiate sports. The purpose of this policy is to develop guidelines to protect the
health, confidentiality, scholarship, and ability of the pregnant student-athlete to participate while
also assisting medical providers, coaches, and administrators with uniform guidelines that
address this issue. This policy sets forth the protections that should be provided for pregnant and
parenting students, including those with pregnancy related conditions. It also prohibits
retaliation against any student-athlete or employee in regards to the enforcement of this
Pregnancy Policy
PROCEDURE
•
Managing the Pregnant Student-Athlete
• If a student-athlete becomes pregnant while she is an active student-athlete with
any sports team at Brevard College, that student-athlete is required to inform the
Sports Medicine Staff as soon as possible/ All information provided to the Sports
Medicine Staff will be kept confidential and only release to appropriate persons
with the specific consent of the student-athlete.
• The student-athlete will not have to immediately withdraw from their sport;
however the student-athlete will be required to provide documentation of medical
clearance to participate in their intercollegiate sport by their primary care
physician and/or OB/GYN within a timely manner. The athletic department will
allow a pregnant or parenting student-athlete to fully participate on their team.
Including all team-related activities. Unless the student-athlete’s physician or
other medical caregiver certifies that participation is not medically safe.
• If the student-athlete chooses to continue participation, the student-athlete must
receive appropriate prenatal counseling from the appropriate athletic trainer along
with the team physician and. A specialist. This counseling helps the studentathlete understand the medical condition and the risk of injury to the studentathlete, as well as the fetus
• Current knowledge indicates that women who exercise at “submaximal levels” do
not appear to be at great risk for spontaneous abortion, do not have a greater
incidence of complications during labor and delivery than their sedentary
counterparts, and do not adversely affect fetal well-being. However, he level of
participation in many sports programs requires sustained maximal exercise and
this is noted to be harmful to both mother and fetus, possibly resulting in
increases in deep-body temperature that exceed the teratogenic threshold. A
higher incidence of fetal growth retardation, and increased risk for premature
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•
birth. The American College of Sports Medicine discourages heavy weight lifting
or similar activities that require straining or valsalva. Depending on your sport
and with our healthcare professional’s approval you may be able to continue
training and competing up to a certain time frame. The decisional-support team
will provide mandatory monitoring of your health and academic progress. And
will assist you in your return to competition if that is your desire.
• If the student-athlete chooses to terminate the pregnancy, it still requires a period
of tome for recovery that will need to be coordinated with the family
physician/OB-GYN and the Sports Medicine Team.
• Only after counseling and discussion has occurred, will the Team Physician ad/or
specialist in conjunction with the student-athlete determine the length of
participation and any other restrictions. The student-athlete must sign a properly
executed document of understanding and waiver before being permitted to
continue their athletic participation.
• No coach or other athletics department personnel shall suggest to any studentathlete that his or her continued participation on a team will be affected in any
way by pregnancy, parental, or marital status.
• The athletic department-s secondary insurance policy does not cover pregnancy
related care and/or any injury, illness, or complication related to pregnancy. All
costs related to pregnancy are the responsibility of the student-athlete.
Legal and Administrative Issues
Brevard College complies with Title IX and does not discriminate on the basis of
pregnancy.
• The athletic Department will allow a leave of absence for pregnancy as long as
medically necessary and reinstate the athlete to the position held before
pregnancy.
• Pregnancy is treated no differently than any other type of temporary medical
condition. The NCAA Division II Manual Rule 14.2.2.2 states:
• Pregnancy Exception: A member institution may approve a two-semester
or three-quarter extension of this 10 semester/15-quarter period of
eligibility for a female student-athlete for reasons of pregnancy.
• The student –athlete should not be forced to terminate a pregnancy because of
financial or psychological pressure or fear of losing their institution grants-in-aid.
• NCAA Bylaw 15.3.4.1. (d) states: “voluntary withdrawal may result in financial
aid…:”
• Pregnant student-athletes should not voluntarily withdraw immediately.
They should be counseled on the issues related to pregnancy, participation,
eligibility extension and financial aid before making this decision.
• A student-athlete with a temporary condition is still expected to complete all
academic tasks to the best of his/ her ability along with other student-athlete
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•
obligations. If he/she fails to meet academic and other obligations on a consistent
basis, the athletic department and the student-athlete will enter into a contract
outlining the responsibilities and expectation of the student-athlete for the renewal
of athletics aid the following year.
No athletic department personnel will publicly release personally identifiable
health information about pregnancy without written, timely authorization for the
student-athlete.
WHERE TO FIND COUNSELING AND HEALTH CARE
If a pregnant student-athlete is in need of counseling, she can report to the Transylvania County
Department of Public Health
Transylvania Department of Public Health
98 East Morgan Street
Brevard, NC 28712
(828) 884-3135
health.transylvaniacounty.org
•
The pregnant student-athlete can find health care and support for all of these issues:
• Family Planning
• Provides a complete physical exam, counseling and education, and followup and provisions of appropriate methods of birth control
• An appointment is required, sliding scale fee
• Appointment is required, call 884-3135
• Sexually Transmitted Diseases
• Confidential testing, diagnosis, and treatment provided free of charge
• No appointment is required
• Available Monday-Friday 8:30am-4:30pm
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USE OF THE HEAD AS A WEAPON IN FOOTBALL AND OTHER CONTACT
SPORTS
POLICY
Brevard College two equipment intensive contact sports: Football and Men’s Lacrosse. In these
sports, it is very easy for one of the athletes to use their helmet and head as a weapon to spear
their opponent to body check and/or tackle them. This practice is extremely dangerous, and can
result in paralysis or death. Even though these injuries cannot be fully prevented due to the
forces that occur during the collision, the chance of these injuries can be minimized by
complying with standards set by helmet manufacturers and proper safety standards set by the
playing rules.
PROCEDURE
Brevard College complies with these specific standards set forth by the American Football
Coaches Association addresses these important points about not using the head as a weapon.
•
•
•
The helmet shall not be used as the brunt of contact in the teaching of blocking or
tackling.
Self-propelled mechanical apparatuses shall not be used in the teaching of blocking or
tackling.
Coaches, players, and officials should place a greater emphasis on eliminating spearing.
Even though these standards were developed by the American Football Coaches Association,
they can and are applied to all contact sports at Brevard College. “Spearing,” or the use of the
head as a weapon is a penalty in Football Men’s Lacrosse, and Men’s and Women’s Ice Hockey.
Officials should be aware of the penalty and take special notice of the enforcement of this
penalty. Any player who continues to use their head as a weapon increases the risk of a
catastrophic injury every time they do it.
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REFERENCES
Bulik, C., Furberg, H., Lichtenstein, P., Pedersen, N., Sullivan, P., & Tozzi, F. (2006).
Prevalence, heritability, and prospective risk factors for anorexia nervosa. Arch Gen
Psychiatry, 63(3), 305-312. doi:10.1001/archpsyc.63.3.305.
Marzola, E., Nasser, J. A., Hashim, S. A., Shih, P., & Kaye, W. H. (2013). Nutritional
rehabilitation in anorexia nervosa: review of the literature and implications for
treatment. BMC Psychiatry, 13(1), 1-26. doi:10.1186/1471-244X-13-290
National Athletic Trainers’ Association Position Statement: Lightning Safety for Athletics and
Recreation, Journal of Athletic Training, 258-270, 48:2, April 2013.
NCAA Guide Line (1d Lightning Safety) from the Sports Medicine Handbook, 2012-13, pages
13-15.
NCAA Sports Medicine Handbook; 2013-2014
Prentice, W. (2006). Arnheim’s principles of athletic training: a competency-based approach.
New York, NY. McGraw-Hill.
Transylvania County Department of Public Health Services. (2014). Retrieved from
http://health.transylvaniacounty.org/Child%20Health/child.htm.
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Appendix 1
Emergency Action Plan
Updated April 2014
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Introduction
The purpose of this document is to provide instructions to members of the Brevard College Athletic
Department in the event of a medical emergency regarding a student-athlete. An emergency is any
sudden life threatening injury or illness that requires immediate medical attention. The development
and implementation of an Emergency Action Plan (EAP) will help ensure that the best care will be
provided in any situation. A copy of this EAP will be kept and accessible in the Head Athletic Trainer’s
office as well as on the Brevard College Athletics Website. All Coaches and relevant Athletic
Department Staff are required to review this document annually.
A serious injury (whereby a student-athlete’s life is in danger or the student-athlete risks permanent
impairment) includes, but it not limited to,: cervical/lumbar spine injury or spinal cord trauma, head
injury, serious bleeding, fractures, heat stress, cardiovascular arrest, seizures, respiratory arrest/distress,
shock, diabetic coma/insulin shock, internal organ injury, and severe sudden illness. If a condition/injury
is NOT life threatening, attempt to contact a Staff Certified Athletic Trainer (ATC). If an ATC is not
available, then contact the Student Health Center. When in doubt as to the seriousness or nature of the
injury/condition, have the student-athlete go to the Emergency Room (ER) or to an Urgent Care Facility.
Preparation for emergencies involves the formulation of an emergency plan, proper coverage of events,
maintenance of appropriate emergency equipment and supplies, utilization of appropriate emergency
medical personnel, and continuing education in the area of emergency medicine and planning.
Hopefully, through careful pre-participation physical screenings, adequate medical coverage, safe
practice and training techniques, and other safety avenues, some potential emergencies may be
averted. However, accidents and injuries are inherent with sports participation, and proper preparation
on the part of the Sports Medicine Team and Athletic Department Staff should enable each emergency
situation to be managed appropriately.
Staff Medical Certification Requirements
All Brevard College Staff Athletic Trainers must be certified by the Board of Certification (BOC), maintain
current North Carolina State Athletic Trainer Licensure, as well as hold a current certification in First
Aid/CPR/AED for the Professional Rescuer through the American Red Cross or Basic Life
Support/CPR/AED through the American Heart Association. Documentation of these certifications and
licensures will be kept on file in the Head Athletic Trainer’s Office.
All Head Coaches and Full-Time Assistant Coaches must acquire and maintain current certification in
First Aid/CPR/AED through a recognized agency before beginning countable athletic related activities.
Documentation of these certifications will be kept on file in the Athletic Director’s Office and/or Director
of Compliance’s Office.
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POLICY
An emergency situation is defined as a situation that is life threatening and endangering to the health of
the student-athlete. General illnesses, such as the flu, colds, etc., are not considered medical
emergencies. Common musculoskeletal injuries, such as sprains, strains, etc., are also not considered
medical emergencies.
During all events at which a Brevard College Athletic Department Team Physician is present, he/she will
make all final decisions regarding the immediate health care of the student-athletes at the playing
venue. If the physician is not present at a specific venue, then emergency action procedures are
designated to the present Staff Certified Athletic Trainer (ATC) on call. That individual will activate EMS
as soon as possible while caring for the student-athlete. Upon arrival, the EMT’s, paramedics, and ER
physicians will assume care and responsibility for the welfare of the student-athlete. The person at the
head of the athlete will be the team leader verbally in regards to the spine boarding process only. All
other decisions will be made by the paramedic/EMT or physician. If possible, a Staff Athletic Trainer will
accompany the student-athlete to the ER in the ambulance. The Athletic Director, Head Athletic Trainer,
and Head Team Physician are to be notified as soon as possible. Follow-up will be done by both the
designated Staff Athletic Trainer and the Team Physician.
Purpose:
Increase the awareness of action that is to be taken in the event of an emergency at NCAA affiliated
events at Brevard College. The Sports Medicine Department has proposed the following guidelines for
an EMERGENY ACTION PLAN (EAP). This plan is intended to educate all parties involved in the event of
an emergency. A copy of this Emergency Action Plan will be kept and accessible in the Head Athletic
Trainer’s office as well as on the Brevard College Athletics Website. All coaches and relevant Athletic
Department Staff are required to review this document annually.
A member of the Brevard College Sports Medicine Staff (i.e., Certified Athletic Trainer or Team
Physician) shall be empowered to have the unchallengeable authority to cancel or modify a practice or
workout for health and safety reasons (i.e., environmental changes), as he or she deems appropriate.
Weather conditions will be monitored using MxVision WeatherSentry Online®.
PROCEDURES
During all events at which a Brevard College Team Physician is present, he/she will make all final
decisions regarding the immediate health care of the student athletes at the playing venue. If a
physician is not present, then the responsibilities of the EAP are designated to the present Staff Certified
Athletic Trainer on call. That individual will designate a secondary responder to activate EMS as soon as
possible while caring for the student athlete. The secondary responder(s) will then assist the first
responder. If no Certified Athletic Trainer is present, the first responder becomes the responsibility of
the coach. EMT/Paramedics will assume care and responsibility of the student-athlete upon arrival. If
accessible, a member of the Brevard College Athletic Department will accompany the student-athlete in
the ambulance. The Athletic Director, Head Athletic Trainer, and Team Physician should be notified
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when an emergency has been appropriately handled in accordance with the EAP. Follow up will be done
by the designated Staff Certified Athletic Trainer and the Team Physician.
1. The first responder should secure the area and begin taking appropriate care of the studentathlete by checking the ABC’s (airway, breathing, circulation) and is to stay with the studentathlete until more qualified help arrives. If a student-athlete is unconscious or a head or
neck injury is suspected, stabilize their head immediately and DO NOT MOVE THE STUDENTATHLETE unless the situation becomes unsafe.
2. The second responder should then call 911 and give the appropriate information (see
specific venue) and remain on the line until the EMS dispatcher/operator states that he/she
has the necessary information or disconnects the call.
3. The second responder should then offer assistance to the first responder.
4. If available, a third responder will meet EMS (see specific venue).
5. If available, a member of the Brevard College Athletic Department will accompany the
student-athlete in the ambulance.
6. Insurance information will be available to accompany the student-athlete to the emergency
room.
7. Follow up will be done by the designated Staff Athletic Trainer and Team Physician.
An Automated External Defibrillator (AED) is available at Brevard College to be used in an emergency
situation.
1. Cervical Injury without Compromised Airway
A. Staff ATC and Team Physician approach the student-athlete and determine no airway
compromise. Airway, breathing, and circulation are all intact.
B. Sports Medicine Staff determine that cervical spine injury is present.
C. Signal given to sideline to bring additional help to the injured athlete. Prior to all games, the
Athletic Training Staff will determine the team of staff/MDs/aides that will respond to an
emergency situation.
D. Staff ATC gains control of the student-athlete’s head to limit movement of the c-spine.
E. Signal to ambulance crew to mobilize ambulance to the athlete and assist Team Physician in
the spine boarding/removal of the athlete.
F. Once all emergency response staff is in place (one person at head, 3 people on each side of
the athlete), the head person states the orders (“1-2-3 roll”) in sequence to roll the studentathlete while the board is placed under the student-athlete. The board is slid under the
student-athlete from the side by an 8th person.
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G. The student-athlete is then rolled back onto the board according to and on the count of the
person at the head (“1-2-3 down”). Once the student-athlete’s entire body is on the board,
straps are placed across the student-athlete to secure them to the board.
H. Once the student-athlete is secured to the board, the head person will then give a command
of (“1-2-3 lift”). The student-athlete is then placed on a gurney to be transported to the hospital
for further evaluation.
2. Cervical Injury with Compromised Airway
A. Staff ATC and Team Physician approach the student-athlete and determine there is an
unconscious, non-breathing victim with a cervical spine injury present.
B. Activate EMS and retrieve AED; also at this time, the head is being stabilized; rescue breathing
can then begin.
C. If the student-athlete is face down, efforts will be made to cautiously turn him/her to a supine
position, but cutting off the shoulder pads and/or jersey should be considered prior to such a
turn. The ATC at the head of the student-athlete will cross his/her arm to facilitate rolling. Four
people will be on the side of the student-athlete that they will be rolling towards; two people
will be on the side of the student-athlete that they are rolling away from to stabilize the hips.
The roll will be directed by the ATC at the head of the student-athlete (“1-2-3 roll halfway”); the
student-athlete will be rolled halfway and stopped, to allow the rollers a chance to adjust their
hand and feet placement. The ATC at the head of the student- athlete will then give the order
(“1-2-3 roll down”) to lower the student-athlete to the ground, now face-up.
D. If the student-athlete does not have a pulse, the student-athlete’s jersey and shoulder pads
will be cut up the middle to allow access to the chest, and the AED will be used following
standard AED procedures.
E. Once the ambulance arrives on the field, the EMT’s/paramedics may then assess the situation
and, with the concurrence of the team physician, take the emergency action that they feel is
necessary.
F. Once an airway is established and it is decided by the Team Physician that the student-athlete
is stable, that student-athlete is spine boarded, taken off the field by the ambulance (always
with the person at the head continuing stabilization), and transported to the emergency room.
G. The scenario at the ER is the same as stated previously.
3. Unconscious Student-Athlete
The unconscious student-athlete will be treated as above, assuming a cervical spine injury until
such time that this injury can be ruled out.
4. Communications and Chain of Command
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In the case of a serious or life-threating situation, all reasonable efforts will be made to contact the
parents of the student-athlete. In the instance of death, the physician overseeing the case will first
attempt to notify the parents prior to notifying any other party. All other effort to communicate with
the necessary parties will be carried out in the following order:
A. First responder contacts Staff Certified Athletic Trainer assigned to sport
B. Staff Certified Athletic Trainer contacts Head Athletic Trainer
C. Head Athletic Trainer contacts Head Team Physician
D. Head Athletic Trainer contacts Athletic Director
E. Head Team Physician contacts emergency contact
F. Head Team Physician or ATC contacts Coach
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Emergency Personnel
The type and degree of sports medicine coverage for an athletic event (practice or contest) may vary
based on factors such as the particular sport or activity, the setting, and the type of training or
competition. With the majority of athletic contests and practices, the first responder to an emergency
situation is typically a member of the Sports Medicine Staff, most commonly a Certified Athletic Trainer
(ATC) or a Coach. A Team Physician will be present at all football games as well as other home athletic
contests, but not on a regular basis. EMTs and Paramedics will be available at all home football games.
Roles of the individuals within the emergency team may vary depending on various factors such as
number of members of the team, the athletic venue itself, or the preference of the Head Athletic
Trainer. The four basic roles within the emergency team include:
A.
B.
C.
D.
Immediate Care of the Athlete
Activation of Emergency Medical Services
Emergency Equipment Retrieval
Direction of EMS to the Scene
A. Immediate Care of the Athlete (Physician, ATC, EMT/Paramedic, Coach, Student Athletic Trainer)
The first and most important role is immediate care of the student-athlete. Acute care in an
emergency situation should be provided by the most qualified individual on the scene. Individuals
with lower credentials should yield to those with more appropriate training. This should be
determined in advance of each training session.
B. Activation of Emergency Medical Services (EMS) (Physician, ATC, Coach, Student Athletic Trainer)
The second role, EMS activation, should be done as soon as the situation is deemed “emergency” or
“life-threatening event “. This is the most critical factor. Activating the EMS system may be done by
anyone on the team by calling 911 from any phone. However, the person chosen for this duty
should be someone who is calm under pressure, who communicates well, and who is familiar with
the location of the sporting event.
C. Emergency Equipment Retrieval (ATC, Coach, Student Athletic Trainer)
The third role, equipment retrieval, may be done by anyone on the emergency team who is familiar
with the types and location of the specific equipment needed. Coaches and support staff are good
individuals for this role.
D. Directions to the Emergency Site (ATC, Coach, Student Athletic Trainer)
After EMS has been activated, one member of the team should be responsible for meeting the
emergency medical personnel as they arrive at the site of the contest, if they are not already there.
Depending on ease of access, this person should have keys to any locked gates or doors that may
hinder the arrival of medical personnel. This individual is also responsible for contacting Campus
Security, notifying them of EMS activation, and the emergency location.
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Emergency Communication
In the event that an emergency occurs involving a student-athlete, a member of the Emergency Team
should promptly contact Emergency Medical Services (EMS). Phone numbers of emergency personnel
should be posted by the phone or in the medical kit. It is the responsibility of the Certified Athletic
Trainer or coach (if an ATC is not present) to bring a cellular phone to the field. A back up
communication plan should be in effect if there is a failure of the primary communication system. It is
important to note in advance the location of a workable telephone. Pre-arranged access to the phone
should be established if it is not easily accessible. A cellular phone with back up battery is preferred.
Contacting the Emergency Medical Services (EMS)
1. If EMS is at the event, then a signal (discussed in advance) should be given to summon them forward
2. If EMS is not on site, activate by calling 911, followed by calling Campus Security at 828-884-8295
3. The following information should be provided to the dispatcher:
A) Your name
B) Exact location where the injury occurred and where you will meet them
C) The number you are calling from
D) The student-athlete’s chief complaint
E) The student-athlete’s age
F) The student-athlete’s level of consciousness
G) The student-athlete’s breathing condition (is the student-athlete breathing or having
difficulty breathing)
H) The care being provided
I) Make sure you hang up only after the dispatcher has hung up
4. Notify someone from the Sports Medicine Staff.
5. As EMS is being dispatched, make sure someone is designated to retrieve any needed emergency
equipment from the sideline.
6. Have coaches serve as crowd control and keep other student-athletes away from the scene.
7. Send someone to meet the ambulance at the designated spot.
8. A member of the Sports Medicine Staff or Coach will accompany the injured student-athlete to the
hospital (Transylvania Regional Hospital). The member of the Sports Medicine Staff should bring
medical and/or insurance information with them to the hospital if accessible.
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Any time EMS is activated or a student-athlete is taken to Emergency Medical Facilities (such as the ER
or Urgent Care) by a Coach, Athletic Trainer, or other, you must notify the Head Athletic Trainer as
well as the Athletic Director.
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Emergency Equipment
The majority of emergency equipment will be under the control of a member of the Sports Medicine
Staff (i.e.: Physician, ATC) or EMT’s. The highest trained provider at the event should be aware of what
equipment is readily available at the venue or event. All necessary emergency equipment should be
quickly accessible. Appropriate personnel should be familiar with the function and operation of
available equipment. The equipment should be in good condition and checked regularly.
The highest trained member of the staff should determine in advance the type and manner in which any
equipment is at or to be delivered to the site. Unless immediately adjacent to the Athletic Training
Room, non-sports medicine staff members should rely on emergency medical services for all equipment.
The following is a list of important available equipment and their locations:
A. Automatic Electronic Defibrillators (AED’s): One AED will always be located in the Boshamer
Gymnasium, located in the athletic training room in the glass box just outside the Head Athletic
Trainer’s office. The second AED will be kept in the Head Athletic Trainer’s Office, and be taken
to all scheduled football practices and/or on the sideline at other home athletic contests.
Coaches should take note of the closest AED to their practice and game locations.
B. Splints: Available in the Athletic Training Room or on site with the ATC (which will be handled by
the ATC or the Physician). The splint bag that is in the Athletic Training Room is located in the
Head Athletic Trainer’s office (red splint bag).
C. First Aid Kit: Each team should have a designated first aid kit. It is the responsibility of the
coaching staff to have this present at all practices and away games, as well as keep it stocked
with necessary supplies.
D. Supplemental Oxygen: An O2 tank with mask will be located in the Athletic Training Room if
necessary.
E. Helmet Removal Equipment (Football): Consisting of charged power screwdriver and/or
facemask clip cutting tool. Available in the Football Athletic Trainer’s Kit at practice or game
site.
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Heat Illness Protocol
POLICY
Recognition of Heat Stroke
The ability to rapidly and accurately assess core body temperature and Central Nervous System (CNS)
functioning is critical to the proper evaluation of exertional heat stroke. Medical Staff should be
properly trained and equipped to assess core temperature via rectal thermometer when feasible.
Most critical criteria for determination are 1) hyperthermic (rectal temperature > 104°F) immediately
post-incident and 2) CNS dysfunction (altered consciousness, coma, convulsions, disorientation,
irrational behavior, decreased mental acuity, irritability, emotional instability, confusion, hysteria, and
apathy).
Other possible significant findings include nausea, vomiting, diarrhea, headache, dizziness, weakness,
hot and wet or dry skin (it is important to note that skin may be wet or dry at time of incident),
increased heart rate, decreased blood pressure, increased respiratory rate, dehydration, and
combativeness.
Aggressive and immediate whole-body cooling is the key to optimizing treatment of exertional heat
stroke. The duration and degree of hyperthermia may determine adverse outcomes. If untreated,
hyperthermia-induced physiologic changes resulting in fatal consequences may occur within vital
organ systems (e.g., muscle, heart, brain, etc.).
PROCEDURES
1. Emergency Treatment of Heat Stroke
Immediate whole-body cooling is the best treatment for exertional heat stroke and should be
initiated within minutes post-incident. It is recommended to cool first and transport second if
onsite rapid cooling is possible. Cooling can be successfully verified by measuring rectal
temperature. If onsite cooling is not an option, the student-athlete should be immediately
transferred to the nearest medical facility.
The following procedures are recommended if exertional heat stroke is suspected:
A. Remove clothing and equipment
B. Move student-athlete immediately to air-conditioned facility or shaded area if possible
C. Cool student-athlete immediately by:
• Immerse student-athlete in tub of cold water; stir water and, if necessary, add
ice throughout cooling process, or
• Place ice bags or ice over as much of body as possible, cover body with cold
towels (replace towels frequently), fan body or spray with cold water
D. Monitor ABC’s, core temperature, and CNS (cognitive, convulsions, orientation,
consciousness, etc.)
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E. Place an intravenous line using normal saline (if appropriate Medical Staff available)
F. Cease aggressive cooling when core temperature reaches approximately 101°F;
continue to monitor
G. Transport student-athlete to nearest emergency medical facility
Ice/cold water immersion has proven to have superior cooling rate compared to other modes;
however, oftentimes with heat stroke, the student-athlete is unresponsive. This may
complicate airway management and other emergency interventions if the student-athlete is
immersed in water. The Sports Medicine Staff should make the decisions on the most feasible
mode of cooling based upon the student-athlete’s physical presentation. Choice of cooling
modes may also be dependent on other factors, such as size limitations, availability of cooling
options, and maintaining the safety of the student-athlete.
2. Recognition of Heat Exhaustion
Most critical criteria for determination are 1) student-athlete has obvious difficulty continuing
intense exercise in heat, 2) lack of sever hyperthermia (usually < 104°F), and 3) lack of severe
CNS dysfunction. If any CNS dysfunction is present, it will be mild and symptoms will subside
quickly with treatment and as activity is discontinued.
Other possible significant findings include physical fatigue/dizziness, dehydration and/or
electrolyte depletion, ataxia and coordination problems, syncope, profuse sweating, pallor,
headache, nausea, vomiting, diarrhea, stomach/intestinal cramps, persistent muscle cramps,
and rapid recovery with treatment.
3. Emergency Treatment of Heat Exhaustion
The following procedures are recommended if heat exhaustion is suspected:
A. Remove student-athlete from play and immediately move to an air-conditioned or
shaded area
B. Remove excess clothing and equipment
C. Cool student-athlete
D. Have student-athlete lie comfortably with legs propped above the heart level
E. If student-athlete is not nauseated, vomiting, or experiencing any CNS dysfunction,
rehydrate orally with chilled electrolyte drink or water. If student-athlete is unable to
take oral fluids, implement intravenous line using normal saline (if appropriate Medical
Staff is available).
F. Monitor heart rate, blood pressure, respiratory, core temperature, and CNS status
G. Transport to nearest emergency medical facility if rapid improvement is not noted with
prescribed treatment
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Emergency Contact List
Emergency Medical System (EMT/Paramedic)
911
Athletic Training Room, Head ATC Office
Assistant Athletic Trainer Office
Colin Covelli, ATC (Head Athletic Trainer)
David Boyd, ATC
Ali Bush, ATC
Yu-Jin Shim, ATC
(828) 884-8316
(828) 884-8272
Cell: (828) 231-1033
Cell: (304) 282-1897
Cell: (850) 418-1988
Cell: (336) 542-7928
Brevard Orthopaedic Office
Brevard Family Practice Office
(828) 884-2055
(828) 884-9362
BC Athletic Director Office
Juan Mascaro
(828) 884-8108
Cell: (828) 553-6575
BC Student Health/Wellness Center
Nora Sheehan, RN
(828) 884-8244
Cell: (828) 506-1162
Stan Jacobsen, Director of Campus Safety Office
27-Hour Campus Safety Line
(828) 884-8381
(828) 577-9590
Transylvania Regional Hospital
Brevard Sisters of Mercy Urgent Care
Looking Glass Eye Center
Transylvania County Health Department
Poison Control
(828) 884-9111
(828) 883-2600
(828) 884-7320
(828) 884-3135
(1-800) 222-1222
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Emergency Plan: Boshamer Gymnasium (Basketball, Volleyball, Weight Room, Athletic Training Room,
Locker Rooms)
Emergency Personal: Certified Athletic Trainer on site for competition; additional Sports Medicine Staff
accessible from the Athletic Training Room located in Boshamer Gymnasium
Emergency Communication: Fixed telephone line is located in the Athletic Training Room. A cellular
phone can also be used to activate EMS. Any time EMS is activated or an athlete is taken to Emergency
Medical Facilities such as the ER or Urgent Care by a Coach, Athletic Trainer, or other, you must notify
the Head Athletic Trainer Colin Covelli, as well as the Athletic Director Juan Mascaro.
Emergency Equipment: Supplies (AED, Splint Kit) located at each event on home side. Additional
equipment can be located in Athletic Training Room.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested; see script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard College. We have a victim
who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at Boshamer Gymnasium. From Highway
276/64, N. Broad St., enter through the North Campus Entrance, turning onto North Campus Drive.
Take a left at the stop sign onto Kings Creek Loop. Boshamer Gymnasium is on the right. The emergency
entrance is located through the main doors. Someone will meet the ambulance outside of the main
doors to direct personnel through the emergency entrance to the exact location of the victim. If you
need to reach us again please dial (give the number you are calling from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard College Campus Address: 1 Brevard College Drive, Brevard, NC 28712
Driving Directions: From Highway 276/64, N. Broad St., enter through the North Campus Entrance,
turning onto North Campus Drive. Take a left at the stop sign onto Kings Creek Loop. Boshamer
Gymnasium is on the right.
Boshamer
Gymnasium
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Emergency Plan: Football Practice Field
Emergency Personal: Certified Athletic Trainer on site for competition; additional Sports Medicine Staff
accessible from the Athletic Training Room located in Boshamer Gymnasium
Emergency Communication: Fixed telephone line is located in the Athletic Training Room. A cellular
phone can also be used to activate EMS. Any time EMS is activated or an athlete is taken to Emergency
Medical Facilities such as the ER or Urgent Care by a Coach, Athletic Trainer, or other, you must notify
the Head Athletic Trainer Colin Covelli, as well as the Athletic Director Juan Mascaro.
Emergency Equipment: Supplies (AED, Splint Kit) located with Athletic Trainer (usually on golf cart, if
available). Additional equipment can be located in Athletic Training Room.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested; see script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard College. We have a victim
who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at the football practice field. From Highway
276/64, N. Broad St., enter through the North Campus Entrance, turning onto North Campus Drive. Go
straight through the stop sign onto Kings Creek Loop to the back of campus. Take the dirt road on the
right, continuing pass the track and softball fields on the right. The football practice field is located at
the end of the dirt road. Someone will meet the ambulance at the beginning of the dirt road to direct
personnel to the exact location of the victim. If you need to reach us again please dial (give the number
you are calling from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard College Campus Address: 1 Brevard College Drive, Brevard, NC 28712
Driving Directions: From Highway 276/64, N. Broad St., enter through the North Campus Entrance,
turning onto North Campus Drive. Go straight through the stop sign onto Kings Creek Loop to the back
of campus. Take the dirt road on the right, continuing pass the track and softball fields on the right. The
football practice field is located at the end of the dirt road.
Football Practice
Field
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Emergency Plan: Softball Field
Emergency Personal: Certified Athletic Trainer on site for competition; additional Sports Medicine Staff
accessible from the Athletic Training Room located in Boshamer Gymnasium
Emergency Communication: Fixed telephone line is located in the Athletic Training Room. A cellular
phone can also be used to activate EMS. Any time EMS is activated or an athlete is taken to Emergency
Medical Facilities such as the ER or Urgent Care by a Coach, Athletic Trainer, or other, you must notify
the Head Athletic Trainer Colin Covelli, as well as the Athletic Director Juan Mascaro.
Emergency Equipment: Supplies (AED, Splint Kit) located in the dugout along the third base line.
Additional equipment can be located in Athletic Training Room.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested see; script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard College. We have a victim
who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at the softball field. From Highway 276/64,
N. Broad St., enter through the North Campus Entrance, turning onto North Campus Drive. Go straight
through the stop sign onto Kings Creek Loop to the back of campus. Take the dirt road on the right,
continuing pass the track on the right. The softball field is located on the right. Someone will meet the
ambulance at the beginning of the dirt road to direct personnel to the exact location of the victim. If
you need to reach us again please dial (give the number you are calling from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard College Campus Address: 1 Brevard College Drive, Brevard, NC 28712
Driving Directions: From Highway 276/64, N. Broad St., enter through the North Campus Entrance,
turning onto North Campus Drive. Go straight through the stop sign onto Kings Creek Loop to the back
of campus. Take the dirt road on the right, continuing pass the track on the right. The softball field is
located on the right.
Softball
Field
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Emergency Plan: Track and Lacrosse Field
Emergency Personal: Certified Athletic Trainer on site for competition; additional Sports Medicine Staff
accessible from the Athletic Training Room located in Boshamer Gymnasium
Emergency Communication: Fixed telephone line is located in the Athletic Training Room. A cellular
phone can also be used to activate EMS. Any time EMS is activated or an athlete is taken to Emergency
Medical Facilities such as the ER or Urgent Care by a Coach, Athletic Trainer, or other, you must notify
the Head Athletic Trainer Colin Covelli, as well as the Athletic Director Juan Mascaro.
Emergency Equipment: Supplies (AED, Splint Kit) located with Athletic Trainer (usually on golf cart, if
available). Additional equipment can be located in Athletic Training Room.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested; see script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard College. We have a victim
who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at the track/inner soccer practice field
(state one). From Highway 276/64, N. Broad St., enter through the North Campus Entrance, turning onto
North Campus Drive. Go straight through the stop sign onto Kings Creek Loop to the back of campus.
Take the dirt road on the right. The track/inner soccer practice field (state one) is located immediately
on the right. Someone will meet the ambulance at the beginning of the dirt road to direct personnel to
the exact location of the victim. If you need to reach us again please dial (give the number you are
calling from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard College Campus Address: 1 Brevard College Drive, Brevard, NC 28712
Driving Directions: From Highway 276/64, N. Broad St., enter through the North Campus Entrance,
turning onto North Campus Drive. Go straight through the stop sign onto Kings Creek Loop to the back
of campus. Take the dirt road on the right. The track/inner soccer practice field is located immediately
on the right.
Track and Inner
Soccer Practice Field
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Emergency Plan: Soccer Game Field
Emergency Personal: Certified Athletic Trainer on site for competition; additional Sports Medicine Staff
accessible from the Athletic Training Room located in Boshamer Gymnasium
Emergency Communication: Fixed telephone line is located in the Athletic Training Room. A cellular
phone can also be used to activate EMS. Any time EMS is activated or an athlete is taken to Emergency
Medical Facilities such as the ER or Urgent Care by a Coach, Athletic Trainer, or other, you must notify
the Head Athletic Trainer Colin Covelli, as well as the Athletic Director Juan Mascaro.
Emergency Equipment: Supplies (AED, Splint Kit) located at each event on home side (between the
press box and Boshamer Gymnasium). Additional equipment can be located in Athletic Training Room.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested; see script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard College. We have a victim
who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at the soccer game field. From Highway
276/64, N. Broad St., enter through the North Campus Entrance, turning onto North Campus Drive. Go
straight through the stop sign onto Kings Creek Loop to the back of campus. The soccer game field is
located on the left. Someone will meet the ambulance at the entrance to the parking lot next to the
soccer game field to direct personnel to the exact location of the victim. If you need to reach us again
please dial (give the number you are calling from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard College Campus Address: 1 Brevard College Drive, Brevard, NC 28712
Driving Directions: From Highway 276/64, N. Broad St., enter through the North Campus Entrance,
turning onto North Campus Drive. Go straight through the stop sign onto Kings Creek Loop to the back
of campus. The soccer game field is located on the left.
Soccer Game
Field
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Brevard College 2014-2015 Policies and Procedures Manual
Emergency Plan: Tennis Courts
Emergency Personal: Certified Athletic Trainer on site for competition; additional Sports Medicine Staff
accessible from the Athletic Training Room located in Boshamer Gymnasium
Emergency Communication: Fixed telephone line is located in the Athletic Training Room. A cellular
phone can also be used to activate EMS. Any time EMS is activated or an athlete is taken to Emergency
Medical Facilities such as the ER or Urgent Care by a Coach, Athletic Trainer, or other, you must notify
the Head Athletic Trainer Colin Covelli, as well as the Athletic Director Juan Mascaro.
Emergency Equipment: Supplies (AED, Splint Kit) located with Athletic Trainer (usually on golf cart, if
available). Additional equipment can be located in Athletic Training Room.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested; see script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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Brevard College 2014-2015 Policies and Procedures Manual
If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard College. We have a victim
who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at the tennis courts. From Highway 276/64,
N. Broad St., enter through the North Campus Entrance, turning onto North Campus Drive. Go straight
through the stop sign onto Kings Creek Loop to the back of campus. The tennis courts are located on
the left, pass the soccer game field. Someone will meet the ambulance at the entrance to the parking
lot next to the tennis courts to direct personnel to the exact location of the victim. If you need to reach
us again please dial (give the number you are calling from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard College Campus Address: 1 Brevard College Drive, Brevard, NC 28712
Driving Directions: From Highway 276/64, N. Broad St., enter through the North Campus Entrance,
turning onto North Campus Drive. Go straight through the stop sign onto Kings Creek Loop to the back
of campus. The tennis courts are located on the left, pass the soccer game field.
Tennis
Courts
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Brevard College 2014-2015 Policies and Procedures Manual
Emergency Plan: Gil Coan Baseball Field
Emergency Personal: Certified Athletic Trainer on site for competition; additional Sports Medicine Staff
accessible from the Athletic Training Room located in Boshamer Gymnasium
Emergency Communication: Fixed telephone line is located inside the press box. A cellular phone can
also be used to activate EMS. Any time EMS is activated or an athlete is taken to Emergency Medical
Facilities such as the ER or Urgent Care by a Coach, Athletic Trainer, or other, you must notify the
Head Athletic Trainer Colin Covelli, as well as the Athletic Director Juan Mascaro
Emergency Equipment: Supplies (AED, Splint Kit) located in the dugout along the third base line.
Additional equipment can be located in Athletic Training Room.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested; see script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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Brevard College 2014-2015 Policies and Procedures Manual
If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard College. We have a victim
who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at the Gil Coan Baseball Field. From
Highway 276/64, N. Broad St., enter through the North Campus Entrance, turning onto North Campus
Drive. Go straight through the stop sign onto Kings Creek Loop to the back of campus. The Gil Coan
Baseball field is located on the right. The emergency entrance is located at the first base/right outfield
gate. Someone will meet the ambulance at the road next to the baseball field to direct personnel to the
exact location of the victim. If you need to reach us again please dial (give the number you are calling
from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard College Campus Address: 1 Brevard College Drive, Brevard, NC 28712
Driving Directions: From Highway 276/64, N. Broad St., enter through the North Campus Entrance,
turning onto North Campus Drive. Go straight through the stop sign onto Kings Creek Loop to the back
of campus. The Gil Coan Baseball field is located on the right.
Gil Coan Baseball Field
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Brevard College 2014-2015 Policies and Procedures Manual
Emergency Plan: Football Stadium at Brevard High School (BHS)
Emergency Personal: Certified Athletic Trainer on site for competition.
Emergency Communication: A cellular phone can be used to activate EMS. Any time EMS is activated
or an athlete is taken to Emergency Medical Facilities such as the ER or Urgent Care by a Coach,
Athletic Trainer, or other, you must notify the Head Athletic Trainer Colin Covelli, as well as the
Athletic Director Juan Mascaro.
Emergency Equipment: Supplies (AED, Splint Kit) located at each event on home side.
Role of First Responders:
1. Provide immediate care to the injured or ill student-athlete
·Check ABC’s (Airway, Breathing, Circulation)
·Begin CPR, administer First Aid as necessary
2. Emergency equipment retrieval (AED, splint bag, anaphylaxis kit, helmet removal tools)
3. Activation of Emergency Medical System (EMS)
·911 call (provide name, address, telephone number; number of individuals injured;
condition of injured; first aid treatment; specific directions; other information as
requested; see script directions below)
·Notify Head Athletic Trainer and Athletic Director
·Notify campus security at (828) 577-9590
4. Direction of EMS to scene
·Open (unlock) appropriate gates
·Designate individual to “flag down” EMS and direct to scene
·Scene control: limit scene to first aid providers and move bystanders away from area
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Brevard College 2014-2015 Policies and Procedures Manual
If the situation is life threatening:
Call 911
And give the following information
Caller:
Hello, my name is __________________________. I am calling from Brevard High School. We have a
victim who has suffered from a possible type of injury (head, neck, leg, etc.). The victim is
conscious/unconscious (state one). We need an ambulance at the Football Stadium. From Brevard
College or Highway 276/64, N. Broad Street, continue past downtown on 276/64 South Broad Street.
Stay left at fork onto County Club Road. Brevard High School is located on the left. Take last access road
on left to Football Stadium parking lot and entrance. Someone will meet the ambulance at the access
road to direct personnel to the exact location of the victim. If you need to reach us again please dial
(give the number you are calling from).
Answer any questions from the dispatcher; do not hang up until dispatcher has already done so.
Brevard High School Address: 609 North Country Club Road, Brevard, NC, 28712
Driving Directions: From Brevard College or Highway 276/64, N. Broad Street, continue past downtown
on 276/64 South Broad Street. Stay left at fork onto County Club Road. Brevard High School is located
on the left. Take last access road on left to Football Stadium parking lot and entrance.
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Brevard High School
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Verification of Staff Training Using the Emergency Action Plan
Name
__________________________
Signature
___________________________
Position
Date
__________________ _________
Verification of Staff Training Using the Emergency Action Plan
Name
__________________________
Signature
___________________________
Position
Date
__________________ _________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
__________________________
Signature
___________________________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
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Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
Signature
__________________________ ___________________________
Verification of Staff Training Using the Emergency Action Plan
Name
__________________________
Signature
___________________________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
__________________ _________
Position
Date
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Position
Date
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Position
Date
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Appendix 2:
Substance Abuse Education
and Drug Testing
Policy & Procedure
2014-2015
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Table of Contents
Introduction
I. Education
II. Types of Drug Testing
1: Institutional Random
2: Institutional Reasonable Suspicion
3: Institutional Team Testing
4: Re-entry Testing
5: Follow-Up Testing
III. Brevard College Athletics Department Drug Testing Policy
3.1: Student-Athletes Eligible for Drug Testing and Selection
3.2: Notification of Drug Testing
3.3: Reasonable Suspicion Testing
3.4 Collection Procedures and Substances Tested
IV. Effects of a Positive Test
4.1: Definition of a Positive Test
4.2: Reporting Results
4.3: Referral to Dean of Students
4.4: Laboratory Testing
4.5: Follow-up Testing
4.6: First Violation Disciplinary Action
4.7: Second Violation Disciplinary Action
4.8: Third Violation Disciplinary Action
4.9: Appeals Process
4.10: Institutional Drug Testing Record Keeping
4.11: Dietary Supplements
Forms
1: Summary of Drug Testing Policy and Consent Form
2: Drug Testing Consent and Authorization for Release
3: Reasonable Suspicion Report Appeals Form
4: Reasonable Suspicion Team/Group Drug Testing
5: Drug Testing Program Student-Athlete Notification/Testing Results Form
6: Drug Testing Reminder Sheet
7: Consequences and Procedures of Initial Positive Drug Test
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Introduction
The Brevard College Athletics Department is committed to keep our student-athletes drug free. The abuse of banned
chemical substances (including diuretics and masking agents) is not permitted by the National Collegiate Athletic
Association (NCAA) and will not be tolerated by the Brevard College Department of Athletics. This includes the misuse
of prescription and over-the-counter drugs, illegal drugs, and those drugs that are not medically indicated. The Brevard
College Athletics Department is concerned that side effects may cause serious injury of the student-athlete and/or their
teammates and opponents. It is our philosophy and policy to help student-athletes help themselves with regard to the
misuse of any harmful chemical agent.
In an attempt to promote a healthy student-athlete lifestyle, the Brevard College Athletics Department conducts a
screening program based on periodic testing designed to identify those who use any substance banned by Brevard
College, the South Atlantic Conference (SAC), and/or the NCAA. The purpose of the drug and substance abuse testing
program is to discourage the use and abuse of legal/illegal legal drugs by student-athletes. Redshirt, active eligible and
ineligible student athletes are subject to institutional drug testing, including student-athletes participating in non-NCAA
sanctioned teams such as cycling, cheerleading and dance.
The Brevard College Athletics Department Substance Abuse and Education and Drug Testing Policy are separate and
distinct from the NCAA policy, though it may contain some of the same banned drug classes. It is provided to enhance
the current Brevard College sanctions administered through Campus Life, with all penalties and counseling taking place.
Unless otherwise stated, the student-athlete must adhere to all requirements set forth by both Campus Life and the
Athletic Department. Each sport’s coaching staff reserves the right to establish and enforce a policy unique to that sport
which can only be stricter in nature than the policies set forth by the Athletics Department and Campus Life. All studentathletes are still subject to the institutional social code of the student handbook; this code takes precedence over all
Brevard College Athletics Drug Education and Testing Policies.
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I. Education
All student-athletes are required to participate in one informative educational seminar at the beginning of each
academic year. The seminar will provide a forum to ask questions and is given newest information; the student-athletes
will learn about the Brevard College Athletics Department Substance Abuse Education Program and its drug testing
policies and procedures that will be given by a member of the Brevard College Athletic Training staff or a designate of
the Athletic Director; information provided includes the consequences of a positive drug test All student-athletes are
expected to comply fully with these policies and are required in compliance with the NCAA Constitution 3.2.4.6 and
Bylaws 14.1.4 and 30.5; the student-athletes will also be required to annually sign a drug testing consent form and
institutional consent statement for both NCAA drug testing and Brevard College drug testing.
II. Types of Drug Testing
Brevard College student-athletes may be selected for testing dependent upon the agency for which they may compete.
Student-athletes may be selected for any of the following types of drug testing: They are stated as follows:
1. Institutional Random: The drug testing schedule will be set by the Drug Testing Coordinator. The studentathletes will be notified the day of or the day before screening. The athletic training staff will notify the team or
selected student-athletes, as well as the head coach of the sport of the time of screening. Drug testing may also
be done on a no notification basis.
2. Institutional Reasonable Suspicion: Student-athletes will be drug screened and/or evaluated if there is
probable cause to suspect alcohol, drug use or abuse. The coaching staff, administrator, academic adviser, or
athletic trainer may be aware of or see certain signs, symptoms, or changes in behavior that may cause him or
her to suspect substance abuse. These staff members have a duty to report any suspicions to either the Head
Athletic Trainer or Athletic Director. Reports will be evaluated by the Head Athletic Trainer, Drug Testing
Coordinator, and Athletic Director who will determine the need for counseling and/or testing.
3. Institutional Team Testing: Entire rosters of selected intercollegiate teams (including cycling, cheer and dance)
can be subject to random drug screens. The selection of a team can be based on random selection or
reasonable suspicion of the entire roster or a specific individual or group of individuals on the team.
4. Re-entry Testing: A student athlete who has had his or her eligibility to participate in intercollegiate sports
suspended as a result of a drug violation may be required to undergo re-entry drug testing after it has been
deemed that re-entry into the intercollegiate sports program is appropriate.
5. Follow-up Testing: A student-athlete who has returned to participation in intercollegiate sports following a
positive drug test under this policy will be subject to follow-up testing. Follow-up testing will be determined by
the Head Athletic Trainer and Drug Testing Coordinator.
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III. Brevard College Athletics Department Drug Testing Policy
The purpose of the drug-testing program at Brevard College is first to identify any student-athlete who may be abusing
illegal drugs or banned substances so that they may receive help and second, to serve as a motivation factor to deter
initial drug usage. Consent to drug testing is a mandatory condition for participating in intercollegiate athletics. All
Brevard College student-athletes, whether scholarship or non-scholarship, will be subject to random selection for the
drug testing program of both the NCAA and Institutional testing as long as they are associated with the athletic
department.
3.1: Student-Athletes Eligible for Drug Testing and Selection: Student-athletes who are eligible for drug testing are, any
student-athlete listed on the NCAA or institutional squad list, which includes those who are actively participating, those
with medical disabilities, red-shirted student-athletes, partial and non-qualifiers, and those who have exhausted
eligibility but are still receiving athletics related financial aid. The drug test list for each testing date will include
randomly selected athletes, up to 10% of each sport’s roster per semester from all Brevard College sports. Studentathletes that are selected will be required to report to the collection area at the time determined by the drug testing
coordinator
3.2: Notification for Drug Testing: Those student-athletes selected for drug testing will be contacted personally or by
phone (no voice mail or e-mail) either the day of or the day before screening by the Drug Testing Site Coordinator or the
Athletic Department Designee. During notification he/she will be required to sign a “Brevard College Student-Athlete
Notification” form. If the athlete is contacted by phone, the athlete must meet with the Drug Testing Site Coordinator as
soon as possible to complete and sign the notification form. The student-athlete will be given a specific time to report
back to the Athletic Training Room in order to provide a urine sample. If he/she is unable produce a sample upon
notification or at their designated time, the student-athlete will be given a maximum of three (3) hours to produce a
valid sample. The time between notification and collection of the urine specimen will be at the Drug Testing Site
Coordinator’s discretion. If the student-athlete fails to meet with the Drug Testing Site Coordinator or cannot provide a
valid sample within the allotted time, he/she will be given a “positive drug test” for that test and subject to the
disciplinary actions set forth by Brevard College Athletics Department. Drug testing may also be done on a zero
notification basis. The Head Coach will also be notified prior to testing and may assist as a secondary contact to assure
compliance.
3.3: Reasonable Suspicion Testing: Brevard College reserves the right to require a student-athlete to submit to testing
when there is reasonable suspicion to do so. For purposes of the section, “reasonable suspicion” shall be defied as
behavior, conduct, or performance by the student-athlete which may lead the College to conclude that there is the
likelihood that the student-athlete is taking or is under the influence of illegal drugs, banned substances or alcohol.
Among the indicators which may be used in evaluating a student-athlete’s behavior, conduct or performance are: class
attendance, significant GPA changes, athletic practice attendance, increased injury rate or illness, changes in physical
appearance, academic/athletic motivational level, emotional condition, mood changes, and legal involvement. A
Student Conduct Code Violation as issued from the Office of Campus Life may also be used as grounds for reasonable
suspicion drug testing. Reasonable suspicion may be based on information received that a student-athlete is using
illegal drugs or alcohol. All reasonable suspicion requests by head coaches will be directed to the Head Athletic Trainer
by way of completing and turning in the specified form to the Head Athletic Trainer. In turn, the Head Athletic Trainer
will forward all approval requests to the Drug Testing Site Coordinator in the Athletic Training Department. In such case,
the determination that “reasonable suspicion” exists to require a student-athlete to submit to testing will be made only
after consultation between the Director of Athletics, Head Athletic Trainer, and the head coach of the sport. Should
there be any disagreement as to whether the athlete should be tested; the Athletic Director will have the final decision.
All must agree that the observations, behavior, conduct or performance of the student-athlete are such that testing for
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reasonable suspicion is required to protect the health of the student-athlete, the health of others, and/or to protect the
integrity of the sport.
3.4: Collection Procedures and Substances Tested: The Drug Testing Site Coordinator will be responsible for the
collection process. A Reality Check Premium Instant Urine Test Cup from Wolfe Inc. will be utilized to detect and/or
identify the following substances: tetrahydrocannabinol (marijuana), cocaine metabolites, amphetamines,
methamphetamine, and opiate metabolites. The detailed protocol is listed below:
1. Upon entering the collection station, the athlete will provide photo identification and/or a client
representative/site coordinator will identify the athlete and the athlete will be officially signed into the
station. The student-athlete will have up to three (3) hours to give a valid urine sample starting at the
designated time in which they are to report.
2. The athlete will select a sealed cup from a supply of such.
3. A collector, serving as validator, will monitor the furnishing of the specimen by observation in order to
assure the integrity of the specimen.
4. Only members of the drug-testing crew should serve as validators.
5. Validators and other collectors must never handle the athlete’s beaker or specimen until after the
specimen is enclosed in the appropriate vials.
6. Athletes may not carry any item other than his/her beaker into the restroom when providing a
specimen. Any problem or concern should be brought to the attention of the Drug Testing Coordinator
for documentation.
7. Once a specimen is provided, the athlete is responsible for keeping the collection beaker closed and
controlled.
8. Fluids and food given to athletes who have difficulty voiding must be from sealed containers (approved
by the collector) that are opened and consumed in the station. These items must be caffeine and
alcohol free, and free of any other banned substances.
9. If the specimen is incomplete, the athlete must remain in the collection station until the sample is
completed. During this period, the athlete is responsible for keeping the collection beaker closed and
controlled.
10. If the student-athlete cannot provide a valid urine sample or the specimen is incomplete, the studentathlete must remain in the collection station until they are able to provide a valid sample (up to 3
hours).
11. The student-athlete may only leave the collection station with prior approval of the Drug Testing Site
Coordinator. Upon return to the collection station, the athlete will begin the collection procedure again.
12. Once an adequate volume of the specimen is provided, the collector who monitored the furnishing of
the specimen by observation will sign that the specimen was directly validated and a collector will check
the temperature, specific gravity and if in range measure of pH of urine and in the presence of the
student-athlete.
13. The collector and witness (if applicable) will sign certifying that the procedures were followed as
described in the protocol. The collector will complete the “Results Form” specifying the results of the
test. Any deviation from the procedures must be described and recorded. If deviations are alleged, the
athlete will be required to provide anther specimen.
14. The athlete should not leave the testing station until such time that the collector has determined the
result of the test as either “Positive” or “Negative” for a banned substance. If the collector deems that
the result of the test is “Positive” for any of the tested substances then the following steps must be
taken: The collector, along with the athlete, will complete a custody and control form and properly seal
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and package the sample in the appropriate manner. Indicate on the form which substance is to be
analyzed and confirmed as a “Positive”. The collector will then send the package through FedEx delivery
to Keystone Laboratory in Asheville, NC for lab confirmation. The collector will then notify the Head
Athletic Trainer, the Athletic Director, and/or the sport coach of the “Positive” test result and the
Athletic Director will initiate a meeting with the student-athlete and coach do discuss the consequences
and plan for the future.
IV. Effects of a Positive Test
4.1 Definition of a Positive Drug Test: In addition to the detection of banned substances found in a urine specimen
above the specified cutoff level, the following actions will also be treated the same as if there was a positive test:
• Failure or refusal to sign the drug testing notification form when instructed
• Failure to be present for the drug test at the designated time and location without sufficient justification
• Failure to provide a urine sample within the designated testing time or according to protocol
• Leaving the collection station before providing a specimen without approval of the site coordinator
• Any attempt to alter the integrity or validity of the urine specimen and/or collection process
4.2: Reporting Results: The Head Athletic Trainer will notify the and Athletic Director of any and all positive test results
including a photocopy of the positive results as well as the student-athlete notification and testing result forms. The
Athletic Director or designee shall notify the student-athlete and the head coach of the positive test result for the
purpose of securing assistance in the prevention of further drug use by the student-athlete. The Athletic Director will
have a meeting with the Head Coach and the student-athlete where the results and disciplinary action will be discussed.
4.3 Referral to Dean of Students: Once a student-athlete tests positive for a banned substance, he/she will be referred
to the Dean of Students in the Campus Life Department for institutional sanctions and to determine if the studentathlete warrants rehabilitation and/or counseling services for substance abuse. If warranted, the counseling service will
determine educational content and duration for this program. The Dean of Students also holds the right to contact the
student-athlete’s parent/legal guardian as well as enforce other sections if deemed necessary.
4.4: Laboratory Testing: Once the Reality Check Premium Instant Urine Test Cup shows a positive result for a banned
substance the positive specimen will be sealed and packed and the athlete will complete and sign a custody and control
form. The test cup will be sent to Keystone Laboratories (3 McDowell Street, Asheville, North Carolina 28801) for
validity and concentration values. The initial positive test will be at the expense of Brevard College but all follow up
testing that must be resent for concentration values will be at the expense of the student-athlete. The cost is
approximately twenty five dollars ($25) and is under discretion of Keystone Laboratories to reduce of increase said fees.
Keystone laboratories will notify Brevard College within thirty (30) calendar days validating the results of the drug test.
4.5 Follow Up Drug Testing: After two (2) weeks from the initial positive test, the student-athlete will be required to give
a second urine sample to confirm that the athlete has stopped using the banned drug(s). The follow up testing may be
on a non-notification basis. This sample, only if showing a positive result, will be sent back to the lab at the expense of
the student-athlete. The values of the second sample will be compared to that of the first sample. If values of the
second sample are shown to be diminished in relation to the original test, it will be considered a passing test. However,
if values from the second urine sample show no decrease or an increase in the banned substance concentration, it will
be counted as his/her second offence. Second offence violations effects are explained in detail below (see section 6.7).
The student-athlete will be required to give a urine sample every two weeks until no traceable amounts of the banned
substances can be found in his/her urine. Every positive test will be sent again to the lab at the expense of the studentathlete. The student-athlete will be required to provide a negative drug test prior to being reinstated to competition.
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4.6: First Violation Disciplinary Action: The student-athlete will be suspended for 20% of the first scheduled in-season
competition in his/her intercollegiate sport (coaches have the discretion to increase the duration of suspension based on
their team rules). Exhibition games will be excluded. The student-athlete may be withheld from practice if deemed
necessary based on the student-athlete’s health status as it is affected by the substances taken. This decision will be
determined by the Head Athletic Trainer, Team Physician and Athletic Director. The student-athlete will retain their
athletic-related financial aid. A student-athlete who tests positive may be subject to additional follow-up testing over
the student-athlete’s athletic career. Any loss of competition imposed will carry over into the following year if it is not
possible to complete the sanctions in the current year. Furthermore, a student-athlete who tests positive in the
nontraditional season (e.g. April for football) would be suspended at the start of the traditional season of competition
(September). Each sport coach upon approval of the Athletic Director has the ability to add on additional sanctions as
written in the team rules up to and including expulsion and cancellation of athletic financial aid.
4.7: Second Violation Disciplinary Action: The student-athlete will be suspended for 50% of the first scheduled in-season
competition in his/her intercollegiate sport (coaches have the discretion to increase the duration of suspension based on
their team rules). Exhibition games will be excluded. The student-athlete may be withheld from practice if deemed
necessary based on the student-athlete’s health status as it is affected by the substances taken. This decision will be
determined by the Head Athletic Trainer, Team Physician, and Athletic Director. The student-athlete will lose 50% of
their athletic-related financial aid (effective the start of the next semester). The student-athlete will be required to
provide a negative drug test to be reinstated into competition. A student-athlete who tests positive may be subject to
additional follow-up testing over the student-athletes athletic career. Any loss of competition imposed will carry over
into the following year if it is not possible to complete the sanctions in the current year. Furthermore, a student-athlete
who tests positive in the nontraditional season (e.g. April for football) would be suspended at the start of the traditional
season of competition (September). Any expenses incurred after the initial positive test are the responsibility of the
student-athlete. Each sport coach upon approval of the Athletic Director has the ability to add on additional sanctions as
written in the team rules up to and including expulsion and cancellation of athletic financial aid.
4.8: Third Violation Disciplinary Action: If the student-athlete provides a third positive specimen, that student-athlete
will be disallowed from ever returning as a participant in any Brevard College Athletic Department-sponsored activity.
The Athletic Director will recommend cancellation and non-renewal of athletics scholarship at the earliest possible
moment consistent with College, conference and NCAA rules. All institutional sanctions for a third violation also will be
carried out through a referral to the Dean of Students.
4.9: Appeals Process: In the event a student-athlete feels the laboratory results are incorrect, they have the right to file
an appeal to have the original sample retested within ninety (90) days after receiving written notification of the positive
result. Note: a fresh specimen will not be allowed for retest. Retesting will result in a minimum of $150 charge which
must be paid for by the student-athlete and must be pre-paid in full to Wolfe, Incorporated by money order.
4.10: Institutional Drug Testing Record Keeping: The Drug Testing Site Coordinator will keep records on the number of
student-athletes tested and the results of the test. All test results that accumulate during a student-athlete’s collegiate
career will be kept the entire time the individual is a student-athlete at Brevard College. These results are kept
confidential to the extent allowed by applicable state and federal laws, rules and regulations. Results will be compared
with previous years’ results to determine the effectiveness of the substance abuse and education program.
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Brevard College Athletic Department Drug Testing Policy Summary
Selection: Student-athletes will be randomly selected for drug testing throughout the year. Up to 10% of athletes from
each sport’s active roster will be selected for random testing per semester. Student-athletes may also be added to the
list under a reasonable suspicion or in response to a request from a certified athletic trainer, coach or administrator.
Notification: All selected student-athletes will be notified by direct contact (in person or direct phone contact the day
of, or day before testing. At this time the student-athlete will also be notified of their assigned drug testing time and
location. Drug testing may also be done on a zero notification basis. Failure to report for testing, showing up late or
failing to provide a valid sample within 3 hours will be considered a positive test result, and the individual may receive
sanctions and penalties at the discretion of the Substance Abuse Committee.
Collection: Brevard College uses drug testing by urine sampling and employs the services Wolfe Incorporated and
Keystone Laboratories. Copies of the protocol for specimen collection can be obtained from the Brevard College
Athletic Training office. Failure to adhere to the collection procedure guidelines and failure to cooperate with the
instructions of the specimen collection crew, as well as any attempts of sample adulterating, manipulating, or
substitution will be treated the same as a positive test result. All individuals taking prescribed or over the counter (OTC)
medications have the responsibility to notify their Staff Certified Athletic Trainer and update their Medical Record.
Positive Test: a student-athlete who tests positive for a banned substance or refuses or does not show up for a
scheduled test will be suspended from participation. The length of suspension will be as follows:
First Offense: 20% of the first scheduled in-season competition
Second Offense: 50% of the first scheduled in-season competition and 50% financial aid/scholarship.
Third Offense: Loss of athletic eligibility and any athletic related financial aid/scholarship.
The student-athlete will also be subject to parental notification and an increased amount of drug tests for the remainder
of his or her athletic career at Brevard College. The student-athlete and/or parents or guardian will be responsible for
any cost associated for a positive drug test.
Institutional Banned Substance Cut-Off Levels and Associated Penalties
Substance
Screening Levels
First Offense
Second Offense
Third Offense
Amphetamines
>300 ng/mL
20%
50%
Loss of Eligibility
Cocaine
>150 ng/mL
20%
50%
Loss of Eligibility
Metabolites
Marijuana
>50 ng/mL
20%
50%
Loss of Eligibility
Methamphetamine
>500 ng/mL
20%
50%
Loss of Eligibility
metabolites
Opiate metabolites
>300 ng/mL
20%
50%
Loss of Eligibility
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Brevard College Institutional Drug Testing Consent Form
_______________________________________________________
Last Name,
First Name
M.I.
________________
Sport
______________
Date of Birth
___________
Grad. Year
_______ I acknowledge that I have reviewed the Brevard College Athletics Department Drug Testing Policy, and
understand that I may be subject to random, reasonable suspicion, team, re-entry, and/or follow-up drug testing
_______ I understand that I can be drug tested on a zero notification basis, meaning that I can be drug tested at any
time for any reason. I understand that refusal to take a drug test, attempt to alter the urine specimen, fail to
provide a urine sample within the designated testing time, CHEAT in any way, and/or leave the collection site
without approval will result in a positive drug test
_______ I understand that improper use and/ or abuse of prescription drugs not prescribed to me is a violation of the
Brevard College Athletic Department Drug Testing Policy.
_______ I authorize Brevard College Athletics’ Department to collect a urine specimen to be tested to determine if
a student-athlete is positive for cocaine, amphetamines, methamphetamines, tetrahydrocannabinol, opiates, as
well as other drugs not listed on this consent form.
_______ I authorize the Brevard College Sports Medicine Staff to send the specimen(s) to be retested by an independent
laboratory for the presence of the substances found in the initial test. I also authorize the independent
laboratory and/or other testing facility to release any and all documentation relating to such test to the Brevard
College Sports Medicine and Athletics’ Department(s)
_______ I authorize the Brevard College Athletics’ Director to release the results of the drug test to my head coach of
any and all intercollegiate sports in which I am a member.
_______ I agree to accept any and all punishment handed down by the Brevard College athletics department, including
loss of playing time, loss of financial aid and any additional punishment from the head coach of my respective
team(s).
_______ I understand that I must sign this consent form in order to be eligible to play on varsity and/or reserve athletic
teams at Brevard College
_______ I understand that the following is the punishment of each positive drug test:
First Offense: 20% of the first scheduled in-season competition
Second Offense: 50% of the first scheduled in-season competition and 50% financial aid/scholarship.
Third Offense: Loss of athletic eligibility and any athletic related financial aid/scholarship.
_______________________________________
___________________
_______________________________________
___________________
Student Athlete Signature
Parent / Guardian Signature (if under age 18)
Date
Date
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Brevard College Department of Athletics Drug Testing
Reasonable Suspicion Reporting Form
I, _________________________________________, under the reasonable suspicion clause that is outlined in the
Brevard College Athletics Department Drug Educations and Drug Testing Policy, report the following objective sign(s) or
behaviors(s) that I reasonably believe that ______________________________________________be referred to the
Athletic Director or his/her designee for possible drug testing. The following sign(s) symptom(s) and/or behaviors(s)
were observed by me over the past________days(s)
Please check below all that apply:
The student-athlete has shown:
___Irritability
___Poor Motivation
___Failure to follow directions
___Verbal/ physical outburst (e.g. to faculty, staff, teammates)
___Sloppy hygiene and/or appearance
The Student-Athlete has demonstrated the following:
___Periods of memory loss
___Smell of marijuana or alcohol
___Staggering or difficulty walking/slurred speech
___Late for Practice/class
___Receiving poor grades
___Weight gain/loss
___Missing appointments
___Red eyes
___Over stimulated
___Student Code of Conduct Violation
___Other: ______________________________________________________________________________________
____________________________________
Print Name of Athletic Dept. Staff
________________________________
Signature of Athletic Dept. Staff /Date
Reviewed by: __________________________________________________________________________
Athletic Director/Designee
Date
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Reasonable Suspicion Team/Group Drug Testing
I, _________________________________, wish to request at the earliest convenience that
(Athletic Dept. Staff Name)
The following team will be drug tested under reasonable suspicion. I have observed suspicious behavior of
The following student-athletes over the past _________________________days/weeks/months.
Student-Athletes name/sport: _________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Suspicious Behavior/ Reasoning for group testing request:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Request is from:
Head Coach:
Athletic Training
Other Athletics Department Staff: _______________________________
Office of the Dean of Students:
_____________________________________________________________________________________
Athletic Staff name (Print and Signature)
Date
_____________________________________________________________________________________
Sports Medicine Staff signature
Date
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Drug Testing Program Student-Athlete Notification/Testing Results Form
Student Athlete: ____________________________
Notification Date: ___________________________
Student Athlete Notified:
in person
Sport: ________________________________
Test Date: _____________________________
direct phone contact
Sports Medicine Representative:
I certify the above student-athlete has been notified of his/her selection for Brevard College Athletic Department drug testing and
informed that failure to sign the notification form or failure to appear for drug testing will be treated as if there was a positive for a
banned substance as defined in the Brevard College Drug Education and Testing Policy
Sports Medicine Representative Signature: ______________________________________________________________
I, Undersigned:
Acknowledge being notified (either in person or by direct telephone contact) to appear for Brevard College Athletic Department
drug testing and have been notified to report the drug-testing station (with picture ID) at:
Boshamer Gym Athletic Training Room at ___________________ am/pm on _____________________
(Location)
(Time)
(Date)
• I will be prepared to provide an adequate specimen and will not over hydrate (do not drink too many fluids)
• I understand that providing a diluted specimen will be cause for follow-up drug testing
• I understand failure to appear at the site on or before the designated time my constitute a withdrawal of my previous
consent to be tested as previously indicated on the Brevard College Athletic Department Drug-Testing Consent Form and
could face the consequences of a positive result.
By signing, I have been notified of my selection for Brevard College Athletic Department drug testing, and am aware of what is
expected of me in preparation for this drug-test.
Student-Athlete Signature: _________________________________________/cell#: _____________________________
Test Type:
Random
Reasonable Suspicion
Team
Re-Entry
Follow-Up
Temperature: ____________
pH: __________
Specific Gravity: ___________
Oxidant/PCC: ____________
Test Results:
Positive Test for substance(s) found:
Amphetamines
Methamphetamines
Cocaine
Marijuana (THC)
Opiate
Overall Test Status:
NEGATIVE
POSITIVE
Athletic Training Staff/Collector Signature: ______________________________________________/date: ______________
Comments: ___________________________________________________________________________________________
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Drug Testing Reminder
I Acknowledge being notified (either in person or by direct telephone contact) to appear for Brevard College
Athletic Department drug testing and have been notified to report the drug-testing station (with picture ID)
at:
Boshamer Gym Athletic Training Room at ___________________ am/pm on _____________________
(Location)
(Time)
(Date)
• I will be prepared to provide an adequate specimen and will not over hydrate (do not drink too many
fluids)
• I understand that providing a diluted specimen will be cause for follow-up drug testing
• I understand that failure to appear for scheduled drug test and/or provide a sample constitutes a
positive test.
Drug Testing Reminder
I Acknowledge being notified (either in person or by direct telephone contact) to appear for Brevard College
Athletic Department drug testing and have been notified to report the drug-testing station (with picture ID)
at:
Boshamer Gym Athletic Training Room at ___________________ am/pm on _____________________
(Location)
(Time)
(Date)
• I will be prepared to provide an adequate specimen and will not over hydrate (do not drink too many
fluids)
• I understand that providing a diluted specimen will be cause for follow-up drug testing
• I understand that failure to appear for scheduled drug test and/or provide a sample constitutes a
positive test.
Drug Testing Reminder
I Acknowledge being notified (either in person or by direct telephone contact) to appear for Brevard College
Athletic Department drug testing and have been notified to report the drug-testing station (with picture ID)
at:
Boshamer Gym Athletic Training Room at ___________________ am/pm on _____________________
(Location)
(Time)
(Date)
• I will be prepared to provide an adequate specimen and will not over hydrate (do not drink too many
fluids)
• I understand that providing a diluted specimen will be cause for follow-up drug testing
• I understand that failure to appear for scheduled drug test and/or provide a sample constitutes a
positive test.
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Consequences and Procedures of Initial Positive Drug Test
First Violation Disciplinary Action: The student-athlete will be suspended for 20% of the first scheduled inseason competition in his/her intercollegiate sport (coaches have the discretion to increase the duration of
suspension based on their team rules). Exhibition games will be excluded. The student-athlete may be
withheld from practice if deemed necessary based on the student-athlete’s health status as it is affected by
the substances taken. This decision will be determined by the Head Athletic Trainer, Team Physician and
Athletic Director. The student-athlete will retain their athletic-related financial aid. A student-athlete who
tests positive may be subject to additional follow-up testing over the student-athlete’s athletic career. Any
loss of competition imposed will carry over into the following year if it is not possible to complete the
sanctions in the current year. Furthermore, a student-athlete who tests positive in the nontraditional season
(e.g. April for football) would be suspended at the start of the traditional season of competition (September).
Each sport coach upon approval of the Athletic Director has the ability to add on additional sanctions as
written in the team rules up to and including expulsion and cancellation of athletic financial aid.
Appeals Process: In the event a student-athlete feels the laboratory results are incorrect, they have the right
to file an appeal to have the original sample retested within ninety (90) days after receiving written
notification of the positive result. Note: a fresh specimen will not be allowed for retest. Retesting will result
in a minimum of $150 charge which must be paid for by the student-athlete and must be pre-paid in full to
Wolfe, Incorporated by money order.
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Appendix 3:
Discontinuance of
Brace/DME Against
Medical Advice
2014-2015
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Discontinuance of Brace / DME Against Medical Advice Form
The Student-Athlete meets all of the following Criteria:
1. Is a Student-Athlete over the age of 18 years old.
2. Exhibits no evidence of an altered level of consciousness or alcohol or drug use that would impair judgment.
3. Understands the nature of the medical condition, as well as the risks and consequences of retuning to
participation too soon.
This is to certify that at my own insistence, and against the medical advice of the Brevard College Sports Medicine Staff, I
have decided to refuse or discontinue the use of the following brace/DME:
Brace / DME Description:______________________________________________________________________________
Injury Description & DOS/DOI:_________________________________________________________________________
The risks to me for not following the advice of the Brevard College Sports Medicine Team include, but are not limited to:
_____Permanent disability/disfigurement
_____ New Injury
_____Additional pain and/or suffering
_____Re-Injury
_____Other: __
__________
__
_______
I have been given the opportunity to ask questions and discuss these risks with the Sports Medicine Staff and Team
Physician(s) concerning my injury and participation status.
I voluntarily agree to release, discharge, indemnify and hold harmless Brevard College, its officers, employees and agents
from any and all costs, liabilities, expenses, claims, demands, or causes of action on account of any loss, personal injury,
or death that might result from my premature return to full collegiate athletic participation against the recommendation
of the Brevard College Sports Medicine Team and Athletic Department. I acknowledge that I will be solely responsible
for any medical expenses that occur as a result of any re-injury or aggravation of my previous injury.
Additional Comments: ___
_
______
______
______
__________________________________________________________________________________________________
Student-Athlete Name: ________ ___ __ _________ Signature: ___ ___
_
____
______ Date: ________
Parent Name:
__ Signature:
Team Physician Name:
__ Signature: __ ________ _ ____ ____ _______ Date: ________
Head ATC Name: _____________ _____
____ Date: ______ _
____ Signature: ____ _ __ ___ _________________ Date: ________
Athletic Director Name: _______ _____ ___ _____ Signature: _______
_____ _______________ Date: ________
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Appendix 4:
Return to Play Against
Medical Advice Form
2014-2015
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Return to Play Against Medical Advice Form
The Student-Athlete meets all of the following Criteria:
4. Is a Student-Athlete over the age of 18 years old.
5. Exhibits no evidence of an altered level of consciousness or alcohol or drug use that would impair judgment.
6. Understands the nature of the medical condition, as well as the risks and consequences of retuning to
participation too soon.
This is to certify that at my own insistence, and against the medical advice of the Brevard College Sports Medicine Staff, I
have decided to return to full athletic participation.
I have not met one or more of the following return to play criteria:
__ __Time Postoperatively
Comments: _______
___________
__ __Full Range of Motion
Comments: ____
___
___________
__ __Muscle Strength
Comments: _____
__
___________
__ __Functional Testing Comments: ____
___
___________
_____Other
Comments: ______________________________________________________________
________________________________________________________________________
The risks to me for not following the advice of the Brevard College Sports Medicine Team include, but are not limited to:
_____Permanent disability/disfigurement
_____ New Injury
_____Additional pain and/or suffering
_____Re-Injury
_____Other: __
__________
__
_______
I have been given the opportunity to ask questions and discuss these risks with the Sports Medicine Staff and Team
Physician(s) concerning my injury and participation status.
I voluntarily agree to release, discharge, indemnify and hold harmless Brevard College, its officers, employees and agents
from any and all costs, liabilities, expenses, claims, demands, or causes of action on account of any loss, personal injury,
or death that might result from my premature return to full collegiate athletic participation against the recommendation
of the Brevard College Sports Medicine Team and Athletic Department. I acknowledge that I will be solely responsible
for any medical expenses that occur as a result of any re-injury or aggravation of my previous injury.
Additional Comments: ___
_
______
______
______
Student-Athlete Name: ________ ___ __ _________ Signature: ___ ___
_
____
______ Date: ________
Parent Name:
__ Signature:
Team Physician Name:
__ Signature: __ ________ _ ____ ____ _______ Date: ________
Head ATC Name: _____________ _____
____ Date: ______ _
____ Signature: ____ _ __ ___ _________________ Date: ________
Athletic Director Name: _______ _____ ___ _____ Signature: _______
_____ _______________ Date: ________
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Appendix 5:
Post-Participation Release
Form
2014-2015
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Post-Participation Release Form
____________________________________________________________________________________________________________
Last Name
First Name
M.I
Sport
Date of Birth
Grad. Year
Please initial next to each statement and sign below.
______I am no longer participating in any Brevard College Athletic Team as of: ___________________
______I certify that I currently have no athletically related injuries or illnesses that require any further
treatment, rehabilitation, or evaluation on the part of the Brevard College Sports Medicine
Department.
______I understand that by signing this form I release the Brevard College Athletic Department and its
secondary athletic insurance company, Mutual of Omaha, from any financial responsibility for any
unreported athletic injuries or illnesses.
__________________________________________________________________________________________
_____________________________________________
Student Athlete Signature
___________
Date
_____________________________________________
Athletic Trainer Signature
___________
Date
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Appendix 6
Student Patient Privacy
Contract
2014-2015
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Brevard College 2014-2015 Policies and Procedures Manual
Work-Study / Volunteer Student & Student Observer: Patient Privacy Contract
I will be a Brevard College Athletic Training Work-Study / Volunteer Student or Student Observer during the
following time period: ____________________________________________
I understand that I will have access to confidential medical information and that I must fully comply with all
HIPAA (Health Insurance Portability and Accountability Act of 1996) guidelines regarding patient privacy. This
may include but is not limited to discussing patients and/or conditions only with appropriate sports medicine
staff while maintaining patient files and documents in an appropriate manner. I understand that I am not to
discuss or disclose any private medical information unless given specific consent by the patient. I understand
that if I have questions regarding HIPAA guidelines, I will seek the advice of a Brevard College Certified Athletic
Trainer. I also understand that my failure to comply with patient privacy rules and regulations could have
serious legal implications for Brevard College Athletic Training and result in my removal from the Brevard
College Athletic Training Room.
I understand and agree to maintain patient privacy at all times.
Student Name (print): __________________________________________
Student Signature:
____________ Date:
____________
Parent/Guardian Name (print):___________________________________ (only if student is under 18)
Parent/Guardian Signature______________________________________ Date: _________________________
Updated 9.9.13
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Appendix 7:
Parent-Guardian Notice of
Injury, Insurance Coverage
Letter
2014-2015
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Brevard College 2014-2015 Policies and Procedures Manual
RE:
Claimant:
Date of Injury:
Injury Description:
Dear Parent/Guardian of Brevard College Student-Athlete:
Our institution carries excess accident medical insurance through Mutual of Omaha, which provides excess medical
coverage for injuries incurred by student-athletes while participating in an intercollegiate sponsored /supervised
activity. If a student-athlete has insurance through another source, the institution’s accident medical policy applies only
toward those expenses not covered by the primary policy. Please read the full “Insurance Policy Letter” on the Sports
Medicine page of bctornados.com for further details concerning this secondary insurance procedure.
We have provided information about our excess accident medical insurance to the medical providers where your son or
daughter is receiving care. However, we wanted to advise that you may receive balance due bills from medical
providers. In the event you receive a bill for balances due, please contact the medical provider, give them Mutual of
Omaha’s billing information listed below, and ask them to direct the bill for balances due to Mutual of Omaha. If the
provider is not willing to bill a secondary insurer, please forward the billing statement with the corresponding
Explanation of Benefits to Mutual of Omaha Special Risk Services:
Mutual of Omaha: Special Risk Services
Attn: NCAA Basic Accident Medical Program
PO Box 31156
Omaha, NE 68131
Claim Inquires: (800) 524-2324 / Fax: (402) 351-4732
Policy / Account #: T5MP-051085-A37
Please note the following important information regarding this policy:
Accident Medical Deductible: The secondary insurance plan requires a $250.00 deductible (per injury) that must be paid
by the student-athlete before Mutual of Omaha will begin payment of claims. Eligible medical expenses payable under
any other insurance policy or service contract (such as the student-athlete’s primary insurance plan) will be used to
satisfy or reduce this Medical Deductible. Please be aware that you may initially receive bills in order to meet this
deductible.
Loss Period: The initial treatment of an injury must be received within 90 days of Injury.
Benefit Period: Benefits are payable for 104 weeks (2 years) from the accident date.
The incident report for the above injury is attached for your review. For further assistance please contact:
Colin Covelli, MSEd, LAT, ATC, CSCS
Head Athletic Trainer
Brevard College Athletic Department
One Brevard College Dr.
Brevard, NC 28712
O: 828.884.8316 F: 828.884.8269
[email protected]
Sincerely,
Brevard College Sports Medicine Staff
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Appendix 8
ACL Return-to-Play
Criteria Policy
2014-2015
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POLICY
Anterior cruciate ligament (ACL) injuries are significant injuries that lead to substantial time away from full
participation in collegiate athletics. There are an estimated 125,000-200,000 ACL reconstructions performed
annually. Studies have shown that females are more likely than males to have an ACL injury, with these
injuries occurring primarily in those student-athletes participating in soccer, basketball, lacrosse, or football.
Even though there is an abundance of literature available regarding ACL criterion, return-to-play, and possible
complications from early return, there is a great lack of consensus as to return-to-play criteria after ACL
reconstruction. The purpose of this policy is to inform the student-athlete on what needs to be accomplished
before they can return to their sport and full activity. This policy will provide the Brevard College Sports
Medicine team with a standardized return-to-play criterion for ACL reconstruction. In addition, each case will
be evaluated individually by the Sports Medicine team. It will be utilized for all student-athletes post ACL
reconstruction at Brevard College in order to provide a more consistent and unified approach in fully clearing
these individuals for participation in their respective sport while consistently maintaining the best level of
medical care possible.
PROCEDURE
1) Criteria
Student-athletes at Brevard College may return to full participation post ACL reconstruction surgery if they
meet all of the following criteria:
1) Time Postoperatively
− Must be 6 months minimum from surgery date or greater
2) Muscle Strength
− Isokinetic Testing
• Quadriceps and hamstrings 80%-90% of the contralateral side at 180° per second and 240° per
second
• Documentation of isokinetic testing results must be submitted to the Sports Medicine staff
− Thigh Circumference
• Difference of < 1 centimeter from contralateral side
3) General Knee Examination
− No effusion
− Full range of motion
− Symptom free
− Stability
• Negative Lachman’s Test
4) Dynamic Functional Testing
− Single Leg Hop and Hold for Distance
• Procedure
(1) Stand with toe of non-injured leg behind tape
(2) Hop forward as far as possible with hands behind back
(3) Land on the same leg
(4) Hold landing for at least 3 seconds; if unstable, repeat hop
(5) Measure 3 trials from toe-to-toe (cm)
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(6) Repeat with injured leg
(7) Calculate mean of 3 hops for limb symmetry
(8) Calculate symmetry index (mean of injured limb divided by mean of non-injured limb, result
multiplied by 100)
(9) Limb symmetry at least ≥ 85%
• Assessment Criteria
(1) Hands behind back
(2) Able to hold landing for at least 3 seconds
(3) Limb symmetry of at least 85% between injured and non-injured legs
− Single Leg Timed Hop Test (optional)
• Procedure
(1) Distance of 6-m is measured
(2) Student-athlete, encouraged to use forceful one-legged hopping motions, performs a series of
hops over the total distance
(3) Complete 3 tests for each limb, with mean times calculated to the nearest one-hundredth of a
second
(4) Calculate symmetry index (mean of non-injured limb divided by mean of injured limb, result is
multiplied by 100)
• Assessment Criteria
(1) Limb symmetry of at least 85% between injured and non-injured legs
− Triple Hop Test for Distance (optional)
• Procedure
(1) Stand on non-injured leg
(2) Perform 3 consecutive hops as far as possible
(3) Land on same foot
(4) Measure total distanced hopped
(5) Measure 3 trials
(6) Repeat with injured leg
(7) Calculate mean of 3 trials for limb symmetry
(8) Calculate symmetry index (mean of injured limb divided by mean of non-injured limb, result
multiplied by 100)
• Assessment Criteria
(1) Limb symmetry of at least 85% between injured and non-injured legs
− Cross-Over Hop Test (optional)
• Procedure
(1) Performed on course consisting of a 15-cm marking strip on the floor which extends
approximately 6-m
(2) Student-athlete hops 3 consecutive times on non-injured leg, crossing over the center strip on
each hop
(3) Measure total distance hopped
(4) Measure 3 trials
(5) Repeat with injured leg
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(6) Calculate mean of 3 trials for limb symmetry
(7) Calculate symmetry index (mean of injured limb divided by mean of non-injured limb, result
multiplied by 100)
• Assessment Criteria
(1) Limb symmetry of at least 85% between injured and non-injured legs
− Drop Vertical Jump (DVJ) (optional)
• Procedure
(1) Student-athlete stand on 31 cm box with feet 35 cm apart
(2) Drop down off box and immediately perform maximum vertical jump, raising both arms
(3) Land on both legs
(4) Perform 3 trials
• Assessment Criteria
(1) Do both feet hit the ground at the same time on initial contact
(2) Pronation of the feet on initial contact
(3) Evidence of medial knee motion during initial contact
(4) Evidence of medial knee motion during the final landing
− Single-Leg Squat (SLS) (optional)
• Procedure
(1) Stand on injured leg and perform single leg squat
(2) Hand out to side or on hips
(3) 10 reps
(4) 45-60° of knee flexion
• Assessment Criteria
(1) Pronation or supination of the foot
(2) Knee valgus
(3) Hip internal rotation
(4) Extension or flexion of the trunk
(5) Able to maintain balance (falling or touching a surface with opposite foot or hand)
(6) Able to perform the entire set of 10 reps
2) Evaluation by Team Physician
Once the student-athlete has met all of the criteria listed above, they will then be evaluated by a Brevard
College Sports Medicine Team Physician, who will then determine the participation status of the studentathlete. ALL STUDENT-ATHLETES MUST BE CLEARED FOR FULL PARTICIPATION BY A
BREVARD COLLEGE SPORTS MEDICINE TEAM PHYSICAIN. Clearance from a physician outside the
Brevard College network-of-care will be taken into consideration, but final clearance must be obtained by a
Brevard College Sports Medicine Team Physician. If the student-athlete had ACL reconstruction from a
physician outside the Brevard College network-of-care, the student-athlete must provide written clearance from
the operating physician, in addition to being cleared by a Brevard College Sports Medicine Team Physician.
3) Postoperative Bracing
Each student-athlete must wear some type of postoperative functional bracing post ACL reconstruction surgery
following return to full participation during practices and games for a minimum of 1 year. Examples of a
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postoperative functional brace include, but are not limited to: Breg FUSION XT Knee Brace with AirTech™
Innovation, DonJoy Defiance III Custom Knee Brace, and DonJoy Armor Knee Brace with FourcePoint Hinge.
Each case will then be reevaluated individually by the Brevard College Sports Medicine team regarding
continuing use of the postoperative brace.
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