Coaches' Reference Guide

Lightening Safety Guidelines 
The following steps are modified from those recommended by the NCAA and the National Severe
Storms Laboratory (NSSL) in the event of lightening or severe storm warning. A storm safety
location (building) is also included in each EAP venue

1. A member of the emergency care team (ATC, coach, athletic training student) is
designated to monitor threatening weather conditions and make the decision to
remove a team or individuals from an athletic venue or event.

2. Monitoring should include obtaining a weather report prior to practice or competition.
Be aware of potential thunderstorms that may form. Be aware of “watches” and
“warnings”. “Watch” means conditions are favorable for severe weather to develop in
an area; a “warning” means that severe weather has been reported in an area and for
everyone to take proper precautions.

3. Be aware of how close lightning is occurring. Count the seconds using the flash-to-bang
(flash of lightning-to clap of thunder) method. Count the seconds and divide by five,
which gives you the distance, in miles, that the lightning strike occurred. By the time the
flash-to-bang count is 30 seconds, all individuals should have moved to safety. Ideally
30 minutes should pass following the last flash of lightning or clap of thunder before
resuming athletic activity. 


Athletic Injury/ Illness Emergency Protocol 
A. Contests and practices hosted at Salem State University (home) sites 
    Medical Emergencies (not breathing, severe bleeding, fracture, heat injury, signs of shock): 
        a. Follow EAP and provide first aid as appropriate 
        b. Activate EMS by calling CAMPUS POLICE Yellow Box- Push RED BUTTONS (know
            where located on campus) X 6111 from campus phone (978)542-6111 from a cell
            phone 
    c. Provide following information: 
        * identify yourself and nature of emergency 
        * give names and condition of injured/ill athlete 
        * describe care being given 
        * directions to the scene 
    d. Monitor vital signs (pulse rate, blood pressure) 
    e. Calm and reassure athlete and treat for shock 
     f. Notify ATC (certified athletic trainer) as soon as possible 

B. NON-EMERGENCIES (sprains, strains, concussion without LOC, illnesses,
contusions, etc) 
    a. Provide appropriate first aid care 
    b. Notify the ATC staff and send the athlete to the athletic training room with a 
        teammate if necessary (during or after practice- whichever is appropriate) 
    c. Send the athlete to appropriate medical facility (hospital or Dr. office ONLY IF 
        unable to contact ATC or unsure of severity of injury). 
    d. Have athlete follow up with ATC staff the next day.

NOTE: When a team/program practices or host contests AT “HOME SITES” which are
LOCATED OFF CAMPUS (e.g. golf, cross country) the same guidelines as outlined above
should be followed. It is imperative that the Head Coach, or designee locate the nearest on-site landline telephone prior to the beginning of the contest or practice and/or have a cell phone
available. In the event of an emergency, dial 911 (from the landline) or 978-741-1212
(City of Salem Police from a Cell phone) to summon EMS.  Inform ATC staff at earliest convenience of situation and athlete involved. If injury appears to be non-emergent, notify the ATC staff at the college to make arrangements to have the athlete transported back to the athletic training room for further assessment and treatment as soon as possible. 

For contests and practices occurring AWAY FROM Salem State University
1. MEDICAL EMERGENCIES (breathing cessation, sever bleeding, concussion with
loss of consciousness, suspected neck or spinal injury, fracture, dislocation, heat injury
or signs of shock) 
    a. Follow first aid principles and provide appropriate care. 
    b. Ask for the host ATC and follow their directions and Emergency Action Plan 
    c. If athlete must be transported to an emergency facility, find out what facility they 
        will be going to and then make arrangements to pick up the athlete after the 
        contest. DO NOT travel with EMS in the ambulance. If needed and warranted, a 
        non-essential team member or assistant coach can accompany the athlete 
    d. Notify an ATC staff member at Salem State University as soon as possible.

2. NON-EMERGENCIES (able to return to Salem State without immediate medical care) 
    a. Provide appropriate first aid until a visiting ATC or medical staff member assists. 
    b. Follow treatment and instructions given by visiting ATC 
    c. Notify an SSU ATC upon returning to Salem State. 
    d. Have athlete follow up with SSU ATC staff the following day.

MISCELLANEOUS 
In the event of hospitalization or surgery, hospital personnel or an SSU ATC would notify
the athlete’s parent(s) or guardian(s) as necessary or appropriate. Medical confidentially
will and must be maintained in all cases.

1. For any non-emergency, athletes should not report to SSU Health Services without first 
    attempting to consult with a staff ATC unless the athletic training room is closed 
    (after/before hours of operation) and the athlete feels that it is an emergency.

2. Ideally, all athletic injuries should be seen and care administered through the certified 
    athletic trainers at Salem State University. It is not recommended that athlete’s seek their 
    own medical care (unless in an emergency situation) without first consulting with the 
    athletic training staff at SSU.

3. For any athlete who has been referred to and/or decides to visit Health Services, 
    Emergency Room, Walk-in Clinic or other health care provider, MUST obtain and 
    present a letter of clearance and/or restrictions to the ATC staff before returning to 
    participation. 


Blood-Borne Pathogens “Standard Precautions”
Care of Athlete:
1. All personnel should be properly trained in First Aid and standard precautions

2. Supplies/Equipment needed for caregivers to treat injured/bleeding athletes: 
    a. gloves e. bandages and dressings 
    b. masks f. sharps container (needles, syringes) 
    c. antimicrobial wipes g. biohazard bags (waste receptacle) 
    d. antiseptics (bleach, alcohol)

3. Pre-event preparation:
Wounds that may bleed or dermatitis skin conditions that may spread should
be covered appropriately and secure enough to remain in place throughout
a competition or practice.

4. Active bleeding of participant: 
    a. bleeding must be stopped and covered. If requested by an official, an athlete 
        maybe removed from event. If so, the athlete can only return to competition with 
        he referee’s approval. 
    b. If a uniform is saturated with blood, it must be changed before return to participation 

5. Managing an acute blood exposure must follow proper guidelines 
    a. gloves wore to prevent direct contact 
    b. gloves should be changed after each individual participant 
    c. hands should be washed with soap and water after removal of gloves

6. If fluids are transferred from one athlete to another, the event should be stopped and the 
    skin cleaned with antimicrobial wipes and the athlete(s) should be instructed to wash 
    the exposed area with soap and water as soon as possible.

7. Any used needles, syringes or scalpels should be disposed of in a labeled sharps container
8. Any bandages or other waste should be disposed of in labeled red biohazard container

9. Soiled uniforms should be placed in a separate bag and washed separately in hot water

Care of Environmental surfaces:
1. Supplies should include: 
    a. gloves, mask, goggles (PPE- personal protective equipment) 
    b. absorbent paper towels or disposable cloths 
    c. Red biohazard bag (waste receptacle) 
    d. disinfection solution- (70 % alcohol or 1:100 bleach/water ratio; good for only 
        24 hours) 
2. Procedure: 
    a. put on gloves 
    b. remove visible organic material by covering with paper towel 
    c. spray surface with proper chemical germicide (alcohol or bleach solution) 
    d. spray a second time with new disposable towels 
    e. place all soiled items in biohazard container 
    f. remove gloves, dispose and wash hands with germicide or soap and water

** IF blood has dried on hard surface (floor) and is difficult to remove, hydrogen
peroxide can help to loosen material. Do Not use on clothing! 


Policy and Management of Head Injuries/Concussions 
Definition: There is no universal agreement on the standard definition or nature of
concussion. Several common features that incorporate clinical, pathologic and
biomechanical injury constructs define the nature of a concussive head injury including: a. concussion a. may be caused either by a direct blow to the head or elsewhere on the body. 
    b. Concussion may cause a graded set of clinical syndromes that may or may not 
        include loss of consciousness. 
    c. Concussion usually show normal results on neuro-imaging studies 
    d. The term “ding” or “bell rung” should not be used to describe a head injury or concussion. 
        Clinical Symptoms of Concussion: 
    a.Vacant stare or confused facial expression 
    b.Delayed verbal and motor response; slow to answer questions or follow directions 
    c.confusion and inability to focus attention; easily distracted 
    d.disoriented; walking in wrong direction; unaware of place or time 
    e.memory deficit (amnesia)

Early Symptoms (minutes to hours): 
    a.headache; dizziness; lack of awareness for surroundings 
    b.nausea or vomiting 
    c.slurred or double vision; photophobia 

Predicting Injury Severity
The American Academy of Neurology (AAN) developed a practice parameter
for the evaluation and management of athletes following a concussion. These are
the guidelines that are followed at Salem State College

** Focus should be placed on symptoms, rather than “grade” of concussion. Each
concussion (head injury) is unique to the athlete, sport and mechanism of injury. 

Criteria for management and return to activity

Important Note:
Athletic trainers’ should be more conservative with athletes who have a prior history of concussions.  Athletes with a history are at increased risk of sustaining subsequent injuries as well as for slowed recovery of signs and symptoms. Always error on the side of caution.

Primary Survey

 

                
Shock
Every injury (both emergencies and non-emergencies) affects the circulatory system
to some degree. Therefore, when treating any injury, you should automatically treat
for shock.

SIGNS TO LOOK FOR:                                                                 WHAT TO DO:

• restlessness, anxiety or weakness                     • Check A(airway), B(breathing)C (circulation)
• rapid breathing and pulse                                     • Elevate legs 8-12 inches cover with blanket
• pale or bluish skin, nail beds or lips                   • IF head injury without spinal injury elevate 
• nausea and/or vomiting                                           head and shoulders
• moist or clammy skin                                             • IF breathing difficulty, chest injury or heart
• thirst                                                                             attack, place in half-sitting position. 

DO NOT GIVE ANYTHING TO EAT OR DRINK!

Anaphylactic Shock 
(Severe Allergic Reaction) 

IS LIFE THREATENING: THIS IS A TRUE EMERGENCY 

What to Look for:
• sneezing, coughing or wheezing                 * severe itching, burning or rash
• shortness of breath                                        * blue around lips and mouth
• tightness and swelling of the throat            * nausea and/or vomiting
• unconsciousness

What to do:
• check A(airway)B(breathing)C(circulation)
• Call EMS (whether athlete is conscious or unconscious)
• Monitor or help athlete “inject” epinephrine (Epi-pen)
• Keep checking ABC’s and have athlete in sitting position to help breathing

Bleeding
What To Do:
• Protect yourself with gloves DO NOT touch a victim’s blood if at all possible.
• Locate bleeding source and: 
    1) apply direct pressure with gauze or towel- when stopped cover injury 
    2) Do not remove first dressing if blood soaked. Apply more on top 
    3) Do not remove impaled object

IF BLEEDING DOESN’T STOP: 
    • Elevate part (arm or leg) above head to slow bleeding

IF BLEEDING STILL DOESN’T STOP: 
    • Activate EMS 
    • Locate pressure point (in arm: brachial artery)(in leg: femoral artery) and continue to apply
      pressure 
    • TREAT FOR SHOCK- by raising legs 8-12 inches (if no head injury)

Sprains, Strains, Contusions, Dislocations

 

Seizures 
CAUSES:
• Epilepsy * Electric Shock
• Heat Stroke * Hypoglycemia
• Poisoning * Brain Injury or stroke

TYPES: 1. Convulsive : convulsions lasting 2-5 minutes with muscle spasm and
Loss of consciousness.
2 Non-convulsive: blank stares and or involuntary movement of extremities.
Unaware of surroundings 
What to DO:                                                              What NOT to do:
    a. Cushion head                                                      a. Give anything to eat/drink
    b. Turn victim on side                                              b. Hold victim down
    c. Move objects out of way                                      c. Put anything in mouth
    d. Look for alert tag                                                  d. Throw liquids or slap face
** most seizures ARE NOT medical emergencies; end within 2-3 minutes and DO NOT require medical attention. If slow recovery, pregnant or other injuries CALL EMS


Diabetic Emergencies 

 

Heat Related Injuries and Illnesses

 

Important Phone Numbers 
EMS: Call Campus Police (978) 542- 6111 (from cell phone)
X 6111 (from campus landline phone)
RED BUTTON on yellow call boxes

SSU Athletic Training Room

Scott Braid 978-542-6563 or 781-526-6513 (cell)


North Shore Medical Center (Salem Hospital)
978- 741-1200