1. Pre-Participation Medical Clearance a. No athlete shall be eligible to participate in any sports unless:

Transcription

1 Sports Medicine

2 2 1. MEDICAL STAFF The sports medicine staff consists of the Team Orthopedic Physician(s), the Assistant Director of Athletics for Sports Medicine, Certified Assistant Athletic Trainers, Graduate Assistant Athletic Trainers, EMT s, and Student Athletic Trainers. The Sports Medicine Staff is empowered by the NCAA to have unchallengeable authority to cancel or modify a workout for health and safety reasons (i.e., environmental changes) as he or she deems appropriate. 2. ATHLETIC ELIGIBILITY/ MEDICAL CLEARANCE Prior to arriving on campus for class registration, all students must provide Health Services with a record of immunization against measles, mumps, and rubella (MMR), meningococcal meningitis response form, and a recent physical examination record. The above mentioned forms must be on file prior to a student-athletes pre-participation medical clearance. No exceptions will be made. 1. Pre-Participation Medical Clearance a. No athlete shall be eligible to participate in any sports unless: 2. Freshman / Transfers / First Time Participants a. A complete Manhattan College Athletics Annual Health Record, NCAA Health Status Questionnaire, Sickle Cell Trait testing proof or signed waiver declining testing, and proof of health insurance are on file (including a copy of the front and back of the insurance card), updated on a yearly basis with the athletic training staff. b. A yearly pre-season physical by the Health Center Nurse Practitioner or Team Physician is complete and all consent forms have been signed. c. All required forms are on file with the Athletic Department (including the NCAA Drug Testing Consent Form). 2. Returning Upperclassman a. A complete Manhattan College Athletics Annual Health Record, NCAA Health Status Questionnaire, Sickle Cell Trait testing proof or signed waiver declining testing, and proof of health insurance are on file (including a copy of the front and back of the insurance card), updated on a yearly basis with the athletic training staff. b. All required forms are on file with the Athletic Department (including the NCAA Drug Testing Consent Form).

3 3 3. Prospective Student Athlete (PSA) Tryouts (Basketball) a. A Perspective Student Athlete (PSA) trying out for basketball is required to fill out the Manhattan College Department of Intercollegiate Athletics Health Status Questionnaire as well as undergo a medical examination or evaluation administers by a physician within 12 months of the date of the PSA s tryout. The examination shall include a sickle cell solubility test (SST), unless documented results of a prior test are provided to the institution or the PSA declines the test and signs the institutions sickle cell testing waiver. PSA medical documentation must be received, reviewed, and approved by a member of the sports medicine staff 72 hours prior to the start of the PSA try-out. 4. Walk-On Tryouts a. All student athletes trying out for a team as a walk-on must provide Health Services with a record of immunization against measles, mumps, and rubella (MMR), meningococcal meningitis response form, and a recent physical examination record. Once Health Services records are complete the student must fill out a Manhattan College Department of Intercollegiate Athletics Health Status Questionnaire and provide results of a sickle cell solubility test (SST), or the student can decline the test and sign the institutions sickle cell testing waiver. If the student makes a roster the student then must complete the pre-participation medical clearance requirements for first time participants prior to the end of the NCAA allowed tryout period. 6. Once an athlete has met the above mentioned requirements he/she will be added to their specific teams Emergency Medical Clearance list. This list is updated on a daily basis and will be placed in the mailbox and ed to each team s head coach. This list should be carried by a member of the coaching staff at all times, and act as an emergency information sheet for an injured athlete. This list is of vital importance if an athlete is unconscious and needs to be transported to a hospital. Included on each teams Emergency Medical Clearance list are the athletes names, emergency contact number (where a family member of the athlete can be reached), and any allergies the athlete may have. Only athletes listed on this sheet may participate in an official team practice or event. 3. INJURY MANAGEMENT PROCEDURE All injuries must be reported to the athletic training staff within 48 hours of occurring for documentation and insurance purposes.

4 4 Any injury or illness that requires a referral to a medical professional or transport to a hospital requires follow up and clearance to return to activity form a member of the Athletic Training Staff. Any athlete that has been injured and removed from competition due to injury may only be permitted to return to competition with clearance by a member of the Athletic Training Staff. Only the Manhattan College Orthopedic Physician or a Certified Athletic Trainer may clear an athlete for return to practice or competition. Injuries sustained as a result of non-athletic related activity or that fall out of the scope of practice for Athletic Trainers in the State of New York will be referred out the appropriate medical profession immediately. Any injury with symptoms that does not improve or resolve within five days shall be referred to the Team Physician or other medical professional deemed appropriate by the Athletic Training Staff. If a student athlete is being held out of activity due to injury by a member of the sports medicine staff, their respective coach will be notified as soon as possible of the participation status for practices and competitions. Coaches will be contacted either in person, via phone, or of the participation status. All student athletes are required, on a yearly basis, to sign an Authorization for the Release of Medical Information. Only the appropriate parties authorized by the student athlete will be informed of the prognosis and diagnosis of the specific injury. If the student athlete has not authorized this information to be released to a coach, the coach will only be notified of participation status, and not the prognosis and diagnosis of the specific injury. 4. WEEKLY ORTHOPEDIC CLINIC Manhattan College Athletic Training will host an Orthopedic Clinic on a weekly basis during the school year. All student athletes that wish to see the team Orthopedic Physician must contact a member of the athletic training staff in advance to schedule an appointment. Weekly orthopedic clinics generally run on Tuesdays at 1130am, but are subject to change at the discretion of the team Orthopedic Physician. 5. ATHLETIC TRAINING ROOM HOURS The Athletic Training Room will be open Monday through Friday from 9am to 7pm, and open on weekend and holidays for scheduled practices and events only. The Athletic Training Room will be open 2 hours prior to scheduled games and competitions and 45 minutes prior to all inseason practices.

5 5 The Athletic Training Room will remain open Monday Friday during the month of June, and Monday Thursday during the month of July and the first two weeks of August. Please contact the Athletic Training Staff for summer Treatment hours. If any questions or concerns arise during the summer months, please contact the athletic training staff via voice mail. 6. PRACTICE SCHEDULES Coaches are required to inform the athletic training staff, in writing, of their team s practice and event schedules a minimum of two weeks ahead of scheduled activity. The two week notice is required in-order to ensure proper practice and event coverage, and when scheduling permits the traveling coverage of Manhattan College intercollegiate athletic events by a member of the sports medicine staff HOUR PRACTICE CHANGE POLICY All changes in practice schedules must be cleared through the Sports Medicine Department 48 hours in advance of the change in time. Verbal confirmation of the change must be made between the coach and a member of the sports medicine staff, in-order for the changed practice time to be covered by the Sports Medicine Department. If a practice change is made during hours the Athletic Training Room is closed it is the responsibility of the coach to contact a staff member verbally and confirm a change in schedule. A voice message left on an office phone or note left in an office mailbox during off-hours may not reach a member of the Athletic Training Staff in time. The Athletic Training Room is open for games and practices only on weekends, therefor a staff member may not receive a note or a phone message left indicating a practice change till Monday. Coaches changing practice times after the 48-hour time period has expired risk not having a practice covered. In-season teams are not permitted to practice without the coverage of a Sports Medicine staff member. 8. ATHLETIC TRAINING ROOM RULES 1. The athletic training room is co-ed; proper attire is required at all times. 2. No cleats or spiked shoes, or any other equipment (balls, bats, etc.) are allowed in the athletic training room. 3. All student-athletes must shower and change prior to entering the athletic training room. 4. Services in the athletic training room are first come first serve. In season athletes will be given priority over out of season athletes.

6 6 5. The athletic training room is for rehabilitation and pre-participation preparation only. The head athletic trainer must approve any other use. 6. No medical supplies or equipment should be taken from the athletic training room, unless special permission is granted. 7. The athletic training room is limited space and, therefore should not be used as a hangout or meeting place. 8. Foul language will not be tolerated in the athletic training room. 9. No self-treatments are permitted. 10. Cell phone use is prohibited in the athletic training room. 11. Food or drinks are not permitted in the athletic training room. 9. SPORT COVERAGE AND TRAVEL All home events will be covered by a member of the sports medicine staff. In most cases, an athletic trainer will not be part of your traveling party. Teams will be able to use the host athletic trainer for injury evaluation and game preparation. If an athletic trainer is needed for travel, and the athletic training staff can accommodate a coach s request, the team will incur all travel costs for the traveling athletic trainer. A complete first aid travel kit will be provided before every road trip, and a call will be placed to the host institution 24 hours prior to the event to inform them of any special needs of the traveling team. It is the responsibility of the coach to make sure the first aid kit is returned to the athletic training room. Any lost or damaged kits will be the responsibility of the coach to replace. Please keep the athletic training staff informed of all practice times and departure times of road trips. Below is a breakdown of In-season and Non-Traditional season (NTS) athletic training coverage for all sports. It should be noted that the Athletic Training Room utilizes walkie-talkies with the ability to directly communicate with the Athletic Administration and the Security Department as well as with each other. 1. In-Season Practices a. An athletic trainer is on site or there is walkie-talkie/cell phone communication with an ATC in the Athletic Training Room. If practices are indoors, there is an athletic trainer in the Athletic Training Room. On the occasion that a team must practice off-campus due to facility conflicts, an athletic trainer may travel with the team. If an athletic trainer is not available, the coach should carry a cell phone.

7 7 2. In-Season Competitions a. All home competitions are covered by a Certified Athletic Trainer (A.T.C). If an A.T.C is not available on-site due to event conflicts, a Student Athletic Trainer will be on-site with a walkie-talkie or cell phone as to be in direct communication with an A.T.C. An MD is present for all home Men s Lacrosse, Men s Basketball and Women s Basketball events. 3. Non-Traditional Season Competitions a. If the policies outlined in the ADH are followed, the events will have an A.T.C on-site or a student athletic trainer on-site with walkie-talkie or cell phone communication to an ATC. 4. Non-Traditional Season Practices a. Coaches have a walkie-talkie or cell phone with which to be in communication with the Athletic Training Room, Athletic Administration and the Security Department. If practice hours are outside of the Athletic Training Room s poster hours, the Security Department will respond. 10. SECOND OPINIONS If a student athlete decides to seek a second opinion for an injury they have incurred while competing at Manhattan College, they must notify the athletic training staff immediately of this decision. Records of all second opinions must be kept on file with the athletic training staff for insurance purposes. Even if an athlete seeks an outside second opinion, he or she may only be cleared to return to play by the Manhattan College team orthopedist. The Manhattan College team orthopedist will have final say on clearance for all Manhattan College athletes. 11. INSURANCE COVERAGE The athletic department carries a secondary insurance policy to cover an athlete s injuries sustained while participating in Manhattan College athletics. This is an excess policy, which pays for only what is not covered by the student-athlete s private insurance. Each student-athlete is required by state and federal law to have their own insurance, and have their insurance information on file with the sports medicine department. All insurance claims must be billed to the athlete s primary insurance first, followed by the Manhattan College Policy secondarily. Manhattan College Sports Medicine is not responsible for co-payments, deductibles and any charges not covered by the college s secondary insurance provider. Any remaining charges not covered by the college s secondary insurance provider will be the responsibility of the student athlete.

8 8 Manhattan College s insurance policy does not assume coverage for the following: 1. Any injury sustained not as a result of intercollegiate competition or practice. 2. Pre-existing conditions. 3. Any injuries not reported to the athletic training staff within 48 hours. 4. Any bills which were incurred by the student not going through the proper channels (i.e., recommendations, second opinions). 12. STEPS TO PROCESS SECONDARY INSURANCE POLICY All Manhattan College student athletes are covered under a secondary insurance policy though BMI Benefits, LLC for all intercollegiate athletic related injuries. Only injuries sustained as a result of NCAA athletic related activities (team training sessions, practices, games / events) are covered by this policy. Injuries sustained outside of official NCAA related activities, and preexisting conditions will not be covered. This policy comes into effect after your primary insurance is done making a payment claim. BMI benefits, LLC covers up to the first $90,000 of all claims not covered by your primary insurance. Injuries resulting in claims that exceed $90,000 will go to the NCAA catastrophic insurance policy. The following steps must be taken in order to insure payment from BMI Benefits, LLC. Step One: Report all injuries to the Manhattan College Sports Medicine Department immediately and fill out a BMI Benefit s claim form. Step Two: Once claims have been completed; have it signed by either the Head or Assistant Trainer. Step Three: Once the claim form has been completely filled out it must be mailed to: BMI Benefits, LLC. PO Box 511, Matawan, NJ Step Four: Process all medical claims through your primary insurance first. Step Five: Once your primary insurance has paid out to its limit, request an Explanation of Benefits (E.O.B.) from your primary insurance company for the paid and unpaid portion of the bills from your claim. Step Six: Submit the E.O.B. s for the unpaid portion of the bills, along with a detailed and itemized bill from the medical provider to BMI Benefits, LLC PO Box 511, Matawan, NJ 07747, for payment, up to the first $90,000 of benefits. Once BMI has reached their $90,000 policy limit, the NCAA s catastrophic injury insurance provider will be contacted by the Sports Medicine Department.

9 9 Student athletes are eligible for bills to be paid up to 104 weeks from the date of the initial injury. The first medical bill must be accrued within 90 days of the initial injury date. The student athlete must report all injuries to the Sports Medicine Staff within 48 hours of the injury, regardless of whether or not the athlete prefers to have their own private physician treat the injury rather than the Manhattan College Sports Medicine Staff. 13. DRUG TESTING AND EDUCATION The following drug testing and education program has been designed by the Manhattan College Athletics department and will be administered by the Athletic Training Staff. It is guided by the NCAA, MAAC, and the College s rules and procedures. The primary intent of the drug testing program is to ensure the well-being of the student athletes. Each student- athlete will be asked to read and sign the NCAA and college policy statements on drug testing at the beginning of each year. Manhattan College is interested in the prevention, and control of drug abuse as well as helping student-athletes with drug problems. Failure to cooperate fully by any athlete will be considered a positive drug test and be treated as such. Drug Testing Procedures The National Center for Drug Free Sport is the official third-party administrator for the NCAA s drug testing programs. Expanded funding for testing now ensures that every Division I institution will be drug tested at least once every year. You may be randomly selected to provide a sample at any time during or outside of the playing season, including during the summer. Because this testing is sponsored directly by the NCAA any positive test will make you automatically ineligible for minimally one year of competition. Additionally, our athletics department conducts its own random testing program. All athletes are subject to random testing throughout the year. Athletic department drug testing is done through Quest Diagnostics Laboratories Athletes will be randomly selected for testing by the Head Athletic Trainer, as will any person for whom there is probable cause. Athletes selected for testing will not receive any prior notification and may be taken to a testing laboratory immediately before, after, or during a practice or immediately following a scheduled class. Athletes may be selected multiple times during the course of the year for testing. Upon completion of the testing laboratory results will be faxed to the Team Physician and the Athletic Director who, in turn will notify the respective head coach and athlete. Refusal to provide a urine sample at the time of testing will automatically be considered a positive test.

10 10 Banned Substances Below is a list of banned drug classes furnished by the NCAA. Use of the drugs in these classes is expressly prohibited (except as a result of certain medical conditions) whether the use occurs in or out of the competitive sports season. For a more complete list of NCAA banned Drug Classes go to: or visit and enter the Division I password: ncaa1. 1. Stimulants 2. Anabolic Agents 3. Alcohol and Beta Blockers (banned for rifle only) 4. Diuretics and Other Masking Agents 5. Street Drugs 6. Peptide Hormones and Analogues 7. Anti-estrogen 8. Beta-2 Agonists Testing Positive for street drugs If a student-athlete who tests positive for street drugs the student-athlete will be subject to the following penalties: 1. First positive test: The student-athlete will attend mandatory drug counseling sessions and be suspended for a minimum of one contest. 2. Second Positive Test: 50% reduction in athletic scholarship aid and a playing suspension equivalent to 50% of the student-athlete s traditional season(s) 3. Third Positive Test: 100% reduction in athletic scholarship aid and dismissal from the program Confidentiality of Test Results All information and records under the Department of Intercollegiate Athletics Drug Policy, including test results, will remain confidential and will be released only to the following persons: Team Physician, Athletic Trainer, Director of Intercollegiate Athletics or designee, head coach, student-athlete s parent(s) or legal guardian(s).

11 11 Drug Testing Medical Exceptions The NCAA list of banned drug classes is composed of substances that are generally reported to be performance enhancing and harmful to one's health. The NCAA bans performance enhancing drugs to protect student-athlete health and safety and ensure a level playing field, and it also recognizes that some of these substances may be legitimately used as medications to treat student-athletes with learning disabilities and other medical conditions. Accordingly, the NCAA allows exceptions to be made for those student-athletes with a documented medical history demonstrating the need for regular use of such a drug. The benefit of a medical exception procedure is that in most cases the student-athlete's eligibility remains intact during the process. Exceptions may be granted for substances included in the following classes of banned drugs: stimulants, beta blockers, diuretics, anti-estrogens, anabolic agents (steroids)*, and peptide hormones* (NCAA Bylaw ) [*anabolic agents and peptide hormones must be approved by the NCAA before the athlete is allowed to participate while taking these medications. The institution, through its director of athletics, may request an exception for use of an anabolic agent or peptide hormone by submitting to The National Center for Drug Free Sport (Drug Free Sport) any medical documentation it wishes to have considered.] In all cases, a student-athlete, in conjunction with his or her physician, must document that other non-banned alternatives have been considered prior to requesting the medical exception for the use of a medication containing a banned substance. It is the responsibility of the institution to educate student-athletes about this policy, and to follow-up with any student- athlete who identifies the use of a banned medication to determine if standard non-banned medications have been pursued and documented. In order for a student-athlete to be granted a medical exception for the use of a medication that contains a banned substance, the student-athlete must: 1. Have declared the use of the substance to his or her athletics administrator responsible for keeping medical records; 2. Present documentation of the diagnosis of the condition; and 3. Provide documentation from the prescribing physician explaining the course of treatment and the current prescription. Requests for medical exceptions will be reviewed by physicians who are members of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports. Medical exceptions will be granted if the student-athlete has presented adequate documentation noted above. Unless requesting a review for the medical use of an anabolic agent or peptide hormone, a studentathlete's medical records or physicians' letters should not be sent to the NCAA unless requested by the NCAA. Also, the use of the substance need not be reported at the time of NCAA drug testing. Following are three treatment issues to help illustrate the medical exception procedure:

12 12 Attention Deficit/Hyperactivity Disorder (ADHD): is one of the most common neurobehavioral disorders of childhood and can persist through adolescence and into adulthood. ADHD is generally diagnosed in childhood, but sometimes not until college or later. The most common medications used to treat ADHD are methylphenidate (Ritalin) and amphetamine (Adderall), which are banned under the NCAA class of stimulants. In order for a medical exception to be granted for the use of these stimulant medications, the student-athlete must show that he or she has undergone standard assessment to identify ADHD. Frequently a student-athlete may find that the demands of college present difficult learning challenges. They may realize that some of their teammates are benefitting from the use of these medications, and figure they should ask their team physician or family doctor to prescribe the same for them. If they do not undergo a standard assessment to diagnose ADHD, they have not met the requirements for an NCAA medical exception. Most colleges provide these types of assessment through their student support services or counseling and testing centers. The student-athlete should either provide documentation of an earlier assessment, or undergo an assessment prior to using stimulant medication for ADHD. If the diagnosis is ADHD, the student-athlete may then pursue treatment with the team physician or family physician for a prescription for stimulant medication, and provide all documentation to the appropriate athletics administrator to keep in the file in the event the student-athlete is selected for drug testing and tests positive. At that point, the athletics administrator will be instructed to provide the documentation for review by the medical panel, and if all is in order, the student-athlete's medical exception is granted. Male-Pattern Baldness: Androgenic alopecia is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness. Hair is lost in a welldefined pattern, beginning above both temples. Over time, the hairline recedes to form a characteristic "M" shape. Hair also thins at the crown of the head, often progressing to partial or complete baldness. Non-banned medications are available to treat this condition. Finasteride (trade name Propecia), which is prescribed in some cases to treat male-pattern baldness, is a banned substance under the class of masking agents, as it interferes with the ability to identify steroid use. Before using finasteride, a student-athlete must exhaust other standard medications and document this effort. All documentation should be submitted to the sports medicine staff to review and maintain in the student-athlete's record. In the event a student-athlete tests positive for the use of finasteride, the institution will then submit the full record for a medical exception review. Hypogonadism: Or testosterone deficiency, results either from a disorder of the testes (primary hypogonadism) or of the hypothalamus or pituitary glands (secondary hypogonadism). Causes of primary hypogonadism include Klinefelter's syndrome, undescended testicles and hemochromatosis. Secondary hypogonadism can be due to aging, increasing body mass index and/or type 2 diabetes mellitus. Treatment for hypogonadism may include testosterone medication. Testosterone falls under the banned drug class "anabolic agents". A student-athlete must request approval to use medication with testosterone prior to participation while using this substance. A full medical documentation of the diagnosis, course of treatment and prescription history must be provided by the institution prior to allowing the student-athlete to compete on this medication. If a student-athlete tests positive for testosterone and has not obtained prior approval to use this substance, the case must go to appeal.

13 13 In all cases, if a student-athlete does not meet the criteria for a medical exception, the studentathlete may request an appeal hearing of the positive drug test. In this case, the student-athlete's eligibility will be suspended pending the outcome of the appeal. 14. DIETARY SUPPLEMENT Manhattan College Sports Medicine does not distribute, promote, or encourage the use of dietary or ergogenic aids to enhance athletic performance. Many of these products are NOT endorsed or approved by the FDA, and often times are misleading and not accurate with what substances they contain. Just because something says that it is healthy or all-natural does not mean that it is safe to take. If a student athlete is currently taking supplements and has concerns or questions about what they are ingesting, he or she may consult a certified athletic trainer or physician. The student athlete is responsible for what they ingest and accept all risks associated with taking a supplement. All athletes are strongly encouraged to use Drug Free Sport Resources Exchange Center (REC) to obtain current and accurate information on dietary supplements or ergogenic aids. All inquiries are confidential. 15. CPR/AED & FIRST AID CERTIFICATION Per NCAA, MAAC and Manhattan College Department of Intercollegiate Athletic rules and regulations, all full time, part time and volunteer coaches must be CPR/AED & First Aid certified to take part in countable activity. Coaches that do not meet the above mentioned requirements may not participate in coaching countable activity until certified. New coaches must meet the requirement with in their first 6 months of employment. 16. EMERGENCY ACTION PLAN Emergency situations may arise at any given moment during an athletic event. When they do occur, it is necessary that an emergency care plan be established to clearly delineate the policies and procedures in order to deliver effective and efficient care. Expedient action must be taken in order to provide the best possible care to the athletes with emergency and/or life threatening conditions. The development and implementation of an emergency action plan will help to ensure that the quality of care provided to our athletes is at its highest. This plan was written with this in mind and provides a detailed description of the emergency action policies of the Sports Medicine Staff at Manhattan College. It is the goal of the Sports Medicine Staff that this emergency care plan will aid in minimizing the time needed to provide an immediate response to a potentially life-threatening situation or medical emergency.

14 14 The following is an outline of the Manhattan College Emergency Action Plan. It has been adopted from the NCAA Sports Medicine Handbook and is updated as needed. Manhattan College also has a crisis response manual that is used in emergencies. Manhattan College Sports Medicine Department and the College s Security Department work very closely in delivering emergent care for the Athletic Department. Every coach and administrator should be aware that emergency care is available by calling security at This is especially important for those coaches of sports who practice outside the normal hours of operation of the athletic training room during their non-traditional season. It is clearly stated in the Athletic Department Handbook (ADH) that coaches whose teams practice outside the normal hours of operation of the training room facility during their nontraditional season may not have an athletic trainer available for coverage. Teams that have actual intercollegiate home contests during their non-traditional season will have a certified athletic trainer for game coverage as long as they follow the guidelines in the ADH. The Sports Medicine Department has recommended to the Athletic Department the necessity for all coaches to be CPR/AED certified. All coaches have also been told they must take cell phones outside to practice in order to have open communication with the Training Room, Athletic Administration and Office of Public Safety. If an athlete is injured at an away contest or event, and a Manhattan College Athletic Trainer is not present. It is the responsibility of the head / assistant coach to seek medical attention for the injured athlete from the host institutions athletic training staff. The athlete should not leave the event prior to being evaluated by the host institutions medical staff, and deemed safe. The head or assistant coach must report all injuries incurred on the road immediately to the Manhattan College Head Athletic Trainer. The following is an outline of the Manhattan College Emergency Action Plan for Draddy Gym, Gaelic Park, and Van Cortlandt Park. It has been adopted from the NCAA Sports Medicine Handbook and is updated as needed.

15 15 DRADDY GYM (Basketball, Volleyball, Track and Field) Emergency Communication: There are available fixed and mobile phones throughout the facility including the front desk, athletic training room and administrative offices of the athletic department. Emergency Equipment: Emergency equipment is located in the Athletic Training Room. This includes: AED, Trauma Kit, Splint Kit, Spine Board, Oxygen, and Manual Suction Unit. Basic First Aid supplies are readily available in the Athletic Training Room. An alarm box with an AED unit is located near the front entrance to the gym in between the men s and women s restrooms. Role of First Responder: 1. Alert Certified Athletic Trainer in gym or in the athletic training room in person, by radio, or by the nearest phone ( ) as soon as injury occurs. If a Certified Athletic Trainer is not available, contact the Office of Public Safety. ( ). 2. If the injury is life threatening or requires activation of EMS (Emergency Medical Services) dial 911 immediately and activate EMS. 3. When calling emergency medical services (EMS), the following information needs to be provided: a. Name of caller b. Location and telephone number of caller (and location of emergency if different). c. Nature of emergency (drowning, cardiac arrest, severe bleeding, unconsciousness). d. Required assistance (ambulance, fire, police). e. Name age, and allergies of the injured individual. f. Suggested approach route, including entrance to gym (i.e., front doors at entrance to the Draddy parking lot, or roll up garage door at the front of the Draddy parking lot). g. Location where emergency personnel will be met and method or description by which they will recognize the individual who will meet them when they arrive. h. The caller should ask if any further information is required and should NOT HANG UP until emergency operator does so first. i. Once EMS has been activated contact campus security ( ), and notify the guard on duty of the emergency situation. Inform the guard of the location and nature of the emergency and ask them to meet EMS personnel upon arrival to campus and escort them to the location of the emergency.

16 16 4. If no Athletic Trainer is available, and Campus Security has not arrived, proceed with First Aid / CPR/ AED by certified personal. a. Do not move any athlete with a suspected spinal injury. b. Check ABC s (Airway-Breathing-Circulation) c. Begin Rescue Breathing, if necessary (Pulse/No Breathing) d. Begin CPR, if necessary (No Pulse/No Breathing) e. Begin AED, if necessary and available (No Pulse/No Breathing) f. Stay with athlete and monitor signs and symptoms. 5. Administer First Aid/CPR until Athletic Trainer, Campus Security, or EMS arrives. Provide care within the scope of you training. Do not move an athlete with a suspected head, neck or back injury. Use universal precautions when dealing with blood/bodily fluids. Stay with athlete until medical personal arrives. 6. If the athlete needs to be transported to a hospital by ambulance, make sure a representative from Manhattan College accompanies the athlete to the hospital, so they are not alone. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 7. If an athlete needs to go to the hospital and does not need an ambulance, the athlete must be escorted to the hospital by a Manhattan College staff member. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 8. Once the athlete has been transported to the hospital, the following individuals must be notified of the athlete s condition: a. Assistant Director of Athletics / Sports Medicine b. Assistant Athletic Trainer c. Director of Intercollegiate Athletics d. Office of Public Safety e. Athlete s parents / guardian f. Team Physician 9. Emergency Information/Clearance sheets contain info on each athlete and should be kept with the head coach at all times for practices and games in case of an emergency.

17 17 GAELIC PARK (Soccer, Lacrosse, Softball) Emergency Communication: There are no fixed phones available at Gaelic Park. Coaches and staff members utilizing the park should carry a mobile phone device at all times while conducting team activities. Fixed phones are located directly across the street from the main entrance to Gaelic Park in the Leo Engineering building. Emergency Equipment: Emergency equipment is located in the Athletic Training Room. This includes: AED, Trauma Kit, Splint Kit, Spine Board, and Oxygen. Basic First Aid supplies are readily available in the Athletic Training Room. Role of First Responder: 1. Alert Certified Athletic Trainer in park or in the Gaelic Athletic Training Room in person, by radio, or via mobile device as soon as injury occurs. If a Certified Athletic Trainer is not available, contact the Office of Public Safety ( ). 2. If the injury is life threatening or requires activation of EMS (Emergency Medical Services) dial 911 immediately and activate EMS. 3. When calling emergency medical services (EMS), the following information needs to be provided: a. Name of caller b. Location and telephone number of caller (and location of emergency if different). c. Nature of emergency (cardiac arrest, severe bleeding, unconsciousness). d. Required assistance (ambulance, fire, police). e. Name age, and allergies of the injured individual. f. Suggested approach route, including entrance to Gaelic park (i.e.,ticket booth / main entrance, or parking lot entrance below the 1 train subway tracks). g. Location where emergency personnel will be met and method or description by which they will recognize the individual who will meet them when they arrive. h. The caller should ask if any further information is required and should NOT HANG UP until emergency operator does so first. i. Once EMS has been activated contact campus security ( ), and notify the guard on duty of the emergency situation. Inform the guard of the location and nature of the emergency and ask them to meet EMS personnel upon arrival to campus and escort them to the location of the emergency.

18 18 4. If no Athletic Trainer is available, and Campus Security has not arrived, proceed with First Aid / CPR/ AED by certified personal. b. Do not move any athlete with a suspected spinal injury. c. Check ABC s (Airway-Breathing-Circulation) d. Begin Rescue Breathing, if necessary (Pulse/No Breathing) e. Begin CPR, if necessary (No Pulse/No Breathing) f. Begin AED, if necessary and available (No Pulse/No Breathing) g. Stay with athlete and monitor signs and symptoms. 5. Administer First Aid/CPR until Athletic Trainer, Campus Security, or EMS arrives. Provide care within the scope of you training. Do not move an athlete with a suspected head, neck or back injury. Use universal precautions when dealing with blood/bodily fluids. Stay with athlete until medical personal arrives. 6. If the athlete needs to be transported to a hospital by ambulance, make sure a representative from Manhattan College accompanies the athlete to the hospital, so they are not alone. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete 7. If an athlete needs to go to the hospital and does not need an ambulance, the athlete must be escorted to the hospital by a Manhattan College staff member. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 8. Once the athlete has been transported to the hospital, the following individuals must be notified of the athlete s condition: a. Assistant Director of Athletics/ Sports Medicine b. Assistant Athletic Trainer c. Director of Intercollegiate Athletics d. Office of Public Safety e. Athlete s Parents/guardians f. Team Physician 9. Emergency Information/Clearance sheets contain info on each athlete and should be kept with the head coach at all times for practices and games in case of an emergency.

19 19 VAN CORTLANDT PARK (Baseball, Cross Country) Emergency Communication: There are no fixed phones available at Van Cortlandt Park. Coaches and staff members utilizing the park should carry a mobile phone device at all times while conducting team activities in the park. Fixed phones are located directly across the street from the baseball field in the Broadway parking garage. Emergency Equipment: Emergency equipment is only available at Van Cortlandt Park during baseball games and cross country meets. This includes: AED, Trauma Kit, Splint Kit, crutches. Role of First Responder: 1. Alert Certified Athletic Trainer in the park or via mobile phone ( ) as soon as injury occurs. If a Certified Athletic Trainer is not available, contact the Office of Public Safety at ( ). 2. If the injury is life threatening or requires activation of EMS (Emergency Medical Services) dial 911 immediately and activate EMS. 3. When calling emergency medical services (EMS), the following information needs to be provided: a. Name of caller b. Location and telephone number of caller (and location of emergency if different). c. Nature of emergency (cardiac arrest, severe bleeding, unconsciousness). d. Required assistance (ambulance, fire, police). e. Name, age, and allergies of the injured individual f. Suggested approach route, including entrance to park (i.e. Baseball field, near the intersection of Broadway and West 242 nd Street, tortoise and hare statue / cross country finish line, near the intersection of Broadway and West 251 st Street). g. Location where emergency personnel will be met and method or description by which they will recognize the individual who will meet them when they arrive. h. The caller should ask if any further information is required and should NOT HANG UP until emergency operator does so first. i. Once EMS has been activated contact campus security ( ), and notify the guard on duty of the emergency situation. Inform the guard of the location and nature of the emergency and ask them to meet EMS personnel upon arrival to campus and escort them to the location of the emergency.

20 20 4. If no Athletic Trainer is available, and Campus Security has not arrived, proceed with First Aid / CPR/ AED by certified personal. a. Do not move any athlete with a suspected spinal injury. b. Check ABC s (Airway-Breathing-Circulation) c. Begin Rescue Breathing, if necessary (Pulse/No Breathing) d. Begin CPR, if necessary (No Pulse/No Breathing) e. Begin AED, if necessary and available (No Pulse/No Breathing) f. Stay with athlete and monitor signs and symptoms. 5. Administer First Aid/CPR until Athletic Trainer, Campus Security, or EMS arrives. Provide care within the scope of you training. Do not move an athlete with a suspected head, neck or back injury. Use universal precautions when dealing with blood/bodily fluids. Stay with athlete until medical personal arrives. 6. If the athlete needs to be transported to a hospital by ambulance, make sure a representative from Manhattan College accompanies the athlete to the hospital, so they are not alone. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 7. If an athlete needs to go to the hospital and does not need an ambulance, the athlete must be escorted to the hospital by a Manhattan College staff member. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 8. Once the athlete has been transported to the hospital, the following individuals must be notified of the athlete s condition: a. Assistant Director of Athletics / Sports Medicine b. Assistant Athletic Trainer c. Director of Intercollegiate Athletics d. Office of Public Safety e. Athlete s parents / guardian f. Team Physician 9. Emergency Information/Clearance sheets contain info on each athlete and should be kept with the head coach at all times for practices and games in case of an emergency.

21 21 DUTCHESS STADIUM (Baseball) Emergency Communication: There are no fixed phones available on the field level of Dutchess Stadium. Coaches and staff members utilizing the park should carry a mobile phone device at all times while conducting team activities on the field. Fixed phones are located in the stadiums main administrative offices located on the stadiums second level behind home plate on the third base side of the field. Emergency Equipment: Emergency equipment is only available at Dutchess Stadium during baseball games and cross country meets. This includes: AED, Trauma Kit, Splint Kit, crutches. Role of First Responder: 1. Alert Certified Athletic Trainer in the stadium as soon as injury occurs. If a certified Athletic Trainer is not available, contact the Manhattan College athletic training room at (718) If the injury is life threatening or requires activation of EMS (Emergency Medical Services) dial 911 immediately and activate EMS. 3. When calling emergency medical services (EMS), the following information needs to be provided: a. Name of caller b. Location and telephone number of caller (and location of emergency if different). c. Nature of emergency (cardiac arrest, severe bleeding, unconsciousness). d. Required assistance (ambulance, fire, police). e. Name, age, and allergies of the injured individual f. Suggested approach route, including entrance to park (i.e. Baseball field, near the intersection of Broadway and West 242 nd Street, tortoise and hare statue / cross country finish line, near the intersection of Broadway and West 251 st Street). g. Location where emergency personnel will be met and method or description by which they will recognize the individual who will meet them when they arrive. h. The caller should ask if any further information is required and should NOT HANG UP until emergency operator does so first. i. Once EMS has been activated contact campus security ( ), and notify the guard on duty of the emergency situation. Inform the guard of the location and nature of the emergency and ask them to meet EMS personnel upon arrival to campus and escort them to the location of the emergency.

22 22 4. If no Athletic Trainer is available, and EMS has not arrived, proceed with First Aid / CPR/ AED by certified personal. a. Do not move any athlete with a suspected spinal injury. b. Check ABC s (Airway-Breathing-Circulation) c. Begin Rescue Breathing, if necessary (Pulse/No Breathing) d. Begin CPR, if necessary (No Pulse/No Breathing) e. Begin AED, if necessary and available (No Pulse/No Breathing) f. Stay with athlete and monitor signs and symptoms. 5. Administer First Aid/CPR until Athletic Trainer, or EMS arrives. Provide care within the scope of you training. Do not move an athlete with a suspected head, neck or back injury. Use universal precautions when dealing with blood/bodily fluids. Stay with athlete until medical personal arrives. 6. If the athlete needs to be transported to a hospital by ambulance, make sure a representative from Manhattan College accompanies the athlete to the hospital, so they are not alone. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 7. If an athlete needs to go to the hospital and does not need an ambulance, the athlete must be escorted to the hospital by a Manhattan College staff member. If a member of the athletic training staff is unable to accompany the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 8. Once the athlete has been transported to the hospital, the following individuals must be notified of the athlete s condition: a. Assistant Director of Athletics / Sports Medicine b. Assistant Athletic Trainer c. Director of Intercollegiate Athletics d. Office of Public Safety e. Athlete s parents / guardian f. Team Physician 9. Emergency Information/Clearance sheets contain info on each athlete and should be kept with the head coach at all times for practices and games in case of an emergency.

23 23 TEAM TRAVEL AND AWAY EVENTS Emergency Communication: If a team is not traveling with a Certified Athletic Trainer to an away contest, it is the responsibility of the Head Coach to make contact with the host teams Certified Athletic Trainer upon arriving at the host venue. The Manhattan College Sports Medicine Department will contact all host teams 24 hours in advance and notify the home teams Athletic Trainer if Manhattan will not be traveling with a Certified Athletic Trainer, as well as inform them of any special needs or assistance required by a Manhattan athlete from the host teams Athletic Trainer. Emergency Equipment: Traveling medical kits are supplied with basic first aid supplies for teams traveling without a Certified Athletic Trainer. Head Coaches are provided with an emergency medical information sheet at the beginning of each season that states the name, emergency contact number of a parent or legal guardian as well as any allergies, or medical conditions an athlete may have (i.e. asthma). Head Coaches are responsible for carrying this emergency medical information sheet on them at all times when traveling or conducting any official team events. Role of First Responder: If an athlete is injured at an away contest or event, and a Manhattan College Athletic Trainer is not present. It is the responsibility of the head / assistant coach to seek medical attention for the injured athlete from the host institutions athletic training staff. The athlete should not leave the event prior to being evaluated by the host institutions medical staff, and deemed safe. The head or assistant coach must report all injuries incurred on the road immediately to the Manhattan College Head Athletic Trainer. If the athlete needs to be transported to a hospital by ambulance, make sure a representative from Manhattan College accompanies the athlete to the hospital, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. If an athlete needs to go to the hospital and does not need an ambulance, the athlete must be escorted to the hospital by a Manhattan College staff member, it is the responsibility of the head/assistant coach of the athlete s team to escort the athlete. An athlete should never be sent to the hospital with another student or student athlete. 1. Once the athlete has been transported to the hospital, the following individuals must be notified of the athlete s condition: a. Assistant Director of Athletics / Sports Medicine b. Assistant Athletic Trainer c. Director of Intercollegiate Athletics d. Office of Public Safety e. Student-athlete s parents / guardian f. Team Physician

24 24 g. If the hospital visit requires the student-athlete to stay for longer than the trip was planned, a member of the coaching staff should stay with the student-athlete. 17. Non-Life Threatening Injury Transportation 1. If an athlete sustains an injury that is considered a non-life threatening injury, but still needs immediate emergency room MD evaluation, the athlete should be transported to St. Johns Riverside Hospital, Yonkers NY, or Phelps Memorial Hospital, Sleepy Hollow NY. Team Physicians Dr. Anthony Maddalo, Dr. Gregg Cavaliere, or Dr. Nicole Solomos with Hudson Valley Bone and Joint Surgeons ( ) should be contacted immediately and informed of the injury and athlete s medical status. The team physicians will dictate what hospital the injured athlete should be taken to: St. John Riverside Hospital Andrus Pavilion 967 North Broadway, Yonkers, NY (914) Phelps Memorial Hospital 701 North Broadway Route 9 at Route 117 Sleepy Hollow, NY (914) Members of the Athletic Training Staff, Coaches or Administrators are to contact one of the following ambulance services to schedule a transport. Empress Ambulance (914) Lifeline Ambulance (718) If ambulance transport is not available and the injury is stable and non-life threatening, the athlete may be transported by an Athletic Trainer, coach or administrator via official college vehicle. Personal vehicles are not to be used for medical transportation. If a college vehicle is not available, Break to The Border ( ) car service may be used and the trip billed to the athletic department.

25 TRANSPORTATION TO MEDICAL APPOINTMENTS When possible a member of the Athletic Training Staff will accompany a student athlete to medical appointments related to sports related injuries. If a member of the Athletic Training Staff is unable to accompany the student athlete to an appointment, it is the responsibility of the coach to provide transportation for the athlete to the appointment. If a coach is unable to provide transportation for a student athlete, Break to the Border car service may be used and billed the respective teams account, or the MAAC special assistance fund. The Athletic Training Staff does not provide transportation to medical appointments for non-sports related injuries, illnesses or conditions. 19. LIGHTNING SAFTEY 1. Designate a chain of command as to who monitors threatening weather and who makes the decision to remove a team or individuals from an athletics site or event. The emergency plan should include planned instructions for participants as well as spectators. 2. Obtain a weather report each day before a practice or event. Be aware of potential thunderstorms that may form during scheduled intercollegiate athletics events or practices. 3. Be aware of National Weather Service-issued (NWS) thunderstorm watches and warnings as well as the signs of thunderstorms developing nearby. A 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. 4. Know where the closest safe structure or location is to the field or playing area, and know how long it takes to get to that safe structure or location. Safe Structure or location is defined as: a. Any building normally occupied or frequently used by people, i.e., a building with plumbing and/or electrical wiring that acts to electrically ground the structure. Avoid using shower facilities for safe shelter and do not use the showers or plumbing facilities during a thunderstorm. b. In the absence of a sturdy, frequently inhabited building, any vehicle with a hard metal roof (not a convertible or golf cart) and rolled up windows can provide a measure of safety. A vehicle is certainly better than remaining outdoors. It is not the rubber tires that make a vehicle a safe shelter, but the hard metal roof, which dissipates the lightning strike around the vehicle. DO NOT TOUCH THE SIDE OF THE VEHICLE! 5. Be aware of how close lightning is occurring. The flash-to-bang method is the easiest and most convenient way to estimate how far away lightning is occurring. Thunder always accompanies lighting, even though its audible

26 26 range can be diminished due to background noise in the immediate environment, and its distance from the observer. To use the flash-to-bang method, count the seconds from the time the lightning is sighted to when the clap of thunder is heard. Divide this number by five to obtain how far away (in miles) the lighting is occurring. For example, if an individual counts 15 seconds between seeing the flash and hearing the band, 15 divided by five equals three; therefore, the lightning flash is approximately three miles away. 6. When considering resumption of an athletics activity the National Severe Storms Laboratory along with the NCAA recommends that everyone should ideally wait at least 30 minutes after the last flash of lightning or the sound of thunder before returning to the field or activity. Lightning awareness should be increased with the first flash of lightning or the first clap of thunder, no matter how far away. This activity must be treated as a wake-up call to intercollegiate athletics personnel. The most important aspect to monitor is how far away the lightning is occurring, and how fast the storm is approaching, relative to the distance of a safe shelter. Specific lightning-safety guidelines have been developed with the assistance of the National Severe Storms Laboratory (NSSL). 20. CONCUSSION MANAGEMENT PLAN The Manhattan College Sports Medicine Department strictly follows the practice parameters for the diagnosis of concussion in sport set by the American Academy of Neurology (AAN). For more information on the AAN s practice parameters please visit their web site at A student athlete with a suspected concussion will be evaluated by an Athletic Trainer at the time of injury. Based on the student athletes symptoms relating to the parameters set by the AAN, the Athletic Trainer will decide if the student athlete needs to be removed from practice or competition, if immediate referral to the Emergency Room (ER) is necessary, or if the student athlete may return to activity. If the student athlete is diagnosed with a concussion and no immediate referral is necessary, the student athlete shall be removed from practice or competition for the remainder of the day, monitored closely and sent home with home care instructions to follow. Student Athletes diagnosed with a concussion must follow up with a member of the Athletic Training Staff daily for re-evaluation. A student athlete diagnosed with a concussion may only be cleared to return to physical activity by the Manhattan College Athletic Department team physician or a neurologist.

27 27 Return to Play Following the Diagnosis of a Concussion: Step 1: No activity with complete rest until all symptoms have resolved. Step 2: 24 hours after symptoms have completely subsided, the athlete may begin light aerobic exercise consisting of 25 minutes on a stationary bike. Step 3: 24 hours after Step 2 if athlete is still symptom free, the athlete may begin aerobic exercise consisting of a 25 minute jog on a treadmill. Step 4: 24 hours after step 3, if the athlete is still symptom free, the athlete may participate in non-contact sport-specific training. Step 5: 24 hours after Step 4 if the athlete is still symptom free, the athlete may participate in contact sport-specific training / practice. Step 6: 24 hours after Step 5 if the athlete is still symptom free the athlete may cleared to return to full activity. Final clearance may only be given by the Manhattan College Athletic Department team physician or a neurologist. At any point during the above protocol if an athlete experiences a return of symptoms, the athlete must immediately discontinue all physical activity and return to complete rest. Once the athlete is symptom free again for 24 hours straight, and the team physician has been consulted, the athlete may start the protocol over from the begin. The six step protocol must be completed for a student athlete to be cleared to return to activity by the team physician or a neurologist. 21. SICKLE CELL TRAIT TESTING POLICY NCAA rules require that all athletes be tested for or sign a waiver refusing Sickle Cell Trait (SCT) testing prior to participating in intercollegiate athletics at Manhattan College. Athletes must be tested at home by their own private physician prior to arriving on campus and provide proof of testing, or maybe tested in the Health Services Department. Athletes tested by the Manhattan College Health Services Department will be financial responsible for all cost incurred by SCT testing. Athletes refusing SCT testing must sign the SCT Testing Waiver form prior to participating in intercollegiate athletics at Manhattan College. The SCT Testing Waiver is available for downloading on the gojaspers.com website, under the sports medicine link. If a student athlete would like to have SCT done, but cannot afford to do so due to financial restrictions the student athlete may request financial assistance through the athletic department to pay for SCT. Any athlete in need of such assistance can request it from the Head Athletic Trainer.

28 COLD WEATHER POLICY All outdoor athletic events or practices at Manhattan College will be conducted under the following wind-chill temperature guidelines. The Certified Athletic Trainer on duty will be responsible for communicating these guidelines to all athletic coaches and administration F - 25 F, Be aware of the potential for cold injury and notify appropriate personnel of the potential F - 15 F, Cover as much exposed skin as possible; provide opportunities and facilities for re-warming F - 0 F, Consider modifying activity to limit exposure or to allow more frequent chances to re-warm. 4. <0 F, Consider termination or rescheduling activity. Recognize early signs of cold-induced stress may prove to be important in preventing cold weather related injuries. The following signs and symptoms are considered to be early warning signs: 1. Shivering 2. Abnormal sensation at the distal extremities (e.g. numbness, pain, burning) 3. Disorientation 4. Slurred speech 5. Treatment - If a student athlete is suffering from a cold-related injury or illness, seek medical attention immediately.

29 HOT WATER POLICY All outdoor athletic events or practices at Manhattan College will be conducted under the guidelines of the following chart. A Certified Athletic Trainer on duty will be responsible for communicating these guidelines to all athletic coaches and administration. Relative Humidity % Low risk: Perform activity as planned; include 5-10 minute fluid breaks every minutes. Moderate risk: Include 5-10 minute fluid breaks every minutes High Risk Range: Consider delaying, rescheduling, canceling events or practices Recognize early signs of heat-induced stress may prove to be important in preventing heat related injuries. The following signs and symptoms are considered to be early warning signs: 1. Exercise associated muscle (heat) cramps: a. Dehydration b. Thirst c. Sweating d. Transient muscle cramps e. Fatigue 2. Exercise (heat) exhaustion: a. Core temp ( degrees F) b. Dehydration c. Lightheadedness d. Syncope e. Headache f. Nausea