PIAA News Updates PIAA Sports Medicine Advisory Committee. Topics Recently Addressed. New High School PIAA Guidelines Michael Cordas, Jr., D.O.

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1 PIAA News Updates 2015 PIAA Sports Medicine Advisory Committee Mission Statement The purpose of the PIAA SMAC is to promote the health and safety of the interscholastic athletes by serving in a medical advisory capacity to the PIAA Board of Directors, to encourage continuing education (in-service) programs for physicians, athletic trainers, and others who contribute to the sports medicine effort at the scholastic level, to promote more effective communication among all persons associated with interscholastic athletics, and to provide, upon request, site coverage at PIAA championship events. Membership on this committee shall include, but not limited to, physicians, certified athletic trainers, and athletic administrators. Topics Recently Addressed Providing Direction to ATC Skin Lesion Review Concussion Review Officials Role During Games Heat illness/acclimatization Seizure Disorder Ambulance Personnel Role Team Physician Responsibility and Liability Pre-Participation Physical Review Sports Nutrition PA Chiropractor Association April 29 May 2,

2 Providing Direction to ATC An ATC may only take direction from a physician- MD or DO The term Physician is a protected term in PA Standard Operating Procedure (SOP) From physician to ATC Liability falls on the physician ATC may not take direction from Physician Assistants, Nurse Practitioners Unless so stipulated in the SOP agreement Skin Lesion Review Who may return athlete to play with skin lesions? Ie herpes, tinea, trycophyton, bacterial (impetigo/boils/mrsa), scabies, lice, molluscum ATC can clear for participation if and only if athlete has clearance form signed by physician stating he/she has been treated adequately per PIAA guidelines Caveat- if the SOP states the PA or NP can sign for the covering school physician, then they can clear as well Form must be handed by the athlete to the physician at the skin check prior to competition, failure to do so results in disqualification The tournament covering physician has final say regarding clearance to participate Concussion Review In discussing Thud in football, which refers to actual contact time during practices, the athletes are only allowed to participate in upwards of 9hrs total per week Goal is to reduce potential concussions during this time period Spring, fall and winter rules bulletins for the officials will emphasize the importance of all involved, including medical personnel, coaches/staff, and officials, to promptly remove athletes who display symptoms of concussion, and allow appropriate evaluation and return to play as quickly and safely as possible April 29 May 2,

3 Concussion Review (Cont.) Concussion being the dynamic entity that it is, is still under thorough evaluation in regards to prevention, treatment and long term complications PA Medical Society, with the PA ATC Society, are in the process of utilizing and implementing a concussion wise doctors program To provide education on diagnosis and treatment of concussions Actual course is online, and will allow the physician to declare him/herself as a concussion expert Officials Role During Games To make the sure the sport is being played as fairly and safely as possible To discuss with the ATC and physician potential of concussion or other injury that he may have seen during play To discuss with the physician any potential heat injury or medical risks that may occur pending the environment Heat illness/acclimatization PIAA has voted to increase the heat acclimatization from 3 to 5 days prior to the start of the season (Football) This must be noncontact cardiovascular training in the elements Gold Standard for heat acclimatization is actually days based on studies that have been by the NCAA, subsequently this is a dynamic evolving process to better the safety of our athletes Physicians and ATC should have a knowledge of the pathophysiologic aspects of heat illness, diagnosis and how to ensue adequate treatment Rapidly progressing illness, that if left untreated, may lead to death April 29 May 2,

4 Seizure Disorder Seizure Definition- uncontrolled electrical activity in the brain, which may produce a physical convulsion, minor physical signs, thought disturbances, or a combination of symptoms. Most, but not all, following a seizure display a post-ictal period In order for the athlete to participate in any sport, as determined by the PIAA, they must be seizure free for a period of 3 months and have proof of therapeutic medication levels This must be documented by a physician, and if athlete has a seizure, they are not allowed to return to play Ambulance Personnel Role Ambulance, ATC, and Physician covering should meet prior to event to discuss the roles they each have during that said event PIAA does not require ambulance to be on site for any sport This is a rule of the school district, and an agreement between school personnel and the EMS services Thus, if directed by the physician to take an athlete to the hospital via the ambulance, the crew needs to do so immediately and does not need to wait for another ambulance to arrive The physician is in charge of the care of the athletes at the event, and the EMS personnel are there to assist as needed The ambulance may also assist in crowd coverage during the event Team Physician Responsibility and Liability The HOME team physician has ultimate medical responsibility of all the athletes present/competing If no physician is available on the home team, the visiting team physician if present is responsible ATC must have standard operating orders from the team physician who has signed the SOP agreement Again making the physician liable for the ATC s decisions Physician must declare this to his/her malpractice carrier The contracted school physician has ultimate responsibility as to who can play and who can not Thus injured athlete needs clearance from the said physician to return to play April 29 May 2,

5 Pre-participation Physical Review The PIAA CIPPE form is the only form that may be utilized as a pre-participation form in the state of PA Form may be downloaded from the PIAA site Emphasis on proper completion, specifically of the medical history portion Form may be filled out by a physician or under the physicians direction/pa or NP Changes are being made to the form all the time for the better June 1 st is the date in which the physical may be completed for the following school year Once completed it may last until May 31 st If athlete is injured, they need to undergo a recertification process Sports Nutrition PIAA has added a registered dietician specially trained in sports nutrition This will help answer questions regarding proper/adequate nutrition and utilization of supplements in sports activities Will help specifically in sports such as wrestling, football and women's sports PA Chiropractor Association Much debate recently regarding their role in sports medicine Meeting recently with the Executive VP of the PA Chiropractor Association and 4 other executive members Also present was a diplomat of their sports medicine program They desire to complete pre-participation physicals and provide care for PIAA events Term Physician is protected in PA- MD and DO PIAA stipulates physician only in their directives in the above cases, as regulated by PA state law Chiropractors fall under their own classification, and their role is yet to be determined April 29 May 2,

6 When In Doubt Always can obtain a copy of the PIAA Sports Medicine Guidelines from Images obtained from Google Images April 29 May 2,