RIVER BLUFF HIGH SCHOOL

2019 - 2020 ATHLETIC PAPERWORK CHECKLIST

Student Athlete’s Name: ________________________________ School: _____________ Date:__________

(As on birth certificate; not nicknames)

Athlete’s Grade (for the 19-20 school year): ______ Sport(s): _____________________________________

Did the athlete attend RBHS, MGM, or LMS all of last year? _____ if NOT, where? __________________

If you are a transfer student you MUST see Tracy in the Athletic Department to complete your transfer prior to practice or trying out.

*Please make a copy of these forms for your personal records.

*Once you complete the entire packet return it to the head coach of your sport before participation. Incomplete packets will not be accepted. All information must be signed and dated after April 1, 2019.

*If your student-athlete will compete at both the MGM/LMS and RBHS, a copy of your Pre-Participation Physical Exam will need to be filed at both schools

To Participate in athletics at River Bluff High School, the following items must be completed and on file:

1. _____ Current Physical. Must be dated after April 1, 2019 to be valid for 19-20 year. (Must be on the form in this packet, signed and dated by athlete, parents and physician) *Please double check that all lines requiring a signature are signed.

2. _____ Sports Health Form. (Must be filled out completely. This contains emergency contacts, health insurance information and consent to participate and provide medical treatment. Please include a copy of insurance card. Information on this sheet will only be used by the RBHS Sports Medicine staff for medical purposes or in the event of an emergency.)

3. _____ Concussion Acknowledgment Form. (Must be signed by athlete and parent/guardian)

(SC State Law) 4. _____ Athletic Parent Permission Form. (Must be signed by athlete and parent/guardian)

5. _____ Drug Testing Acknowledgement Form. (Must be signed by athlete and parent/guardian)

No athlete will be allowed to participate (tryout or practice) without all paperwork being turned in.

To be eligible to compete per the SCHSL, each athlete must have:

o Current Pre-Participation Physical Examination on file dated after April 1, 2019 o Parent Permission Form on file. o Birth Certificate on file o Academic eligibility o * If new to RBHS due to a transfer, all transfer paperwork (copy of final report from previous semester) must be

completed and approved.

Parent’s Permission & Acknowledgment of Risk for Son or Daughter to Participate in Athletics

Name of Athlete (please print)

As a parent or legal guardian of the above named student-athlete. I give permission for his/her participation in athletic events and the physical evaluation for that participation. I understand that this is simply a screening evaluation and not a substitute for regular health care. I also grant permission for treatment deemed necessary for a condition arising during participation of these events, including medical or surgical treatment that is recommended by a medical doctor. I grant permission to athletic trainers, nurses and coaches as well as physicians or those under their direction who are part of athletic injury prevention and treatment, to have access to necessary medical information. I know that the risk of injury to my child/ward comes with participation in sports and during travel to and from play and practice. I have had the opportunity to understand the risk of injury during participation in sports through meetings, written information or by some other means. My signature indicates that to the best of my knowledge, my answers to the above questions are complete and correct. I understand that the data acquired during these evaluations may be used for research purposes.

Signature of Athlete

Date

Signature of Parent/Guardian

Date

PREPARTICIPATION PHYSICAL EVALUATION

HISTORY FORM (Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep a copy of this form in the chart.)

Name ___________________________________________________________________ Sex __F __M Age ___ Date of Birth ___________________ Grade ____

School __________________________________ Sport(s) __________________________________________________________ Date of Exam ________________

Address ___________________________________________________________________________________________________ Phone ______________________

EMERGENCY CONTACT NAME ______________________________________________ Relationship ____________________ Phone ______________________

Medicines and Allergies: Please list all of the prescription and over-the-counter medicines and supplements (herbal and nutritional) that you are currently taking

_____________________________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________

Do you have any allergies? Yes No If yes, please identify specific allergy below.

Medicines Pollens Food Stinging Insects

GENERAL QUESTIONS Yes No

1. Has a doctor ever denied or restricted your participation in sports for any

reason?

2. Do you have any ongoing medical conditions? If so, please identify below

Asthma Anemia Diabetes Infections Other

___________________________________________________

3. Have you ever spent the night in the hospital?

4. Have you ever had surgery?

HEART HEALTH QUESTIONS ABOUT YOU Yes No

5. Have you ever passed out or nearly passed out DURING or AFTER

exercise?

6. Have you ever had discomfort, pain, tightness, or pressure in your chest

during exercise?

7. Does your heart ever race or skip beats (irregular beats) during exercise?

8. Has a doctor ever told you that you have any heart problems? If so, check

all that apply:

High blood pressure A heart murmur

High cholesterol A heart infection

Kawasaki disease Other ______________________

9. Has a doctor ever ordered a test for your heart? (For example, ECG/EKG,

echocardiogram)

10. Do you get lightheaded or feel more short of breath than expected during

exercise?

11. Have you ever had an unexplained seizure?

12. Do you get more tired or short of breath more quickly than your friends

during exercise?

HEART HEALTH QUESTIONS ABOUT YOUR FAMILY Yes No

13. Has any family member or relative died of heart problems or had an

unexpected or unexplained sudden death before age 50 (including

drowning, unexplained car accident, or sudden infant death syndrome)?

14. Does anyone in your family have hypertrophic cardiomyopathy, Marfan

syndrome, arrhythmogenic right ventricular cardiomyopathy, long QT

syndrome, short QT syndrome, Brugada syndrome, or catecholaminergic

polymorphic ventricular tachycardia?

15. Does anyone in your family have a heart problem, pacemaker, or

implanted defibrillator?

16. Has anyone in your family had unexplained fainting, unexplained seizures,

or near drowning?

BONE AND JOINT QUESTIONS Yes No

17. Have you ever had an injury to a bone, muscle, ligament, or tendon that

caused you to miss a practice or a game?

18. Have you ever had any broken or fractured bones or dislocated joints?

19. Have you ever had an injury that required x-rays, MRI, CT scan,

injections, therapy, a brace, a cast, or crutches?

20. Have you ever had a stress fracture?

21. Have you ever been told that you have or have you had an x-ray for neck

instability or atlantoaxial instability? (Down syndrome or dwarfism)

22. Do you regularly use a brace, orthotics, or other assistive device?

23. Do you have a bone, muscle, or joint injury that bothers you?

24. Do any of your joints become painful, swollen, feel warm, or look red?

25. Do you have any history of juvenile arthritis or connective tissue disease?

MEDICAL QUESTIONS Yes No

26. Do you cough, wheeze, or have difficulty breathing during or after

exercise?

27. Have you ever used an inhaler or taken asthma medicine?

28. Is there anyone in your family who has asthma?

29. Were you born without or are you missing a kidney, an eye, a testicle

(males), your spleen, or any other organ?

30. Do you have groin pain or a painful bulge or hernia in the groin area?

31. Have you had infectious mononucleosis (mono) within the last month?

32. Do you have any rashes, pressure sores, or other skin problems?

33. Have you had a herpes or MRSA skin infection?

34. Have you ever had a head injury or concussion?

35. Have you ever had a hit or blow to the head that caused confusion,

prolonged headache, or memory problems?

36. Do you have a history of seizure disorder?

37. Do you have headaches with exercise?

38. Have you ever had numbness, tingling, or weakness in your arms or legs

after being hit or falling?

39. Have you ever been unable to move your arms or legs after being hit or

falling?

40. Have you ever become ill while exercising in the heat?

41. Do you get frequent muscle cramps when exercising?

42. Do you or someone in your family have sickle cell trait or disease?

43. Have you had any problems with your eyes or vision?

44. Have you had any eye injuries?

45. Doe you wear glasses or contact lenses?

46. Do you wear protective eyewear, such as goggles or a face shield?

47. Do you worry about your weight?

48. Are you trying to or has anyone recommended that you gain or lose

weight?

49. Are you on a special diet or do you avoid certain types of foods?

50. Have you ever had an eating disorder?

51. Do you have any concerns that you would like to discuss with a doctor?

FEMALES ONLY Yes No

52. Have you ever had a menstrual period?

53. How old were you when you had your first menstrual period?

54. How many periods have you had in the last 12 months?

Explain “yes” answers here

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I hereby state that, to the best of my knowledge, my answers to the above questions are complete and accurate.

Signature of athlete ________________________________________ Signature of parent/guardian _________________________________ Date ______________________________

Parent’s Permission & Acknowledgement of Risk for Son or Daughter to Participate in Athletics As the parent or legal guardian of the above named student-athlete, I give my permission for his/her participation in athletic events and the physical evaluation for that participation. I understand that this is simply a screening

evaluation and not a substitute for regular health care. I also grant permission for treatment deemed necessary for a condit ion arising during participation of these events, including medical or surgical treatment that is

recommended by a medical doctor. I grant permission to nurses, athletic trainers and coaches as well as physicians or those under their direction who are part of athletic injury prevention and treatment, to have access to

necessary medical information. I know that the risk of injury to my child/ward comes with participation in sports and during travel to and from play and practice. I have had the opportunity to understand the risk of injury

during participation in sports through meetings, written information or by some other means. My signature indicates that to the best of my knowledge, my answers to the above questions are complete and correct. I

understand that the data acquired during these evaluations may be used for research purposes. Signature of athlete ____________________________________________________________________________________ Date _________________________

Signature of parent/guardian ____________________________________________________________________________ Date _________________________

PREPARTICIPATION PHYSICAL EVALUATION

PHYSICAL EXAMINATION FORM Name ______________________________________________________________________________________________ Date of Birth ___________________

EXAMINATION

Height Weight Male Female

BP / ( / ) Pulse Vision R 20/ L20/ Corrected Yes No

MEDICAL NORMAL ABNORMAL FINDINGS

Appearance

Marfan stigmata (kyphoscoliosis, high-arched palate, pectus excavatum, arachnodactyly,

arm span > height, hyperlaxity, myopia, MVP, aortic insufficiency)

Eyes/ears/nose/throat

Pupils equal

Hearing

Lymph nodes

Hearta

Murmurs (auscultation standing, supine, +/- Valsalva)

Location of point of maximal impulse (PMI)

Pulses

Simultaneous femoral and radial pulses

Lungs

Abdomen

Genitourinary (males only)b

Skin

HSV, lesions suggestive of MRSA, tinea corporis

Neurologicc

MUSCOSKELETAL

Neck

Back

Shoulder/arm

Elbow/forearm

Wrist/hand/fingers

Hip/thigh

Knee

Leg/ankle

Foot/toes

Functional

Duck-walk, single leg hop

a Consider ECG, echocardiogram, and referral to cardiology for abnormal cardiac history or exam. b Consider GU exam if in private setting. Having third party present is recommended. c Consider cognitive evaluation or baseline neuropsychiatric testing if a history of significant concussion.

Cleared for all sports without restriction

Cleared for all sports without restriction with recommendations for further evaluation or treatment for _________________________________________________ ________________________________________________________________________________________________________________________________________

Not cleared

Pending further evaluation

For any sports

For certain sports __________________________________________________________________________________________________________________

Reason ___________________________________________________________________________________________________________________________

Recommendations

_________________________________________________________________________________________________________________________

I have examined the above-named student and completed the participation physical evaluation. The athlete does not present apparent clinical

contraindications to practice and participate in the sport(s) as outlined above. If conditions arise after the athlete has been cleared for participation, the

physician may rescind the clearance until the problem is resolve and the potential consequences are completely explained to the athlete (and

parents/guardians).

Name of physician (print/type) __________________________________________________________________________ Date ___________________________

Address ____________________________________________________________________________________________ Phone __________________________

Signature of physician __________________________________________________________________________________________________________, MD or DO

2019 - 2020 SPORTS HEALTH FORM

EMERGENCY CONTACT INFORMATION (Please Print Legibly) [Please do not leave any blanks unfilled]

Athlete’s Name _____________________________________________________ Email______ _____________________________ Sex _____ Age _____ Date of Birth ____________Grade ______ Sport(s)_______________________________________________ Allergies/ Medication Allergies___________________________________ Current Medications: _____________________________ Significant Medical History/Existing Conditions ____________________________________________________________________ Sickle Cell Trait/ Anemia: Yes / No Mailing Address _____________________________________________________ City ___________________ Zip _____________ Home Phone: _____________________________________ Student’s Cell Phone: _________________________________________ Mother’s Name _________________________ Phone ______________ Cell/Other _______________ Email _________________ Father’s Name __________________________ Phone ______________ Cell/Other _______________ Email _________________ In an EMERGENCY, if the Parents cannot be reached, please notify:

Name ______________________________ Relation _________________ Cell __________________ Other # _________________ Preferred Hospital ________________________________________ Family Doctor __________________________ Phone __________ Family Dentist _______________________ Phone __________

HEALTH INSURANCE INFORMATION

Do you have health insurance? Y / N Do you have Medicaid? Y / N Medicaid Number_________________________

Name of Company _______________________________________Mailing Address _______________________________________

Insured’s Name _________________________________________ Policy # ______________________________________________

Does your insurance plan require you to be seen by your primary care physician before being seen by a specialist? Y / N

Does your insurance require a second opinion before surgery? Y / N ***Lexington School District 1 carries athletic accident insurance on all its athletes, intended to be an “excess” policy designed to help pay secondarily to the athlete’s primary health insurance. In the event of injury, while participating as a part of a SCHSL sanctioned sports team representing River Bluff High School, the athlete should seek the attention of the sports medicine staff as soon as possible. One of the head athletic trainers will fill out the top portion of the insurance claim form (AKA Notification of Injury Form). If the injury is a non-emergency, the form should be filled out prior to a physician visit. The parent/ guardian should complete the claim form, follow the attached directions, and mail the completed form to the insurance company. *** Sports Medicine staff should be notified of injury immediately or claim may be invalid. Please note the claim must be filed within 90 days of injury.

CONSENT TO PARTICIPATE IN ATHLETICS AND RISK WAIVER

As the parent or legal guardian of the above named student-athlete, I give my permission for his/her participation in athletic events and the physical evaluation for that participation. I understand that the pre-participation physical examination is simply a screening evaluation and not a substitute for regular healthcare. I grant permission to nurses, certified athletic trainers and coaches as well as physicians or those under their direction who are part of athletic injury prevention and treatment, to have access to necessary medical information. I know that the risk of injury to my child comes with participation in sports and during travel to and from play and practice. I have had the opportunity to understand the risk of injury during participation in sports through meetings, written information or by some other means.

CONSENT FOR MEDICAL TREATMENT/RELEASE OF INFORMATION/ DUTY TO REPORT INJURIES

I/We give consent for certified athletic trainers, coaches, and physicians to use their own judgment in securing medical aid and ambulance service in the case the parents/guardians cannot be reached. In the event of an accident requiring immediate medical attention, I herby grant permission to physicians, certified athletic trainers, and/or appropriate healthcare professionals to attend to my son/daughter. It is understood that the school cannot be held responsible for any medical bills incurred because of illness or injury. Furthermore, I/We give permission for our son/ daughter to be evaluated and treated by the school’s certified athletic training staff and/or team physicians if he/she becomes injured while participating as an athlete at River Bluff High School during the school year. I/We also authorize the school’s sports medicine staff to be given medical information concerning my son/daughter by a physician or their staff. Likewise, the school’s sports medicine staff may release medical information to physician’s offices, coaching staff, nurses, administrators and faculty at River Bluff High School as they see appropriate. I also commit to reporting ALL injuries to the Sports Medicine Staff, including but not limited to any symptoms related to a concussion. I also understand that the sports medicine staff will follow return to play protocols for all injuries. Student’s Signature _________________________________________________________________ Date _____________________ Parent’s Signature __________________________________________________________________ Date _____________________

Concussion Acknowledgement Form for Parents and Student Athletes

Student Athlete’s Name (Please Print): __________________________________________________________________ Sports Participating In: ___________________________________________________ School Year: 20_____ - 20_____ In accordance with the South Carolina State law “Student Athlete Concussions, Guidelines, Management” (R65, H3061), schools are required to distribute information sheet to inform and educate student athletes and their parents of the nature and risk of concussion and head injury to student athletes, including the risks of continuing to play after a concussion or brain injury or returning to play too soon after a concussion or brain injury. The law requires that each year, before beginning practice for an interscholastic sport, including cheerleading, a high school student athlete and the student athlete’s parents must be given an information sheet, and both must sign and return the form acknowledging receipt of the information to the athletic trainer. The law further states that a high school athlete who is suspected of sustaining a concussion or brain injury in a practice or game, shall be removed from play at the time of injury and may not return to play until the student athlete has received written medical clearance by a physician. Parent and Student Athletes – please read the attached “Concussion – A fact sheet for student-athletes” information sheet and the River Bluff High School Concussion Management Plan. After reading these fact sheets, please sign below and ensure that your student athlete also signs the form. Once signed, have your student athlete return this form to the athletic trainer or his/her coach. I am a student athlete participating in the above mentioned sport(s). I have received and read the Concussion Information Sheet and the Concussion Management Plan for my school. I understand the nature and risk of concussion and brain injury to student athletes, including the risks of continuing to play after a concussion or brain injury. I agree to inform the coaches and athletic trainers of any concussive symptoms that I encounter. I also understand that after written medical clearance from a physician is given, I must be released by the athletic trainers at River Bluff High School after following and completing a gradual stepwise 5 day return to play protocol. ______________________________________ __________________________________________ _______________ Printed Student Athlete Name Signature of Student Athlete Date I, as the parent or legal guardian of the above named student, have received and read the Concussion Information Sheet and River Bluff High School Concussion Management Plan. I understand the nature and risk of concussion and brain injury to student athletes, including the risks of continuing to play after concussion or brain injury. I will inform the coaches and athletic trainers of any concussive symptoms that I observe. I also understand that after written medical clearance from a physician is given, my child must be released by the athletic trainers at River Bluff High School after following and completing a gradual stepwise 5 day return to play protocol. ______________________________________ ___________________________________________ ______________ Printed Parent/ Guardian Name Signature of Parent/ Guardian Date

River Bluff High School Concussion Management Plan

4/2018

EDUCATION & ACKNOWLEDGEMENT

§ A concussion fact sheet will be available as a part of the education process of athletes and their parents. Before being allowed to participate, all River Bluff High School student athletes and their parents must read the concussion fact sheet and sign the concussion awareness statement acknowledging that they have read and understand the information on the fact sheet and this management plan and understand their responsibility to report their injury and illnesses, including signs and symptoms of a concussion, to a staff athletic trainer.

§ Staff athletic trainers and coaches will complete the CDC Concussion Course in accordance with SCHSL rules. § When an athlete is concussed, an attempt to contact his/her parent will be made as soon as possible. Both parent

and athlete should have further education in concussion management, including but not limited to the “Athlete Information” portion of the SCAT5 Form (Sports Concussion Assessment Tool 5th Edition) and/or individual advice from the athletic training staff on concussion signs, symptoms, and care.

EVALUATION

§ Any athlete experiencing symptoms should report to the athletic training staff as soon as possible. § Any athlete exhibiting signs, symptoms, or behaviors consistent with concussion shall be removed from athletic

activities by an athletic trainer (or coach/ referee in the absence of the athletic trainer) and evaluated by a medical staff member (staff athletic trainer or team physician) as soon as possible.

§ A physical examination with a battery of neurological tests or a SCAT5 Assessment will be performed by a staff athletic trainer as soon as possible after the time of injury for any athlete exhibiting signs, symptoms, or behaviors consistent with concussion.

§ All concussed athletes will be evaluated by a River Bluff High School team physician or a physician of the parent’s choice that is trained in concussion management.

§ A concussed athlete should regularly report to the athletic training room for assessment of symptoms (ideally each school day). The “Symptom Evaluation” portion of the SCAT5 document will be used to assess symptoms and the severity of those symptoms. Complete SCAT5 assessments may also be conducted periodically to monitor recovery. In the instance the concussed athlete is a middle school student athlete, the daily assessment will be provided by the designated individual at that school or a time will be scheduled to meet with the RBHS medical staff at River Bluff High Schools campus until the athlete is asymptomatic.

RETURN TO PLAY

§ No concussed athlete will return to play the same day. § A concussed athlete must be given medical clearance by a physician trained in concussion management. § Once a concussed athlete in asymptomatic, the athlete will undergo stepwise exertional testing over several days

administered by the athletic training staff as described in the Zurich Consensus Statement. Only upon successful completion of the stepwise testing and a physician’s written clearance, may the athlete return to play. (Day 1 – Light aerobic exercise, Day 2 – Moderate aerobic exercise, Day 3 – Heavy aerobic non-contact activity, Day 4 – Sports Specific Practice, Day 5 – Full contact practice, Day – 6 Return to competition)

§ In the event that a symptomatic athlete is cleared by a physician, the RBHS athlete will not return to play until the stepwise return to play protocol outlined in the consensus statement is followed and passed.

OTHER CONSIDERATIONS

§ Appropriate school personnel will be notified as soon as possible of a concussed athlete by a staff athletic trainer. The athletic trainer, school nurse or designated individual will notify the athlete’s guidance counselor and a notification will be made to the athlete’s teachers. A concussion fact sheet and/or a list of classroom accommodations granted by the treating physician will be provided as necessary.

§ This plan will be reviewed annually by the RBHS Concussion Policy Team, which consists of the athletic training staff, the principal (or his designee), athletic director, school nurse, and a team physician.

CONCUSSIONA fAct sheet for student-Athletes

What is a concussion? A concussion is a brain injury that:

• Is caused by a blow to the head or body.– From contact with another player, hitting a hard surface such

as the ground, ice or floor, or being hit by a piece of equipment such as a bat, lacrosse stick or field hockey ball.

• Can change the way your brain normally works.• Can range from mild to severe.• Presents itself differently for each athlete.• Can occur during practice or competition in ANY sport. • Can happen even if you do not lose consciousness.

hoW can i prevent a concussion?Basic steps you can take to protect yourself from concussion:

• Do not initiate contact with your head or helmet. You can still get a concussion if you are wearing a helmet.

• Avoid striking an opponent in the head. Undercutting, flying elbows, stepping on a head, checking an unprotected opponent, and sticks to the head all cause concussions.

• Follow your athletics department’s rules for safety and the rules of the sport.

• Practice good sportsmanship at all times.• Practice and perfect the skills of the sport.

it’s better to miss one game than the Whole season. When in doubt, get checked out.For more information and resources, visit www.NCAA.org/health-safety and www.CDC.gov/Concussion.

What are the symptoms of a concussion?You can’t see a concussion, but you might notice some of the symptoms right away. Other symptoms can show up hours or days after the injury. Concussion symptoms include:

• Amnesia.• Confusion.• Headache.• Loss of consciousness. • Balance problems or dizziness. • Double or fuzzy vision. • Sensitivity to light or noise. • Nausea (feeling that you might vomit).• Feeling sluggish, foggy or groggy. • Feeling unusually irritable.• Concentration or memory problems (forgetting game plays, facts,

meeting times). • Slowed reaction time.

Exercise or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games may cause concussion symptoms (such as headache or tiredness) to reappear or get worse.

What should i do if i think i have a concussion? Don’t hide it. Tell your athletic trainer and coach. Never ignore a blow to the head. Also, tell your athletic trainer and coach if one of your teammates might have a concussion. Sports have injury timeouts and player substitutions so that you can get checked out.

Report it. Do not return to participation in a game, practice or other activity with symptoms. The sooner you get checked out, the sooner you may be able to return to play.

Get checked out. Your team physician, athletic trainer, or health care professional can tell you if you have had a concussion and when you are cleared to return to play. A concussion can affect your ability to perform everyday activities, your reaction time, balance, sleep and classroom performance.

Take time to recover. If you have had a concussion, your brain needs time to heal. While your brain is still healing, you are much more likely to have a repeat concussion. In rare cases, repeat concussions can cause permanent brain damage, and even death. Severe brain injury can change your whole life.

Reference to any commercial entity or product or service on this page should not be construed as an endorsement by the Government of the company or its products or services.

DO YOU KNOW YOUR STUDENT’S SICKLE CELL TRAIT STATUS?

Ifyouknowthatyoursonordaughterisacarrierofthesicklecelltrait,itisimportantthatyoudocumentthisinformationonhisorherannualphysicalform(question#42ontheapprovedSCHSLphysicalform)andnotifytheco-headathletictrainers.Whileanathlete'sstatusmaynotbealimitingfactorforathleticparticipation,coachesandstaffmustbeeducatedonhowtohandlepotentialemergenciesshouldtheyarise.

ForseveralyearstheNCAAhasrequiredathletestoshowproofofsicklecelltraitstatus.TheSCHSLdoesnotrequirestudentathletestoshowproof,butweencourageparentstobecertainwhenrespondingonthephysicalform.Ifyoudonotknowyoursonordaughter’ssicklecelltraitstatusthereareseveraloptionsavailabletoobtainhisorherstatus:

1) IfyoursonordaughterwasborninSouthCarolinafrom1997tothepresent,youcanobtainhis/hernewbornscreeningresultsthroughDHECatthefollowinglink:

http://www.scdhec.gov/Health/FHPF/LabCertificationServices/NewbornMetabolicScreening/NBSInformation/

Ifyoucan’tgainaccessviathelinkorhaveaquestionthatisn'tansweredontheDHECsiteemailRobertaBartholdiatbarthork@dhec.sc.gov.

2) IfyoursonordaughterwasborninSouthCarolinabefore1997,contactyourchild’sinitialmedicalproviderorpediatriciantoobtainyournewbornscreeningresults.

3) IfyourchildwasnotborninthestateofSouthCarolinaortheaboveoptionsfailed,werecommendabloodtest.ContactJamesR.ClarkSickleCellFoundationastheysometimesofferfreetesting.YourchildcanalsogettestedatDHECorthroughhisorherpediatrician.

Pleaseconsidertheseoptionsifyouareunsureofyourstudent-athlete’ssicklecelltraitstatus.

What is sickle cell trait?

Know your sickle cell trait status.

Engage in a slow and gradual preseason conditioning regimen.

Build up your intensity slowly while training.

Set your own pace. Use adequate rest and recovery between repetitions, especially during “gassers” and intense station or “mat” drills.

Avoid pushing with all-out exertion longer than two to three minutes without a rest interval or a breather.

If you experience symptoms such as muscle pain, abnormal weakness, undue fatigue or breathlessness, stop the activity immediately and notify your athletic trainer and/or coach.

Stay well hydrated at all times, especially in hot and humid conditions.

Avoid using high-caffeine energy drinks or supplements, or other stimulants, as they may contribute to dehydration.

Maintain proper asthma management.

Refrain from extreme exercise during acute illness, if feeling ill, or while experiencing a fever.

Beware when adjusting to a change in altitude, e.g., a rise in altitude of as little as 2,000 feet. Modify your training and request that supplemental oxygen be available to you.

Seek prompt medical care when experiencing unusual physical distress.

People at high risk for having sickle cell trait are those whose ancestors come from Africa, South or Central America, India, Saudi Arabia and Caribbean and Mediterranean countries.

sickle cell trait is not a disease. Sickle cell trait is the inheritance of one gene for sickle hemoglobin and one for normal hemoglobin. Sickle cell trait will not turn into the disease. Sickle cell trait is a life-long condition that will not change over time.

A FAct Sheet For Student-AthleteS

Do you knoW if you have sickle cell trait?

hoW can i Prevent a collaPse?

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SICKLE CELL TRAITDuring intense exercise, red blood cells containing the sickle hemoglobin can change shape from round to quarter-moon, or “sickle.”

Sickled red cells may accumulate in the bloodstream during intense exercise, blocking normal blood flow to the tissues and muscles.

During intense exercise, athletes with sickle cell trait have experienced significant physical distress, collapsed and even died.

Heat, dehydration, altitude and asthma can increase the risk for and worsen complications associated with sickle cell trait, even when exercise is not intense.

Athletes with sickle cell trait should not be excluded from participation as precautions can be put into place.

Sickle cell trait occurs in about 8 percent of the U.S. African-American population, and between one in 2,000 to one in 10,000 in the Caucasian population.

Most U.S. states test at birth, but most athletes with sickle cell trait don’t know they have it.

The NCAA recommends that athletics departments confirm the sickle cell trait status in all student-athletes.

Knowledge of sickle cell trait status can be a gateway to education and simple precautions that may prevent collapse among athletes with sickle cell trait, allowing you to thrive in your sport.

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For more information and resources, visit www.NCAA.org/health-safety

SuddenCardiacArrest(SCA)InformationforParentsandStudentAthletesDefinition:SuddenCardiacArrest(SCA)isapotentialfatalconditionwheretheheartunexpectedlystopsbeating.Becausetheheartstopsbeatingbloodwillnolongerbesuppliedtothebrainandorgans.Cause:StructuralandelectricalalimentsoftheheartwillcauseSCA. Oneoftheconditionswillcauseanathletetohaveanabnormalheartbeatthatcanbecomefatalifnottreatedinatimelymanner. MostillnessesresponsibleforSCAarepassedfromparentstochildrenthroughgenes. CommonothercausesofSCAcanbebluntnon-penetratingblowstothechestand/oruseofrecreational/performanceenhancingdrugsorenergydrinks.WarningSigns: EmergencyResponse:

- SCAstrikesimmediately- WithanycollapsedandunresponsiveathleteSCAshouldbesuspected- Nopulse

- Actquickly;secondscanbecritical- Recognizewarningsigns- Activate911/EMS- ProvideCPR- UtilizeAutomatedExternalDefibrillator

(AED)RiskFactors:Thefollowingneedtobefurtherevaluatedbyyourprimarycareprovider.

� Familyhistoryofheartdisease/cardiacarrest� Fainting,seizures,orconvulsionsduringphysicalactivity� Faintingorseizurefromemotionalexcitement,distress,orbeingstartled� Dizzinessorlightheadedness(especiallyduringexertion)� Chestpain(especiallyduringexertion)� Palpitations:awarenessoftheheartbeating� Extremeorunusualtirednessorshortnessofbreath(especiallyduringexertion)� Highbloodpressure

HowtoreduceriskofSCA:Appropriateprevention,recognition,andtreatmentarevitaltopreventSCA.Oneimportantstepinpreventionisayearlypre-participationscreeningevaluationpreformedbyamedicalprovider.

� Readandaccuratelycompletethepersonalhistoryandfamilyhistorysectionofthepre-participationphysicalexamination

� Beawareofanyfamilyhistoryo Familymemberwhodiesunexpectedlybeforeage50o Familymemberdiagnosedwithheartconditionso Familymemberwhosuddenlydiedduringphysicalactivity,seizures,SuddenInfantDeath

Syndrome(SIDS)ordrowning� Takethewarningsignsseriously.Speaktoyourphysicianaboutanyabnormalitiesyoufeel� Beawareofschoolspreventativemeasures� Ifcardiovasculardisorderisexpectedhaveyourchildevaluatedbyaheartspecialistorcardiologist.

Anelectrocardiogram(ECG)canhelpidentifyunderlyingcardiacconditionsthatputathletesatgreaterrisk.However,it’snotauniversalstandardrightnowbecauseofcost,physicianinfrastructureandsensitivityandspecificityconcerns.PleaseseetheoppositesideofthispageifyouareinterestedinaECGheartscreening.

Information usedinthisdocumentwasobtained fromtheAmericanHeartAssociation (www.heart.org), ParentHeartWatch(www.parentheartwatch.org), SuddenCardiacArrestFoundation (www.sca.aware.org),theNationalAthleticTrainersAssociation(www.nata.org)andtheMarylandDepartment ofPublicEducation(http://marylandpublicschools.org/).Visitthesesitesformoreinformation.

Hypertrophic Cardiomyopathy Screening What is Hypertrophic Cardiomyopathy (HCM)?

HCM is a disease in which the muscle of the heart becomes abnormally thickened. This makes it harder for the heart to pump blood and can affect the heart’s electrical system. Nationally, HCM affects roughly 1 in 500 people.

HCM is the most common cause of sudden death among athletes and is the leading cause of sudden heart-related death among people 30 and younger.

Who should be screened?

People with HCM have very few to no symptoms. Because of that it goes largely undiagnosed. This disease is usually inherited – if you have a family member with HCM you should be screened.

Also, if you have experienced any of the following symptoms: shortness of breath, chest pain, or

fainting during exercise; dizziness; fatigue; or heart palpitations. How is the screening performed?

An Echocardiogram is performed on each participant. This test lasts only 10 minutes and is non- invasive. A technician spreads a small amount of gel on your chest and performs and ultrasound of your heart. These images show the structure and movement of the heart, and blood flow through it with each beat- allowing any abnormalities to be easily seen and identified.

How much does this cost?

This screening does not require insurance or a physician’s order and costs just $50 per person. Results will be mailed after the screening.

When will this screening be offered? This screening will be offered for Lexington 1 students on May 4th, 2019 at White Knoll High school in conjunction with district wide Pre-Participation Physical Examinations. If interested in this screening but unable to attend the May 4th date, contact one of the Athletic Trainers at your school for possible alternate dates and times.

SPORTS MEDICINE INFORMATION FOR PARENTS & ATHLETES

Co-Head Athletic Trainers

Scott Ganucheau, MS, ATC, SCAT

Office: (803) 821-0847 sganucheau@lexington1.net

Stacey Baynham, MS, ATC, SCAT Office: (803) 821-0848 sbaynham@lexington1.net

What is an Athletic Trainer?

Certified athletic trainers are health care professionals who specialize in preventing, recognizing, managing and rehabilitating injuries that result from physical activity. As part of a complete health care team, the certified athletic trainer works under the direction of a licensed physician and in cooperation with other health care professionals, athletics administrators, coaches and parents. Athletic trainers (ATs) must earn a degree from an accredited athletic training curriculum. Accredited programs include formal instruction in areas such as injury/illness prevention, first aid and emergency care, assessment of injury/illness, human anatomy and physiology, therapeutic modalities, and nutrition. More than 70 percent of certified athletic trainers hold at least a master’s degree. Here at River Bluff High School we have the ability to do an initial evaluation of the injured athlete and give our medical recommendation of what you and your athlete should do. We also have the ability and equipment to treat and rehabilitate most injuries at no cost to you.

What happens when my student athlete gets injured?

• First, your student athlete should be evaluated by one of the 3 certified athletic trainers on the sports medicine staff at RBHS. • Once evaluated, they will be treated for their injury and a decision will be made if they need to see a physician. If you are not

present at the game or practice, you will be contacted ASAP by one of the athletic trainers for our recommendation. • Treatment times in the RBHS athletic training room are immediately after school and by appointment or as available during

Independent Learning Time. All injured athletes are expected to report to the athletic training room immediately after school for treatment until cleared for participation. They should come dressed in shorts and t-shirt. After treatment all athletes will report to practice wearing the appropriate gear even if they cannot participate. All athletes are expected to be at practice even if injured if only for learning purposes.

• We have a group of Team Physicians from Palmetto Health Orthopedics (formerly known as Moore Center for Orthopedics). If necessary or requested, we will be able to assist you in scheduling you an appointment quickly and efficiently but if you already have a family physician or orthopedist you are comfortable with, we encourage you to continue using them. Please let us know if we can help you with scheduling any appointments, as we have many medical contacts in the midlands.

v AFTER ANY DOCTORS VISIT: Athlete must bring a note of diagnosis from the treating physician with notes of any restrictions or (clearance note) for full release to return to play! The athlete will still need to be released by the Athletic Trainer after following return to play protocols

My student athlete was injured during a team function, but did not report it to the RBHS staff. What should I do?

If at all possible, contact a member of the sports medicine staff for a recommendation before going to the doctor. We may be able to save you an unnecessary trip to the emergency room or doctor’s office. If unable to contact any of the Athletic Trainers before visit, please bring a note from MD of diagnosis and any other important paperwork from the Physician!

v Athletes may not be allowed to participate in practice or games without providing the Sports Medicine staff proper written documentation from the doctor.

What kind of physician should my child see?

It depends on the medical issue that the athlete is dealing with. Please keep this in mind when making appointments for your children. • Orthopedics is the branch of medicine concerned with diseases, injuries, and conditions of the musculoskeletal system --

relating to the body's muscles and skeleton, and including the joints, ligaments, tendons, and nerves. Orthopedists specialize in athletic injuries such as sprains, strains, spasms, etc.

• A family doctor is a physician whose practice is not oriented to a specific medical specialty such as sports medicine but instead covers a variety of medical problems in patients of all ages. In addition to diagnosing and treating illness, they also provide preventive care, including routine checkups, health-risk assessments, immunization and screening tests, and personalized counseling on maintaining a healthy lifestyle. Family physicians also manage other medical conditions, often coordinating care provided by other subspecialists

SPORTS MEDICINE INFORMATION FOR PARENTS & ATHLETES

Team Physicians at Palmetto Health Orthopedics: • Dr. Mickey F. Plymale, Dr. S.Wendell Holmes Jr., Dr. Frank K. Noojin III, and other Palmetto Health USC Physicians

Other options to see a physician other than normal operating hours.

• After evaluation, we can then send you to see one of our team orthopedists at the Black and Blue Clinic at Palmetto Health Orthopedics (formerly known as Moore Center Orthopedics). The Black and Blue Clinic is open from 8 a.m. – 11 a.m. on Saturday mornings during the fall season.

• Palmetto Health Orthopedics also offers a Convenient Care clinic for walk-in appointments that go past normal office hours. It is open Monday through Saturday from 8 a.m – 8 p.m. for orthopedics injuries at the Northeast Columbia office [101 Business Park Blvd., 2nd Floor, Columbia, SC 29223]. Ask an Athletic Trainer for more information.

• Lexington Urgent Care [811 W Main St, Lexington, SC 29072] is open until 10:00 p.m. This may save you some time instead of going to an emergency room for minor medical conditions that need immediate care.

Does my student athlete have insurance provided by the school? YES. All student athletes have insurance while they play sports for Lexington District One Schools. However, this is provided as a secondary insurance to help with any medical costs that your primary insurance may not pick up. IT MAY NOT PAY ALL YOUR MEDICAL COSTS.

Remember, you sign an assumption of risk on your physical for Lexington School District One. Injuries will likely occur. Be prepared. If you do not have insurance, we recommend you purchase insurance somewhere while your student athlete participates in athletics. Also, the insurance you can purchase through the school at the beginning of the year covers school hours only. This is a school athletic insurance not a general athletic insurance. IT WILL NOT COVER AFTERSCHOOL ACTIVITIES, CLUB ATHLETICS, AND OR ANY INJURIES SUSTAINED OUTSIDE OF RIVER BLUFF ATHLETICS.

How do I file the school insurance? An insurance form is filled out and must be signed by the sports medicine staff. It is very important that the sports medicine staff is notified immediately about the injury or the claim may be invalid or denied. This form is then given to you or sent home for you to fill out. Please take this form with you to the scheduled doctor’s appointment. Instructions to send itemized bills and notification of injury are included. The address is located in the top left corner of the notification of injury form. The insurance company will contact you to handle claims from there. Please return these to the insurance company as soon as possible to make sure your claim is handled as soon as possible. This needs to be completed within 90 days of the date of injury. Please keep a copy of the form for your records. If you have any questions, please contact the sports medicine staff.

Note to all Gator student athletes and parents from the Sports Medicine Staff.

PHYSICALS: Each student athlete is required to have a physical examination prior to any participation in any interscholastic sport, including workouts, conditioning, try-outs, practice, etc. It must be dated after April 1st of the previous school year. For example, a physical dated after April 1, 2019 will be valid for the 2019-2020 school year. Sports physicals will be offered in the spring for the next school year for a minimal charge. Keep in mind that all monies collected during the physical date will be used to purchase athletic training items that your athlete will use in the upcoming season (equipment, supplies, tape, Band-Aids, etc.) If you choose not to attend these sessions, you will be responsible for obtaining a physical before the athlete is allowed to participate.

1. HYDRATE o Make sure you drink plenty of fluid the entire pre-season and in-season. Even when you are not thirsty, drink! o Stay away from tea, sodas, and energy drinks. Concentrate on drinking a mixture of water and sports drinks.

2. EAT o Always eat before practice but give yourself enough time to digest before participating in activity. o Eat breakfast, lunch and dinner. Do not skip a meal. Good nutrition is important for you to perform at your best. o Eat a well-balanced meal when you are not practicing.

3. Report ANY and ALL injuries or illnesses to the Sports Medicine Staff.

4. RETURN the Medical Information Sheet as well as a copy of your insurance card to the Sports Medicine Staff as soon as possible. This sheet will give us the information to contact you. So please make sure all phone numbers are up-to-date. This will insure that your son/daughter receives appropriate medical care in a timely fashion. If we are unable to contact you, these forms will provide all the information that the healthcare provider will need to proceed with the appropriate treatment of the athlete.