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Supporting Best Practices in Youth Athlete Safety
SAFE PLAY ACTH.R. 829
What is the SAFE PLAY Act?
An amendment to the P u b l i c H e a l t h S e r v i c e A c t to require the C e n t e r fo r D i s e a s e C o n t ro l and H e a l t h a n d H u m a n S e r v i c e s to recommend guidelines for:•Education, awareness, and training about children’s cardiac conditions to increase early diagnosis and prevent death•Prevention and treatment of youth athlete concussion•Heat advisory and heat acclimatization guidelines for secondary school athletics•Emergency action plans for athletics•Safe energy drink use by youth athletes
Supporting Athletes, Families and Educators to Protect the Lives of Athletic Youth
Grants and Awards for Schools
The money from these grants and awards will go to the purchase of:•AEDs, and/or • the implementation of nationally recognized CPR and AED training courses at schools
• According to the SAFE PLAY Act, a local educational agency would submit a grant application, demonstrating the need for these funds. Demonstrable need includes: – Schools with more students– Schools without an AED on the grounds or – Schools with a response time that is longer than
normal. – Other considerations could include the need for
expanding the CPR/AED training program.
Grant Eligibility Requirements
• Defined in section 9101 of the Elementary and Second Education Act of 1965.– The term Local Educational Agency means a public
board of education within a state with administrative control of public elementary schools, secondary schools within a city, township or school district.
What is an Eligible Local Educational Agency?
As of April 29, 2015 the Bill was sent to the subcommittee on Early Childhood, Elementary and Secondary Education.
Current Status of the Bill
• Target audience• Increasing your awareness of these life
threatening injuries/illnesses • Provide you and your school with resources
and best practice guidelines to increase the safety of school sports
• We hope to gain your support on this bill!
Why we choose to present this topic:
Emergency Action Plans and Sudden Cardiac Arrest
EAPs – Why are they important?• National Athletic Trainers’ Association Position Statement:
– EVERY institution/organization that sponsors athletic activities MUST have a written emergency action plan due to the risk of “an untoward event” requiring access to emergency medical services
H. R. 829 - SAFE PLAY Act directs the CDC and HHS to… – Recommend guidelines for the development of emergency action
plan– Develop specific EAP guidelines for specific injuries, sports, and
venues.
How to develop an effective EAP• Six primary components that must be met
– Emergency personnel– Roles of Emergency personnel– Communication– Equipment– Transportation– Documentation
Useful resources for EAPs• Anderson, J. C., Courson, R. W., Kleiner, D. M., and McLoda, T. A.
(2002). National Athletic Trainers’ Association Position Statement: Emergency Planning in Athletics. Journal of Athletic Training, 37(1). 99-104.
• CDC Recommendations for Concussion-Specific EAP http://www.cdc.gov/concussion/pdf/HeadsUpOnConcussionInSportsPolicies-a.pdf
Sudden Cardiac Arrest• Heart conditions in athletes are rare, but when they do
occur, can be catastrophic and deadly• Conditions can include: hypertrophic cardiomyopathy,
arrhythmias, coronary artery abnormalities, Marfan’s syndrome, and commotio cordis (acute).
• Most athletes with a heart condition are asymptomatic until they collapse.
• NATA Position Statement: Physical Examinations and Disqualifying Conditions
• Guidelines include medical and family history and full physical examination
• Administered by a physician upon entry into new level of competition
Prevention – Pre-participation exam• Health issues can be found during the pre-participation exam (PPE).• However, limitations exist due to costs of extra tests and time
constraints.
– Sample PPE Forms
EAP and heart conditions• In the event of a sudden cardiac emergency…• A well-implemented EAP can increase the survival rate of the victim • The response time of EMS, early access of an AED, and early CPR
intervention are vital to the victim’s survival • All medical personnel (ATC, physicians, ATS) and coaches should be
up to date with CPR and AED certifications. • National Athletic Trainer’s Association Position Statement:
Preventing Sudden Death in Sports• Creating and implementing EAPs with an ATC and physician with
specific policies regarding sudden cardiac arrest and collapse is the optimal option for secondary schools
• SAFE PLAY Act requires the Department of Health and Human Services to provide grants and awards to schools for the purchase of AEDs and to implement accredited CPR/AED training courses.
Useful resources for heart health • American Academy of Pediatrics Pre-Participation Evaluation page:
https://www.aap.org/en-us/about-the-aap/Committees-Councils-Sections/Council-on-sports-medicine-and-fitness/Pages/PPE.aspx
• Casa, D. J., Guskiewicz, K. M., Anderson, S. A., Courson, R. W., Heck, J. F., Jimenez, C. C., McDermott, B. P., Miller, M. G., Stearns, R. L., Swartz, E. E., and Walsh, K. M. (2012). National Athletic Trainers’ Association Position Statement: Preventing Sudden Death in Sports. Journal of Athletic Training, 47(1). 96-118.
• Conley, K. M., Bolin, D. J., Carek, P. J., Konin, J. G., Neal, T. L., and Violette, D. (2014). National Athletic Trainers’ Association Position Statement: Preparticipation Physical Examinations and Disqualifying Conditions. Journal of Athletic Training, 49(1). 102-120.
• Duquette, D. (2012, March 1st). CDC Genomics and Health Impact Blog. Retrieved from: http://blogs.cdc.gov/genomics/2012/03/01/cardiac-death-of-the-young/
S A F E P L AY AC T
Prevention and Treatment of Youth Athlete
Concussions
SAFE PLAY ACT H.R. 829
• “Supporting Athletes, Families, and Educators to Protect the Lives of Athletic Youth Act”• Education, awareness, and training about children’s
cardiac conditions to increase early diagnosis and prevent death
• Prevention and treatment of youth athlete concussion
• Heat advisory and heat acclimatization guidelines for secondary school athletics
• Guidelines for emergency action plans for athletics• Guidelines for safe energy drink use by youth athletes
SAFE PLAY ACT PROPOSES THAT …
An amendment be made to the Elementary and Secondary Education Act of 1965 to require a state, as a condition of receiving funds under such Act, to certify that it requires:
• 1. LEAs to implement a standard plan for concussion safety and management for public schools
• 2. Public schools to post information on the symptoms of, the risks posed by, and the actions a student should take in response to, a concussion
• 3. Public school personnel who suspect a student has sustained a concussion in a school-sponsored activity to notify the parents and prohibit the student from participating in such activity until they receive a written release from a health care professional
• 4. A public school’s concussion management team to ensure that a student who has sustained a concussion is receiving appropriate academic supports
THE VERMONT LAW ALREADY MANDATES...
• Athletes that undergo a concussion must be removed from play and may not return to play until completing a 6 step return to play program
• http://education.vermont.gov/documents/EDU-Act_58_Concussion_Guidelines.pdf
VERMONT ACT 68
All coaches (every 2 years) and officials of “collision sports” must receive training in recognizing the symptoms of concussion and how to reduce the risks of concussion. New coaches and officials of “collision sports” must receive this training before either coaching or officiating. Information concerning concussion and its impacts must be provided to student athletes and their parents at least once per school year.
Student-athletes and parent must acknowledge (sign and return school form) receipt of the school’s Action Plan.
Student-athlete must be evaluated by and have written permission from a health care provider (as defined by Act 68) prior to returning to training or competition.
Action Plan:Each school must have an action plan with the following policies:A. School must designate an individual who make the initial
decision to remove a student athlete from play when it is suspected the athlete may have suffered a concussion;
B. School must outline the steps required before a student athlete can return to athletic or learning activity;
C. School must designate an individual who will make the final decision regarding the student’s return to athletic activity; and
D. School must designate the responsibility for informing parents/guardians if a student athlete sustained a concussion.
HEADS UP CONCUSSION TRAINING
• The CDC has created a training session for coaches, parents, and even physicians on what a concussion is, how to diagnose it, and how to treat and return to play protocols
• http://www.cdc.gov/headsup/youthsports/training/index.html
TOOL-KIT
http://www.biavt.org/learn-more/concussion-toolkit.html
RETURN TO LEARN
http://www.biavt.org/images/RTLProtocol.pdf
Heat Advisory and Heat
Acclimatization Guidelines for
Secondary School Athletics
SAFE PLAY Act
Directs the National Oceanic and Atmospheric Administration to develop public education and awareness materials and resources to be disseminated to schools regarding: risks from exposure to excessive heat and humidity
recommendations for how to avoid heat-related illness.
Strategies for heat acclimatization
Requires public schools to develop excessive heat action plans for school-sponsored athletic activities.
What is Heat Illness?
Risk Factors
Environmental Conditions
Barriers to Evaporative Heat Loss
Wet-Bulb Globe Temperature the Previous Day and Night
Inappropriate work-to-rest ratios
Predisposing medical conditions
Lack of education and awareness
Overzealousness or reluctance to report problems, issues, or illnesses Inadequate heat acclimatization
High muscle mass-to-body fat ratio
No emergency plan
Minimal access to fluids before and during practice and rest breaks
Delay in recognition of early warning signs
High intensity of exercise and/or poor physical conditioning
Sleep loss
Dehydration or inadequate water intake
Use of diuretics or certain medications
Skin disorder
Prevention of Heat Illness
PPE to detect risk factors
Acclimatization
Sick athletes should not be allowed to participate
Maintaining hydration
Education
Work to Rest ratio
For More Information
National Athletic Trainers’ Association Position Statement: Exertional Heat Illnesses
VERMONT PRINCIPALS’ ASSOCIATION - Procedure for Athletic Participation in the HEAT
National Oceanic and Atmospheric Administration – Heat Safety
Acclimatization
14-day heat acclimatization period
Goal: to increase exercise heat tolerance and enhance the ability to exercise safely and effectively in warm and hot conditions
Should begin on the first day of practice or conditioning prior to the start of regular season
All student athletes should follow the program, even those who arrive after the first day of practice
14-day heat acclimatization period
ENERGY DRINKS
Effects on Youth
Safe Play Act and Energy Drinks
H.R. 829-SAFE PLAY H.R. 829 directs the Centers for
Disease Control and Prevention (CDC) and the Department of Health and Human Services (HHS) to develop information and guidelines on energy drink consumption.
What is in an Energy Drink?⦿ “ Energy drinks are beverages that
contain caffeine, taurine, vitamins, herbal supplements, and sugar or sweeteners, and are marketed to improve energy, weight loss, stamina, athletic performance, and concentration”.
Energy Drink Vs. Sports Drink
⦿ Energy Drinks● Designed to act as a
stimulant● Quick bursts of
energy● Contain mostly
caffeine and sugar○ Caffeine level not
regulated by FDA
⦿ Sports Drinks● Increase endurance,
replace electrolytes, rehydrate
● Contain mostly carbohydrates, potassium, and sodium
Nutritional Information⦿ Sugar
● Spikes blood sugar and gives consumer a sugar high○ Sugar crash
⦿ Caffeine and Guarana● Stimulants
○ Temporary energy
Drink Serving Sugar PerServing
CaffeinePer Serving
Rockstar 8fl. oz 30g 80mg
Full Throttle
8fl. oz 29g 72mg
MonsterEnergyXXL
8fl. oz 27g 80mg
Red Bull 8.3fl. oz 27g 80mg
Effects on the Body⦿ Short Term
● Brain○ Blocks effects of
adenosine leading to insomnia
○ Fight or flight response releasing adrenaline
● Heart○ Adrenaline increases
heart rate● Dehydration● Diuretic effect
⦿ Long Term● Diabetes● Cavities● Obesity
○ Increasing cortisol levels
● Premature aging● Inconsistent sleeping
patterns
Risks Associated with Energy Drinks
⦿ Caffeine overdose●Heart palpitations, high blood pressure,
nausea/vomiting, possible death
⦿ Type 2 diabetes⦿Miscarriages⦿ Poor dental health⦿ Obesity
ReferencesHeneman, K., Zinderberg-Cherr, S. (2007). Some Facts About Energy Drinks. Nutrition and Health Info-Sheet. Department of Nutrition University of California
Fox News. (2014). How energy drinks affect your body.
National Health Services UK. (2014). Warnings issued over energy drinks.
S. M. Seifert, J. Schaechter, E. Hershorin, S. Lipshultz. (2011). Health Effects of Energy Drinks on Children, Adolescents, and young Adults. Pediatrics. 127. 3 511-522.
The National Athletic Trainers Association Supports the SAFE PLAY Act
NATA Past President Jim Thornton's thoughts:“Having an athletic trainer in every secondary school makes it safer for the student athletes.”W h y n o t p a s s t h i s a n a c t t h a t m a ke s i t s a f e r f o r y o u r c h i l d re n a s t h e y p l a y s p o r t s ?
Reasons to have an Athletic Trainer at every secondary school:•Skilled at developing E m e rg e n c y Ac t i o n P l a n s which every secondary school should have•Trained in managing c a rd i a c emergencies•Trained in c o n c u s s i o n assessment and management•Trained in detecting and managing h e a t i l l n e s s e s early before they become criticalP l a y e r s a f e t y i s i n c re a s e d b y h a v i n g a l i c e n s e d h e a l t h c a re p ro v i d e r a t a l l s p o r t i n g a c t i v i t i e s !
How YOU can help
• NATA urges you to become a Co-sponsor of H.R. 829 by contacting• Michael Barnard with Senator Robert
Menendez• [email protected]
• Erick Siahaan with Representative Lois Capps • [email protected]
Supporting Athletes, Family and Educators to Protect the Lives of Athletic Youth (SAFE PLAY) Act
• This Act will increase awareness on concussions, heat illnesses and the consumption of energy drinks which will in turn increase the safety and health of our student athletes.
• Get this Act into congress and your school will be better prepared to prevent and manage these conditions.
For more information contact:
Amy Callender, Director of Government Affairs for NATA at (972)-532-8853
QUESTIONS?
Thank you from the Athletic Training Students at Castleton
University
Tyler Hoare, Audrey Wostal, Meghan Els, Shelby Alberghini, Rebecca Swart, Tyler Konopka, Michaela Babineau, Caitlin Ryan and Megan Wilberg
