VISION
Murrieta Mesa High School Athletic Training is committed to providing high quality preventative injury care and skillful injury management to our student-athletes and all those who compete on our campus.
MISSION
The Athletic Training Clinic here at Murrieta Mesa High School is dedicated to providing the best quality care to all student-athletes in a skillful, professional, and beneficial manner. The staff serves the athletic department by implementing prevention, evaluation, treatment, and rehabilitation to ensure the health and safety of the athlete. It is our job to ensure the athlete will experience a healthy and safe recovery, return to play, and to continue their athletic achievement to their fullest ability.
Concussion Information
You are receiving this information sheet about concussions because of California state law AB 25 (effective January 1, 2012), now Education Code § 49475:
- The law requires a student-athlete who may have a concussion during a practice or game to be removed from the activity for the remainder of the day.
- Any student-athlete removed for this reason must receive a written note from a physician trained in the management of concussion before returning to practice.
- Before a student-athlete can start the season and begin practice in a sport, a concussion information sheet must be signed and returned to the school by the student-athlete and the parent or guardian.
*Every 2 years all coaches are required to receive training about concussions (AB 1451), sudden cardiac arrest (AB 1639), and heat illness (AB 2500), and certification in First Aid training, CPR, and AEDs.
What is a concussion and how would I recognize one?
A concussion is a kind of brain injury. It can be caused by a bump or hit to the head, or by a blow to another part of the body with the force that shakes the head. Concussions can appear in any sport and can look differently in each person. Most concussions get better with rest and over 90% of athletes fully recover. However, all concussions should be considered serious. If not recognized and managed the right way, they may result in problems including brain damage and even death. Most concussions occur without being knocked out. Signs and symptoms of concussion (see back of this page) may show up right after the injury or can take hours to appear. If your child reports any symptoms of concussion or if you notice some symptoms and signs, seek medical evaluation from your team’s athletic trainer and a physician trained in the evaluation and management of concussion. If your child is vomiting, has a severe headache, or is having difficulty staying awake or answering simple questions, call 911 for immediate transport to the emergency department of your local hospital.
There is an increasing concern that head impact exposure and recurrent concussions may contribute to long-term neurological problems. One goal of concussion education is to prevent a too early return to play so that serious brain damage can be prevented.
| Symptoms may include one or more of the following: | |
| • Headaches
• “Pressure in head” • Nausea and/or Vomiting • Neck pain • Sadness • Has trouble standing or walking (dizziness) • Blurred, double, or fuzzy vision • Bothered by light or noise • Feeling sluggish or slowed down • Feeling foggy or groggy • Drowsiness |
• Concentration or memory problems
• Repeating the same question/comment • Confused • Loss of memory • “Don’t feel right” • Tired or low energy • Nervousness or feeling on edge • Irritability • More emotional • Change in sleep patterns
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| Signs observed by teammates, parents and coaches include: | |
| • Loses consciousness (even briefly)
• Looks dizzy, dazed, or stunned • Moves clumsily or awkwardly • Slurred speech, or speaks/answers questions slowly • Looks spaced out |
• Confused about plays, assignments, or position
• Cannot recall events before or after the injury • Is unsure of game, score, or opponent • Any change in typical behavior or personality • Seizures or “has a fit” |
What can happen if my child keeps playing with concussion symptoms or returns too soon after getting a concussion?
Athletes with the signs and symptoms of concussion should be removed from play immediately. There is NO same day return to play for a youth with a suspected concussion. Youth athletes may take more time to recover from concussion and are more prone to long-term serious problems from a concussion.
Even though a traditional brain scan (e.g., MRI or CT) may be “normal”, the brain has still been injured. Animal and human research studies show that a second blow before the brain has recovered can result in serious damage to the brain. If your athlete suffers another concussion before completely recovering from the first one, this can lead to prolonged recovery (weeks to months), or even to severe brain swelling (Second Impact Syndrome) with devastating consequences.
On the CIF website is a Graded Concussion Symptom Checklist. If your child fills this out after having had a concussion, it helps the physician, athletic trainer or coach understand how they are feeling and hopefully will show improvement over time. You may have your child fill out the checklist at the start of the season even before a concussion has occurred so that we can understand if some symptoms such as headache might be a part of their everyday life. We call this a “baseline” so that we know what symptoms are normal and common for your child. Keep a copy for your records and turn in the original. If a concussion occurs, your child can fill out this checklist again. This Graded Symptom Checklist provides a list of symptoms to compare over time to follow your child’s recovery from the concussion.
What is Return to Learn?
Following a concussion, students may have difficulties with short- and long-term memory, concentration, and organization. They may require rest while recovering from injury (e.g., limit texting, video games, loud movies, or reading), and may also need to limit school attendance for a few days. As they return to school, the schedule might need to start with a few classes or a half-day. If recovery from a concussion is taking longer than expected, they may also benefit from a reduced class schedule and/or limited homework; a formal school assessment may also be necessary. Your school or physician can help suggest and make these changes. Students should complete the Return to Learn guidelines, successfully returning to a full school day and normal academic activities, before returning to play (unless your physician makes other recommendations). Go to the CIF website (cifstate.org) for more information on Return to Learn.
How is Return to Play (RTP) determined?
Concussion symptoms should be completely gone before returning to competition. A RTP progression is a gradual, stepwise increase in physical effort, sports-specific activities, and then finally unrestricted activities. If symptoms worsen with activity, the progression should be stopped. If there are no symptoms the next day, exercise can be restarted at the previous stage. RTP after concussion should occur only with medical clearance from a physician trained in the evaluation and management of concussions, and a stepwise progression program monitored by an athletic trainer, coach, or other identified school administrator. Please see cifstate.org for a graduated return to play plan. [AB 2127, a California state law effective 1/1/15, states that return to play (i.e., full competition) must be no sooner than 7 days after the concussion diagnosis has been made by a physician.]
Hydration Policy
Murrieta Mesa High School Hydration Policy
What is dehydration? → Dehydration is when the body loses fluids, mostly water, and does not adequately replenish the proper amount that is needed. This causes an unbalance in our bodies, and leads to dehydration. 1-2% of body weight that is lost through dehydration can have a negative impact on athletes performances as well as physiologic function. If 3% or more of body weight is lost this causes an increased chance of heat illnesses to occur.
SIGNS AND SYMPTOMS: Coaches should be aware of the signs and symptoms that can indicate a heat illnesses. Some indications include:
Weakness and/or fatigue Cold, pale, clammy skin Nausea and/or vomiting
Fainting Heavy sweating Excessive thirst
Muscle cramps Confusion or disorientation
**It is important to note that once you are thirsty you are already dehydrated. Dehydration can be avoided if athletes properly hydrate before during and after physical activities.**
Which athletes are more susceptible to heat illnesses?
Wearing dark or excessive clothing History of heat illnesses
Not acclimated to the heat Poor physical condition
Increased BMI Overzealousness
Medication and/or drugs
How can we check if an athlete is dehydrated?
Weight checks
Check weight before and after practices.
Record how much weight is lost to accurately determine how much fluid should be consumed.
→ Weighed in tshirt and shorts
→ Urine
→ Lemonade urine color to clear urine color =well- hydrated
→ Regular amount of light colored urine = well-hydrated
→ Apple Juice urine color or darker = not hydrated
→ Small amounts of dark urine = not hydrated
How can athletes avoid heat illness/dehydration?
What NOT to drink during physical activity
Coffee
Fruit juices with more than 8% carbohydrates
Iced tea
Energy drinks
Carbonated soda
Heat Illness
Heat Index Guidelines:
When does heat affect games/practices?
A heat index MUST be used to determine the cancellation or modifying practices.
Coaches will be informed prior to school ending whether or not these changes will occur.
A heat index can be found at http://www.nws.noaa.gov/om/heat/index.shtml
Heat Index below 98:
-Full practice, but monitor athletes for signs of heat related illnesses. Provide fluid replacement
Heat Index between 98 – 106:
-Modified Practice – this could include lighter practice attire (no pads), frequent water and rest breaks (every 15-20 minutes), shorter
practices, practices later in the day (when cooler), or “walk-thru” practices
Heat Index above 106:
-All activity cancelled – team meetings only
Sudden Cardiac Arrest
What is sudden cardiac arrest?
Sudden Cardiac Arrest (SCA) is a life-threatening emergency that occurs when the heart suddenly stops beating. When this happens blood stops flowing to the brain and other vital organs. SCA is NOT a heart attack. A heart attack is caused by a blockage that stops the flow of blood to the heart. SCA is a malfunction in the heart’s electrical system, causing the victim to collapse. The malfunction is caused by a congenital or genetic defect in the heart’s structure. It strikes people of all ages who may seem to be healthy, even children and teens. When SCA happens, the person collapses and does not respond or breathe normally. They may gasp or shake as if having a seizure, but their heart has stopped.
| Potential Indicators That SCA May Occur | Factors That Increase the Risk of SCA |
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What causes and how common is sudden cardiac arrest in the United States?
SCA occurs because of a malfunction in the heart’s electrical system or structure. The malfunction is caused by an abnormality the person is born with, and may have inherited, or a condition that develops as young hearts grow. A virus in the heart or a hard blow to the chest can also cause a malfunction that can lead to SCA. As the leading cause of death in the U.S., there are more than 300,000 cardiac arrests outside hospitals each year, with nine out of 10 resulting in death. Thousands of sudden cardiac arrests occur among youth, as it is the #2 cause of death under 25 and the #1 killer of student athletes during exercise.
Who is at risk for sudden cardiac arrest?
SCA is more likely to occur during exercise or physical activity, so student-athletes are at greater risk. While a heart condition may have no warning signs, fainting is often mistakenly attributed to stress, heat, or lack of food or water. Studies show that many young people do have symptoms but neglect to tell an adult because symptoms can be misinterpreted as typical in active student athletes; This may be because they are embarrassed, they do not want to jeopardize their playing time, and they mistakenly think they are out of shape and need to train harder, or they simply ignore the symptoms, assuming they will “just go away.” Additionally, Adults assume students are OK and just “check the box” on health forms without asking them and/or do not know or report some health history factors that increase the risk of SCA.
What should you do if your student-athlete is experiencing any of these symptoms?
We need to let student-athletes know that if they experience any SCA-related symptoms it is crucial to alert an adult and get follow-up care as soon as possible with a primary care physician. If the athlete has any of the SCA risk factors, these should also be discussed with a doctor to determine if further testing is needed.
Wait for your doctor’s feedback before returning to play, and alert your coach, athletic trainer, and school nurse about any diagnosed conditions.
What if my student has warning signs or is diagnosed with a heart condition that puts them at risk?
Well-child exams and sports physicals do not check for conditions that can put student athletes at risk. State law requires student athletes who faint or exhibit other cardio-related symptoms to be re-cleared to play by a licensed medical practitioner who is experienced in evaluating cardiovascular (heart) conditions. There are many precautionary steps that can be taken to prevent the onset of SCA including activity modifications, medication, surgical treatments, or implanting a pacemaker and/or implantable cardioverter defibrillator (ICD). Your practitioner should discuss the treatment options with you and any recommended activity modifications while undergoing treatment. In many cases, the abnormality can be corrected, and students can return to normal activity
What is CIF doing to help protect student-athletes?
CIF amended its bylaws to include language that adds SCA training to coach certification, practice, and game protocol that empowers coaches to remove from play a student-athlete who exhibits fainting—the number one warning sign of a potential heart condition. A student-athlete who has been removed from play after displaying signs or symptoms associated with SCA may not return to play until he or she is evaluated and cleared by a licensed health care provider. Parents, guardians and caregivers are urged to dialogue with student-athletes about their heart health and everyone associated with high school sports should be familiar with the cardiac chain of survival so they are prepared in the event of a cardiac emergency.
What is an AED?
An automated external defibrillator (AED) is the only way to save a sudden cardiac arrest victim. An AED is a portable, user-friendly device that automatically diagnoses potentially life-threatening heart rhythms and delivers an electric shock to restore normal rhythm. Anyone can operate an AED, regardless of training. Simple audio direction instructs the rescuer when to press a button to deliver the shock, while other AEDs provide an automatic shock if a fatal heart rhythm is detected. A rescuer cannot accidently hurt a victim with an AED—quick action can only help. AEDs are designed to only shock victims whose hearts need to be restored to a healthy rhythm. Check with your school for locations of on-campus AEDs.
For more information about Sudden Cardiac Arrest visit:
Eric Paredes Save A Life Foundation: http: www.epsavealife.org
CardiacWise (20-minute training video): http.www.sportsafetyinternational.org
National Federations of State High School Associations: https://nfhslearn.com/courses/sudden-cardiac-arrest
