update physical packet - woodstown

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UPDATE PACKET WOODSTOWN HIGH SCHOOL Athletic Department 140 EAST AVENUE WOODSTOWN, NEW JERSEY 08098 Ms. Andrea Bramante 856-769-0144 ext. 55232 Director of Athletics Supervisor of Health/Physical Education [email protected] Certified Athletic Trainer- Mr. Dan Evans (ext. 55234) School Nurse- Ms. Karen Gillespie (ext. 55230) [email protected] PRE-SEASON MEDICAL CHECK LIST Student-Athletes must return the following forms completed in order to become eligible for athletic participation: PLEASE RETURN TO NURSE’S OFFICE -Athletic Participation Acknowledgment Form -Health History Update Questionnaire Form -NJSIAA Steroid Testing Consent Form PLEASE KEEP FOR INFORMATIONAL PURPOSES -Concussion Policy Acknowledgment Form -Sudden Cardiac Death In Young Athletes Form Student-Athletes must have a current physical on file in the Nurse’s office dated within 365 days. All paperwork must be returned to the Nurse’s office. **PLEASE REMOVE THE LAST THREE PAGES OF THIS PACKET AND KEEP FOR INFORMATIONAL PURPOSES** Any questions regarding the required paperwork, please contact us. PAPER WORK DUE DATES FALL AUGUST 1, 2017 WINTER NOVEMBER 3, 2017 SPRING FEBRUARY 2, 2018 4/20/2017

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Page 1: Update Physical Packet - Woodstown

UPDATE PACKET

WOODSTOWN HIGH SCHOOL Athletic Department

140 EAST AVENUE WOODSTOWN, NEW JERSEY 08098

Ms. Andrea Bramante 856-769-0144 ext. 55232 Director of Athletics Supervisor of Health/Physical Education [email protected] Certified Athletic Trainer- Mr. Dan Evans (ext. 55234) School Nurse- Ms. Karen Gillespie (ext. 55230) [email protected]

PRE-SEASON MEDICAL CHECK LIST

Student-Athletes must return the following forms completed in order to become eligible for athletic participation: PLEASE RETURN TO NURSE’S OFFICE -Athletic Participation Acknowledgment Form -Health History Update Questionnaire Form -NJSIAA Steroid Testing Consent Form PLEASE KEEP FOR INFORMATIONAL PURPOSES -Concussion Policy Acknowledgment Form -Sudden Cardiac Death In Young Athletes Form Student-Athletes must have a current physical on file in the Nurse’s office dated within 365 days. All paperwork must be returned to the Nurse’s office. **PLEASE REMOVE THE LAST THREE PAGES OF THIS PACKET AND KEEP FOR INFORMATIONAL PURPOSES** Any questions regarding the required paperwork, please contact us. PAPER WORK DUE DATES

FALL AUGUST 1, 2017 WINTER NOVEMBER 3, 2017 SPRING FEBRUARY 2, 2018

4/20/2017

Page 2: Update Physical Packet - Woodstown

SCHOLASTIC STUDENT-ATHLETE SAFETY ACT INFORMATION FACT SHEET FOR PARENTS/GUARDIANS

Prior to participation on a school-sponsored interscholastic or intramural athletic team or squad, each student-athlete in grades six through 12 must present a completed Preparticipation Physical Evaluation (PPE) form to the designated school staff member. Important information regarding the PPE is provided below, and you should feel free to share with your child’s medical home health care provider.

1. The PPE may ONLY be completed by a licensed physician, advanced practice nurse (APN) or physician assistant (PA) that has completed the Student-Athlete Cardiac Assessment professional development module. It is recommended that you verify that your medical provider has completed this module before scheduling an appointment for a PPE.

2. The required PPE must be conducted within 365 days prior to the first official practice in an athletic season. The PPE form is available in English and Spanish at http://www.state.nj.us/education/students/safety/health/records/athleticphysicalsform.pdf.

3. The parent/guardian must complete the History Form (page one), and insert the date of the required physical examination at the top of the page.

4. The parent/guardian must complete The Athlete with Special Needs: Supplemental History Form (page two), if applicable, for a student with a disability that limits major life activities, and insert the date of the required physical examination on the top of the page.

5. The licensed physician, APN or PA who performs the physical examination must complete the remaining two pages of the PPE, and insert the date of the examination on the Physical Examination Form (page three) and Clearance Form (page four).

6. The licensed physician, APN or PA must also sign the certification statement on the PPE form attesting to the completion of the professional development module. Each board of education and charter school or nonpublic school governing authority must retain the original signed certification on the PPE form to attest to the qualification of the licensed physician, APN or PA to perform the PPE.

7. The school district must provide written notification to the parent/guardian, signed by the school physician, indicating approval of the student’s participation in a school-sponsored interscholastic or intramural athletic team or squad based upon review of the medical report, or must provide the reason(s) for the disapproval of the student’s participation.

8. For student-athletes that had a medical examination completed more than 90 days prior to the first official practice in an athletic season, the Health History Update Questionnaire (HHQ) form must be completed, and signed by the student’s parent/guardian. The HHQ must be reviewed by the school nurse and, if applicable, the school’s athletic trainer. The HHQ is available at http://www.state.nj.us/education/students/safety/health/records/HealthHistoryUpdate.pdf.

For more information, please review the Frequently Asked Questions which are available at http://www.state.nj.us/education/students/safety/health/services/athlete/faq.pdf. You may also direct questions to Ms. Karen Gillespie WHS/MS nurse , ext. 55230, Mr. Dan Evans, Certified Athletic Trainer, ext. 55234, and Ms. Andrea Bramante, Director of Athletics ext. 55232.

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Page 3: Update Physical Packet - Woodstown

Woodstown-Pilesgrove Regional School District

Athletic Participation Acknowledgment Form Student-Athlete Name __________________________________________ (please print) Grade: 9 10 11 12 Sport ______________________________ Date of Birth ________________ School attended in 8th grade_____________________________ Salem County Vo-Tech Student: YES OR NO (please circle) Did you transfer from another school: YES OR NO (please circle) If yes, name and state of school____________________ STUDENT AGREEMENT I hereby apply for the privilege of participation in the above named sport. I have read and understand the attached Athletic Participation Contract and agree to abide by all rules pertaining to the Woodstown-Pilesgrove Regional School District athletic program. Any infraction on my part may lead to suspension or dismissal from the team. PARENTAL CONSENT I/We hereby give our permission for the above named student-athlete to participate in the above name sport. I/We have read and understand the attached Athletic Participation Contract and agree to abide by all rules pertaining to the Woodstown-Pilesgrove Regional School District athletic program. I/We realize that organized high school athletics involve the potential for injury that is inherent in all sports. I/We acknowledge that even with the best coaching, use of the most advanced protective equipment, and strict observance of rules, injuries are still a possibility. On rare occasions these injuries can be so severe as to result in total disability, paralysis, or even death. I/We acknowledge that I/we have read and understand this warning. Furthermore, I/we release the Woodstown-Pilesgrove School District from all liability for injuries incurred by my/our child during or resulting from participation in the athletic program, whether it occurs during practice, during a contest, or traveling to/from a practice or contest. NJSIAA STEROID TESTING POLICY – CONSENT TO RANDOM TESTING I/We consent to random testing in accordance with the attached NJSIAA steroid testing policy. We understand that, if the student or the student’s team qualifies for a state championship tournament or state championship competition, the student may be subject to testing for banned substances. CONCUSSION POLICY ACKNOWLEDGMENT I/We acknowledge that I/we have received and reviewed the attached Sports-Related Concussion and Head Injury Fact Sheet. SUDDEN CARDIAC DEATH BROCHURE ACKNOWLEDGMENT I/We acknowledge that I/we have received and reviewed the attached Sudden Cardiac Death in Young Athletes pamphlet. Student-Athlete Signature ___________________________________________ Date _______________ Parent/Guardian Name _____________________________________________ (please print) Parent/Guardian Signature __________________________________________ Date _______________ 8/2015

Page 4: Update Physical Packet - Woodstown

   

 

State of New JerseyDEPARTMENT OF EDUCATION

HEALTH HISTORY UPDATE QUESTIONNAIRE

Name of School __________________________________________________________________________________

To participate on a school-sponsored interscholastic or intramural athletic team or squad, each student whosephysical examination was completed more than 90 days prior to the first day of official practice shall provide ahealth history update questionnaire completed and signed by the student’s parent or guardian.

Student _________________________________________________________________ Age______ Grade ________

Date of Last Physical Examination_________________________________ Sport______________________________

Since the last pre-participation physical examination, has your son/daughter:

1. Been medically advised not to participate in a sport? Yes____ No____If yes, describe in detail __________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

2. Sustained a concussion, been unconscious or lost memory from a blow to the head? Yes____ No____If yes, explain in detail___________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

3. Broken a bone or sprained/strained/dislocated any muscle or joints? Yes____ No____If yes, describe in detail __________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

4. Fainted or “blacked out?” Yes____ No____If yes, was this during or immediately after exercise?___________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

5. Experienced chest pains, shortness of breath or “racing heart?” Yes____ No____If yes, explain__________________________________________________________________________________

_____________________________________________________________________________________________

6. Has there been a recent history of fatigue and unusual tiredness? Yes____ No____

7. Been hospitalized or had to go to the emergency room? Yes____ No____If yes, explain in detail___________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

8. Since the last physical examination, has there been a sudden death in the family or has any member of the familyunder age 50 had a heart attack or “heart trouble?” Yes____

9. Started or stopped taking any over-the-counter or prescribed medications? Yes____ No____If yes, name of medication(s)___________________________________________________________________________________________________________________________________________________________________

Date:________________________ Signature of parent/guardian ___________________________________________

PLEASE RETURN COMPLETED FORM TO THE SCHOOL NURSE’S OFFICE E14-00284

Page 5: Update Physical Packet - Woodstown

 

1161 Route 130, P.O. Box 487, Robbinsville, NJ 08691 609-259-2776 609-259-3047-Fax

NJSIAA STEROID TESTING POLICY

CONSENT TO RANDOM TESTING

In Executive Order 72, issued December 20, 2005, Governor Richard Codey directed the New Jersey Department of Education to work in conjunction with the New Jersey State Interscholastic Athletic Association (NJSIAA) to develop and implement a program of random testing for steroids, of teams and individuals qualifying for championship games. Beginning in the Fall, 2006 sports season, any student-athlete who possesses, distributes, ingests or otherwise uses any of the banned substances on the attached page, without written prescription by a fully-licensed physician, as recognized by the American Medical Association, to treat a medical condition, violates the NJSIAA’s sportsmanship rule, and is subject to NJSIAA penalties, including ineligibility from competition. The NJSIAA will test certain randomly selected individuals and teams that qualify for a state championship tournament or state championship competition for banned substances. The results of all tests shall be considered confidential and shall only be disclosed to the student, his or her parents and his or her school. No student may participate in NJSIAA competition unless the student and the student’s parent/guardian consent to random testing. By signing below, we consent to random testing in accordance with the NJSIAA steroid testing policy. We understand that, if the student or the student’s team qualifies for a state championship tournament or state championship competition, the student may be subject to testing for banned substances. ___________________________ Signature of Student-Athlete Print Student-Athlete’s Name Date

___________________________ Signature of Parent/Guardian Print Parent/Guardian’s Name Date May 1, 2010

Page 6: Update Physical Packet - Woodstown

     

2014-15 NJSIAA Banned Drugs IT IS YOUR RESPONSIBILITY TO CHECK WITH THE APPROPRIATE OR DESIGNATED ATHLETICS STAFF BEFORE USING ANY SUBSTANCE

The NJSIAA bans the following classes of drugs:

x Stimulants x Anabolic Agents x Alcohol and Beta Blockers (banned for rifle only) x Diuretics and Other Masking Agents x Street Drugs x Peptide Hormones and Analogues x Anti-estrogens x Beta-2 Agonists

Note: Any substance chemically related to these classes is also banned.

THE INSTITUTION AND THE STUDENT-ATHLETE SHALL BE HELD ACCOUNTABLE FOR ALL DRUGS WITHIN THE BANNED DRUG CLASS REGARDLESS OF WHETHER THEY HAVE BEEN SPECIFICALLY IDENTIFIED.

Drugs and Procedures Subject to Restrictions

x Blood Doping x Local Anesthetics (under some conditions) x Manipulation of Urine Samples x Beta-2 Agonists permitted only by prescription and inhalation x Caffeine if concentrations in urine exceed 15 micrograms/ml

NJSIAA Nutritional/Dietary Supplements Warning

Before consuming any nutritional/dietary supplement product, review the product with the appropriate or designated athletics department staff!

x Dietary supplements are not well regulated and may cause a positive drug test result. x Student-athletes have tested positive and lost their eligibility using dietary supplements. x Many dietary supplements are contaminated with banned drugs not listed on the label. x Any product containing a dietary supplement ingredient is taken at your own risk.

NOTE TO STUDENT-ATHLETES: THERE IS NO COMPLETE LIST OF BANNED SUBSTANCES. DO NOT RELY ON THIS LIST TO RULE OUT ANY SUPPLEMENT INGREDIENT. CHECK WITH YOUR ATHLETICS DEPARTMENT STAFF PRIOR TO USING A SUPPLEMENT.

Page 7: Update Physical Packet - Woodstown

 

Some Examples of NJSIAA Banned Substances in Each Drug Class

Stimulants Amphetamine (Adderall); caffeine (guarana); cocaine; ephedrine; fenfluramine (Fen); methamphetamine; methylphenidate (Ritalin); phentermine (Phen); synephrine (bitter orange); methylhexaneamine, “bath salts” (mephedrone) etc. exceptions: phenylephrine and pseudoephedrine are not banned.

Anabolic Agents (sometimes listed as a chemical formula, such as 3,6,17-androstenetrione) Androstenedione; boldenone; clenbuterol; DHEA (7-Keto); epi-trenbolone; etiocholanolone; methasterone; methandienone; nandrolone; norandrostenedione; stanozolol; stenbolone; testosterone; trenbolone; etc.

Alcohol and Beta Blockers (banned for rifle only) Alcohol; atenolol; metoprolol; nadolol; pindolol; propranolol; timolol; etc.

Diuretics (water pills) and Other Masking Agents Bumetanide; chlorothiazide; furosemide; hydrochlorothiazide; probenecid; spironolactone (canrenone); triameterene; trichlormethiazide; etc.

Street Drugs Heroin; marijuana; tetrahydrocannabinol (THC); synthetic cannabinoids (eg. spice, K2, JWH-018, JWH-073)

Peptide Hormones and Analogues Growth hormone(hGH); human chorionic gonadotropin (hCG); erythropoietin (EPO); etc.

Anti-Estrogens Anastrozole; tamoxifen; formestane; 3,17-dioxo-etiochol-1,4,6-triene(ATD), etc.

Beta-2 Agonists Bambuterol; formoterol; salbutamol; salmeterol; etc.

ANY SUBSTANCE THAT IS CHEMICALLY RELATED TO THE CLASS, EVEN IF IT IS NOT LISTED AS AN EXAMPLE, IS ALSO BANNED! IT IS YOUR RESPONSIBILITY TO

CHECK WITH THE APPROPRIATE OR DESIGNATED ATHLETICS STAFF BEFORE USING ANY SUBSTANCE.

Page 8: Update Physical Packet - Woodstown

Woodstown-­‐Pilesgrove  Regional  School  District    

Sports-­‐Related  Concussion  and  Head  Injury  Fact  Sheet      

A concussion is a brain injury that can be caused by a blow to the head or body that disrupts normal functioning of the brain. Concussions are a type of Traumatic Brain Injury (TBI), which can range from mild to severe and can disrupt the way the brain normally functions. Concussions can cause significant and sustained neuropsychological impairment affecting problem solving, planning, memory, attention, concentration, and behavior. The Centers for Disease Control and Prevention estimates that 300,000 concussions are sustained during sports related activities nationwide, and more than 62,000 concussions are sustained each year in high school contact sports. Second-impact syndrome occurs when a person sustains a second concussion while still experiencing symptoms of a previous concussion. It can lead to severe impairment and even death of the victim. Legislation (P.L. 2010, Chapter 94) signed on December 7, 2010, mandated measures to be taken in order to ensure the safety of K-12 student-athletes involved in interscholastic sports in New Jersey. It is imperative that athletes, coaches, and parent/guardians are educated about the nature and treatment of sports related concussions and other head injuries. The legislation states that: • All Coaches, Athletic Trainers, School Nurses, and School/Team Physicians shall complete an

Interscholastic Head Injury Safety Training Program. • All school districts, charter, and non-public schools that participate in interscholastic sports will

distribute annually this educational fact to all student athletes and obtain a signed acknowledgement from each parent/guardian and student-athlete.

• Each school district, charter, and non-public school shall develop a written policy describing the prevention and treatment of sports-related concussion and other head injuries sustained by interscholastic student-athletes.

• Any student-athlete who participates in an interscholastic sports program and is suspected of sustaining a concussion will be immediately removed from competition or practice. The student-athlete will not be allowed to return to competition or practice until he/she has written clearance from a physician trained in concussion treatment and has completed his/her district’s graduated return-to-play protocol.

Quick Facts • Most concussions do not involve loss of consciousness • You can sustain a concussion even if you do not hit your head • A blow elsewhere on the body can transmit an “impulsive” force to the brain and cause a concussion

Signs of Concussions (Observed by Coach, Athletic Trainer, Parent/Guardian) • Appears dazed or stunned • Forgets plays or demonstrates short term memory difficulties (e.g. unsure of game, opponent) • Exhibits difficulties with balance, coordination, concentration, and attention • Answers questions slowly or inaccurately • Demonstrates behavior or personality changes • Is unable to recall events prior to or after the hit or fall

Symptoms of Concussion (Reported by Student-Athlete) • Headache • Nausea/vomiting • Balance problems or dizziness • Double vision or changes in vision • Sensitivity to light/sound • Feeling of sluggishness or fogginess

Difficulty with concentration, short term memory, and/or confusion

Page 9: Update Physical Packet - Woodstown

What Should a Student-Athlete do if they think they have a concussion? • Don’t hide it. Tell your Athletic Trainer, Coach, School Nurse, or Parent/Guardian. • Report it. Don’t return to competition or practice with symptoms of a concussion or head injury. The

sooner you report it, the sooner you may return-to-play. • Take time to recover. If you have a concussion your brain needs time to heal. While your brain is healing

you are much more likely to sustain a second concussion. Repeat concussions can cause permanent brain injury.

What can happen if a student-athlete continues to play with a concussion or returns to play to soon? • Continuing to play with the signs and symptoms of a concussion leaves the student-athlete vulnerable to

second impact syndrome. • Second impact syndrome is when a student-athlete sustains a second concussion while still having symptoms

from a previous concussion or head injury. • Second impact syndrome can lead to severe impairment and even death in extreme cases. Should there be any temporary academic accommodations made for Student-Athletes who have suffered a concussion? • To recover cognitive rest is just as important as physical rest. Reading, texting, testing-even watching

movies can slow down a student-athletes recovery. • Stay home from school with minimal mental and social stimulation until all symptoms have resolved. • Students may need to take rest breaks, spend fewer hours at school, be given extra time to complete

assignments, as well as being offered other instructional strategies and classroom accommodations. Student-Athletes who have sustained a concussion should complete a graduated return-to-play before they may resume competition or practice, according to the following protocol: • Step 1: Completion of a full day of normal cognitive activities (school day, studying for tests, watching

practice, interacting with peers) without reemergence of any signs or symptoms. If no return of symptoms, next day advance.

• Step 2: Light Aerobic exercise, which includes walking, swimming, and stationary cycling, keeping the intensity below 70% maximum heart rate. No resistance training. The objective of this step is increased heart rate.

• Step 3: Sport-specific exercise including skating, and/or running: no head impact activities. The objective of this step is to add movement.

• Step 4: Non contact training drills (e.g. passing drills). Student-athlete may initiate resistance training. • Step 5: Following medical clearance (consultation between school health care personnel and student-

athlete’s physician), participation in normal training activities. The objective of this step is to restore confidence and assess functional skills by coaching and medical staff.

• Step 6: Return to play involving normal exertion or game activity. For further information on Sports-Related Concussions and other Head Injuries, please visit:

www.cdc.gov/concussion/sports/index.html www.nfhs.com www.ncaa.org/health-safety www.bianj.org www.atsnj.org

8/2015

Page 10: Update Physical Packet - Woodstown

 

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360

Tren

ton,

NJ 0

8625

-036

0(p

) 609

-292

-783

7w

ww

.stat

e.nj

.us/

heal

th

Lead

Aut

hor:

Amer

ican

Aca

dem

y of

Ped

iatr

ics,

N

ew Je

rsey

Cha

pter

Writ

ten

by: I

nitia

l dra

ft b

y Su

shm

a Ra

man

Heb

bar,

MD

& S

teph

en G

. Ric

e, M

D P

hD

Addi

tiona

l Rev

iew

ers:

NJ D

epar

tmen

t of E

duca

tion,

NJ D

epar

tmen

t of H

ealth

and

Sen

ior S

ervi

ces,

Amer

ican

Hea

rt A

ssoc

iatio

n/N

ew Je

rsey

Cha

pter

, NJ

Acad

emy

of F

amily

Pra

ctic

e, P

edia

tric

Car

diol

ogist

s,N

ew Je

rsey

Sta

te S

choo

l Nur

ses

Revi

sed

2014

:Ch

riste

ne D

eWitt

-Par

ker,

MSN

, CSN

, RN

;La

kota

Kru

se, M

D, M

PH; S

usan

Mar

tz, E

dM;

Step

hen

G. R

ice,

MD

; Jeff

rey

Rose

nber

g, M

D,

Loui

s Tei

chho

lz, M

D; P

erry

Wei

nsto

ck, M

D

Web

site

Res

ourc

es

STAT

E OF N

EW JE

RSEY

DEPA

RTM

ENT

OF ED

UCAT

ION

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Page 11: Update Physical Packet - Woodstown

 

!

Oth

er d

iseas

es o

f the

hea

rt th

at c

an le

ad to

sudd

en d

eath

in y

oung

peo

ple

incl

ude:

●M

yoca

rditi

s (m

y-oh

-car

-DIE

-tis)

, an

acut

einfla

mm

atio

n of

the

hear

t m

uscl

e (u

sual

lydu

e to

a v

irus)

.●

Dila

ted

card

iom

yopa

thy,

an

enla

rgem

ent

of th

e he

art f

or u

nkno

wn

reas

ons.

●Lo

ng Q

T sy

ndro

me

and

othe

r ele

ctric

alab

norm

aliti

es o

f the

hea

rt w

hich

cau

seab

norm

al fa

st h

eart

rhyt

hms t

hat c

an a

lso

run

in fa

mili

es.

●M

arfa

n sy

ndro

me,

an

inhe

rited

diso

rder

that

affe

cts h

eart

val

ves,

wal

ls o

f maj

orar

terie

s, ey

es a

nd th

e sk

elet

on. I

t is

gene

rally

seen

in u

nusu

ally

tall

athl

etes

,es

peci

ally

if b

eing

tall

is no

t com

mon

inot

her f

amily

mem

bers

.

Are

ther

e w

arni

ng si

gns t

o w

atch

for?

In m

ore

than

a th

ird o

f the

se su

dden

car

diac

deat

hs, t

here

wer

e w

arni

ng si

gns t

hat w

ere

not r

epor

ted

or ta

ken

serio

usly

. War

ning

signs

are

:

●Fa

intin

g, a

seiz

ure

or c

onvu

lsio

ns d

urin

gph

ysic

al a

ctiv

ity;

●Fa

intin

g or

a se

izur

e fro

m e

mot

iona

lex

cite

men

t, em

otio

nal d

istre

ss o

r bei

ngst

artle

d;

●D

izzi

ness

or l

ight

head

edne

ss, e

spec

ially

durin

g ex

ertio

n;

●Ch

est p

ains

, at r

est o

r dur

ing

exer

tion;

●Pa

lpita

tions

- aw

aren

ess o

f the

hea

rtbe

atin

g un

usua

lly (s

kipp

ing,

irre

gula

r or

extr

a be

ats)

dur

ing

athl

etic

s or d

urin

g co

oldo

wn

perio

ds a

fter a

thle

tic p

artic

ipat

ion;

●Fa

tigue

or t

iring

mor

e qu

ickl

y th

an p

eers

;or

●Be

ing

unab

le to

kee

p up

with

frie

nds d

ueto

shor

tnes

s of b

reat

h.

Wha

t are

the

curr

ent r

ecom

men

datio

nsfo

r scr

eeni

ng y

oung

ath

lete

s?

New

Jers

ey re

quire

s all

scho

ol a

thle

tes t

o be

exam

ined

by

thei

r prim

ary

care

phy

sicia

n(“m

edic

al h

ome”

) or s

choo

l phy

sicia

n at

leas

ton

ce p

er y

ear.

The

New

Jers

ey D

epar

tmen

tof

Edu

catio

n re

quire

s use

of t

he sp

ecifi

cAn

nual

Ath

letic

Pre

-Par

ticip

atio

n Ph

ysic

alEx

amin

atio

n Fo

rm.

This

proc

ess b

egin

s with

the

pare

nts a

ndst

uden

t-at

hlet

es a

nsw

erin

g qu

estio

ns a

bout

sym

ptom

s dur

ing

exer

cise

(suc

h as

che

stpa

in, d

izzi

ness

, fai

ntin

g, p

alpi

tatio

ns o

rsh

ortn

ess o

f bre

ath)

; and

que

stio

ns a

bout

fam

ily h

ealth

hist

ory.

The

prim

ary

heal

thca

re p

rovi

der n

eeds

tokn

ow if

any

fam

ily m

embe

r die

d su

dden

lydu

ring

phys

ical

act

ivity

or d

urin

g a

seiz

ure.

They

als

o ne

ed to

kno

w if

any

one

in th

efa

mily

und

er th

e ag

e of

50

had

anun

expl

aine

d su

dden

dea

th su

ch a

sdr

owni

ng o

r car

acc

iden

ts. T

his i

nfor

mat

ion

mus

t be

prov

ided

ann

ually

for e

ach

exam

beca

use

it is

so e

ssen

tial t

o id

entif

y th

ose

atris

k fo

r sud

den

card

iac

deat

h.

The

requ

ired

phys

ical

exa

m in

clud

esm

easu

rem

ent o

f blo

od p

ress

ure

and

aca

refu

l list

enin

g ex

amin

atio

n of

the

hear

t,es

peci

ally

for m

urm

urs a

nd rh

ythm

abno

rmal

ities

. If t

here

are

no

war

ning

sign

sre

port

ed o

n th

e he

alth

hist

ory

and

noab

norm

aliti

es d

iscov

ered

on

exam

, no

furt

her e

valu

atio

n or

test

ing

isre

com

men

ded.

Whe

n sh

ould

a st

uden

t ath

lete

see

ahe

art s

peci

alis

t?

If th

e pr

imar

y he

alth

care

pro

vide

r or s

choo

lph

ysic

ian

has c

once

rns,

a re

ferr

al to

a c

hild

hear

t spe

cial

ist, a

ped

iatr

ic c

ardi

olog

ist, i

sre

com

men

ded.

Thi

s spe

cial

ist w

ill p

erfo

rma

mor

e th

orou

gh e

valu

atio

n, in

clud

ing

anel

ectr

ocar

diog

ram

(ECG

), w

hich

is a

gra

ph o

fth

e el

ectr

ical

act

ivity

of t

he h

eart

. An

echo

card

iogr

am, w

hich

is a

n ul

tras

ound

test

to a

llow

for d

irect

visu

aliz

atio

n of

the

hear

tst

ruct

ure,

will

like

ly a

lso

be d

one.

The

spec

ialis

t may

als

o or

der a

trea

dmill

exe

rcise

test

and

a m

onito

r to

enab

le a

long

erre

cord

ing

of th

e he

art r

hyth

m. N

one

of th

ete

stin

g is

inva

sive

or u

ncom

fort

able

.

Can

sudd

en c

ardi

ac d

eath

be

prev

ente

dju

st th

roug

h pr

oper

scre

enin

g?

A pr

oper

eva

lua t

ion

shou

ld fi

nd m

ost,

but

not a

ll, c

ondi

tions

that

wou

ld c

ause

sudd

ende

ath

in th

e at

hlet

e. T

his i

s bec

ause

som

edi

seas

es a

re d

ifficu

lt to

unc

over

and

may

only

dev

elop

late

r in

life.

Oth

ers c

ande

velo

p fo

llow

ing

a no

rmal

scre

enin

gev

alua

tion,

such

as a

n in

fect

ion

of th

e he

art

mus

cle

from

a v

irus.

This

is w

hy sc

reen

ing

eval

uatio

ns a

nd a

revi

ew o

f the

fam

ily h

ealth

hist

ory

need

tobe

per

form

ed o

n a

y ear

ly b

asis

by th

eat

hlet

e’s p

rimar

y he

alth

care

pro

vide

r. W

ithpr

oper

scre

enin

g an

d ev

alua

tion,

mos

tca

ses c

an b

e id

entifi

ed a

nd p

reve

nted

.

Why

hav

e an

AED

on

site

dur

ing

spor

ting

even

ts?

The

only

effe

ctiv

e tr

eatm

ent f

or v

entr

icul

arfib

rilla

tion

is im

med

iate

use

of a

nau

tom

ated

ext

erna

l defi

brill

ator

(AED

). An

AED

can

rest

ore

the

hear

t bac

k in

to a

norm

al rh

ythm

. An

AED

is a

lso

life-

savi

ng fo

rve

ntric

ular

fibr

illat

ion

caus

ed b

y a

blow

toth

e ch

est o

ver t

he h

eart

(com

mot

io c

ordi

s).

Effec

tive

Sept

embe

r 1, 2

014,

the

New

Jers

eyD

epar

tmen

t of E

duca

tion

requ

ires t

hat a

llpu

blic

and

non

publ

ic sc

hool

s gra

des K

thro

ugh

12 sh

all:

●H

ave

an A

ED a

vaila

ble

at e

very

spor

tsev

ent (

thre

e m

inut

es to

tal t

ime

to re

ach

and

retu

rn w

ith th

e AE

D);

●H

ave

adeq

uate

per

sonn

el w

ho a

re tr

aine

din

AED

use

pre

sent

at p

ract

ices

and

gam

es;

●H

ave

coac

hes a

nd a

thle

tic tr

aine

rs tr

aine

din

bas

ic li

fe su

ppor

t tec

hniq

ues (

CPR)

; and

●Ca

ll 91

1 im

med

iate

ly w

hile

som

eone

isre

trie

ving

the

AED

.

SUD

DEN

CAR

DIA

C D

EATH

IN Y

OUN

G A

THLE

TES

Page 12: Update Physical Packet - Woodstown

     

 

Page 13: Update Physical Packet - Woodstown