Health Awareness

Concussion Prevention and Management

Kansas State Law & Participation Requirement

Effective July 1, 2011, Kansas law (The School Sports Head Injury Prevention Act), states that any student participating in athletics or spirit teams must provide a signed Concussion and Head Injury Information Release Form to the school office (signed by both a parent/guardian and the student). The form must be on file before the student participates in their first practice of the school year.

Legal Requirements for Coaches and Athletes

In addition, the law requires the following:

Coaches are to remove athletes from play whenever a concussion is suspected.
The athlete must have medical clearance to return to play.

KSHSAA Guidelines for Return to Play

Additional guidelines adopted by the Kansas State High School Activities Association require:

The return to play after a suspected concussion cannot occur on the same day that the signs and/or symptoms of concussion were observed, and
After medical clearance, the return to play must follow a graduated protocol.

Concussion Vital Signs Baseline Testing

Concussion Vital Signs baseline testing will be a requirement for Olathe School District athletes participating in contact and limited-contact sports in grades 9-12. Concussion Vital Signs testing includes written consent from a parent/guardian. Baseline testing should be completed prior to competition.

Student-athletes will be baseline tested every two years starting with the first year of participation in a contact or limited-contact sport.
Individual Concussion Vital Signs baseline testing will be available to all student-athletes in the district at the request of their coach, parent, or licensed health care provider.
Student-athletes who are suspected of sustaining a concussion will be removed from play with recommendations to seek evaluation from a concussion specialist. For parents/guardians electing to seek care from a primary care provider (PCP) an MD/DO clearance is needed for return-to-play decisions.
A post-injury Concussion Vital Signs testing is used at the direction of an attending physician as part of their evaluation and/or clearance.
Olathe School District athletic trainers will not interpret the test results of the Concussion Vital Signs post-injury test.

Immediate Removal & Return to Play Protocol

All student-athletes who are suspected of having suffered a concussion or head injury during a sport competition or practice session must be immediately removed from the sport competition or practice session.

Recommended from the National Federation of State High School Association and KSHSAA that clearance should not be issued on the same day the athlete was removed from play.
All student-athletes who are diagnosed with a concussion by an MD/DO will be required to complete a five-step return-to-play (RTP) progression.
The RTP will only begin under the direction of the attending MD/DO and the supervision of the school's athletic trainer.
The student-athlete will begin the RTP once symptoms have resolved.
The five-step RTP protocol can only be done in a minimum of five days. The student-athlete must remain asymptomatic for 24 hours to be able to advance to the next step. Each step is more demanding than the last and will exponentially tax and test different areas of the body.
Exceptions for advancement of the RTP protocol will only be made if specifically outlined in writing by attending MD/DO.
Full clearance will only be granted by the attending MD/DO. However, the physician of care may allow the athletic trainer to return the student-athlete to competition following successful completion of the graduated RTP protocol, with clear documentation from the attending MD/DO.

Documentation & Academic Accommodations

Evaluation Process & Parent/Coach Involvement

Concussion Forms

Partnership & Cost

Sudden Cardiac Arrest (SCA) Awareness

The beating of the heart is controlled by an electrical conduction system that causes the heart muscle to contract rhythmically and in an organized manner. Sudden Cardiac Arrest (SCA) occurs when there is a problem with the heart’s electrical conduction system which causes the chambers of the heart to beat irregularly and start to quiver or “fibrillate.” When the heart fibrillates, blood stops pumping throughout the body and within minutes, the heart stops beating and the person experiences sudden cardiac arrest. The person stops breathing, becomes unconscious, and collapses. Without quick intervention including cardiopulmonary resuscitation (CPR) and defibrillation with an automated external defibrillator (AED), the person will die.

Who is at Risk for SCA?

Sudden cardiac arrest can happen to anyone, and while rare in children it unfortunately does happen. Sudden cardiac arrest tends to occur in children during exercise or athletic sports activities, and is a leading cause of death in student athletes between the ages of 10-19 years old. Risk factors for children include being male, having heart disease or structural abnormalities of the heart, or having an abnormal heart rhythm. Other risk factors include being overweight or obese, having high blood pressure, exposure to drugs (especially illicit drugs that cause the heart to beat quickly), and family history such as having a family member who experienced sudden cardiac death before age 50. Occasionally a sudden hard blow to the chest can cause the heart to fibrillate and cause sudden cardiac arrest; this is known as “commotio cordis.”

Adults are also at risk for sudden cardiac arrest, with more than 350,000 total adult deaths from sudden cardiac arrest outside of hospitals each year.

What Are the Warning Signs or Symptoms?

Sudden cardiac arrest typically occurs without warning and is completely unexpected. However, in about a third of cases, warning signs are present but are frequently ignored or attributed to something else. Warning signs include chest pain during exercise, extreme fatigue with activity, feeling dizzy, lightheaded, or fainting, seizure activity that occurs with exercise, feeling like the heart is racing, or feeling a sensation of the heart beating hard or irregularly (“having palpitations”).

Can Sudden Cardiac Arrest be Prevented?

One of the best ways to prevent sudden cardiac arrest is to know if your child has a predisposing health condition or a family history of heart problems that increases their risk of a sudden cardiac arrest. Regular (annual) well-child checkups and sports physicals with a healthcare provider can help to identify risk factors or heart problems that need to be addressed, to make sure your student is healthy and ready for exercise and athletics. All student athletes participating in middle and high school athletics must have a sports physical prior to being allowed to play, but children, especially student athletes, may not tell an adult or coach they are having symptoms because they are afraid they will not be able to continue in their sport. They may also not know or recognize their symptoms are an indication of an impending life-threatening event. Educating and empowering our children to report when they don’t feel well is an important step in intervening before a problem occurs!

The Olathe Public Schools opens its facilities several times throughout the year for students and families to have access to youth cardiac screenings. Check social media and district news outlets for information about these events throughout the year.

Treatment for Sudden Cardiac Arrest

When a sudden cardiac arrest occurs, responding immediately with CPR and defibrillation with an AED, along with activating the emergency response system by calling 911, can dramatically increase the chances of survival. High quality CPR helps to keep blood and oxygen pumping through the body, and the AED can stop the heart from fibrillating and restore a normal heart rhythm. Olathe School District PE teachers, coaches, athletic trainers, and school nurses are trained in CPR and AED use, and can respond to a sudden cardiac arrest. Additionally, every district building has at least one AED, and the middle and high schools have several AEDs. Athletic trainers also have AEDs that they bring to events so that they are readily available. The district activity centers (ODAC and CBAC) also have several AEDs. We highly recommend that everyone learns how to perform CPR and use an AED. There are many resources (see below) in Johnson County where anyone can learn how to perform CPR.

SCA Resources

More Information About Sudden Cardiac Arrest:

Local Agencies Offering CPR/AED training:

Heat Safety

The following policy on fluid replacement, rehydration, prevention, and heat illness has been developed in accordance with the National Athletic Trainers Association Fluid Replacement Position Statement (2017), the NATA Exertional Heat Illness Position Statement (2015), recommendations from the Korey Stringer Institute, and Kansas State High School Activities Association guidelines. This policy is intended to protect the health of student athletes participating in both indoor and outdoor sports.

Rationale of Fluid Replacement

When participating in hot humid environments, student athletes may become deprived of essential fluids, carbohydrates, and electrolytes, leading to dehydration and possibly heat illness. Dehydration can occur with as little as a 1-2% drop in body weight due to loss of fluids. Student athletes who are not properly hydrated prior to the start of physical activity can notice signs of dehydration in as little as an hour or sooner. Dehydration places student athletes at risk for heat related illness such as heat cramps, heat exhaustion, and heat stroke.

Signs and Symptoms of Dehydration

Rehydration Guidelines

It is the expectation of the Olathe School District athletic department that all athletes have freely accessible water during practice, regardless of temperature. The athletic trainer, coaches, and other staff will promote consumption of water during practices and games.

Prior to Exercise

17-20 fluid ounces should be consumed two to three hours prior to exercise.
7-10 fluid ounces should be consumed 10-20 minutes prior to exercise.

During Exercise

7-10 fluid ounces should be consumed every 10-20 minutes during exercise.
Student athletes should drink prior to becoming thirsty.

After Exercise

Fluids should be replaced within two hours of the end of physical activity.
20-24 fluid ounces should be encouraged for every pound of weight lost.

Definition of Heat Illness

Heat illness is closely associated with physical activity and its occurrence increases with a rise in temperature and relative humidity. It is usually classified in four categories: heat syncope, heat cramps, heat exhaustion, and heat stroke. Although most often occurring in hot, humid weather, heat illness can also occur with the absence of both heat and humidity.

Heat Syncope

It occurs during high heat and humidity due to inadequate blood flow to the brain, resulting in loss of consciousness.
Signs and symptoms include loss of consciousness or fainting, light-headedness, fatigue, pale/clammy skin.

Heat Cramps

It occurs during or after intense exercise as an acute, painful and involuntary muscle contraction.
Causes may include dehydration, electrolyte imbalances, neuromuscular fatigue or a combination of factors.
Signs and symptoms: dehydration, thirst, transient muscle cramps, and fatigue.

Heat Exhaustion

It occurs most frequently in hot, humid conditions and causes an inability to continue to exercise.
It may be caused by dehydration, heavy sweating, sodium loss, and energy depletion.
Signs and symptoms: fast and weak pulse, persistent muscle cramps, urge to defecate, weakness, fainting, nausea, decreased urine-output, cool and clammy skin, diarrhea, core body temperature between 97-104℉

Heat Stroke

It occurs when the core temperature is elevated at greater than 104°F and central nervous system dysfunction.
This is caused by the body's inability to cool itself due to environmental conditions and due to heat production which overwhelms the body’s temperature regulation system.
Signs and symptoms: fast heart rate, low blood pressure, sweating, skin may be hot and dry, hyperventilation, altered mental status, vomiting, diarrhea, seizures, central nervous system changes, altered consciousness.
Life threatening if not promptly recognized and treated!

Guidelines for Prevention of Heat Illness

Pre-participation examinations should ask if a student athlete has a history of heat illness.
Athletic trainers and coaching staff will encourage water consumption during practices and will be aware of signs and symptoms of heat illness and how to intervene.
Student athletes will follow acclimatization guidelines outlined in the KSHSAA position statement.
An athletic director or athletic trainer will use a wet-bulb globe temperature to determine what “zone” the site is in and the need for any practice modifications or terminations. If conditions change significantly after the initial WBGT is taken, then it will be reassessed. Ideally, these readings are taken at the practice site.
Cold immersion tubs will be ready anytime the weather is above 80°F. If no tub is available, a tarp or other device with ice and water for filling is adequate.

Activity Guidelines

If the WBGT is less than 79.9°F (green zone):

Normal activity; no restriction to student-athletes' access to water.

If the WBGT is 80°-84.6°F (zone 1, yellow):

Fatigue is possible with prolonged exposure and/or physical activity.
Monitor at-risk athletes closely.
Minimum three rest/hydration breaks per hour. Break length minimum four minutes.
Cold tubs prepared and ready (recommended).

If the WBGT is 84.7°-87.7°F (zone 2, orange):

Heat cramps or heat exhaustion is possible.
Two-hour maximum length of practice
For football, helmets and shoulder pads only. No protective equipment when conditioning.
Minimum four rest/hydration breaks per hour. Break length minimum four minutes.
Cold tubs prepared and ready.

If the WBGT is 87.8°-89.7°F (zone 3, red):

Heat cramps or heat exhaustion are likely; heatstroke is possible.
One hour maximum length of practice.
No protective equipment to be worn.
No conditioning.
Rest/hydration breaks must total 20 minutes.
Cold tubs prepared and ready.

If the WBGT is 89.8°F or greater (black zone):

No outdoor activities or use of un-air conditioned facilities will be permitted.

Treatment of Heat Illness

Heat Syncope

Move the student-athlete to a cool area and elevate the legs above the heart.
Have the athlete drink water if conscious.
Monitor airway, breathing and circulation.
No return to play until evaluated by a medical professional.

Heat Cramps

Remove the student-athlete from play and replace lost fluids.
Begin mild stretching and massage of the contracted area.
The student-athlete can return to play once cramping has ceased and fluids have been replaced.

Heat Exhaustion

Move the student-athlete to a cool area and assess cognitive function and vital signs.
Remove excess clothing and equipment, start fluid replacement, and cool the student-athlete with fans, ice towels on their extremities and in their armpit and groin.
If possible, assess core body temperature utilizing a rectal thermometer.
The student-athlete should not return to activity for 24-48 hours.
If signs and symptoms aren’t improving, activate emergency medical services.

Heat Stroke

Activate emergency medical services and the emergency action plan.
Assess vital signs and, if possible, core body temperature using a rectal thermometer.
Remove excess clothing and equipment and place in a cold water immersion tank (50°F) until the core temperature is 101-102°F.
- Make sure to circulate water.
Cool first, transport second!
Must be cleared by a physician before returning to activity.

Heat stroke has a 100% survival rate if proper cooling is initiated within 10 minutes of collapse.