Sports Medicine

• MIAA SMC Cold Weather Reference Document 
• NATA: Environmental Cold Injuries
• NFHS: Participating in Cold Weather-Minimizing the Risk
• NFHS: Guidleings for Competition in the Cold 

Concussion Corner Page

• MA Legislature of CPR for Coaches
• Is Your School Prepared to Handle Sudden Cardiac Arrest?
• NATA Sudden Cardiac Arrest Info

AED Information:

Helpful information regarding Automated External Defibrillator (AED)

• American Heart Association
• MGL: An Act Related to Medical Emergency Response Plans for Schools
• DESE Guidance on Emergency Plans for Schools
• NATA Official Statement

• MA DPH EEE and West Nile Virus (WNV) Info. Summer/ Fall 2022
• MA Government Resources 

• MIAA Heat Modification Policy
• WBGT Measurement Template
• Kestrel Heat Stress Trackers
• NATA Guidelines Preventing Sudden Death in Conditioning Sessions
• Korey Stringer Institute website
• Korey Stringer Institute Heat Acclimatization
• Heat Stress and Athletic Participation

• Hydration Statement
• Energy Drinks
• NFHS Supplements Position Statement

Dietary Supplements: 

• NFHS Guidelines on Handling Lightning During Disturbances 
• NFHS Lightning Safety

LIGHTNING SAFETY

Reprinted with permission from NCAA and NSSL, for informational purposed only.

Lightning is the most consistent and significant weather hazard that may affect interscholastic athletics. Within the United States, the National Severe Storms Laboratory (NSSL) estimates that 100 fatalities and 400-500 injuries requiring medical treatment occur from lightning strikes every year. While the probability of being struck by lightning is extremely low, the odds are significantly greater when a storm is in the area and the proper safety precautions are not followed.

Prevention and education are the keys to lightning safety. Education begins with background information on lightning. The references associated with this guideline are an appropriate resource. Prevention should begin long before any interscholastic athletic event or practice. The following steps are recommended by the NSSL to mitigate the lightning hazard:

1. Designate a chain of command as to who monitors threatening weather and who makes the decision to remove teams or individuals from an athletic site or event. An emergency plan should include planned instructions for participants as well as spectators.
2. Obtain a weather report each day before a practice or event. Be aware of potential thunderstorms that may form during scheduled interscholastic athletic events or practices.
3. Be aware of National Weather Service-issued (NWS) thunderstorm watches and warnings as well as the signs of thunderstorms developing nearby. A watch means conditions are favorable for severe weather to develop in an area; a warning means that severe weather has been reported in an area and for everyone to take proper precautions.
4. Know where the closest safe structure or location is to the field or playing area, and know how long it takes to get to that safe structure or location.

   Safe structure or location is defined as:

   • Any building normally occupied or frequently used by people, i.e. a building with plumbing and/or electrical wiring that acts to electrically ground the structure. Avoid using shower facilities for safe shelter and do not use the showers or plumbing facilities during a thunderstorm.
   • In the absence of a sturdy, frequently inhabited building, any vehicle with a hard metal roof (not a convertible or golf cart) and rolled-up windows can provide a measure of safety. A vehicle is certainly better than remaining outdoors. It is not the rubber tires that make a vehicle a safe shelter, but the hard metal roof which dissipates the lightning strike around the vehicle. DO NOT TOUCH THE SIDES OF THE VEHICLE!
5. Be aware of how close lightning is occurring. The flash-to-bang method is the easiest and most convenient way to estimate how far away lightning is occurring. Thunder always accompanies lightning, even though its audible range can be diminished due to background noise in the immediate environment, and its distance from the observer. To use the flash-to-bang method, count the seconds from the time the lightning is sighted to when the clap of thunder is heard. Divide this number by five to obtain how far away (in miles) the lightning is occurring. For example, if an individual counts 15 seconds between seeing the flash and hearing the bang, 15 divided by five equals three; therefore, the lightning flash is approximately 3 miles away.

LIGHTNING AWARENESS

Lightning awareness should be increased with the first flash of lightning or the first clap of thunder, no matter how far away. This activity must be treated as a wake-up call to interscholastic athletic personnel. The most important aspect to monitor is how far away the lightning is occurring, and how fast the storm is approaching, relative to the distance of a safe shelter.

Specific lightning-safety guidelines have been developed for the NCAA with the assistance of the National Severe Storms Laboratory (NSSL). 

• As a minimum, NSSL staff strongly recommend that by the time the monitor obtains a flash-to-bang count of 30 seconds, all individuals should have left the athletic site and reached a safe structure or location. Athletic events may need to be terminated. 
• The existence of blue sky and the absence of rain are not protection from lightning. Lightning can, and does strike as far as 10 miles away from the rain shaft. It does not have to be raining for lightning to strike. 
• If no safe structure or location is within a reasonable distance, find a thick grove of small trees surrounded by taller trees or a dry ditch. Assume a crouched position on the ground with only the balls of the feet touching the ground, wrap your arms around your knees and lower your head. Minimize contact with the ground, because lightning current often enters a victim through the ground rather than by a direct overhead strike. MINIMIZE YOUR BODY’S SURFACE AREA, AND MINIMIZE CONTACT WITH THE GROUND! DO NOT LIE FLAT! If unable to reach safe shelter, stay away from the tallest trees or objects (such as light poles or flag poles), metal objects (such as fences or bleachers), individual trees, standing pools or water, and open fields. Avoid being the highest object in a field. Do not take shelter under a single, tall tree. 
• A person who feels his or her hair stand on end, or skin tingle, should immediately crouch, as described above. 
• Avoid using the telephone, except in emergency situations. People have been struck by lightning while using a land-line telephone. A cellular phone or portable remote phone is a safe alternative to land-line phones, if the person and the antenna are located within a safe structure or location, and if all other precautions are followed. 
• When considering resumption of an athletic activity, NSSL staff recommends that everyone should ideally wait at least 30 minutes after the last flash of lightning or sound of thunder before returning to the field or activity. 
• People who have been struck by lightning do not carry an electrical charge. Therefore, cardiopulmonary resuscitation (CPR) is safe for the responder. If possible, an injured person should be moved to a safer location before starting CPR. Lightning-strike victims who show signs of cardiac or respiratory arrest need emergency help quickly. Prompt, aggressive CPR has been highly effective for the survival of victims of lightning strikes. 

Note: Commercial weather warning services with sophisticated cloud-to-ground lightning detection devices are available. They may offer a cost effective, efficient method of making accurate, timely decisions on location and movement of lightning storms. Such devices are helpful in making decisions regarding stoppage of play, practice, evacuation, and return to activity.