• Knowing the location of the nearest phone and the emergency number - 911 or 9-911 if using a campus phone.
  
• Designating someone to make the call and whether he or she will need change for the call.
  
• Knowing who has the key for the gate to allow EMS to enter.
  
• Designating someone to meet and direct EMS.
  
• Knowing what information the caller must report to EMS:

General Definitions

1. Cerebral Concussion: Head-trauma-induced alteration in mental status that may or may not involve loss of consciousness. Concussions are graded in 4 categories.
2. Antegrade Amnesia: Memory loss of events following the impact.
3. Retrograde Amnesia: Memory loss for events preceding the impact. (the longer this interval the more severe the injury)

Second Impact Syndrome: Two concussions (bellringer or mild) in a short period of time
**50% of the cases of second impact syndrome result in death**
In almost every situation (sports injury) the blood pressure drops. The exception is head injuries in which the blood pressure rises. Consequently, it is important to monitor heart rate, respiration, blood pressure (serial reassessment every 5-10 minutes).
Signs demanding emergency attention

1. Increasing headache, nausea, or vomiting
2. Inequality of pupils
3. Progressive impairment of consciousness
4. Gradual rise in blood pressure (upon cessation of activity)
5. Diminution of pulse
**These signs and symptoms may indicate a subdural hematoma, which has a 70% mortality rate**

In the absence of a Certified Athletic Trainer or Physician, these guidelines should be used to determine whether an athlete can return to play:

No palpable tenderness

No swelling or discoloration

Can perform a full range of motion compared to the uninvolved side

Exhibits 90% strength compared to the uninvolved side

Lower extremity injuries - is able to run/jump without pain or limp

Upper extremity injuries - is able to perform a full swing/throw without pain

1. Establish a chain of command that identifies who is to make the call to remove individuals from the field.
2. Name a designated weather watcher (A person who actively looks for the signs of threatening weather and notifies the chain of command if severe weather becomes dangerous).
3. Have a means of monitoring local weather forecasts and warnings.
4. Designate a safe shelter for each venue.
5. Use the Flash-to-bang count to determine when to go to safety. By the time the flash-to-bang count approaches thirty seconds all individuals should be already inside a safe structure.
6. Once activities have been suspended, wait at least thirty minutes following the last sound of thunder or lightning flash prior to resuming an activity or returning outdoors.
7. Avoid being the highest point in an open field, in contact with, or proximity to the highest point, as well as being on the open water. Do not take shelter under or near trees, flagpoles, or light poles.
8. Assume the lightning safe position (crouched on the ground, weight on the balls of the feet, feet together, head lowered, and ears covered) for individuals who feel their hair stand on end, skin tingle, or hear "crackling" noises. Do not lie flat on the ground.
9. Observe the following basic first aid procedures in managing victims of a lightning strike:

10. All individuals have the right to leave an athletic site in order to seek a safe structure if the person feels in danger of impending lightning activity, without fear of repercussions or penalty from anyone.

Safe Shelter:

1. A safe location is any substantial, frequently inhabited building. The building should have four solid walls (not a dug out), electrical and telephone wiring, as well as plumbing, all of which aid in grounding a structure.
2. The secondary choice for a safer location from the lightning hazard is a fully enclosed vehicle with a metal roof and the windows completely closed. It is important to not touch any part of the metal framework of the vehicle while inside it during ongoing thunderstorms.
3. It is not safe to shower, bathe, or talk on landline phones while inside of a safer shelter during thunderstorms (cell phones are ok).

Flash-to-Bang:

To use the flash-to-bang method, begin counting when sighting a lightning flash. Counting is stopped when the associated bang (thunder) is heard. Divide this count by five to determine the distance to the lightning flash (in miles).

For example, a flash-to-bang count of thirty seconds equates to a distance of six miles. Lightning has struck from as far away as 10 miles from the storm center.
"If you hear it, clear it; if you see it, flee it."

Postpone or suspend activity if a thunderstorm appears imminent before or during an activity or contest, (irrespective of whether lightning is seen or thunder heard) until the hazard has passed. Signs of imminent thunderstorm activity are darkening clouds, high winds, and thunder or lightning activity.

Below are possible treatments for injuries that may occur during activity:

Vital Signs

Pulse at wrist or neck: Normal Resting: 60-80 BPM

If the athlete is caring for themselves (such as ice or heat) for several days, see a physician when:

**Trained professionals should perform the assessment of orthopedic injuries**