• Athletic Sports Team Health Requirements

    Required Forms:  In order for students to participate in try-outs, practices, scrimmages and/or games, they must fully complete all required forms and return the forms to the lead coach of that sport.  The following forms must be completed by the parent/guardian and/or the student’s health care provider.

    1.  Athletic Sports Consent and liability Release (Parent and Student)

    2.  Physical Examination Form for Athletic Sports (Part A-Parent, Part B-Health Care Provider)

    3.  Concussion Information Sheet for Team Sports (Parent and Student)

    4.  Sudden Cardiac Arrest Information Sheet (Parent and Student)

    5.  Emergency Card for Athletic Sports Teams  (Parent)

    Forms are available in Forms & Files page.

    Concussion Information

    A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head that can change the way the brain normally works.  Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth.  Even a 'ding', ' getting your bell rung', or  what seems to be a mild bump or blow to the head can be serious.

     Per California Education Code 49475(a)(1) 'An athlete who is suspected of sustaining a concussion or head injury in an athletic activity shall be immediately removed from the athletic activity for the remainder of the day, shall not be permitted to return to the athletic activity until he or she is evaluated by a licensed health care provider who is trained in the management of concussions and is acting within the scope of his or her practice. The athlete shall not be permitted to return to the athletic activity until he or she receives written clearance to return to the athletic activity from that licensed health care provider.'

    The Signs and Symptoms of a Concussion:

     A.   Signs are indications of an injury or illness that can be observed by another person

    • Appears dazed or confused
    • Is confused about assignment or position
    • Forgets an instruction
    • Unsure of game, score, or opponent
    • Moves clumsily
    • Answers questions slowly
    • Loses consciousness (even briefly)
    • Shows mood, behavior, or personality changes
    • Cannot recall events prior to or immediately after hit or fall


    B.    Symptoms are indications of an injury or illness that are felt by the injured or ill person, but cannot be readily observed by another person

    • Headache or “pressure” in head
    • Nausea with or without vomiting
    • Balance problems or dizziness
    • Double or blurry vision
    • Sensitivity to light or noise
    • Feeling sluggish, hazy, foggy, or groggy
    • Concentration or memory problems
    • Confusion
    • Just not “feeling right” or is “feeling down”

    Sudden Cardiac Arrest Information

    Sudden cardiac arrest (SCA) is when the heart stops beating, suddenly and unexpectedly. 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.

    Recognize the Warning Signs and Risk Factors of Sudden Cardiac Arrest.

    Tell your coach and consult your health care provider if these conditions are present in your student athlete:

    Potential indicators that SCA may occur:

    •  Fainting or seizure, especially during or right after exercise;
    •  Fainting repeatedly or with excitement or startle;
    •  Excessive shortness of breath during exercise;
    •  Racing or fluttering heart palpitations or irregular heartbeat;
    •  Repeated dizziness or lightheadedness;
    •  Chest pain or discomfort with exercise;
    •  Excessive, unexpected fatigue during or after exercise.
       

    Factors that increase the Risk of SCA:

    •  Known structural heart abnormality, repaired or unrepaired;
    •  Family members with unexplained fainting, seizures, drowning or near drowning, or car accidents;
    •  Family history of known heart abnormalities or sudden death before age 50;
    •  Specific family history of Long QT Syndrome, Brugada Syndrome, Hypertrophic Cardiomyopathy, or Arrhythmogenic Right Ventricular Dysplasia (ARVD);
    •  Use of drugs, such as cocaine, inhalants, “recreational” drugs, excessive energy drinks or performance-enhancing supplements.
       

    How Common is Sudden Cardiac Arrest in the United States?

    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, studies show that many young people do have symptoms but neglect to tell an adult.  This may be because they are embarrassed, they do not want to jeopardize their playing time, 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, some health history factors 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, trainer and school nurse about any diagnosed conditions.

    Return to Play (RTP)

    The California Interscholastic Federation (CIF) amended its bylaws to include language that adds SCA training to coach certification and practice and game protocol that empowers coaches to remove from play a student-athlete who exhibits fainting.  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 (medical doctor or doctor of osteopathy).  Parents, guardians and caregivers are urged to dialogue with student athletes about their heart health.