department of athletics policies & procedures - UNC Wilmington ...

Sickle-Cell Policy
PURPOSE: The following policy regarding athletes with the Sickle Cell Trait and the
assessment and management as well as return to play guidelines has been developed in
accordance with the University of North Carolina Wilmington Department of Athletic
Training’s Mission Statement to provide quality healthcare services and assure the wellbeing
of each student-athlete at UNCW. This policy is based on the National Athletic
Trainers’ Association Consensus Statement regarding Sickle Cell Trait and the Athlete
which can be found at: http://www.nata.org/statements/consensus/sicklecell.pdf.
SICKLE CELL TRAIT DEFINITION:
Sickle cell trait is the inheritance of one gene for sickle hemoglobin and one for normal
hemoglobin. During intense or extensive exertion, the sickle hemoglobin can change the
shape of red blood cells from round to crescent-shaped. This “sickling” of the red blood cells
may put our student-athletes in great danger during intense exercise. Under unusual
circumstances, serious morbidity and mortality resulting from complications in the collegiate
student-athlete might include: infarction of the spleen with hypoxia or exercise, exertional
heat illness such as exertional rhabdomyolysis (due to muscle break-down), heat stroke,
renal failure, or sudden death syndrome. Hypoxia (seen in high altitude training with poor
conditioning or combined with asthma), acidosis, dehydration, hyperthermia, or hypothermia
can trigger shape changes of red blood cells that may precipitate vaso‐occlusive
complications.
Sickle cell anemia is more commonly found in the African American (1 out 12), Middle
Eastern, and Central and South American populations compared to the Caucasian population
(1out of 2,000 – 10,000). Currently, the U.S. Department of Health & Human Services
requires mandatory testing for ALL newborns to test if the trait is present. This complication
may result in a decrease amount of oxygen supply to the tissues of the body. There are NOT
any restrictions to athletic participation, but recommendations by the National Athletic
Trainer’s Association have been proposed during exertional exercise for those individuals
with sickle-cell trait. Although the consequences can be severe sufficient rest, hydration, and
cooling may be the treatment required to prevent most cases of “exertional sickling”.
Signs of a Sickle Cell Crisis
Sickling collapse can be mistaken for cardiac collapse or heat collapse. However, unlike
sickling collapse, cardiac collapse tends to be “instantaneous’ (see sudden cardiac arrest
policy), has no “cramping” with it, and the athlete (with ventricular fibrillation) who hits
the ground no longer talks. Unlike heat collapse, sickling collapse often occurs within
the first half hour onfield, as during initial sprints. Core temperature is not greatly
elevated.
246