Sports Medicine Handbook - NCAA

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intended to eliminate MRSA colonization should not be used in patients with active infections. Decolonization regimens may have a role in preventing recurrent infections, but more data are needed to establish their efficacy and to identify optimal regimens for use in community settings. After treating active infections and reinforcing hygiene and appropriate wound care, consider consultation with an infectious disease specialist regarding use of decolonization when there are recurrent infections in an individual patient or members of a defined group. MRSA infections in the community are typically SSTI, but can also cause severe illness such as pneumonia. Most transmissions appear to be from people with active MRSA skin infections. Staph and MRSA infections are not routinely reported to public health authorities, so a precise number is not known. It is estimated that as many as 300,000 hospitalizations are related to MRSA infections each year. Only a small proportion of these have disease onset occurring in the community. It has also been estimated that there are more than 12 million outpatient (i.e., physician offices, emergency and outpatient departments) visits for suspected staph and MRSA SSTIs in the U.S. each year. Approximately 25 to 30 percent (80 million persons) of the population is colonized in the nose with staph bacteria at a given time and approximately 1.5 percent (4.1 million persons) is colonized with MRSA. In an effort to educate the public about the potential risks of MRSA, organizations such as the CDC, <strong>NCAA</strong> and the National Athletic Trainers’ Association (NATA) have issued official statements recommending all health care personnel and physically active adults and children take appropriate precautions if suspicious skin infections appear, and immediately contact their health care provider. Individual cases of MRSA usually are not required to be reported to most local/state health departments; however, most states have laws that require reporting of certain communicable diseases, including outbreaks regardless of pathogens. So in most states if an outbreak of skin infections is detected, the local and/or state health department should be contacted. Skin Infections in Athletics Recognition of MRSA is critical to clinical management. Education is the key, involving all individuals associated with athletics, from student-athletes to coaches to medical personnel to custodial staff. Education should encompass proper hygiene, prevention techniques and appropriate precautions if suspicious wounds appear. Each institution should develop prevention strategies and infection control policies and procedures. 61
62 Skin Infections in Athletics Skin Infections in Wrestling Data from the <strong>NCAA</strong> Injury Surveillance Program indicate that skin infections are associated with at least 17 percent of the practice timeloss injuries in wrestling. It is recommended that qualified personnel, including a knowledgeable, experienced physician, examine the skin of all wrestlers before any participation (practice and competition). Male student-athletes shall wear shorts and female student-athletes should wear shorts and a sports bra during medical examinations. Open wounds and infectious skin conditions that cannot be adequately protected should be considered cause for medical disqualification from practice or competition (see Guideline 2a). The term “adequately protected” means that the wound or skin condition has been deemed as non-infectious and adequately treated as deemed appropriate by a health care provider and is able to be properly covered. The term “properly covered” means that the skin infection is covered by a securely attached bandage or dressing that will contain all drainage and will remain intact throughout the sport activity. A health care provider might exclude a student-athlete if the activity poses a risk to the health of the infected athlete (such as injury to the infected area), even though the infection can be properly covered. If wounds can be properly covered, good hygiene measures such as performing hand hygiene before and after changing bandages and throwing used bandages in the trash should be stressed to the athlete. (See Wrestling Rule WA-15.) Medical Examinations Medical examinations must be conducted by knowledgeable physicians and/or certified athletic trainers. The presence of an experienced dermatologist is recommended. The examination should be conducted in a systematic fashion so that more than one examiner can evaluate problem cases. Provisions should be made for appropriate lighting and the necessary facilities to confirm and diagnose skin infections. Wrestlers who are undergoing treatment for a communicable skin disease at the time of the meet or tournament shall provide written documentation to that effect from a physician. The status of these individuals should be decided before the screening of the entire group. The decision made by a physician and/or certified athletic trainer “on site” should be considered FINAL. Guidelines for Disposition of Skin Infections Unless a new diagnosis occurs at the time of the medical examination conducted at the meet or tournament, the wrestler presenting with a skin lesion shall provide a completed Skin
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2011-12 NCAA® Sports Medicine Hand
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2 PREFACE The health and safety pri
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4 FOREWORD Shared Responsibility fo
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6 Sports Medicine Administration Oc
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8 Medical Evaluations, Immunization
Page 11 and 12: 10 Medical Evaluations, Immunizatio
Page 13 and 14: 12 Emergency Care and Coverage Guid
Page 15 and 16: 14 Lightning Safety Dangerous Locat
Page 17 and 18: 16 Catastrophic Incident in Athleti
Page 19 and 20: 18 Dispensing Prescription Medicati
Page 21 and 22: 20 Nontherapeutic Drugs July 1981
Page 23 and 24: 22 NCAA Alcohol, Tobacco and Other
Page 25 and 26: 24 Preseason Preparation directly d
Page 27 and 28: 26 Preseason Preparation NCAA Footb
Page 29 and 30: 28 Medical Disqualification of the
Page 31 and 32: 30 Cold Stress and Cold Exposure to
Page 33 and 34: 32 Cold Stress and Cold Exposure Re
Page 35 and 36: 34 Prevention of Heat Illness The A
Page 37 and 38: 36 Prevention of Heat Illness Refer
Page 39 and 40: 38 Assessment of Body Composition J
Page 41 and 42: 40 Assessment of Body Composition i
Page 43 and 44: 42 Assessment of Body Composition p
Page 45 and 46: 44 Nutrition and Athletic Performan
Page 47 and 48: 46 Nutrition and Athletic Performan
Page 49 and 50: 48 Dietary Supplements or muscle ma
Page 51 and 52: 50 “Burners” (Brachial Plexus I
Page 53 and 54: 52 “Burners” (Brachial Plexus I
Page 55 and 56: 54 Concussion or Mild Traumatic Bra
Page 61: 60 Skin Infections in Athletics In
Page 65 and 66: 64 Skin Infections in Athletics Ref
Page 67 and 68: 66 Menstrual-Cycle Dysfunction Janu
Page 69 and 70: 68 Blood-Borne Pathogens and Interc
Page 75 and 76: 74 The use of local injectable anes
Page 77 and 78: 76 The Use of Injectable Corticoste
Page 79 and 80: 78 Depression: Intervention for Int
Page 81 and 82: 80 Depression: Intervention for Int
Page 83 and 84: 82 Participation by the Student-Ath
Page 85 and 86: 84 Pregnancy in the Student-Athlete
Page 87 and 88: 86 The Student-Athlete with Sickle
Page 89 and 90: 88 should provide an environment in
Page 91 and 92: 90 Protective Equipment June 1983
Page 93 and 94: 92 Protective Equipment Sport 5. Fo
Page 95 and 96: 94 Protective Equipment Mandatory P
Page 97 and 98: 96 Eye Safety in Sports January 197
Page 99 and 100: 98 Mouthguards January 1986 • Rev
Page 101 and 102: 100 Head and neck injuries causing
Page 103 and 104: 102 Guidelines for Helmet Fitting a
Page 105 and 106: 104 Use of Trampoline and Minitramp
Page 108 and 109: Appendixes Also found on the NCAA w
Page 110 and 111: NCAA Legislation Involving Health a
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Tobacco Use Medical Expenses Medica
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Student-Athlete Welfare and Safety
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NCAA Injury Surveillance Program Su
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Figure 1 Competition and Practice I
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Acknowledgements John R. Adams West
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The NCAA salutes the more than 400,
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Sports Medicine Handbook - NCAA

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