Emergency Action Plans

Seamless triage saves a life of an athlete

Yuri Hosokawa, PhD, ATC

Vice President of Communication, Vice President of Education



Earlier this summer, when everyone was relieved to have completed the spring sport season, we were invited to give a lecture and hands-on training for exertional heat stroke emergency at CoxHealth Sports Medical Conference in Springfield, MO. This was their second annual gathering to review and practice updated policy and procedures for athlete health and safety. Physicians, athletic trainers, emergency medical technicians, athletic directors and coaches of local high schools attended this meeting. During the hands-on training, multiple scenarios were practiced. For example, what do you do when the first responder was an individual who was not medically licensed? What is the chain of command when an athletic trainer is present and not present? What cooling modalities are acceptable? What precautions must be taken during cooling? This lab also reiterated the importance of cool first, transport second. I am happy to say that their updated policy specifically states to cool first and then transport after the patient’s rectal temperature is down to 102 degrees Fahrenheit and that no other measures of body temperature assessment is acceptable. Throughout the meeting, I was very impressed to see their collaboration and understanding of each other’s role and I know their athletes are in good hands.

A month and half after the meeting, I received an email from CoxHealth stating that their emergency preparedness was put to a test– where an athlete was successfully recognized and treated for exertional heat stroke.

Sarah Bankhead (ATC, athletic trainer at CoxHealth), who treated the athlete, recalls the day as follows: When our athletes were putting away the blocking bags after practice, a coach noticed one of the athletes closing his eyes and beginning to fall over in the shed. The coach caught him and immediately called for help. The first coach to reach him checked his pulse and noticed shallow rapid breathing­­. The head coach called 911 and the other two coaches started putting ice in the groin, neck, and armpit areas. I, the athletic trainer, soon came over with a rectal thermometer, inserted it, and got an initial temperature of 108 degrees Fahrenheit. After confirmation of exertional heat stroke, a tarp was immediately place underneath the athlete and began to be filled with ice and water to start the cooling process before the emergency medical service arrived. We ensured that the athlete’s temperature was cooled to 102 degrees Fahrenheit, and then the athlete was transported via ambulance for follow up evaluation. The athlete has made a full recovery with no deficits thanks to the quick actions of those above, an effective policy in place, and the Sports Safety Summit which prepared my coaches to respond

Many teams have now begun their fall pre-season training. Do you know the chain of command and procedures when a heat emergency occurs on your practice field? It is never too late to review and build a consensus among the stakeholders of your sports medicine team. Take a “time out” and go over your emergency action plan. #Strive2Protect


Collaborative Solutions for Safety in Florida High School Sports

William Adams, PhD, LAT, ATC


On March 9-10, 2017, Drs. Douglas Casa, PhD, ATC, FACSM, FNATA, FNAK and William Adams, PhD, ATC along with KSI staff member Courteney Benjamin, MS, CSCS traveled to the University of Florida to attend their Collaborative Solutions for Safety in Florida High School Sports meeting. Organized by the University of Florida and the Florida Association of Sports Medicine, the aim of the meeting was to begin the steps of health and safety policies for the Florida’s high school student-athletes.


The meeting was attended by representatives from various regions within the state of Florida and included sports medicine physicians, athletic trainers, high school administrators, coaches and the Florida High School Athletics Association. Dr. Casa spoke on the importance of implementing evidence-based best practice policies focused on the leading causes of death in sport and provided numerous case examples as to how these policies have been effective at reducing the number of sport-related deaths. Dr. Adams followed by discussing the current standing of health and safety policies mandated for high school athletics in Florida.




Following these initial talks, the rest of the meeting consisted of various break out sessions specifically designed to stimulate discussion amongst the group and discuss strategies for how to implement changes to current policies related to emergency action plans, environmental monitoring and activity modification guidelines, concussion, AEDs and coaching education. Discussing the current barriers for implementing the aforementioned policies and strategies to overcome these barriers with the attendees, who many are the state leaders in their respective professions, allowed everyone in the room to participate to assist in developing a plan going forward to present to the Florida High School Athletics Association to further protect their student-athletes.


Overall, this meeting was a tremendous success and we are truly thankful for the University of Florida and FASmed for organizing this meeting and for the University of Florida for hosting the meeting at their facilities.  Having a group of highly motivated individuals from across the state of Florida come together to discuss how they can improve high school student-athlete health and safety is a model example of ways other states can have similar successes. The coordinated efforts of sports medicine professionals, high school and state high school athletics association administrators and coaches is instrumental for preventing sudden death in our young athletes who have a full life to live in front of them.



Heat Safety Pledge

By Lesley Vandermark, Assistant Director of Research 

Update: The Mission-KSI Heat Safety Pledge for high schools is well underway! We’ve had over 15 schools qualify, with several more applications in the works. Get your school on the list to get some great cooling products from Mission Athletecare!

Congratulations to Marshwood High School in Maine, which was the first school accepted. We have also accepted schools from Alabama, Arkansas, District of Columbia, Florida, Maine, Maryland, Massachusetts, New Jersey, North Carolina, Ohio, Tennessee, and Texas.

A little background on the Heat Safety Pledge: Mission Athletecare prides itself on creating the best athletic environment for performance and safety. As part of that goal, they wanted to find a way to reward schools for upholding appropriate policies for heat safety. Mission wants to donate $1 Million of product to schools nationwide who are striving to keep athletes safe.

And this is where KSI comes in. Mission masterminds, with the help of KSI of course, devised the Heat Safety Pledge, 6 pillars aimed at safety while exercising in the heat. We feel that these are the 6 key areas that help high schools athletes perform at their best and stay safer while exercising in the heat.

  • Pillar 1: Thermometer– A wet bulb globe thermometer is on site at school and used to determine activity modifications based on environmental conditions. It is school policy to modify work to rest cycles based on environmental conditions.
  • Pillar 2: Certification– All coaching staff is certified in first aid, cardiopulmonary resuscitation and the use of an automated external defibrillator. Additionally, education is provided related to preventing sudden death in sport.
  • Pillar 3: Athletic Trainer– An athletic trainer is employed at your school and is on-site during practices and events.
  • Pillar 4: Emergency Action Plan– A specific emergency action plan for each athletic facility has been developed where sports games and practices occur. This plan is reviewed with the healthcare team every year.
  • Pillar 5: Heat Acclimatization Guidelines– School has adopted nationwide high school preseason heat acclimatization guidelines set forth by the National Athletic Trainers’ Association.
  • Pillar 6: Water Stations/Body Cooling- Adequate water is available and placed at various stations around the athletic fields for all sports. At water stations, body cooling is standard practice. This can be as simple as encouraging players to remove equipment during rest breaks as using ice/cold towels.

Some of the pillars of the heat safety pledge require little funding, emergency action plans for example; and can be implemented right away! Appropriate heat acclimatization is regulated by some state athletic associations, so if your state meets the KSI heat acclimatization standards, you already satisfy one of the pillars. But even in states without good guidelines, appropriate heat acclimatization procedures cost no money and can prevent heat illness.

On the same note, we’re talking to YOU high school athletic trainers, your employment helps satisfy one pillar as well. What a way to get some much needed supplies for your school! Take a look at the Heat Safety Pledge today to see if your high school qualifies. If you’re unsure, use the KSI Prevention section for more information on common practice standards. Contact Mission for more information on how to apply.