Sports Medicine Advisory Committee

Minutes
August 22, 2006 • 7 p.m.
Robert W. Hughes FHSAA Building
Gainesville, Florida


The following members were in attendance: Dr. James Berk (Gainesville); Dr. Dennis Cardone (Fort Myers); Dr. Jeff Matilsky (Gainesville); Dr. Michael Moser (Gainesville); Dr. Michael Reilly (St. Petersburg); Dr. Charles Sand (Tampa); Dr. Kris Stowers (Tallahassee); Mr. David Wilson, Lincoln High School Coach, (Tallahassee); Alex Bouldrick, (FHSAA Intern); Jamie Watkins (FHSAA Staff); Shanell Young (FHSAA Staff); and Denarvise Thornton (FHSAA Staff).

1. Welcome, Introductions and Purpose
Mr. Thornton called the meeting to order and reviewed travel expense procedures and allowed members to introduce themselves. The committee welcomed new member Dr. Dennis Cardone.

2. Review agenda and complete expense vouchers.

3. Approval of Jan. 10, 2006 SMAC Meeting Minutes
The committee accepted the minutes from the last meeting as presented. The committee also reviewed the actions of the board of directors with regard to the Considerations for Fall Preseason Practice as published in the FHSAA fall sports manuals. The committee supports the position of making this recommended guideline mandatory and suggests some changes in the language, which include providing guidance regarding practice schedule after the acclimatization period. Dr. Cardone requested a summary of the presentation on mouth guards presented by Dr. Elkins at the previous meeting. The committee’s position is to monitor studies in this area conducted by the NFHS SMAC.

It was moved by Dr. Stowers and seconded by Dr. Sand to approve the minutes.

4. Review Minutes of NFHS Sports Medicine Advisory Committee Meeting Apr. 8-10, 2006.
The committee reviewed the minutes of the most recent NFHS SMAC and requests FHSAA staff to follow-up to First-Aid, CPR and AED Training item as discussed at the NFHS annual legal meeting.

5. Email: Addressing Food Allergies and Sports in Florida (Risa Hawkins)
The committee reviewed an email submitted by parent, Risa Hawkins, requesting the FHSAA set guidelines to administer the use of an Epi Pen should an athlete suffer from an anaphylactic allergic condition.
Some areas to be addressed in establishing a procedure involve: liability to member schools, education and responsibilities of the coaches/coaching staff, and shelf life of the product.
The committee recognizes the value of educating the athletic community with regard to the subject but feel establishing a requirement for coaches and member schools regarding the subject needs to be studied more. Taking this approach will provide the topic national attention with respect to establishing a protocol for use and coaches’ education.
The committee strongly recommends parents of student-athletes with this condition to communicate the condition to the athletic administration of the student-athletes’ schools and to properly indicate this information on the FHSAA Pre-participation Evaluation Form.
The committee requests FHSAA staff to submit the topic to the NFHS SMAC for inclusion in the next edition of Sports Medicine Handbook published by NFHS.

6. E-Mail: Cardiac Screening (Charles Sand, SMAC member)
The committee discussed an email addressed to school superintendents soliciting their support in providing Echocardiograms by High School Hearts, an alliance of Cardiologists and Ultrasound Technologists. The original email indicates the organization’s interest in implementing a Cardiac Screening Program in all Florida district high schools in similar fashion to the Hearing and Scoliosis screenings currently being performed for $55 per student/student-athlete.
The committee is concerned with the availability of adequate and reliable resources for mass screening including the appropriate number of echocardiogram technologists for such timely implementation. Additional concerns include but are not limited to the funding of such a program and the significant infrequency of detectable and clinically significant “cardiac anomalies” in this population of young athletes. Recommendations by numerous medical associations including the American College of Cardiology, American Heart Association, American Medical Society for Sports Medicine, and American Academy of Family Physicians indicate that current practice of history physical or pre-participation evaluation/screening is sufficient for medical referrals to follow-up with echocardiograms and/or other indicated diagnostic testing.
The committee is not opposed to any district that decides to implement a cardiac screening program, but such implementation should remain at the discretion of the member school or school district level.

7. E-Mail: Soccer Water Break Review (Mac Bleakley, Soccer Official)
The committee reviewed an email submitted by Mr. Bleakley communicating his displeasure with the FHSAA’s mandatory water break policy in soccer and urges the FHSAA to consider the position established by Florida Youth Soccer Association (FYSA). However, the FYSA instituted a mandatory water break effective beginning the 06-07 season.
The committee supports the current FHSAA policy, which extends through the entire soccer season. Florida is unique in that it currently has two soccer seasons, fall and winter. It was noted that the winter temperature in Florida is considerably warmer than the winter temperature in other parts of the country.

8. E-Mail: Wrestling Infections Disease Transmission (Jim Clark, Athletic Director)
The committee reviewed Mr. Clark’s communication requesting the FHSAA to consider establishing a “health rule that after two teams or two rounds on a mat that it be sanitized.” After discussion various aspects of the recommendation, i.e. cleaning product use, procedure for cleaning, if requiring this process for contests, why not practice, enforcement of the violations of the policy, etc.
Because the NFHS has made it a point of emphasis to address infectious diseases that may be transmitted by skin-to-skin contact or skin-to-mat contact, the committee recommends this establishment of a procedure for cleaning the mats be forwarded to NFHS for review.
Mr. Thornton informed the committee that FHSAA staff emphasized the NFHS Communicable Disease and Skin Infection Procedures during the online rules presentation viewed by FHSAA wrestling coaches and contest officials.
The committee recommends this topic be referred to the NFHS SMAC for review. (Motion by Stowers; seconded by Berk).

9. Update/FYI
A. Practice Policy
The committee reviewed the Preseason Practice Guidelines (the FHSAA’s practice policy) as published in the fall regulations manual. In light of recent youth deaths, which were heat related, the committee supports the concept of the practice policy being implemented as mandatory beginning in the 07-08 school season.
B. Steroid Initiative
Mr. Thornton shared with the committee information mailed to member schools in the fall “pack-out.” Posters, videos and pamphlets were included in the information as a part of FHSAA’s “Nothing Beats Hard Work” campaign promoting education of steroids and supplements as a preventative measure for student-athletes’ use.
C. Gatorade Heat/Hydration Video
Mr. Thornton reported that member schools also received a complimentary copy of a video presented by Gatorade regarding heat illness and hydration.

10. Physical / Decline Due to Religious Reason (Discussion)
This item was withdrawn from the agenda.

11. Review Dixie County Health Department Physical Form (Staff)
Dixie County Health Department submitted a copy of its pre-participation evaluation form for review by the SMAC. Upon reviewing the form, the committee noted this form to be compatible with forms created by other organizations, but lacked the necessary language adopted by FHSAA in compliance with s.1006.20, Florida Statutes, and FHSAA By-law 11.8.
The committee also shared its sentiments regarding the need forms varying from the FHSAA’s form but with no strong opposition, provided the forms incorporate the criteria within the FHSAA’s pre-participation evaluation form.

12. Soccer Head Injuries.org (Staff)
The committee reviewed communications from this organization promoting safety in soccer as it relates to concussions resulting from participating in the sport. The FHSAA provided this organization with a membership directory allowing the organization to share its safety materials with FHSAA membership.
Staff noted the organization currently promotes the use of a particular headgear in its efforts, but currently, NFHS rules committee and NFHS SMAC are studying the topic.

13. Team Physician / ATC Access to Players during Away Games (Michael Moser, SMAC Member)
Dr. Moser presented to the committee a communication submitted to him by Dr. Steve Lucie requesting permission for visiting athletic trainers and doctors gaining admission into FHSAA championship games. Staff clarified for the committee that this opportunity is afforded the teams participating in the FHSAA Finals. Each school is allowed a number of passes for its team and team personnel and the school determines which personnel receive a floor pass.
The committee supports the current practice by the FHSAA and emphasizes the need schools to educate its support staff of the procedures used.

14. Open Discussion
A. Preparticipation Cardiovascular Screening of Young Athletes
The committee addressed this topic when discussing the pre-participation evaluations
B. Article: New Jersey Steroid Testing
FHSAA staff updated the committee on New Jersey’s steroid testing program. Staff noted that funding of the program and reiterated its position on using education for the student-athletes and member schools of Florida.
Florida has been selected as one of four states in the Sports Illustrated Program that provides the ATLAS and ATHENA programs to 17 of its member schools. The FHSAA has partnered with the Hanley Center (Palm Beach County) for the implementation of this program.
FHSAA staff updated the committee on Florida legislative action regarding steroid testing to date.

C. ESPN Article: NFL won’t bite on dentists’ concussion device
Staff shared this article with the committee for information purposes. The committee took no action regarding the article.

Dr. Reilly adjourned the meeting at 9 p.m.