Prep Voices : A periodic forum examining controversial issues in Orange County prep sports : TODAY: THE BLOOD RULE : THE RULE

The National Federation of State High School Athletic Assns. has adopted a set of rules in response to the remote risk of one athlete infecting another with HIV or other blood-borne infectious diseases.

Each National Federation rule book contains the following Communicable Disease Procedures, as does the 1993-94 edition of the CIF Constitution and By-Laws.

Communicable Disease Procedures

While risk of one athlete infecting another with HIV/AIDS during competition is close to nonexistent, there is a remote risk that other blood-borne infectious diseases can be transmitted. For example, Hepatitis B can be present in blood as well as in other body fluids. Procedures for reducing the potential for transmission of these infectious agents should include, but not be limited to, the following:


1. The bleeding must be stopped, the open wound covered and if there is a excessive amount of blood on the uniform it must be changed before the athlete may participate.

2. Routine use of gloves or other precautions to prevent skin and mucous-membrane exposure when contact with blood and other body fluids is anticipated.

3. Immediately wash hands and other skin surfaces if contaminated (in contact) with blood or other body fluids. Wash hands immediately after removing gloves.

4. Clean all blood-contaminated surfaces and equipment with a solution made from a proper dilution of household bleach or other disinfectants before competition resumes.

5. Practice proper disposal procedures to prevent injuries caused by needles, scalpels and other sharp instruments or devices.

6. Although saliva has not been implicated in HIV transmission, to minimize the need for emergency mouth-to-mouth resuscitation, mouthpieces, resuscitation bags, or other ventilation devices should be available for use.

7. Athletic trainers/coaches with bleeding or oozing skin conditions should refrain from all direct athletic care until the condition resolves.

8. Contaminated towels should be properly disposed of/disinfected.


9. Follow acceptable guidelines in the immediate control of bleeding and when handling bloody dressings, mouth guards and other articles containing body fluids.


In addition to the Communicable Disease Procedures are the Sport-Specific Rules, which are guidelines constructed by the National Federation rules committee for the specific sport.

All instances below are in reference to bleeding players, those with open wounds or excessive blood on the uniform. In each case, play will be stopped, an open wound must be covered and a player shall receive proper treatment. A bloodied uniform must be changed or cleansed.


Sport-Specific Rules

Baseball and softball--If medical care or treatment can be administered in a reasonable amount of time, individual would not have to leave game. The length of time considered reasonable is umpire judgment. The re-entry rule would apply to players.

Basketball--Player must leave the game and may not return prior to the first opportunity for such a player to re-enter.

Football--A timeout occurs when an official discovers a player who is bleeding, has an open wound or excessive blood on the uniform. Such player shall be considered injured and must be replaced for at least one down, unless the halftime or overtime intermission occurs. This timeout, if not charged, is an official’s timeout.


Soccer--Player must leave game and cannot return until the next legal substitution opportunity.

Swimming and Diving--When detection of blood occurs prior to start of a relay race, the start shall be delayed while competitor receives proper treatment or a legal substitution occurs. Once a relay race begins and blood is detected in the starting area or on a competitor who is not in the water (except the fourth swimmer), the race is stopped. The area and competitor shall be properly treated and the race resume after an appropriate recovery period. If bleeding cannot be stopped, wound is not properly covered or there is no legal substitute provided on the relay entry card, the team shall forfeit the race.

Track and Field--Contestants may complete the running event or field event trial, but may not participate further until appropriate treatment is administered.

Volleyball--Game shall be stopped at earliest possible time and player removed for proper treatment.


Water Polo--Game shall be stopped and player removed. No timeout is charged and player may return after receiving proper treatment.

Wrestling--Match shall be stopped and will not resume until appropriate treatment is administered.