On July 1, 2012, New York State enacted the Concussion Management and Awareness Act. The Commissioner of Education worked with the Commissioner of Health to produce guidelines for school districts to follow in protecting the health and well-being of concussed students. The Fort Plain Central School District has responded to the New York State Concussion Management and Awareness Act by developing a district-wide Concussion Management Protocol. This Protocol outlines procedures for district staff, parents, and students to follow in managing head injuries; as well as guidance in returning to activities following a concussion.
What is a concussion?
A concussion is a reaction by the brain to a jolt or force that can transmitted to the head by an impact or blow occurring anywhere on the body. Essentially, a concussion results from the brain moving back and forth or twisting rapidly inside the skull.
Facts about concussions from the Center for Disease Control (CDC)
- An estimated 4 million people under age 19 sustain a head injury annually. Of these, approximately 52,000 die and 275,000 are hospitalized.
- An estimated 300,000 sports and recreation related concussions occur every year.
- Students who have had at least one concussion are at an increased risk for another concussion.
Requirements of School Districts
- Each school coach, physical education teacher, nurse, and athletic trainer will have to complete an approved course on concussion management on biennial basis.
- School coaches and physical education teachers must complete the CDC course.
- School nurses and certified athletic trainers must complete the concussion course.
- Districts must provide parents concussion management information and have parents sign a parental permission form.
Removal from Athletics:
- Any student that has or is believe to have sustained a mild traumatic injury must immediately be removed from athletic activities.
- No students will be allowed to resume athletic activity until they have been symptom free for 25 hours and have been evaluated by and received written and signed authorization from a licensed physician. For interscholastic athletics, clearance must come from the school medical director.
- Such authorization must be kept in the student’s permanent health record.
- Schools shall follow directives issued by the student’s treating physician.
Symptoms of a concussion are the result of a temporary change in the brain’s function. In most cases, the symptoms of a concussion generally resolve over a short period of time; however, in some cases, symptoms will last for weeks or longer. Children and adolescents are more susceptible to concussions and take longer than adults to recover.
It is imperative that any student who is suspected of having a concussion is removed from athletic activity (e.g. recess, PE class, sports) and remains out of such activities until evaluated and cleared to return to activity by a physician.
Symptoms include, but are not limited to:
- Problems in Brain Function
- Confused state -Dazed look, vacant stare, confusion about what happened or is happening.
- Memory problems – Cannot remember assignment on the play, opponent, score of the game, or period of the game. Cannot remember how or with whom he or she traveled to the game, what he or she is wearing, what was eaten for breakfast etc.
- Symptoms reported by the athlete – Headache, nausea, or vomiting, blurred or double vision, oversensitivity to sound, light or touch, ringing in the ears, feeling foggy or groggy.
- Lack of sustained attention -Difficulty sustaining focus adequately to complete a task or a coherent thought or conversation.
- Speed of Brain Function: Slow response to questions, slow slurred speech, incoherent speech, slow body movements, slow reaction time.
- Unusual Behaviors: Behaving In a combative, aggressive or very silly manner, or just atypical for the Individual. Repeatedly asking the same question over and over. Restless and irritable behavior with constant motion and attempts to return to play or leave. Reactions that seem out of proportion and inappropriate. Changing position frequently and having trouble resting or finding a comfortable position. These can be manifestations of post-head trauma difficulties.
- Problems with Balance and Coordination: Dizzy, slow, clumsy movements, Inability to walk a straight line or balance on one foot with eyes closed.
- The coach must use the CONCUSSION CHECKLIST to evaluate any athlete suspected of a head injury/concussion.
- If a head injury/concussion occurs or any signs/symptoms of a concussion are observed, the student MUST NOT return to play – GAME OR PRACTICE.
- Parents should be notified of the injury. The concussion checklist should be sent to the Doctor with the student.
- Regardless of what doctor the parents send their child to, the Chief School Medical Officer is the only person who can legally release the child to play.
- Coaches should adhere to the RETURN TO PLAY PROTOCOL, a gradual progression to return to full activity. Coaches are mandated to complete the “Heads Up Concussion In Youth Sports” course through the CDC.
- The coach must submit “Certificate of Completion” for Concussion Management to District Office.
Return to Play Protocols
The following protocol has been established in accordance to the National Federation of State High School Associations and the International Conference on Concussion in Sport, Prague 2004/2015.
When an athlete shows ANY signs or symptoms of a concussion:
- The athlete will not be allowed to return to play in the current game or practice.
- The athlete should not be left alone, and regular monitoring for deterioration is essential over the initial few hours following injury.
- The athlete should be medically evaluated following the injury.
- Return to play must follow a medically supervised stepwise process.
The cornerstone of proper concussion management is rest until all symptoms resolve and then a graded program of exertion before return to sport. The program is broken down into six steps in which only one-step is covered a day. The six steps involve the following:
- No exertional activity until asymptomatic for 24 hours.
- Light aerobic exercise such as walking or stationary bike, etc. No resistance training.
- Sport-specific exercise such as skating, running, etc. Progressive addition of resistance training may begin.
- Non-contact training/skill drills.
- Full contact training in a practice setting.
- Return to competition
If any concussion symptoms recur, the athlete should drop back to the previous level and try to progress after 24 hours of rest.
The student-athlete should also be monitored for recurrence of symptoms due to mental exertion, such as reading, working on a computer, or taking a test.