Concussion

CONCUSSION MANAGEMENT PROTOCOL

I.) Pre-Season Protocol for Student Athletes:

All coaches will view the CDC “Heads Up” program (video) and will become familiar with the CDC “Heads Up” guidelines for understanding and recognition of the signs and symptoms of a head injury and/or concussion. Coaches must sign a STATEMENT OF ASSURANCE that they have reviewed the above information, understand it, and their questions have been answered to their satisfaction.
All athletes will view the CDC “Heads Up” program and will receive a printed copy of the CDC “Heads Up” fact sheets for athletes.
All parents of athletes will be encouraged to view the CDC “Heads Up” program and will also be given a copy of the CDC “Heads Up” fact sheet for parents. Hamilton Central School’s Return-to-Play policy for concussion in athletes will be attached to the ATHLETIC INFORMATION FORM. Parents will sign that they have reviewed it and understand the policy.

II.) Sideline Management of Head Injury/Suspected Concussion:

When a player shows any signs/symptoms of a concussion (utilizing sideline cards), the first priority is to remove the athlete from the current practice or game.
The player suspected of having a concussion will not be allowed to return to the current practice or game, even if symptoms appear to have resolved or the player denies injury or symptoms.
The athlete will not be left alone at any time.
The athlete will be evaluated at intervals by the coach(es) or physician.
If there are any signs of deterioration in the athlete’s physical or mental condition, 911 must be called immediately, and parents notified.
Parents must be notified when an athlete is suspected of having a concussion.
The athlete suspected of having symptoms of a concussion, but is stable, must be evaluated by the Emergency Department or their PCP as soon as possible. Parents must be advised to seek immediate medical care if a concussion is suspected.
An athlete with a witnessed loss of consciousness (LOC) of any duration should not be moved, and 911 will be called immediately. Emergency medical personnel will immobilize and spine board the athlete, and transport them immediately to the nearest Emergency Department by emergency vehicle only.
ALWAYS GIVE PARENTS THE OPTION OF EMERGENCY TRANSPORT EVEN IF IT IS NOT FELT TO BE NECESSARY.
A school injury/incident report must be completed within 24 hours following an injury and submitted to the school nurse.

III.) Return to Play Protocol: (See Appendix A)

The concussed athlete will not be allowed to return to play until medically cleared by their physician. This must be in writing.
Medical clearance allows the concussed athlete to begin the Six Step Return-To-Play Process only. The Six Step Return -To-Play Process is a policy at Hamilton Central School, and is attached.
Supervision of the concussed athlete’s Return-To-Play program will be provided by the school nurse, coach(es), athletic director, and the athlete’s physician. The athlete will see the school nurse daily, until at full play.
Progression of the concussed athlete’s Return-To-Play process will be individualized, and will be determined on a case-by-case basis. Factors that may affect the rate of progression include:

Previous history of concussion
Duration and type of symptoms
Sport the athlete will return to
Final decision by primary care provider

Academic accommodations will be made for the concussed athlete, if necessary, to ensure that the concussed athlete will have a safe and successful return to school. This will be determined by their personal physician. Accommodations may include, but are not limited to:

Rest breaks, if needed, during the school day in a quiet location.
Reduced course and work load, if necessary.
Avoid overstimulation, (such as cafeteria or noisy hallways).
Avoid re-injury, especially in PE class and crowded hallways/stairs.
Extra time and quiet location for testing, if needed.
Provide student with class notes or allow student to audiotape classes.
Allow student to wear sunglasses to help with light sensitivity, if needed.
The school guidance counselor and nurse will communicate on a regular basis with all staff involved in the athlete’s academic program, as needed.

Appendix A

Hamilton CENTRAL SCHOOL

RETURN -TO -PLAY POLICY

FOLLOWING A CONCUSSION

The following protocol will follow guidelines established by the New York State Public High School Athletic Association (NYSPHSAA), the New York State Athletic Administrators Association (NYSAAA), the National Federation of State High School Associations and the International Conference on Concussion in Sport, Prague 2004.

An athlete who has been diagnosed with a concussion must be medically cleared, in writing, to return to play. When the concussed athlete is cleared to return, they must follow the Six Step Return-to-Play process outlined below:

1.	No exertional activity until asymptomatic and cleared to return by physician. This must be in writing.
2.	Light aerobic exercise such as walking or stationary bike, etc. No resistance training.
3.	Sport specific exercise such as skating, running, etc. Progressive addition of resistance training may begin.
4.	Non-contact training/skill drills.
5.	Full contact training in practice setting (following medical clearance).
6.	Return to competition/play.

The cornerstone of proper concussion management is rest until all symptoms resolve and then a graded program of exertion before returning to sport. The program is broken down into six steps in which only one step is covered a day.

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.

The ultimate decision for return to play for a concussed athlete, if deemed necessary, will be made by a physician.

I have reviewed the Hamilton Central School’s Return-to-Play policy for concussion in athletes.

Parent/Guardian Signature ______________________________________________

Date ___________

Hamilton Central School - Six Step Return-To-Play Progress Sheet

The student athlete must be free of symptoms in order to progress from one step to the next, as per protocol. A minimum of 24 hours must lapse between steps. If symptoms occur/recur, the student must drop back to the previous step after 24 hours. No step may be skipped.

Student Name _________________________________________

Date of concussion ________________

Step 1---no exertional activity until asymptomatic and medically cleared: