Concussion Management

  • A concussion is defined as a type of traumatic brain injury, caused by a bump, blow or jolt to the head that can change the way the brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a "ding," "getting your bell rung," or what seems to be a mild bump or blow to the head can be serious.

    According to the Centers for Disease Control, in New York State in 2009, approximately 50,500 children under the age of 19 visited the emergency room for a traumatic brain injury, and approximately 3,000 of those patients were hospitalized.

    Most people who suffer a concussion do recover quickly. However, in more severe cases, a concussion can be fatal. Unlike a broken bone or a laceration, outward signs of a concussion can't be seen. By learning to identify the signs and symptoms of head trauma, coaches, teachers and parents can help keep children safe.

    The state's "Concussion Management and Awareness Act," which went into effect in July 2012, requires:

    • The immediate removal from athletic activities, including physical education
      classes, interscholastic sports and other extracurricular activities, of any student that has or 
      is believed to have sustained a mild traumatic brain injury.
    • No students will be allowed to resume athletic activity until they have been symptom-
      free for 24 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's medical director.  
    • Education and training for coaches, teachers and other school personnel on the 
      symptoms and treatment of mild traumatic brain injuries on a biennial basis.

    Protocol if Concussion is Suspected 

    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 include:

    1. No exertional activity until asymptomatic for seven consecutive days.
    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.
    6. 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.

    Removal from Athletics

    Require the immediate removal from athletic activities of any pupil that has or is believed to have sustained a mild traumatic brain injury. No athlete demonstrating symptoms of concussion should return to practice or play (RTP) the day of injury. RTP should be on a following day after appropriate neurological testing and the school physician’s clearance. Close observation of athlete should continue for a few hours. Parents or guardians of the athlete should be made aware of proper protocol, symptoms to watch for and contact medical personnel if concerned.

    On Field Evaluation

    During practices and contest, athletes demonstrating signs and symptoms of a concussion should be evaluated by the coach and/or athletic trainer and then, if determined to have a possible concussion, the athlete should not be permitted to continue any activity at which the athlete must follow all protocols and procedures as outlined in this policy. The concussion checklist must be filled out immediately with copies to be provided to the school nurse and Director of HPEA.  If applicable, the athlete will be subject to neurological testing through ImPACT in order to provide critical data for medical professionals determining the athletes ability to resume play.

    Physical Education

    Physical Education must report to the nurse any student exhibiting the signs and symptoms of a head injury. Any student, including athletes, who were reported to the nurse as exhibiting signs and symptoms of a head injury must be out of physical education class for a minimum of seven days and must have physician’s note to return to class as well as clearance from the School Chief Medical Officer. If the student is on an athletic team they must follow the return to play protocol.

    Return to Play (RTP)

    No pupils will be allowed to resume athletic activity until they have been symptom free for 24 hours and have been evaluated by and received written and signed authorization from a licensed physician. Clearance must also come from the School Chief Medical Officer. Such authorization must be kept in the pupil’s permanent heath record. Schools shall follow directives issued by the pupil’s treating physician, unless otherwise directed by the School Chief Medical Officer.

    ImPACT Testing

    Given the inherent complexities of concussion management, it is important to manage concussions on an individualized basis and to implement baseline testing and/or post-injury neurocognitive testing whenever possible. Neurocognitive assessment can help to objectively evaluate the concussed athlete’s post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion.  The district will test ALL student-athletes participating in the following sports: Football, Soccer, Wrestling, Cheerleading, Basketball, Baseball, and Softball.  In some cases a child may be tested more than once, depending on the results of the test.  ImPACT baseline and post-injury test results may be released to the students primary care physician, neurologist, other treating physician, or any licensed healthcare professional as indicated by the family.  Results may also be released to the District Medical Examiner and athletic trainer.  General information about the test data may also be shared with a child's guidance counselor and teacher, for the purposes of providing temporary academic modifications, if necessary. 

    There is no charge for the testing.