|Adoption Date: 1/1/1900, Revised: 02/24/2014, 01/08/21|
Concussion Management Policy
Regulation # 5141.7R
CONCUSSION MANAGEMENT PROTOCOL REGULATION
A “concussion” is a traumatic brain injury, caused by a blow to the head, face or neck, or a blow to the body that cause a sudden jarring of the head, that alters the way the brain functions.
A concussion may be “simple” meaning that the concussion resolves without complication over 7-10 days. It is estimated that 80% to 90% of concussion are of this severity. Simple concussions can be managed appropriately by primary care physicians or by certified athletic trainers working under medical supervision. Management of a simple concussion includes rest until all symptoms resolve, followed by a step-by-step program of exertion before return to sport. All concussions require evaluation by a licensed physician and medical clearance by the District’s Chief Medical Officer for return-to-play/physical activity.
A “complex” concussion involves cases when the student suffers persistent symptoms, including persistent symptoms that recur with exertion. A complex concussion may have characteristics such as concussion convulsions, prolonged loss of consciousness (longer than one minute) or prolonged cognitive impairment. Students who suffer complex concussions should be referred to and managed by physicians with specific expertise in the management of concussive injury, such as sports physicians, sports neurologists or neurosurgeons.
A concussion cannot be graded until all symptoms have resolved and the student returns to practice/competition/physical activity.
Evaluation and Management of Concussions
When a student shows ANY features of a concussion, proper protocol is:
These individuals will receive a symptoms checklist and recommendations for student accommodations (such as limited computer work, reading activities, assistance to class, etc.) until symptoms subside. A student who demonstrates signs and symptoms during class should be attended to promptly and, if necessary, should be directed to the School Nurse. If the student is symptomatic, the Parents should be contacted.
The implementation of baseline and/or post-injury neurocognitive testing, such as ImPACT (Immediate Post Concussion Assessment and Cognitive Test), can help to objectively evaluate the individual’s post-injury condition and track recovery for safe return to cognitive and physical activities.
The return-to-play/physical activity protocol is a progressive program designed to incrementally increase the student’s level of exertion. The protocol may be administered by the coach, physical education teacher, athletic director, school nurse or athletic trainer. If the student experiences any signs or symptoms of a concussion during the progression, all activities will be stopped and will not resume until authorized to do so, in writing, by a licensed health care provider.
Return-to-Play/Physical Activity Protocol
This protocol will be started once the student is symptom free for 24 hours, and cleared by the District’s Chief Medical Officer. If there are any signs/symptoms, the activity must stop. When the student is asymptomatic after successful completion of each day of the protocol, the student may proceed to the next day.
Day 1: Low impact, non-strenuous, light aerobic activity to be done at 50-60% maximal effort for 20-30 minutes (e.g., fast walking, stationary bike - under supervision).
Day 2: Higher impact, higher exertion, moderate aerobic activity to be done at 60-70% maximal effort for 30-40 minutes (e.g., jogging/running). No resistance training.
Day 3: Sport specific non-contact activity. Low resistance weight training with a spotter to be done at 70-80% of maximal effort for at least 10-15 minutes and activity should last 45-60 minutes in total.
Day 4: Sport specific activity, non-contact drills. Higher resistance weight training with a spotter to be done at 80-90% of maximal effort for at least 10-15 minutes and activity should last 60-90 minutes.
Day 5: Full contact training drills and intense aerobic activity to be done at 90-100% of maximal effort for at least 10-
Day 6: Return to full activity with clearance from the District’s Chief Medical Officer.
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