Concussion Protocol

List of 7 items.

• SIGNS & SYMPTOMS OF A CONCUSSION

  Concussions can appear in many different ways. Concussions cannot be seen, and most occur without loss of consciousness.  Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear.  Listed below are some of the signs and symptoms frequently associated with concussions. Most signs, symptoms and abnormalities after a concussion fall into the four categories listed below. A coach, parent or other person who knows the athlete well can often detect these problems by observing the athlete and/or by asking a few relevant questions of the athlete, official or a teammate who was on the field or court at the time of the concussion. Below are some suggested observations and questions a nonmedical individual can use to help determine whether an athlete has suffered a concussion and how urgently he or she should be sent for appropriate medical care.

   

  1. Problems in Brain Function

  • Confused State – dazed look, vacant stare or confusion about what happened or is happening.
  • Memory Problems – can’t remember assignment on play, opponent, score of game, or period of the game; can’t remember how or with whom he or she traveled to the game, what he or she was wearing, what was eaten for breakfast, etc.
  • Symptoms Reported by Athlete – headache, nausea or vomiting; blurred or double vision; oversensitivity to sound, light or touch; ringing in ears; feeling foggy or groggy; dizziness.
  • Lack of Sustained Attention – difficulty sustaining focus adequately to complete a task, a coherent thought or a conversation.

   

  2. Speed of Brain Function - Slow response to questions, slow slurred speech, incoherent speech, slow body movements and slow reaction time.

   

  3. Unusual Behaviors - Behaving in a combative, aggressive or very silly manner; atypical behavior for the individual; repeatedly asking the same question; restless and irritable behavior with constant motion and attempts to return to play; reactions that seem out of proportion and inappropriate; and having trouble resting or “finding a comfortable position.”

   

  4. Problems with Balance & Coordination - Dizziness, slow clumsy movements, inability to walk a straight line or balance on one foot with eyes closed.

   

  If no medical personnel are on hand and an injured athlete has any of the above symptoms, he/she should be sent for appropriate medical care.

   

• CHECKING FOR CONCUSSION

  Every OLPH coach has received a lanyard with a, Heads Up Concussion checklist, from the Centers for Disease Control, with common symptoms associated with concussions.  Each OLPH coach has also taken and passed the concussion training course mandated by the State of Illinois.  In addition to observation and direct questioning for symptoms, medical professionals and athletic trainers have a number of other instruments to evaluate attention, processing speed, memory, balance, reaction time, and ability to think and analyze information (called executive brain function). These are the brain functions that are most likely to be adversely affected by a concussion and most likely to persist during the post concussion period.

   

  If an athlete seems “clear” he or she should be exercised enough to increase the heart rate and then evaluate if any symptoms appear.

   

  The Centers for Disease Control and Prevention (CDC) has also developed a tool kit (“Heads Up: Concussion in High School Sports”), which has been made available to all schools, and has additional information for coaches, athletes and parents.

• SIDELINE MANAGEMENT OF CONCUSSION

  1. Coaches will use their best judgment based on mechanism of injury, observation, history and unusual behavior and reactions of the athlete, even without loss of consciousness, assume a concussion has occurred if the head was hit and even the mildest of symptoms occur.

   

  2. If confusion, unusual behavior or responsiveness, deteriorating condition, loss of consciousness, or concern about neck and spine injury exists, the athlete should be referred at once for emergency care.

   

  3. If a medical professional, or athletic trainer is available, they should monitor every 5-10 minutes, mental status, attention, balance, behavior, speech and memory should be examined until stable over a few hours. If appropriate medical care is not available, an athlete even with mild symptoms should be sent for medical evaluation.

   

  4. No athlete suspected of having a concussion should return to the same practice or contest, even if symptoms clear in 15 minutes.

• CONCUSSION OVERSIGHT TEAM (COT)

  The Concussion Oversight Team’s purpose is to establish appropriate and scientifically sound protocols for OLPH students’ safe return to the classroom and the playing field.  The COT will also be advocates for the safety of all students, while ensuring that all requirements of HB 20138 are met.

   

  The Concussion Oversight Team will include:

   

  1)     School Principal

  2)     School Athletic Director

  3)     School Nurse

  4)     OLPH Coach

  5)     OLPH Teacher

• SIDELINE DECISION-MAKING AND RETURN-TO-PLAY PROTOCOL

  1. No athlete should return to play (RTP) on the same day as a suspected concussion.

   

  2. Coaches must fill out an Accident Report form for any player suspected of having a concussion, and return it to the OLPH Athletic Office within 24 hours of the incident. 

   

  3. Any athlete removed from play because of a concussion must have medical clearance from a medical doctor or athletic trainer, submitted to OLPH’s Concussion Oversight Team.  The team will review the clearance and notify the coach or coaches when the athlete is eligible to return to play or practice.

   

  4. After medical clearance, RTP will follow the steps and guidelines provided by the medical note for each individual athlete.

• MANAGEMENT OF CONCUSSIONS

  Every concussion is different, and treatment and recovery from a concussion is an individualized process.  A student with signs or symptoms of a concussion should be evaluated by a health care professional.  Maximizing a student’s recovery potential following a concussion depends on timely implementation of cognitive and physical rest.

   

  Increasing evidence is suggesting that initial signs and symptoms, including loss of consciousness and amnesia, may not be very predictive of the true severity of the injury and the prognosis or outcome. More importance is being assigned to the duration of such symptoms and this, along with data showing symptoms may worsen some time after the head injury, has shifted focus to continued monitoring of the athlete. This is one reason why these guidelines no longer include an option to return an athlete to play even if clear in 15 minutes and why there is no discussion about the “Grade” of the concussion.

   

  Any athlete who is removed from play because of a concussion should have medical clearance from an appropriate health care professional before being allowed to return to play or practice. The Second International Conference on Concussion held in Prague recommends an athlete should not return to practice or competition in sport until he or she is asymptomatic including after exercise.

   

  Recent information suggests that mental exertion, as well as physical exertion, should be avoided until concussion symptoms have cleared. Premature mental or physical exertion may lead to more severe and more prolonged post concussion period. Therefore, the athlete should not study, play video games, do computer work or phone texting until his or her symptoms are resolving. Once symptoms are clear, the student-athlete should try reading for short periods of time. When 1-2 hours of studying can be done without symptoms developing, the athlete may return to school for short periods gradually increasing until a full day of school is tolerated without return of symptoms.

   

  Once the athlete is able to complete a full day of school work, without PE or other exertion, the athlete can begin the gradual return to play protocol as outlined below. Each step increases the intensity and duration of the physical exertion until all skills required by the specific sport can be accomplished without symptoms. These recommendations have been based on the awareness of the increased vulnerability of the brain to concussions occurring close together and of the cumulative effects of multiple concussions on long-term brain function. Research is now revealing some fairly objective and relatively easy-to-use tests which appear to identify subtle residual deficits that may not be obvious from the traditional evaluation. These identifiable abnormalities frequently persist after the obvious signs of concussion are gone and appear to have relevance to whether an athlete can return to play in relative safety. The significance of these deficits is still under study and the evaluation instruments represent a work in progress. They may be helpful to the professional determining return to play in conjunction with consideration of the severity and nature of the injury; the interval since the last head injury; the duration of symptoms before clearing; and the level of play.

• RETURN TO LEARN PROTOCOL

  Because concussions and their subsequent recovery affect learning, OLPH is committed to safely and gradually having students return to full participation in the classroom.  Concussions and their plans for recovery vary among individual students.  Students that have completed the Return To Play protocol aren’t necessarily ready to return to the classroom.  Likewise, students that have completed the Return To Learn protocol may not be necessarily ready to return to their respective sports practices or games. 

   

  OLPH students that are suspected of having suffered a concussion, or have a medically documented concussion, must adhere to the following RTL protocol.

   

  1. No School – Complete physical and cognitive rest until medical clearance. 
  2. Return to school with academic accommodations.  The student may return to school and the COT will ensure that accommodations noted by the student’s doctor are met.
  3. Return to school full time with no accommodations.