To Parents, Teachers, Coaches, and anyone else who may be involved,
What is a concussion?
A concussion can be defined as “a trauma induced alteration in mental status that may or may not involve the loss of consciousness.” (Steven P. Broglio, et al., 2014) In the event that a concussion is suspected from an activity at school, the concussion can be handled by any designated appropriate individuals such as the nurse, athletic trainer, or administration staff which for the purpose of this document will be referred to as the “Concussion Management Team.” The student should be treated with the following guidelines.
- Administration of first aid (do not give the student medication unless prescribed specifically with concussion considerations in mind)
- Ensure the student is under constant supervision
- Monitor symptoms for deterioration
- Transport the student immediately if he shows any of the following signs
- Pupillary size difference
- Loss of Consciousness (Even briefly)
- Increasing head pain
- Decreased coordination
- Slurred Speech
- Seizures or Convulsions
- Difficulty recognizing people or places
- Increasing confusion
- Unusual behavior
- Notify the Concussion Management Team to monitor for symptoms if a concussion is suspected
- Approve and Implement adjustments to the student’s schedule
Teachers and Staff
In the classroom setting, brain injuries often correlate to a variety of challenges with education. Most students will display cognitive symptoms that result in decreased speed of reading, difficulty with multiple step equations, and difficulty retaining attention for a prolonged period of time. In the circumstance that a concussion is suspected, teachers should;
Observe symptoms of a student, and communicate those symptoms to the parents and anyone else who may be involved such as the nurse, athletic trainer, or coaches.
Coaches and P.E. Teachers
Coaches and Physical Education Teachers must recognize the signs and symptoms of a concussion and mechanisms that cause them, such as bumps, blows, or jolts to the head.
Any student who is suspected of concussion needs to be evaluated by a medical professional before returning to participation of any sort. This includes (but is not limited to) running, jogging, and lifting.
Parents or Guardians
In the event of a head injury parents must be notified by any of the involved personnel, likely a licensed healthcare professional. The parents need to understand the following:
- What a concussion is (Defined above)
- Medical attention needs or specifics (referrals, check-ins, supervision, ect.)
- The potential effects of learning and performance
- Diagnosis is the responsibility of a Physician
- No medication unless prescribed by their physician
Concussions that happen outside of school
Concussions that happen outside of school campus still must be managed appropriately. The CDC recommends the following guidelines (if applicable).
- Allow extra time for test/in-class assignment completion
- Assign a peer to take notes for the student
- Allow the student to record classes/lectures
- Increase repetition in assignments to reinforce learning
- Break assignments down into smaller activities (if possible)
- Provide Alternate methods for the student to demonstrate mastery such as multiple choice questions, as opposed to long essay responses
- Arrange preferential seating-such as moving the student away from windows or bright areas
- Set reasonable expectations
- Involve the family in management plans
- Follow recommendations that are prescribed by their Physician, Physician’s Assistant, Nurse, Athletic Trainer or School Administration.
(Susan Davies, et al., n.d.)
Special instructions and considerations for the student are listed below
Rest (physically and mentally), including training or playing sports until symptoms resolve and you are medically cleared
No prescription or non-prescription drugs without medical supervision. Specifically: · No sleeping tablets Do not use aspirin, anti-inflammatory medication or sedating pain killers
Do not drive until medically cleared
Do not use a phone, computer, or any device with a bright screen
Do not train or play sport until medically cleared (Sport Concussion Assessment Tool – 3rd edition, 2003)
Return to the sport progression.
If your student receives a blow to the head in which a concussion is suspected, they will have to follow a strict return to play procedure. This procedure is listed below and takes an average of 3 weeks to complete before returning to the sport.
Athlete will rest until 100% free of symptoms and baseline levels return to normal. (Measured by ImPACT testing if the injury was specifically a PHS sports related injury) On the first day that the athlete is 100% free of symptoms, the following return to play will begin.
Day 1: Athlete will run a half mile on the track.
Day 2: Athlete will run a full mile on the track.
Day 3: Athlete will run 2 miles on the track
Day 4: Athlete will do non-contact sports specific drills
Day 5: Athlete will resume full sports practice but will not return to a game on day 5.
If an athlete has any symptoms whatsoever, they will have to restart the return to play the following day with day 1.
The return to play must be completed under the supervision of a healthcare professional and therefore, weekend days will often not count. This also allows the athlete to take the full amount of recovery time necessary.
If progression takes longer than 28 days, the student should be referred to a physician.
If a student does not have an ImPACT pre-concussion baseline test on file, the athlete will have to remain out for three weeks’ minimum.
If you have any questions, please do not hesitate to contact a Healthcare Professional, the School Athletic Trainer or Nurse.
Sport Concussion Assessment Tool – 3rd edition. (2003). Brittish Journal of Sports Medicine.
Steven P. Broglio, P. A., Robert C. Cantu, M., Gerard A. Gioia, P., Kevin M. Guskiewicz, P. A., Jeffrey Kutcher, M., & Michael Palm, M. T. (2014). National Athletic Trainers’ Association Position Statement: Management of Sport Concussion. Retrieved from National Athletic Trainers’ Association: https://www.nata.org/sites/default/files/Concussion_Management_Position_Statement.pdf
Susan Davies, M., Gerry Gioia, P., Wayne Gordon, P., Mark Halstead, M., Karen McAvoy, P., & PsyD, E. R. (n.d.). Returning to Schools After a Concussion. Retrieved from Center for Disease Control and Prevention: www.cdc.gov/concussion
Trillium Lakelands School Board Concussion Return to Classroom Policy. (2014). Trillium Lakelands School Board Concussion Return to Classroom Policy. Trillium Lakelands, United States of America: Trillium Lakelands District School Board.