Concussions: Factsheet, Policies and Forms

  • Concussions (traumatic brain injuries) are common in athletics and should be taken seriously.  
     
    If an athlete is suspected of sustaining a traumatic brain injury (concussion) either during practice or a game he or she is evaluated on the sideline by the athletic trainer, Mr. Koch.  In the case of varsity football games, a medical doctor will also assess the injured athlete on the sideline.
     
    The head injury evaluation process includes a comprehensive assessment which records the individual's signs and symptoms, assessment of cognitive and cranial nerve function, as well as balance.  A musculoskeletal examination of the head and neck may also be performed.  Vital signs may be monitored to make sure that the athlete is stable and that their condition is not worsening while being monitored during the assessment prior to being either released to the parent or sent for a medical examination.  
     
    Once a student athlete is suspected of having signs of concussive behavior or reports possible concussive symptoms due to a possible head injury, they must also be evaluated by a medical doctor prior to returning to participation. The athletic trainer will inform the parent of the need to seek a medical evaluation and provide medical referral forms for your convenience.  Once the athletic trainer has the medical diagnosis and plan of care from the physician, he will coordinate a supervised return to play protocol for that athlete. One of the tools that assist the attending physician and the athletic trainer with regard to the return to play protocol is the ImPACT neuro-cognitive test.  All of our contact and collision sport participants establish a baseline score prior to participation.  Once they have been diagnosed with a traumatic brain injury (concussion) and their symptoms have resolved they may take a post trauma ImPACT test in order to determine if they have returned to a statistically normal level (within a set statistical variation of their baseline scores) of neuro-cognitive processing.
     
    The return to play process includes 6 steps which begins with a period of rest which requires that the student must be symptom free with a normal day of school activities (without exertion) prior to beginning the exertional portion (steps 2-5) of the return to play protocol.  Steps 5- 6 are a return to full participation in practice (5) followed by step 6 which is a full return to participation in games.  Both steps 5-6 require a physician's approval.
     
    A graduated return to school strategy will be determined by the attending physician and will be coordinated by the medical staff (nursing and athletic trainer) in conjunction with the guidance and teaching staffs. 
     
    If a student athlete is diagnosed with a concussion (traumatic brain/head injiury) in a non-school event/activity, as per the school physician, the student may have to complete the exertional return to play protocol prior to being cleared to participate in a school sponsored sport.  This protocol may be completed either with the school athletic trainer or under the supervision of a physical therapist.  If completed under the supervision of a physical therapist, proper documentation must be submitted to the Roxbury High School medical staff (nursing, athletic trainer) stating that the protocol has been sucessfully completed. At that point, the school physician will have to agree to allow the athlete to participate in a school sponsored sport.  
     
    From my experience of the past twenty years of assessing traumatic brain injuries, I have found that no two are exactly the same and the symptoms and signs vary depending on the mechanism of injury and the individual. Therefore each plan of care is catered to the individual's needs within the confines of the Board of Education policy.
Last Modified on December 14, 2017