Concussion Policy and Procedure
Any concussed student demonstrating signs and symptoms of expanding intracranial lesion will be referred immediately to a physician, including EMS transport to ER if loss of consciousness has occurred, if symptoms worse, or if symptoms are not resolving to the satisfaction of the certified athletic trainer or attending physician. Concussed student with signs and symptoms that completely resolve and meet return to activity standards may return to participate at the discretion of physician, physician assistant and certified athletic trainer.
Grade I concussion:
- No LOC; transient confusion; mental status abnormalities on examination resolve in less than 15 minutes. Retrograde amnesia should be resolved in less than 5 minutes.
- Remove student from activity. Examine immediately and at 5 minute intervals for the development of mental status abnormalities or post-concussive symptoms at rest and with exertion.
Grade II Concussions:
- Transient confusion, no LOC, concussion symptoms or mental status abnormalities lasting more than 15 minutes, or amnesia greater than 5 minutes.
- NO return to activity that day. Examine on-site frequently for signs of expanding intracranial pathology. Communication of monitoring instructions to caregiver, including symptoms for immediate transport to hospital. Re-examine the following day.
Grade III Concussion:
- Any LOC.
- Maintain C-Spine immobilization and have student transported via EMS for physician evaluation.
Recovery from a concussion requires the limitations of physical activity and mental activity in order to allow the brain to heal. These activities may include limiting assignments, allowing more time to complete quizzes and tests, and reduced homework. Activities such as watching TV, texting, playing games or excessive computer use may slow the recovery process. Neurocognitive tests like the ImPACT are computerized tests that document the students cognitive and speed skills. The test has been validated as an accurate measure of brain function recovery following a sports concussion. All students should have a baseline test before practice or competition, and should a student sustain a concussion, a repeat test can be performed and compared to the baseline test. This can help show the degree of injury and help measure when recovery has occurred. Stoneleigh-Burnham School has implemented ImPACT for our student-athletes.
To better manage instances of concussion in our sports program, Stoneleigh-Burnham requires the following:
- All coaches must complete an annual training in the area of current concussion management practices. This training should include up-to-date information on the identification of concussions, the signs and symptoms associated with the injury, the risks involved with allowing athletes to continue to play while symptomatic, methods of concussion assessment and the importance of gradual return to play practices.
- Students suspected of having a concussion should be immediately removed from the activity and evaluated before being allowed to resume physical activity. All concussion evaluations should be done by a licensed health profession (physician, physicians assistant, nurse and/or athletic trainer). All concussions sustained during an athletic activity will be evaluated by the athletic trainer or nurse on campus, ImPACT tested and referred to a physician. All students MUST be evaluated by a physician who will determine the treatment protocol both athletically and academically, based on the severity of the concussion. Academic limitations will be at the discretion of the attending physician and set forth by the academic dean. Students on academic restrictions that are experiencing residual symptoms longer than 3 weeks, are required by the school to be evaluated by a Neurologist or equivalent specialist.
- Students will be required to be in full academic standing BEFORE they will be eligible to participate in the athletic return to play protocol. Full academic standing is considered to be asymptomatic for at least 24 hours, returned to a normal academic schedule, and normal course load. Students on a reduced academic schedule will be unable to participate in ANY non-academic activities in or outside of school. Students with prolonged absences may be required to take a medical leave from school.
Return to Play Policy
According to a change in Massachusetts legislation, in addition to treating physicians, physician assistants are now able to clear individuals with concussions both academically and physically. Once cleared academically, students must follow the proper return to play protocol presented by the athletic trainer before they resume physical activity.
a. Students must be asymptomatic for more than 24 hours.
b. The student must display normal cognitive function as exhibited on the ImPACT test.
c. The student must provide written clearance from a physician or physician assistant.
d. Day 1: Light Aerobic Exercise
Goal: Increase the athlete’s heart rate
Time: 5 to 10 minutes
Activities: Exercise bike, walking or light jogging
NO weight lifting, running, or jumping
e. Day 2: Moderate Exercise
Goal: Limited body and head movement
Time: Reduced from typical routine
Activities: Moderate jogging, brief running, moderate-intensity stationary bike moderate-intensity weight lifting.
f. Day 3: Non-contact Exercise
Goal: More intense exercise, no contact
Time: Close to typical routine
g. Day 4: Practice
Goal: Reintegrate in full contact practice
h. Day 5: Play
Goal: Return to competition
*If at any time the student begins experiencing symptoms, all activity should stop and the student should be re-evaluated. The student will not be allowed to progress to the next step if the symptoms are experienced within 24 hours. All students will be treated on an individual basis, based on the results and treatment protocol set forth by the attending physician, physician assistant, nurse or athletic trainer.
Questions or concerns? Please contact Athletic Trainer Allyson Bryant.