JJIF-R1
Protocol for Head Injuries and Concussions
A concussion team, including athletic director (if sports-related), school nurse, and guidance counselor in consultation with the student’s parent(s)/guardian(s) and physician, will review student incidents of concussion and develop student’s reentry plans, which include resumption of academics and athletics. These individuals will maintain regular communications of information regarding student status, limitations, and progression within reentry plan after concussion. The protocols will be reviewed and updated annually by the School Health Advisory Committee or as needed.
I. Training Program
Prior to student participation in extracurricular athletics each year, the AWRSD Athletic Department will provide current training approved by the Massachusetts Department of Public Health (MDPH), written materials or a list of internet links for Department approved online courses. These will be available to all students and their parents, prior to students’ participation. Annual training in the prevention and recognition of sports-related head injury, and associated health risks including second impact syndrome will also be completed by associated AWRSD staff and individuals, including coaches, volunteers, school physician, school nurses, and the Athletic Director. Documentation of completion of this MDPH approved annual training will be maintained by the school nurse and/or Athletic Director (See attached – “Parent/Athlete Head Injury Disclosure Form”)
Ongoing informational and educational opportunities related to the impact of concussion on learning and reentry plans for return to academics will be made available to teachers and staff on a regular, intermittent basis, when requested and as laws, regulations, or protocols change.
II. Prerequisites for Student-Athletes
Documentation of a physical examination prior to a student’s participation in extracurricular athletic activities will be reviewed by a AWRSD nurse for eligibility. Prior to student start of athletic activities, the Athletic Director will distribute to parents the AWRSD Athletics Participation Permission Form and the AWRSD Athlete’s Medical History Form and will maintain a record of completed forms. Students and their parents/guardians must sign these forms prior to starting each seasonal extracurricular athletic activity.
III. Reporting Head Injuries or Suspected Concussions
All school personnel will report head injuries and/or suspected head injuries to the school nurse. For head injuries and suspected concussions, occurring during the school day and non-school sponsored activities, school nurse, guidance counselor, and other school staff will report to each other. Teachers will be notified when a medical diagnosis of concussion is confirmed.
IV. Assessment and Communication
1) Upon suspicion of a head injury, the coach will remove the student athlete from play and perform an assessment for signs and symptoms of concussion. Depending on the severity of symptoms, the coach will activate EMS (for severe symptoms), keep the student out of play and notify parents/guardians (mild to moderate symptoms), or return to play (no signs or symptoms of concussion present).
2) The coach will notify a parent/guardian immediately in person or by phone if student exhibits signs or symptoms of concussion; followed by information to parent/guardian in writing or electronically, by the next business day (201.010C). Parents will be provided with two forms:
a. ‘Report of Head Injury During Sports Season’ form to be completed and signed by the coach and parent/guardian
b. ‘Post Sports Related Head Injury Medical Clearance and Authorization’ form to be completed and signed by a duly licensed physician; a certified athletic trainer in consultation with a licensed physician; a duly licensed nurse practitioner in consultation with a licensed physician; a duly licensed neuropsychologist in coordination with the physician managing the student’s recovery (105 CMR 201.011)
3) The coach or designee communicates by the end of the next business day with the Athletic Director and the school nurse that the student has been removed from practice or competition for a head injury, suspected concussion, signs and symptoms of a concussion, or loss of consciousness (201.010D)
V. Returning to Academics after Concussion
This protocol may be initiated by a notification from: 1) hospital personnel, 2) a student’s primary care physician, 3) a student’s parent/guardian, or 4) a local resource person (e.g. Brain Injury Consultant, coach, athletic trainer, etc.).
The guidance counselor/nurse is notified that a student is returning to school following a documented concussion or mild brain injury.
1. Guidance counselor and/or nurse:
a. Gathers information from the nurse/physician regarding the student’s injury, current condition, and prognosis.
b. Contacts the student’s teacher(s) and informs them of the student’s injury, discusses the possible consequences of concussion and the typical short-lived nature of these problems, and reviews the list of red flags (signs and symptoms of concussion).
c. Sends the Academic Rubric to all of the student’s teachers.
d. Interviews the student’s classroom teacher(s) after the first day back in school and then again, with sufficient frequency to ensure that possible problems are identified immediately.
e. Enters an ‘Alert’ flag on MMS.
f. Notes in the student’s cumulative file the occurrence of traumatic brain injury (TBI) for possible future reference.
VI. Returning to Athletics after Concussion
The student will provide two forms to the athletic director for review prior to athletic reentry:
1) Report of Head Injury During Sports Seasons Form completed and signed by the coach or parent/guardian; and
2) Post Sports Related Head Injury Medical Clearance and Authorization Form signed by a duly licensed physician; a certified athletic trainer in consultation with a licensed physician; a duly licensed nurse practitioner in consultation with a licensed physician; a duly licensed neuropsychologist in coordination with the physician managing the student’s recovery (105 CMR 201.011).
The return to play decision may also involve the parents, school nurse, counselors and teachers as appropriate.
The Return to Play Guidelines, which outlines a progressive stepped approach for gradual return to activity and steps to take if symptoms recur is available to parents and students on the AWRSD Athletic website.