Concussion Information
A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussions may show up right after the injury or can take hours or days to fully appear. It is the responsibility of all of those involved in an activity to be alert to concussion symptoms (coaches, officials, teammates, parents, teachers, etc.). If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.
Symptoms may include one or more of the following:
Headaches
“Pressure in head”
Nausea or vomiting
Neck pain
Balance problems or dizziness
Blurred, double, or fuzzy vision
Sensitivity to light or noise
Feeling sluggish or slowed down
Feeling foggy or groggy
Drowsiness
Change in sleep patterns
Amnesia
“Don’t feel right”
Fatigue or low energy
Sadness
Nervousness or anxiety
Irritability
More emotional
Confusion
Concentration or memory problems (forgetting game plays)
Repeating the same question/comment
Signs observed by teammates, parents, and coaches include:
Appears Dazed
Vacant facial expression
Confused about assignment
Forgets plays
Is unsure of game, score, or opponent
Moves clumsily or displays incoordination
Answers questions slowly
Slurred speech
Shows behavior or personality changes
Can’t recall events prior to hit
Can’t recall events after hit
Seizures or convulsions
Any change in typical behavior or personality
Loses consciousness
Signs observed in the classroom may include:
All of the above plus…
Difficulty focusing
More emotional/irritable than usual
Drowsiness
Reduced academic performance
Easily distracted
Sensitive to light or reported visual changes
Difficulty concentrating
Difficulty remembering
Sensitivity to noise
Slowed response
What happens after a student is suspected of suffering a concussion?
Any student displaying signs, symptoms or behaviors consistent with a concussion must be removed from physical activity immediately. Close observations of the student should continue for several hours. Should a student sustain a hit to the head that warrants close observation, the concussion signs and symptoms checklist will be utilized, and based on the data collected, medical clearance maybe requested. Students may not return to learn or physical activity after a concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance.
My child has been diagnosed with a concussion, now what?
If your child has been diagnosed with a concussion, your first step is to contact your school nurse. She will want to know all the details of the incident and will guide you through the steps that your child's school will follow. Any student that has been diagnosed with a concussion, by a physician, will be placed on the the District 58 Concussion Protocol. This protocol goes through five stages of recovery for your child to follow.
Stage 1: The child is maintaining complete cognitive rest at home; please help your child limit screen time. If your child was diagnosed with a concussion by a physician other than their primary care doctor, this is the time to make the appointment to see them. Your child's primary care doctor will need to complete the backside of the Post-Concussion Consent Form.
Stage 2: This is when the student returns to school, but will still be limiting screen time and maintaining some cognitive rest. Students will limit school work and tests and will try to avoid loud situations. Physical education and recess are replaced with downtime in the health office or library. Some students find that attending school for half-days during this stage to be beneficial. NOTE: The Post-Concussion Consent form MUST be completed and returned before the student is able to attend classes.
Stage 3: Students will gradually increase their workload while still monitoring their symptoms. Physical education and recess are still replaced with downtime in the health office or library.
Stage 4: Students return to full participation in class. This is the to time ensure that all missing work or exams have been completed. Physical education and recess are still replaced by downtime in the health office or library.
Stage 5: In order for students to progress to Stage 5, medical clearance from the primary care physician must be obtained. The physician will have already completed the backside of the Post-Concussion Consent form, which will have stated whether the child needs to return to the doctor for medical clearance OR if the school nurse is able to use her discretion to return the student to physical activity.
Taking concussions seriously and giving students the appropriate accommodations helps not only the concussion heal, but the student to feel less stressed while still experiencing symptoms.
How does my child move through the Protocol Stages?
The first day a student returns to school, they will meet with the school nurse. This is when the Post-Concussion Consent form is turned in and a conversation regarding the accommodations the student is entitled to takes place. Each day, the student is asked to stop into the health office to visit the school nurse. Information regarding the past 24 hours will be collected through an evidence-based evaluation form and will be evaluated by the school nurse to determine if progression to the next stage will take place. This will then be communicated with the student's teachers so that they are aware of the accommodations that should still be in place for that child. At times, it may be more beneficial for the school nurse to communicate with the child's parents to get a better picture.
How can we support a student’s best chance for a full recovery?
We know that a student’s best chance for a full recovery from a concussion depends on timely implementation of two critical components: cognitive rest (i.e. learning) and physical rest (i.e. sports, PE, intramurals, recess). Determining the appropriate balance between the amount of cognitive and/or physical exertion and rest is critical for facilitating recovery. Each concussion is different, therefore, an individualized plan to best support the student is required, and should be frequently monitored and adjusted as symptoms improve.
What can happen if my student returns to physical activity too soon or continues play?
We can only enforce the Concussion Protocol at school and school sponsored sports. If you choose to allow your child to participate in outside school activities before they have completed the protocol, please advise that evidence supports that returning to learning and physical activity too quickly after a concussion may worsen symptoms and prolong recovery. Students with the signs and symptoms of concussion should be removed from physical activity immediately. Continuing physical activity with the signs and symptoms of a concussion leaves the student especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the student suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling with devastating and even fatal consequences. Students often fail to report symptoms of injuries, and concussions are no different. As a result, education of administrators, coaches, parents, teachers and students is the key to student safety.
What about for my student athlete who participates in interscholastic sports?
The Return-to-Play Policy of the IESA and IHSA requires athletes to provide their coach with written evidence that they have participated in an evaluation from an appropriate healthcare professional (i.e. a licensed physician or a certified athletic trainer working in conjunction with a licensed physician) and have been cleared to return to play prior to resuming physical activity, including practices and games, following removal from an activity due to an apparent head injury. In accordance with state law, all schools are required to follow this policy.
Things to know:
As the school nurse, I am your #1 advocate! I encourage students to become a good self-advocate for themselves during this time. Communicating effectively with their teachers can ease anxiety and stress that can accompany concussion symptoms. If students are finding this to be a challenge, I want them to know that I am a friendly ally that can help them work through their healing process.
All of our staff members have been trained on the District 58 Concussion Protocol. Teachers are provided guidance on how to successfully help a student diagnosed with a concussion on how to maintain their academics.
If a student has been diagnosed with a concussion, the Post-Concussion Consent Form MUST be completed by the parent before the student can return to school. This form allows the school nurse to communicate effectively with the physician regarding the recovery plan for your child.
If a doctor has decided to give your child medication for symptoms related to their concussion, please be advised that the Medication Authorization Form must be completed and turned in with the medication.
Resources:
CDC's Head's Up Campaign