Head Injury and Concussion

HEAD INJURY AND CONCUSSION PROTOCOL

Barnard School is committed to the safety of all our students. The purpose of this protocol is to educate our coaches, parents, administrators, school personnel, volunteers and student athletes on the seriousness of brain injuries and concussions.

NH law requires that schools educate parents/guardians and student-athletes of the nature and risks of concussions and continuing to play with a concussion on an annual basis. All student-athletes and their parent/guardian must return a signed form indicating they are aware of and understand Barnard School’s head injury and concussion protocols before they are allowed to practice with the team.

In addition, all coaches and physical education staff are required to complete a head injury and concussion training course prior to beginning their duties. These courses are offered online or printed copies are available in the school nurse’s office. At the completion of the course, coaches and PE staff will be able to:

• Understand a concussion and the potential consequences of this type of injury

• Recognize concussion signs and symptoms and how to respond

• Learn the steps for returning to activity (play and school) after a concussion

• Focus on prevention and preparedness to help keep athletes and students safe

Coaches and PE staff may choose to take either one of the following courses. A certificate of completion must be on file with the school and updated yearly.

• Centers for Disease Control and Prevention Heads Up Concussion in Youth Sports On-Line Training Program (www.cdc.gov/headsup/youthsports/training/index.html)

• National Federation of State High School Associations Concussion in Sports – What You Need to Know (www.nfhslearn.com/courses/61129/concussion-in-sports)

REMOVAL FROM PLAY

Any Barnard School coach and/or physical education teacher who suspects that a student or athlete may have sustained a head injury or concussion in a practice, game or class must immediately remove the student from play. The school nurse, if available, should be notified immediately to assess the student and determine an appropriate plan of care. If the injury occurs after-school and the nurse is unavailable, it is the coaches’ responsibility to notify the athlete’s parents/guardians of the injury and, if warranted, call for emergency care. Any student/athlete who has been removed from play may not return to play on the same day. This is necessary to ensure safety and recovery for the injured student because the signs and symptoms of a concussion may not appear or be noticed for hours to days after the initial injury.

RETURN TO PLAY/LEARNING

Any student/athlete exhibiting signs or symptoms of a concussion must be evaluated and medically cleared by a physician before returning to play. The student/athlete must present written authorization from the physician as well as written permission from a parent/guardian to the school nurse in order to return to play. “Play” includes participation in any sports team practice or game in addition to physical education classes and recess.

After the initial evaluation and diagnosis of a concussion by the physician the student/athlete should provide a copy of the physician’s recommendations to the school nurse before returning to school. A sample form is attached. The student will be placed on the Concussion Protocol.

PLAN FOR GRADUAL RETURN TO PLAY

Returning to sports and physical activity should be a gradual process. The student/athlete will begin at Day 1 after their first symptom-free day. The student may move on to the next step only if symptoms do not return. The return of symptoms indicates that the student may be pushing too hard. If symptoms return, the student must rest for 24 hours. Once symptom-free again, the student can start at the previous level.

Day 1- No physical activity

Day 2- Light aerobic exercise

· Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weight lifting at this point.

Day 3- Moderate physical activity

· Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting (less time and/or less weight from their typical routine).

Day 4- Heavy non-contact physical activity

· Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement).

Day 5- Full contact practice

· The athlete may return to practice and full contact (if appropriate for the sport) in controlled practice.

Day 6- Full contact game play/competition

The Concussion Protocol begins immediately after injury.

• Student/athlete is suspected of sustaining a head injury or concussion.

• Coach/physical education teacher/school staff immediately removes the student from play and notifies the school nurse, if available.

  • • School nurse will assess the student, notify parent/guardian and refer the student for further evaluation as needed.

• If after-school and the nurse is unavailable the coach must notify the parent/guardian of the injury and if warranted, call for emergency care.

  • • The coach should ensure the school nurse is notified of the injury prior to the next school day.

• The student/athlete will not be allowed to return to play on the same day. (Includes recess, physical education class and sports practice/games.)

• Parent/Student will inform school nurse of concussion diagnosis.

• School Nurse reviews the medical information and recommendations.

• Notifies appropriate staff.

Academic Phase 1 (first one-two weeks)

• No school work expectations

• Listening and following classroom instruction is all that is allowed

  • Teachers will collect essential work that will be expected to be made up and hold it for the student.

  • Teachers will mark non-essential work as exempt

End of two week period:

• Student resumes full workload

• Teacher provides missed essential work and identifies the makeup period that is consistent with our makeup policy.

Academic Phase 2

• After 2 weeks School Nurse will communicate with physician

• If physician extends because the student is still experiencing symptoms

  • Student’s academic workload may be adjusted

    • Teachers will continue to collect essential work.

    • Makeup period will be commensurate with the length of injury.

Weeks 3 and 4:

• Student will resume full workload.

• School nurse will extend based upon communication with the physician.

• 504 may be warranted

• Weeks 4+ academic workload remains adjusted until cleared.

Student is cleared of the injury to resume academic work.

• Written and signed notification of clearance by both physician and parent required.

• Staff will be notified of clearance by the school nurse.

• All academic work is returned to the teacher for evaluation and grade entry.

See Concussion Protocol Flowchart below.