Return to Play (RTP) Management
The RTP decision will be made after an incremental increase in activity with an initial cardiovascular challenge, followed by sport-specific activities that do not place the athlete at risk for concussion. The following criteria will be followed and satisfied before an athlete is eligible for functional RTP testing:
Near asymptomatic or asymptomatic at rest (GSC <10)
Asymptomatic or absence of increasing symptoms in cognitive exercises (classroom work)
ImPACT test at baseline or within normal demographics
Athlete must be at or above their SCAT-3 Baseline score if the baseline score is available
Concussion Policy
Definition and Recognition of Concussions:
A concussion shall be defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.
Concussions can be caused by a direct blow to the head, face, neck, or elsewhere on the body with an “impulsive” force transmitted to the head.
Concussions usually result in the rapid onset of short-lived impairment of neurological function that usually resolves spontaneously. In some cases, these signs and symptoms may last minutes to hours.
Concussions may result in neuropathologic manifestations, but most acute clinical symptoms are reflective of functional disturbances and not structural disturbances causing no abnormalities on a standard neuroimaging study.
Concussions result in a graded set of symptoms that may include a loss of consciousness. The resolution of these symptoms usually follow a sequential course clinically. However, not every case is the same and each case should be treated as such.
Signs and Symptoms of Concussion
Loss of consciousness (LOC) Confusion Post-traumatic amnesia (PTA)
Retrograde amnesia (RGA) Disorientation Delayed verbal and / or motor response
Inability to focus Headache Nausea / vomiting
Visual disturbances Disequilibrium Feeling in a “fog”, “zoned out”
Vacant stare Emotional lability Dizziness
Slurred / incoherent speech Excessive drowsiness
Home Care
An athlete with a concussion should be instructed to avoid taking medications except acetaminophen after the injury.
Athletes will be advised to avoid ingesting alcohol, illicit drugs, or other substances that might interfere with cognitive function and neurological recovery.
Athletes will be advised to rest but complete bed rest is not recommended. Avoiding activities that potentially increase symptoms.
An athlete with a concussion should be instructed to eat a well-balanced diet that is nutritious in both quality and quantity.
An athlete should be awakened during the night to check on deteriorating signs and a symptom only if he or she experienced LOC, had prolonged periods of amnesia or was still experiencing significant symptoms at bedtime.
Oral or written instructions (appendix 3) for home care should be given to the athlete and to a responsible adult (e.g., parent or roommate) who will observe and supervise the athlete during the acute phase of the concussion while at home or in the dormitory.