5141.7 - Student Sports - Concussion and Head Injuries

5141.7(a)

Students

Student Sports – Concussion and Head Injuries

The Board of Education recognizes that concussions and head injuries are commonly reported injuries in children and adolescents who participate in sports and other recreational activities. The Board acknowledges the risk of catastrophic injuries or deaths are significant when a concussion or head injury is not properly evaluated and managed.

Commencing July 1, 2010, and each school year thereafter, any coach of intramural or interscholastic athletics employed by the District shall complete an initial training course, approved by the State Board of Education, regarding concussions and head injuries, prior to commencing the coaching assignment for the season. For the school year beginning July 1, 2011, and each school year thereafter, and after the completion of the initial training course regarding concussions and head injuries, each coach shall annually review current and relevant information regarding concussions and head injuries prior to the start of the coaching assignment. This annual review is not required in any year the coach is completing a refresher course. Beginning July 1, 2015, and each school year thereafter, a coach must complete a approved refresher course not later than five years after the initial training course in order to maintain his/her coaching permit and to coach in the District.

In compliance with applicable state statutes, the coach of any intramural or interscholastic athletics shall immediately remove any student athlete participating in intramural or interscholastic athletics who (1) is observed to exhibit signs, symptoms or behaviors consistent with a concussion following an observed or suspected blow to the head or body during a practice, game or competition, (2) is diagnosed with a concussion, or (3) is otherwise suspected of having sustained a concussion or head injury because such student athlete is observed to exhibit signs, symptoms or behaviors consistent with a concussion regardless of when such concussion or head injury may have occurred.

The coach shall not permit such student athlete to participate in any supervised team activities involving physical exertion, including, but not limited to, practices, games or competitions, until such student athlete receives written clearance to participate in such supervised team activities involving physical exertion from a licensed health care professional trained in the evaluation and management of concussions. A “licensed health care professional” means a physician licensed pursuant to Chapter 370 of the General Statutes, a physician assistant licensed pursuant to Chapter 370 of the General Statutes, an advanced practice registered nurse licensed pursuant to Chapter 378 of the General Statutes or an athletic trainer licensed pursuant to Chapter 375a of the General Statutes

Following medical clearance, the coach shall not permit such student athlete to participate in any full, unrestricted supervised team activities without limitations on contact or physical exertion, including, but not limited to, practices, games or competitions, until such student athlete (1) no longer exhibits signs, symptoms or behaviors consistent with a concussion at rest or with exertion, and (2) receives written clearance to participate in such full, unrestricted supervised team activities from a licensed health care professional trained in the evaluation and management of concussions.

Legal Reference:   Connecticut General Statutes

PA 10-62 An Act Concerning Student Athletes and Concussions

Policy adopted: March 28, 2013 WINDSOR LOCKS PUBLIC SCHOOLS

Windsor Locks, Connecticut

5141.7R(a)

Students

Student Sports – Concussion and Head Injuries

Concussion and Head Injury Management in Student Sports

A. Duties of the Athletic Director or Administrator in Charge of Athletics:

1. Annually, each spring, the Athletic Director or the administrator in charge of athletics, if there is no Athletic Director, shall review, with the District’s Medical Advisor and athletic trainer, any changes that have been made regarding the management of concussion and head injuries.

2. By the conclusion of the school year, the Athletic Director or administrator in charge of athletics will identify the competitive sport activities in the District for which compliance with the concussion and head injury policy is required. A list of competitive sports activities and the District’s policy and procedures will be distributed to all members of the coaching staff.

3. The Athletic Director or the administrator in charge of athletics, if there is no Athletic Director, shall be responsible for determining that all coaches of intramurals or interscholastic sports have fulfilled the required initial training and subsequent follow-up regarding concussions and head injuries prior to the coach’s commencement of his/her assignment, effective July 1, 2010.

B. Training of Coaches

All coaches shall undergo training in head injuries and concussion management as required by state statute, commencing July 1, 2010 in a program approved by the State Board of Education. All coaches shall receive annual refresher training. The Centers for Disease Control and Prevention (CDC tool kit, “Heads Up: Concussion in High School Sports,” will be used as the refresher guide for coaches, athletes, and parents.

C. Parent/Student Information Sheet

On a yearly basis, a concussion and head injury information sheet shall be signed and returned by the student athlete and the athlete’s parent/guardian prior to the student athlete’s initiating practice or competition. This information sheet may be incorporated into the parent permission sheet which permits students to participate in extracurricular athletics.

D. Coaches Responsibility

1. Based on mechanism of injury, observation, history and unusual behavior and reactions of the athlete, even without loss of consciousness, assume a concussion has occurred if the head was hit and even the mildest of symptoms occur. The student athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be immediately removed from play.

2. If confusion, unusual behavior or responsiveness, deteriorating condition, loss of consciousness, or concern about neck and spine injury exists, the athlete should be referred at once for emergency care.

3. If no emergency is apparent, the athlete should be monitored every 5 to 10 minutes regarding mental status, attention, balance, behavior, speech and memory until stable over a few hours. If appropriate medical care is not available, an athlete even with mild symptoms should be sent for medical evaluation.

4. No athlete suspected of having a concussion should return to the same practice or contest, even if symptoms clear in 15 minutes, no sooner than twenty-four hours after removal and only after the athlete receives written clearance from a licensed health care professional trained in the evaluation and management of concussions.

E. Return to Play After Concussion or Head Injury

1. A student athlete who has been removed from play may not participate in any supervised team activities involving physical exertion, including, but not limited to practices, games, or competitions, sooner than twenty-four hours after such athlete was removed from play until the athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussions and receives a written clearance to return to play from that health care provider. After medical clearance, all coaches should be cognizant of recurring signs and symptoms and closely monitor the athlete’s return to play.

Regulation approved: March 28, 2013 WINDSOR LOCKS PUBLIC SCHOOLS

Windsor Locks, Connecticut

5141.7R

Appendix A

HEADS UP: CONCUSSION IN YOUTH SPORTS

A Fact Sheet for COACHES

(To download the coaches fact sheet in Spanish, please visit:

www.cdc.gov/ConcussionInYouthSports)

THE FACTS

• • • •  A concussion is a brain injury.

      •  All concussions are serious.

      •  Concussions can occur without loss of consciousness.

      •  Concussions can occur in any sport.

      •  Recognition and proper management of concussions when they first occur can help prevent further injury or even death.

WHAT IS A CONCUSSION?

A concussion is an injury that changes how the cells in the brain normally work. A concussion is caused by a blow to the head or body that causes the brain to move rapidly inside the skull. Even a ding, getting your bell rung, or what seems to be a mild bump or blow to the head can be serious. Concussions can also result from a fall or from players colliding with each other or with obstacles, such as a goalpost.

The potential for concussions is greatest in athletic environments where collisions are common.1 Concussions can occur, however, in any organized or unorganized sport or recreational activity. As many as 3.8 million sports- and recreation-related concussions occur in the United States each year.2

RECOGNIZING A POSSIBLE CONCUSSION

To help recognize a concussion, you should watch for the following two things among your athletes:

1. A forceful blow to the head or body that results in rapid movement of the head.

-and-

2. Any change in the athlete’s behavior, thinking, or physical functioning. (See the signs and symptoms of concussion.)

SIGNS AND SYMPTOMS

SIGNS OBSERVED BY COACHING STAFF

• • • •  Appears dazed or stunned

      •  Is confused about assignment or position

      •  Forgets sports plays

      •  Is unsure of game, score, or opponent

      •  Moves clumsily

      •  Answers questions slowly

      •  Loses consciousness (even briefly)

      •  Shows behavior or personality changes

      •  Can’t recall events prior to hit or fall

      •  Can’t recall events after hit or fall

SYMPTOMS REPORTED BY ATHLETE

•  Headache or pressure in head

•  Nausea or vomiting

•  Balance problems or dizziness

•  Double or blurry vision

•  Sensitivity to light

•  Sensitivity to noise

•  Feeling sluggish, hazy, foggy, or groggy

•  Concentration or memory problems

•  Confusion

•  Does not feel right

Adapted from Lovell et al. 2004

Athletes who experience any of these signs or symptoms after a bump or blow to the head should be kept from play until given permission to return to play by a health care professional with experience in evaluating for concussion. Signs and symptoms of concussion can last from several minutes to days, weeks, months, or even longer in some cases.

Remember, you can’t see a concussion and some athletes may not experience and/or report symptoms until hours or days after the injury. If you have any suspicion that your athlete has a concussion, you should keep the athlete out of the game or practice.

PREVENTION AND PREPARATION

As a coach, you can play a key role in preventing concussions and responding to them properly when they occur. Here are some steps you can take to ensure the best outcome for your athletes and the team:

• Educate athletes and parents about concussion. Talk with athletes and their parents about the dangers and potential long-term consequences of concussion. For more information on long-term effects of concussion, view the following online video clip: http://www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.htm#Video. Explain your concerns about concussion and your expectations of safe play to athletes, parents, and assistant coaches. Pass out the concussion fact sheets for athletes and for parents at the beginning of the season and again if a concussion occurs.

• • • •  Insist that safety comes first.

        •  Teach athletes safe playing techniques and encourage them to follow the rules of play.

        •  Encourage athletes to practice good sportsmanship at all times.

        •  Make sure athletes wear the right protective equipment for their activity (such as helmets, padding, shin guards, and eye and mouth guards). Protective equipment should fit properly, be well maintained, and be worn consistently and correctly.

        •  Review the athlete fact sheet with your team to help them recognize the signs and symptoms of a concussion.

Check with your youth sports league or administrator about concussion policies. Concussion policy statements can be developed to include the leagues commitment to safety, a brief description of concussion, and information on when athletes can safely return to play following a concussion (i.e., an athlete with known or suspected concussion should be kept from play until evaluated and given permission to return by a health care professional). Parents and athletes should sign the concussion policy statement at the beginning of the sports season.

• • • •  Teach athletes and parents that it’s not smart to play with a concussion. Sometimes players and parents wrongly believe that it shows strength and courage to play injured. Discourage others from pressuring injured athletes to play. Don’t let athletes persuade you that they’re just fine after they have sustained any bump or blow to the head. Ask if players have ever had a concussion.

      •  Prevent long-term problems. A repeat concussion that occurs before the brain recovers from the first usually within a short period of time (hours, days, or weeks) can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in brain swelling, permanent brain damage, and even death. This more serious condition is called second impact syndrome.4, 5 Keep athletes with known or suspected concussion from play until they have been evaluated and given permission to return to play by a health care professional with experience in evaluating for concussion. Remind your athletes: It’s better to miss one game than the whole season.

ACTION PLAN

WHAT SHOULD A COACH DO WHEN A CONCUSSION IS SUSPECTED?

1. Remove the athlete from play. Look for the signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head. Athletes who experience signs or symptoms of concussion should not be allowed to return to play. When in doubt, keep the athlete out of play.

2. Ensure that the athlete is evaluated right away by an appropriate health care professional. Do not try to judge the severity of the injury yourself. Health care professionals have a number of methods that they can use to assess the severity of concussions. As a coach, recording the following information can help health care professionals in assessing the athlete after the injury:

• Cause of the injury and force of the hit or blow to the head

• Any loss of consciousness (passed out/knocked out) and if so, for how long

• Any memory loss immediately following the injury

• Any seizures immediately following the injury

• Number of previous concussions (if any)

3. Inform the athlete’s parents or guardians about the possible concussion and give them the fact sheet on concussion. Make sure they know that the athlete should be seen by a health care professional experienced in evaluating for concussion.

4. Allow the athlete to return to play only with permission from a health care professional with experience in evaluating for concussion. A repeat concussion that occurs before the brain recovers from the first can slow recovery or increase the likelihood of having long-term problems. Prevent common long-term problems and the rare second impact syndrome by delaying the athletes return to the activity until the player receives appropriate medical evaluation and approval for return to play.

If you think your athlete has sustained a concussion take him/her out of play, and seek the advice of a health care professional experienced in evaluating for concussion.

For more information and to order additional materials free-of-charge, visit:

www.cdc.gov/ConcussionInYouthSports

For more detailed information on concussion and traumatic brain injury, visit:

http://www.cdc.gov/ncipc/tbi/TBI.htm

REFERENCES

1. Powell JW. Cerebral concussion: causes, effects, and risks in sports. Journal of Athletic Training 2001; 36(3):307-311.

2. Langlois JA, Rutland-Brown W, Wald M. The epidemiology and impact of traumatic brain injury: a brief overview. Journal of Head Trauma Rehabilitation 2006; 21(5):375-378.

3. Lovell MR, Collins MW, Iverson GL, Johnston KM, Bradley JP. Grade 1 or ding concussions in high school athletes. The American Journal of Sports Medicine 2004; 32(1):47-54.

4. Institute of Medicine (US). Is soccer bad for children’s heads? Summary of the IOM Workshop on Neuropsychological Consequences of Head Impact in Youth Soccer. Washington (DC): National Academy Press; 2002.

5. Centers for Disease Control and Prevention (CDC). Sports-related recurrent brain injuries-United States. Morbidity and Mortality Weekly Report 1997; 46(10):224-227. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/00046702.htm.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION

Content Source: National Center for Injury Prevention and Control, Division of Injury Response

Page Located on the Web at http://www.cdc.gov/ConcussionInYouthSports/english/toolkit_coaches_factsheet.htm

DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL AND PREVENTION

SAFER  HEALTHIER  PEOPLE™

5141.7R

Appendix B

Fact Sheet for Student Athletes

What is a concussion?

A concussion is a brain injury that:

• • • •  Is caused by a bump, blow, or jolt to the head.

      •  Can change the way your brain normally works.

      •  Can range from mild to severe.

      •  Can occur during practices or games in any sport.

      •  Can happen even if you haven’t been knocked out.

      •  Can be serious even if you’ve just been “dinged” or had your “bell rung.”

How can I prevent a concussion?

It’s different for every sport. But there are steps you can take to protect yourself from concussion.

•  Follow your coach’s rules for safety and the rules of the sport.

•  Practice good sportsmanship at all times.

•  Use the proper sports equipment, including personal protective equipment (such as helmets)

•  In order for equipment to protect you, it must be:

• Appropriate for the game, position, and activity

• Well maintained

• Properly fitted

• Used every time you play

How do I know if I’ve had a concussion?

You can’t see a concussion, but you might notice some of the symptoms right away. Other symptoms can show up days or weeks after the injury. It’s best to see a health care professional if you think you might have a concussion. An undiagnosed concussion can affect your ability to do schoolwork and other everyday activities. It also raises your risk for additional serious injury.

What are the symptoms of a concussion?

• • • •  Nausea (feeling that you might vomit)

      •  Balance problems or dizziness

      •  Double or fuzzy vision

      •  Sensitivity to light or noise

      •  Headache

      •  Feeling sluggish

      •  Feeling foggy or groggy

      •  Concentration or memory problems (forgetting game plays)

      •  Confusion

What should I do if I think I have a concussion?

•  Tell your coaches and your parents. Never ignore a bump, blow, or jolt to the head. Also tell your coach if one of your teammates might have a concussion.

•  Get a medical checkup. A health care professional can tell you if you have had a concussion and when you are OK to return to play.

•  Give yourself time to recover. If you have had a concussion, your brain needs time to heal. While your brain is still healing, you are much more likely to suffer another concussion.

5141.7R

Form

HEADS UP: CONCUSSION IN YOUTH SPORTS

A Fact Sheet for Parents and Athletes

(Requirement to Read and Signed by Parents and Athletes) Return This Form to Team Coach.

WHAT IS A CONCUSSION?

A concussion is a brain injury that is caused by a bump or blow to the head. It can change the way your brain normally works. It can occur during practices or games in any sport. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. A concussion can happen even if you haven’t been knocked out. You can’t see a concussion. Signs and symptoms of a concussion can show up right after the injury or may not appear or be noticed until days or weeks after the injury. If your child reports any symptoms of concussion, or if you notice the symptoms yourself, seek medical attention right away.

Parents and Guardians

What are the signs and symptoms of a concussion observed by Parents/Guardians?

If your child has experienced a bump or blow to the head during a game or practice, look for any of the following signs and symptoms of a concussion:

• • • •  Appears dazed or stunned

      •  Is confused about assignment or position

      •  Forgets an instruction

      •  Is unsure of game, score, or opponent

      •  Moves clumsily

      •  Answers questions slowly

      •  Loses consciousness (even briefly)

      •  Shows behavior or personality changes

      •  Can’t recall events prior to being hit or falling

      •  Can’t recall events after being hit or falling

How can a Parent/Guardian help their child prevent a concussion?

Every sport is different, but there are steps your children can take to protect themselves from concussion.

• • • •  Ensure that they follow their coach’s rules for safety and the rules of the sport.

      •  Encourage them to practice good sportsmanship at all times.

      •  Make sure they wear the right protective equipment for their activity (such as helmets, padding, shin guards, and eye and mouth guards). Protective equipment should fit properly, be well maintained, and be worn consistently and correctly.

      •  Learn the signs and symptoms of a concussion.

What should a Parent/Guardian do if they think their child has a concussion?

1. Seek medical attention right away. A health care professional will be able to decide how serious the concussion is and when it is safe for your child to return to sports. Notify your child's coach if you think your child has a concussion.

2. Keep your child out of play. Concussions take time to heal. Don’t let your child return to play until a health care professional says it’s OK. Children who return to play too soon— while the brain is still healing—risk a greater chance of having a second concussion. Second or later concussions can be very serious. They can cause permanent brain damage, affecting your child for a lifetime.

3. Tell your child’s coach about any recent concussion in ANY sport or activity. Your child’s coach may not know about a concussion your child received in another sport or activity unless you tell the coach.

Athletes

What are the symptoms of a concussion?

• • • •  Headache or “pressure” in head

      •  Nausea or vomiting

      •  Balance problems or dizziness

      •  Double or blurry vision

      •  Bothered by light

      •  Bothered by noise

      •  Feeling sluggish, hazy, foggy, or groggy

      •  Difficulty paying attention

      •  Memory problems

      •  Confusion

      •  Does not “feel right”

What should an athlete do if they think they have a concussion?

• • • •  Tell your coaches and your parents. Never ignore a bump or blow to the head even if you feel fine. Also, tell your coach if one of your teammates might have a concussion.

      •  Get a medical checkup. A doctor or health care professional can tell you if you have a concussion and when you are OK to return to play.

      •  Give yourself time to get better. If you have had a concussion, your brain needs time to heal. While your brain is still healing, you are much more likely to have a second concussion. Second or later concussions can cause damage to your brain. It is important to rest until you get approval from a doctor or health care professional to return to play.

      •  It is better to miss one game than the whole season.

How can athletes prevent a concussion?

Every sport is different, but there are steps you can take to protect yourself.

• • • •  Follow your coach’s rules for safety and the rules of the sport.

      •  Practice good sportsmanship at all times.

      •  Use the proper sports equipment, including personal protective equipment (such as helmets, padding, shin guards, and eye and mouth guards). In order for equipment to protect you, it must be:

        • • •  The right equipment for the game, position, or activity

            •  Worn correctly and fit well

            •  Used every time you play

            •  Repaired and maintained

Student Signature: _______________________________________________________________  Date: _________________________

Parent/Guardian Signature: ______________________________________________________  Date: _________________________

For more detailed information on concussion and traumatic brain injury, visit:

http://www.cdc.gov/injury  or www.cdc.gov/ConcussionInYouthSports