Concussion Protocol
NEWARK ACADEMY CONCUSSION IDENTIFICATION MANAGEMENT AND RETURN-TO-PLAY POLICY
Introduction:
A concussion is a “traumatic brain injury induced by biomechanical force” and caused by either a “direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head” [BJSM, 2017]. Common symptoms include headache, nausea, dizziness, feeling mentally foggy, fatigue, difficulty with sleep, confusion, trouble concentrating, and a decrease in memory. Signs and symptoms of a concussion range from mild to severe, and may be delayed from a few minutes to days after the injury. A student does not need to lose consciousness to suffer a concussion, and often diagnostic testing (i.e. CT scan, MRI) is normal. Concussions are no longer given “grades” or diagnosed as “mild-moderate-severe.” All head injuries are taken seriously and treatment is provided based on each individual’s symptoms.
Students participating in contact sports are at a higher risk for sustaining a concussion. The days of “toughing it out” or “shaking it off” are no longer acceptable. Permitting a student-athlete to return-to-play before recovering from a concussion increases the chance of a more serious brain injury that can result in severe disability and/or death. Please note that the policy and procedure stated in this document applies to ALL Newark Academy students at ALL levels, who sustain a concussion or exhibit concussion-like symptoms.
Policy:
Parents/guardians of a student-athlete shall receive a concussion information sheet, along with all pre-participation examination forms, on a yearly basis via Magnus Health. The student-athlete and their parents/guardians shall read and sign the form, acknowledging the receipt of this information. If these forms are not submitted when due, the student-athlete will NOT be permitted to participate in pre-season camps, practices and/or games. There will be no exceptions or exemptions to this policy.
All coaches will annually complete a concussion course to understand, recognize, and properly manage concussions. A certificate of completion must be submitted to the athletic department via Magnus Health as verification.
Procedure:
1. When a student-athlete sustains a hit to the head they can only be evaluated by the Certified Athletic Trainer(s), School Nurse(s), or Licensed Physician trained in the evaluation and management of concussions.
2. A student-athlete exhibiting concussion-like symptoms will be removed from participation and not allowed to return the same day.
3. If the evaluating medical staff determines it’s safe for the student-athlete to go home, take home instructions (i.e. head injury sheet) will be given to the athlete and parent/guardian.
4. If the evaluating medical staff determines the athlete needs further immediate medical attention, they will refer the parents/guardian and athlete to the emergency room or licensed physician trained in the evaluation and management of concussions.
5. The treating physician will determine diagnosis. In the event the student-athlete is diagnosed with a concussion, a note must be provided to the school stating such. The medical note should include any academic accommodations, physical activity restrictions, and/or permission for low level exertion. In the event the treating physician deems the student-athlete does NOT have a concussion, a note from the physician must be provided to the school stating “no concussion” and “may return to full contact activities.”
6. If academic accommodations are prescribed by the treating physician for a student diagnosed with a concussion, a gradual return to school strategy will be implemented. Specific medical accommodations will be managed by the medical staff at Newark Academy at the discretion of the treating physician or school physician. Specific academic accommodations prescribed by the treating physician or school physician will be managed by the Dean of Students (upper school students) or Middle School Principal (middle school students). These administrators will alert appropriate faculty members at Newark Academy to ensure academic accommodations are followed.
7. After the prescribed rest period established by the treating physician, the student-athlete must meet the following criteria in order to start the return-to-play protocol: remain asymptomatic for at least 24 hours, and return to normal cognitive activities without any symptoms or academic accommodations.
8. The return-to-play protocol is completed under the supervision of a certified athletic trainer, physical therapist, or other medical professional trained in concussion management. The steps in the return-to-play protocol are as followed:
Day 1: Light aerobic exercise (i.e. stationary cycling, swimming)
Day 2: Sport specific exercise (i.e. running, dynamic drills)
Day 3: Non-contact training drills including resistance training
*Repeat concussion test before the next step if prescribed by the treating physician.
*Medical clearance note from treating physician needed before full practice. Medical
referral forms are available to use and should be given to the parent/guardian or athlete when able.
Day 4: Full contact drills/practice
Day 5: Return to normal game play
There should be at least 24 hours between each step of the return-to-play protocol. If symptoms arise during exercise, the student-athlete will discontinue exercise for the day and go back to the previous step. If the student fails multiple times, the Newark Academy medical staff will contact the treating physician or school physician.
This policy was written in accordance with the guidelines set forth by the NJSIAA Medical Advisory Board in April 2010 and has been adjusted to meet the specific needs of our students at Newark Academy. This has been a collaborative effort among Patricia Neary, RNC; Kathleen Ollen, RN; Dr. Daniel Harrington; Victoria Montemorano, ATC; Seth Lieberman, Director of Athletics; and Liz Bona, Associate Director of Athletics.
