A concussion response procedure and treatment plan shall be developed and approved by the District Medical Director and/or other licensed healthcare professionals employed by the District.

This procedure and treatment plan shall:

• Provide guidance for school staff who may respond to a student with a suspected head injury
• Outline removal-from-play requirements
• Establish emergency response criteria
• Include monitoring expectations
• Provide return-to-learn and return-to-play protocols

The procedure and treatment plan shall be appended to this regulation and made accessible to appropriate staff.

Concussion Management Team

The District may establish a Concussion Management Team (CMT) which will oversee and implement the District's concussion management policies and protocols.

The team may include:

1. The Athletic Director and/or Director of Physical Education
2. A school nurse
3. District Medical Director
4. A coach and/or Physical Education teacher
5. A certified athletic trainer
6. School Administration/Pupil Personnel Services staff
7. Teacher
8. Private medical provider or specialist
9. Other appropriate personnel as designated by the District

The primary focus of the team is student health and recovery.

Responsibilities of the CMT

The following is a list of tasks that may be performed by the CMT annually:

1. Oversee required NYSED-approved training for coaches, physical education teachers, nurses, and athletic trainers on concussion and Mild Traumatic Brain Injury (MTBI), and ensure documentation of completion is maintained.
2. Address the educational needs of teachers, other appropriate staff, students, and parents/guardians regarding concussion awareness, identification, reporting requirements, and post-concussion management.
3. Implement and monitor a coordinated communication plan among appropriate staff to ensure that private healthcare provider orders for post-concussion management are received, implemented, and followed.
4. Work with the District's Medical Director to establish and annually review a standard treatment plan and emergency procedure for when a student sustains a concussion during the school day or at a school-sponsored athletic event.
5. Advocate for appropriate academic and physical accommodations to reduce delays in a student’s ability to return to full activities.
6. Provide concussion information to parents and persons in parental relations throughout each school year.

Identification of Concussions

Symptoms of a concussion include, but are not limited to:

1. Amnesia
2. Confusion or appearing dazed
3. Headache or head pressure
4. Loss of consciousness
5. Balance difficulty or dizziness
6. Double or blurry vision
7. Sensitivity to light and/or sound
8. Nausea, vomiting, and/or loss of appetite
9. Irritability, sadness, or personality changes
10. Feeling sluggish, foggy, groggy, or lightheaded
11. Concentration or focusing problems
12. Slowed reaction times or drowsiness
13. Fatigue and/or sleep disturbances

Students who develop any of the above signs or whose symptoms worsen must be evaluated immediately by a physician.

Parent/Guardian will be given forms: concussion checklist and concussion protocol checklist. The physician must complete the concussion protocol checklist form. This form must be returned to the school nurse.

Neurocognitive Testing and Sideline Assessments

The District may allow credentialed District staff to use validated neurocognitive computerized testing as a concussion assessment tool. These programs establish baselines for student athletes and allow for post-concussion performance evaluations.

These tools may include:

• ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing)
• SCAT 5 (Sport Concussion Assessment Tool)
• ACE (Acute Concussion Evaluation)
• BESS (Balance Error Scoring System)

The District recognizes that trained staff must administer these tests under appropriate conditions. Neurocognitive testing is not a replacement for medical evaluation.

Parents may request copies of results and are encouraged to share them with medical providers.

Procedure for Removal of Student from Activities Due to Concussion

The following procedure will be followed if a student sustains or is believed to have sustained a concussion during any school-sponsored activity:

1. The student will not return to play in the current game, practice, or event.
2. The student will not be left alone and must be monitored regularly.
3. Trained staff will evaluate the student.
4. A concussion checklist will be provided to the student and parent/guardian.
5. Parents/guardians must be contacted immediately.
6. The student must be picked up by a parent/guardian over age 18.
7. If severe, EMS will be contacted and the student transported to the emergency room.
8. An incident report must be completed and the school nurse notified. The Athletic Director will also be notified for sports-related injuries.
9. If utilized, post-concussion neurocognitive testing will be administered to evaluate readiness for return to activity.

Post-Concussion Management

Post-concussion management shall follow NYSED Guidelines for Concussion Management in Schools and private healthcare provider orders.

A coordinated communication plan shall ensure:

• Academic accommodations are implemented
• Physical activity restrictions are followed
• Staff are informed on a need-to-know basis
• Documentation is maintained

A student shall not resume participation in athletic activities until:

• Written approval is granted by the District Medical Director; or
• In the case of a nonpublic school student, written approval is provided by the student’s private physician.

Cognitive Rest

Cognitive rest requires avoidance of activities requiring concentration or mental stimulation, including but not limited to:

• Computers and video games
• Television
• Driving
• Texting
• Reading or writing
• Homework or tests
• Band, chorus, plays
• Employment
• Loud music
• Bright lights

Staff and parents should monitor for recurring symptoms. If symptoms return, the activity should cease.

Physical Rest

Physical rest includes:

• Adequate sleep
• Frequent rest periods
• Avoiding exertional activities

Students must avoid:

• Contact/collision activities
• High-intensity exercise
• Activities increasing heart rate or head pressure

Each student must be treated individually based on symptom presentation.

Return to Physical Activities

Return to physical activity shall follow a graduated progression, typically introducing a new activity level every 24 hours.

If symptoms return:

• The student must stop activity
• Return to the previous level

Progression must follow private healthcare provider and/or District Medical Director orders.

Students shall be monitored daily by District staff during progression.

 Review

This Concussion Management Regulation shall be reviewed at least every three (3) years or sooner if required due to updates in law, regulation, or NYSED guidance.

The review shall include evaluation of implementation effectiveness and necessary updates to reflect current best practices.