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3000-8000 - Regulations
7552R CONCUSSION MANAGEMENT
The Board recognizes that concussions and head injuries are the commonly reported injuries in children and adolescents who participate in sports and recreational activities. Therefore, the District has developed the following regulation for the implementation of the Concussion Management and Awareness Act and Commissioner's regulations to support the proper evaluation and management of concussion injuries.
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;
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. The following is a list of tasks that may be performed by the CMT annually:
1) Oversee the training of coaches, physical education teachers, nurses and athletic trainers on concussion and Mild Traumatic Brain Injury (MTBI).
2) Implement a coordinated communication plan to ensure that all staff is aware of and following post-concussion orders from private physicians.
3) Work with the District's Medical Director to establish 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.
4) Advocate for appropriate academic and physical accommodations to reduce delays in a student's ability to return to full activities.
5) Provide information on concussion 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 (e.g., decreased or absent memory of events prior to or immediately after the injury, or difficulty retaining new information);
2) Confusion or appearing dazed;
3) Headache or head pressure;
4) Loss of consciousness;
5) Balance difficulty or dizziness, or clumsy movements;
6) Double or blurry vision;
7) Sensitivity to light and/or sound;
8) Nausea, vomiting, and/or loss of appetite;
9) Irritability, sadness, or other changes in personality;
10) Feeling sluggish, foggy, groggy, or lightheaded;
11) Concentration or focusing problems;
12) Slowed reaction times, drowsiness;
13) Fatigue and/or sleep issues (e.g., sleeping more or less than usual).
Students who develop any of the following signs, or if the above listed symptoms worsen, must be seen and evaluated immediately by a physician.
Parent/Guardian will be given forms: concussion checklist and concussion protocol checklist. The physician needs to complete 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. The tests also measure verbal and visual memory, processing speed, and reaction time. These tools may include ImPACT (Immediate Post Concussion Assessment and Cognitive Testing) and SCAT 5 (Sport Concussion Assessment Tool).
The District may also allow staff to use sideline assessment tools when necessary. The District recognizes the need for trained staff to administer these tests, along with the time and conditions needed for a successful evaluation of a student's condition.
Parents may request a copy of the results. Staff will instruct parents to offer these results and the results from any sideline testing to medical providers to aid in the diagnosis and treatment of injured students. Neurocognitive testing is not a replacement for a medical evaluation to diagnose a concussion.
Procedure for Removal of Student from Activities Due to Concussion
The following procedure will be followed in the event that a student sustains or is believed to have sustained a concussion during any school sponsored activity:
1) The student will not be allowed to return to activity or play in the current game, practice, or event. It shall be presumed that he/she has been injured until proven otherwise.
2) The student will not be left alone, and should be monitored regularly to check for deteriorating symptoms.
3) Trained staff will be available to identify a potential concussion.
4) A concussion checklist to be given to the student and his/her parent or guardian to aid in diagnosis.
5) Parents or guardians must be contacted following an injury. Parental contact information must be up to date in case of an emergency.
6) The student must be picked up by a parent or guardian over the age of 18. The student will not be released on his or her own or to a friend or fellow student.
7) If the injury is severe, an ambulance will be called to transport the student to the emergency room. If parents are not present, they will be contacted and instructed to meet the student and the ambulance at the emergency room.
8) The incident will be reported to the school nurse and an incident report must be filled out. In situations involving school sports teams, Athletic Director will also be notified.
9) If the District utilizes Neurocognitive Testing as a concussion tool to obtain baseline and post-concussion performance data, the District will administer this tool to the student to gather post-concussion performance data and evaluate readiness for return to activity.
Refer to the NYS Education Dept. Guidelines for Concussion Management in Schools
Cognitive rest requires that the student avoid participation in, or exposure to, activities that require concentration or mental stimulation including, but not limited to:
• Computers and video games
• Television viewing
• Reading or writing
• Studying or homework
• Taking a test or completing significant projects
• Participation in band, chorus, plays, etc.
• Loud music
• Bright lights
Parents/guardians, teachers, and other district staff should watch for signs of concussion symptoms such as fatigue, irritability, headaches, blurred vision, or dizziness; reappearing with any type of mental activity or stimulation. If any these signs and symptoms occur, the student should cease the activity. Return of symptoms should guide whether the student should participate in an activity.
Physical rest includes:
getting adequate sleep,
taking frequent rest periods or naps, and avoiding physical activity that requires exertion.
Some activities that should be avoided include, but are not limited to:
• Ones that result in contact and collision and are elevated risk for re-injury
• High speed and/or intense exercise and/or sports
• Any activity that results in an increased heart rate or increased head pressure (e.g., straining or strength training). Students may find that they need to rest during the school day and should be allowed to do so if needed. Every student will be different and should be treated individually. One student may be able to attend school full days without difficulties, while another may find lights, noise and other stimulation causes fatigue and needs rest periodically.
Return to Physical Activities
A gradual return to physical activity typically is done by progressing a student through levels of activity that increase in duration and/or intensity. Gradual return to activity should occur with the introduction of new activity level every 24 hours. If any post-concussion symptoms return, the student should stop the activity and drop back to the previous level of activity. Current research suggests that some level of symptoms with activity is acceptable. Therefore, schools will need to follow provider orders on return to activities. Students should be monitored by district staff daily following each progressive level of physical activity, for any return of signs and symptoms of concussion. A gradual progression should be followed based on private healthcare provider’s or other specialist’s orders and recommendations.