Policy 7516 – Concussion Management

PURPOSE:

The Board of Education of the Greater Johnstown School District recognizes the seriousness of concussions in children and adolescents who participate in school sponsored sports and recreational activities and the outstanding need to manage the potential consequences of mild traumatic brain injuries.  Therefore, the District hereby adopts the following policy to enact appropriate training for school personnel, set forth the proper evaluation and management of head injuries and to comply with New York State’s Concussion Management Awareness Act.

A concussion is defined as a disturbance in brain function caused by a direct or indirect force to the head and can cause harmful, long-term effects to brain functions.  Often, signs of a concussion are a confused state, memory problems, and lack of sustained attention. While recoveries from concussions vary from child-to-child, avoiding re-injury and over-exertion until fully recovered are critical to proper concussion management.  The following policy shall represent the minimum standards that must be complied with by the Greater Johnstown School District relating to mild traumatic brain injuries.

POLICY:

While District staff will exercise reasonable care to protect students, head injuries during athletics or other school sponsored activities may still occur.  The following preventative measures shall be instituted to educate school personnel and parents regarding concussions and the importance of proper medical treatment:

Training:

In order to provide the appropriate education, care and attention to students who may receive a concussion, personnel must be able to recognize the signs, symptoms and behaviors consistent with a concussion.  Accordingly, the Greater Johnstown School District shall require a biennial course of instruction for all school coaches, physical education teachers, nurses and athletic trainers which shall include, but not be limited to, the definition of “concussion,” signs and symptoms of mild traumatic brain injuries, how such injuries may occur, practices regarding prevention and the guidelines for the return to school and to certain activities after a pupil has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school.  Such training may be completed by means of classroom instruction, online providers or teleconference approved by the Department of Education.

Parents shall be educated through preseason meetings for sports and/or information sheets provided to parents.

Concussion Management Team:

The Greater Johnstown School District may, in its discretion, establish a concussion management team which may be composed of the athletic director (if any), a building nurse, the school physician, a coach of an interscholastic athletic team, an athletic trainer or such other appropriate personnel as designated by the school district.  The team shall oversee the District’s implementation of the training requirement set forth herein.  Additionally, every concussion management team may establish and implement a program which provides information on mild traumatic brain injuries to parents and persons in parental relation throughout the year.

Parental Permission:

The Greater Johnstown School District shall provide a permission form to the parent or person in parental relation prior to student participation in any interscholastic sports.  The permission form shall either include the definition of “concussion,” signs and symptoms of mild traumatic brain injuries, how such injuries may occur and the guidelines for the return to school and certain school activities after a pupil has suffered a mild traumatic brain injury or a reference how to obtain such information from the Department of Education and the Department of Health Internet websites.

CONCUSSION MANAGEMENT PROTOCOL

The Superintendent of Schools, in consultation with the appropriate district personnel and the Chief School Medical Officer hereby develop the following standard protocols to guide the return to activity.  Such protocols shall be case-by-case and shall consider recommendations of the student’s physician and the District’s Chief Medical Officer.

Any student reporting or exhibiting those signs, symptoms or behaviors while participating in a school sponsored class, extracurricular activity or interscholastic athletic activity shall be removed from the game or activity, and be evaluated as soon as possible by an appropriate health care professional.  In the event that there is any doubt as to whether a pupil has sustained a concussion, District personnel shall presume that he or she has been so injured until proven otherwise.  The school athletic director or building nurse will notify the student’s parents or guardians and recommend appropriate monitoring to parents or guardians and following up with a physician.

If a student sustains a concussion other then when engaged in a school-sponsored activity, the District expects the parent/legal guardian to report the condition to the building nurse so that the District can support the appropriate management of the condition.

Return to Play:

There are many risks to premature return to play including, but not limited to, greater risk for a second concussion due to a lower concussion threshold, second impact syndrome (abnormal brain blood flow that can result in death), exacerbation of any current symptoms, and increased risk for additional injury due to alteration in balance.  The Greater Johnstown School District utilizes the NYSPHAA return to play recommendations, in addition to proper concussion management protocol pursuant to NYS Laws, Rules and Regulations.

Return to play following a concussion involves a stepwise progression once the individual is symptom free.  Students are prohibited from returning to play the day the concussion is sustained.  After diagnosis of a concussion by a treating physician, the student will be removed from all activity for minimum of seven (7) days, even if asymptomatic.  Once the student is symptom free for twenty-four (24) hours and has been evaluated by and received written and signed authorization from a licensed physician, the District’s Chief Medical Officer shall make a final decision on return to activity, including physical education class and after-school sports.  The authorization shall be kept on file in the pupil’s permanent health record.  Any student who is reported to have signs or symptoms upon return to activity must be removed from play and reevaluated by their health care provider.  A return to play progression shall be generally followed below (unless directed otherwise by the student’s treating physician or Chief Medical Officer):

PLAY PROGRESSION:

  • Day 1: (after asymptomatic for 24 hours and cleared by physician): Light aerobic activity – low impact, non-contact (i.e., stationary bike, walking < 70% max hr.), no more than 25 minutes
  • Day 2: Moderate aerobic activity- Increase the intensity of the aerobic activity- no resistance exercises or weight training, no more than 35 minutes
  • Day 3: Sport-specific activity – any simple movement that does not involve the risk of a collision (sports specific skills at moderate intensity), no more than 45 minutes
  • Day 4: Non-contact training drills – sport specific drills at full intensity
  • Day 5: Full contact practice – normal training activities
  • Day 6: Return to play – normal play is allowed with close monitoring of symptoms

Each step shall take twenty-four (24) hours so that an athlete will take approximately one (1) week to proceed through the full rehabilitation protocol once they are asymptomatic at rest and with Physician approval.  If any post concussion symptoms occur while in the step program, then the student shall not be allowed to participate again until asymptomatic for twenty-four (24) hours.  Upon their return, they shall drop back to the previous asymptomatic level and attempt to progress through the stages again.

CONCUSSION MANAGEMENT IN THE CLASSROOM:

Students recovering from concussions may experience significant academic difficulties due to impaired cognitive abilities.  Mental exertion and environmental stimulation can aggravate concussion symptoms such as headache and fatigue, which in turn can prolong recovery.  To ensure academic progress and set optimal conditions for a successful recovery, academic accommodations shall be available to the student.

Adopted:  May 17, 2012
Revised: 12/6/18