Essex Westford School District:  Concussion Action Plan

This document contains:

1. Concussion Action Plan For Students Who Participate In School Sports
2. Concussion Action Plan For Students Who Do Not Participate In School Sports

1. Concussion Action Plan For Students Who Participate In School Sports

Management of School Sponsored Sports-Related Concussions

Essex Westford School District (EWSD) has developed this protocol to address the issue of the identification and management of concussions for students who participate in school sports.  Act 68 was passed into law in 2013 and requires that schools have an action plan (text in italics are items required by Act 68).

A safe return to activity protocol (learning and athletics) is important for all athletes following any injury, but it is essential after a concussion.  The goal of this concussion protocol is to ensure that concussed athletes are identified, treated and referred appropriately for return to learn and return to play. Consistent use of a concussion management protocol will ensure that the athlete receives appropriate follow-up and/or academic accommodations in order to make certain that the athlete is fully recovered prior to returning to full athletic play activity.

This protocol will be reviewed annually by school nurse and athletic director or designee.  Changes and modifications will be reviewed and written notifications will be provided to athletic department staff, coaches and other appropriate school personnel.

All coaches are required to certify concussion management training every two(2) years. Parents and athletes must be educated about concussions annually.   The written documentation of coaches annual training shall be kept in the coaches personnel file and the student/parents in the student file and be tracked by athletic director or designee.

Recognition of Concussion

These signs and symptoms – following a witnessed, reported or suspected blow to the head or body – are indicative of a probable concussion.

Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion must be removed from competition or practice and will not be allowed to train or compete with a school athletic team until the athlete has been examined by and received written permission to participate in athletic activities from a health care provider (per Act 68, approved by the VT Legislature in 2013).  

The contracted certified athletic trainer (where applicable), school nurses, athletic director, and the concussion certified coaches have been designated as the individual(s) who can make the initial decision to remove a student athlete from play when it is suspected the

athlete may have suffered a concussion.

Athletes with a suspected concussion should not be permitted to drive home.  The school must notify parents/guardians as soon as possible and within 24 hours if student sustains a concussion.

The contracted certified athletic trainer (where applicable), school nurses, athletic director, and the concussion certified coaches are the individual(s) assigned to inform parents/guardians that their student/child may have sustained a concussion.

Act 68 requires that schools must outline the steps required before a student athlete can return to athletic or learning activity.

Return to Learn Protocol (RTL): The following steps are required before the student can return to academic activity (for more detail see Return to Learn Protocol). The EWSD school nurse will coordinate and implement the RTL protocol.  All students are required to complete all of the RTL protocol.  Starting at RTL Step 4 the student athlete may be considered for beginning the Return to Play Protocol with clearance from a licensed healthcare provider.  BIAVT Concussion Tool Kit

1. Home – Symptom-limited Activity-activities that do not provoke symptoms
2. Home – Light Mental & Physical Activity
3. School – part time – maximum accommodations
4. School  - part time – moderate accommodations
5. School – full time – minimal accommodations
6. School – full time – full academics, no accommodations

Return to Play Protocol: For more detail see Return to Play Protocol-pages 11-15 of the All Schools All Concussions Toolkit. BIAVT Concussion Tool Kit   

• This program should be supervised by an athletic trainer, school nurse or health care professional trained in the management of concussions
• This program should start only once the student is able to attend school part to full time with the appropriate healthcare professional’s approval.
• it is important to wait for 24 hours between steps because symptoms may develop several hours after completing a step.

Step 1: Aerobic conditioning - Walking, swimming, or stationary cycling

Step 2: light aerobic exercise at a slow to medium pace. To begin RTP Step 2 the student athlete must          have completed Step 5 of the RTL protocol.

Step 3:  Sports specific drills – skating drills in hockey, running drills in soccer/basketball.

Step 4: Non-contact training drills – include more complex training drills (passing in soccer/ice   hockey/basketball. Running specific pattern plays, etc).

Step 5: Full contact practice.

Step 5: Full clearance for return to play.

Step 6: Return to Sport

The school nurse or licensed healthcare provider are the person(s) designated by the school to approve the Graded Return to non-contact physical activities.

The contracted certified athletic trainer (where applicable) or licensed healthcare provider are the individual(s) who make the final decision regarding the student’s return to athletic activity.

Remember: When in doubt, sit them out

2.  Concussion Action Plan For Students Who Do Not Participate In School Sports

Management of Concussions Not Related To School Sponsored Sports

Essex Westford School District (EWSD) has developed this Concussion Action Plan to address the issue of the identification and management of concussions.  Vermont State Concussion Law, Act 68 was passed into law in 2013 and recommends schools with athletic teams have a concussion action plan.  The law applies to middle and high school student athletes in school sponsored sports.  It is considered best practice to have a plan that outlines supports for all student concussions, no matter the age of the student or the cause of the injury. Therefore, this plan is intended to cover  students who have a concussion from an event that is not related to a school sponsored sport.  Furthermore, this action plan is intended for students who are not participating in school sponsored athletics during the recovery process.

A safe return to activity (learning and athletics) is essential following a concussion.  The goal of this concussion action plan is to ensure that concussed students are identified, treated, and referred appropriately for return to learn and return to physical activity.  Consistent use of a concussion management protocol will ensure that a student receives appropriate follow-up and accommodations in order to make certain that they are fully recovered prior to returning to full learning and physical activities involved during the school day.

Recognition of Concussion

These signs and symptoms - following a witnessed or suspected blow to the head or body - are indicative of a probable concussion.

Action Steps

1. For a head injury with signs and symptoms indicative of a probable concussion that occurs during the school day, the school nurse will assess the student and call the parent/guardian to recommend follow up with the student’s medical provider and request documentation regarding the plan of care.

2. For a concussion sustained outside of regular school hours, the parent/guardian should notify the school nurse of the  concussion and provide documentation from the student’s medical provider.

3. If the injured student participates in a school sponsored sport, then they will be required to go through the Return to Play Protocol if their injury occurred after their last sport clearance on file.

Return to Learn Protocol (RTL):  A student’s return to school following a concussion is an extremely individualized process. Concussion management is best accomplished by good communication and collaboration among parents, the school, and the health care providers.  The following steps are recommended before a student can return to academic activity after a concussion or suspected concussion.  The school nurse will coordinate the RTL Protocol.

1. Home - Symptom-limited Activity - activities that do not provoke symptoms
2. Home - Light Mental & Physical Activity
3. School - part time - maximum accommodations
4. School - part time - moderate accommodations
5. School - full time - minimal accommodations
6. School - full time - full academics, no accommodations

Returning to Physical Activity:  The return to sports and physical activities (i.e. physical education, sports, physical play at recess, dance) should start only once the student is able to attend school part to full time and with the appropriate healthcare professional’s approval.  For students who are, or who will be, participating in a school sponsored athletic program will need to follow up with the school trainer (where applicable) or the school athletic director for the Return To Play Protocol.

• Return to Physical Education:  Step 1

• The student may return to physical education activities with caution
• No conditioning drills, no physical fitness tests, no contact sports
• Allow student to sit out and rest at any time

• Return to Physical Education:  Step 2

• Student may return to full PE activities with the understanding that the student will be allowed to participate at their own level of comfort.  At the onset of discomfort or concern, allow the student to rest and report to the Health Office.

Resources:

http://www.biavt.org

https://www.cdc.gov/headsup/providers/return_to_activities.html