PURPOSE:
The Board of Education of the North Colonie Central School District recognizes the seriousness of concussions in children and adolescents who participate in school sponsored sports and recreational activities and the need to manage the potential consequences of mild traumatic brain injuries (concussions). 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 the New York State Concussion Management Awareness Act.
Concussions are defined as mild traumatic brain injuries which occur as a result of trauma to the head, jaw or from a violent snapping of the neck that can cause harmful, long-term effects to brain functions. Recovery from concussions is unpredictable and will vary greatly between individuals. Physical and mental rest along with a properly supervised return to play and return to school protocols, are necessary to ensure complete recovery. The following policy shall represent the minimum standards that must be complied with by the North Colonie Central 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 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.
Parents shall be educated through preseason meetings for sports and/or information sheets provided, and/or made available to parents. Staff shall be educated through normal school communication channels.
CONCUSSION MANAGEMENT TEAM (CMT):
The North Colonie Central School District shall assemble a concussion management team that shall consist of the following individuals as needed:
- School Physician
- Athletic Trainer/First Aider
- School Nurses
- Athletic Director
- School Principals
- Athletic Coaches/Academic Teachers
- Director of Pupil Services
- Guidance Counselors
- Outside resources (medical specialists/counselors)
CM Athletic/PE Communication Protocol
The CMT will act as a liaison for any student returning to school to play following a concussion. The CMT will review the student’s condition and any directives of the student’s physician and establish an appropriate plan to ensure a safe return to school and/or athletics for the students.
PARENTAL PERMISSION:
The North Colonie Central 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 for participation shall either include;
a. 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
b. a reference how to obtain such information from the Department of Education and the Department of Health websites.
CONCUSSION MANAGEMENT PROTOCOL:
Any student demonstrating signs, symptoms, and behaviors of a concussion while participating in a school sponsored class, extracurricular activity or interscholastic athletic event, shall be removed from the event or activity and be evaluated as soon as possible by the school physician, athletic trainer or school nurse. In the event that a school health care provider is not available, the district will refer any concussed student to their primary care physician or emergency room, if necessary. If 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 District shall notify the student’s parent(s) or guardian(s) and recommend that the parent(s) or guardian(s) conduct appropriate monitoring and follow up with a physician.
Any student returning to school following a concussion diagnosis must have a proper medical release from a physician. However, in consultation with the school nurse and or certified athletic trainer the chief school physician shall have the authority to make the final decision in regard to return to school and or return to play protocol. Any student who continues to exhibit concussion related signs or symptoms upon return to activity must be removed from participation and re- evaluated by their primary care physician or chief school physician.
In the event that a student receives a concussion diagnosis, the school’s concussion management team (CMT) will be notified to assist the student with both the return to play and return to school protocols. Compliance and adherence of these protocols are necessary to ensure a student’s complete recovery.
NEUROCOGNITIVE TESTING (IMPACT):
Students who participate in interscholastic athletics may, depending upon the sport, be subject to neurocognitive baseline testing (Impact) prior to the start of their sport season. In the event that a student sustains a concussion, they will be tested again post injury to help determine their cognitive recovery. Post injury testing will only occur after a student’s symptoms have completely resolved and before any return to physical activity is permitted.
Baseline and post injury testing is conducted at the high school by the school’s athletic trainers. Baseline testing for certain sports may occur during a student’s freshman and junior years. Interpretation of the test results is done by the School Physician. Only those students who demonstrate satisfactory results on post injury testing as determined by the School Physician, will be allowed to begin the return to play protocol.
RETURN TO PLAY PROTOCOL:
A proper Return to Play Protocol following a concussion ensures that a student can return to physical activity safely while also decreasing the risk of re-injury. Protecting students from Post Concussion and Second Impact Syndromes are vital. Return to play is a stepwise progression that a student will undergo after: 1) a complete resolution of symptoms has occurred for at least twenty-four (24) hours; and 2) he/she has been evaluated and received written and signed authorization from a licensed physician; and 3) medical clearance to return to activities, including physical education class and after-school sports, has been given by the School Physician or the student’s primary care physician. 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 School Physician).
The Athletic Trainer, under the direction of the School Physician, will administer the Return to Play Protocol. Each step in the progression should take twenty-four (24) hours. If any symptoms return at any time during the progression the student must return to the previous step and wait for symptoms to resolve. The student’s parents and School Physician will be notified in such an event. Following a successful completion of the progression, the student will be cleared to resume full athletic/physical activity without restriction by the School Physician.
Step 1: Low impact, non-contact, cardiovascular activity
Step 2: Non-contact, sport specific drills
Step 3: Semi-contact, sport specific drills
Step 4: Full contact training in a practice setting
*The above progression is based upon current recommendations from the National Federation of High School Sports (NFHS) and New York State Public High School Athletic Association (NYSPHSAA).
RETURN TO PHYSICAL EDUCATION PROTOCOL:
Following a concussion diagnosis, any student returning to physical education classes must also have a proper medical release from a physician. Upon receiving a physician’s release, the school nurse will clear a student to return to physical education classes. Students returning to physical education must also follow a return to PE progression.
Step 1: Low impact, non contact, cardiovascular PE activity
Step 2: Non contact PE activity, moderate intensity
Step 3: Full intensity PE activity
RETURN TO SCHOOL PROTOCOL:
In order to ensure a full recovery from a concussion, students must also follow a Return to School Protocol as well. Similar to the Return to Play progression, the Return to School progression involves a gradual return to the academic demands of the school day. Because recovery from concussions is highly variable and based on several factors, not all students will follow the same progression. However, the individual needs of each student will be taken into consideration when a student is released to return to school by either their primary care physician or School Physician.
When a student is medically cleared to return to school, the CMT members pertinent to the individual student’s academic needs will be contacted and notified of their medical status and any restrictions. The CMT will continue to assist in a student’s academic recovery until fully medically released by a physician.
The amount of time needed to accomplish each step will vary between individuals and will be directed by the physician.
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: October 22, 2012