Concussion Policies and Procedures

The new law, Chapter 166 of the Acts of 2010, clearly states that students who become unconscious, who suffer a concussion, or who are suspected of having suffered a concussion may not return to the competition or practice where the injury occurred. In addition, the new law states that the injured student may not engage in any extracurricular athletic activity without written authorization. Therefore, our guidance, like that of Centers for Disease Control’s Heads Up: Concussion in Youth Sports initiative, is: “Keep the athlete out of play the day of the injury and until a health care professional, experience in evaluating for concussion, says the athlete is symptom-free and it’s OK to return to play.”

The policy of the Everett Public Schools mandates that In order to participate in Everett High School Athletics or extracurricular activities, each student must:
• Present a physical from their own physician or come to the high schools sports screening prior to the start of the season.
• Complete Pre screening questionnaire with up-to- date information of any history of a concussion or head and neck injury.

 Athletic Trainer Certified (ATC) will review the pre screening questionnaire and will retain all the documentation of concussions and head/neck injury on file. The ATC will inform coaches and Athletic Director (AD) of any history of concussion and head/neck injuries.

At the beginning of each season, student athletes will be provided an informational sheet with the symptoms of concussions, reference to information available online, and a Head Injury Report form. School rules and regulations made by the ATC, AD, guidance, and administrators on concussions will appear in the student handbook.

2. The AD shall complete the annual training
3. The AD must ensure that
• the training requirements for staff, parents, volunteers, coaches and students are met, recorded, and records are maintained
• all students meet the physical examination requirements prior to participation in any extracurricular activity
• all students participating in extracurricular athletic activities have completed and submitted pre participation forms of concussion history
• pre participation forms are reviewed
• report of head injury forms are completed by the parent and/or coach and reviewed by the AD, ATC, school nurse and team physician
• annual statistics are reported to the DESE.

ImPACT Testing
All student athletes participating in contact sports (football, soccer, field hockey, lacrosse, basketball, hockey, wrestling, baseball, and softball) will take the ImPACT test. This is a computerized concussion management program. These student athletes will take the ImPACT test prior to beginning the season for a baseline score. Forty-eight hours after suspecting a concussion, the student athlete will take a post injury test. After the first post injury test, the student athlete will continue to take post injury tests until they are ready to return. The ImPACT test does not take the place of seeing a physician. The student athlete must still see a physician regarding the concussion. ImPACT baselines will be renewed every two years, unless there is a change in health or certain medications, it may be less than two years. Student athletes not involved in contact sports will have the option of taking the ImPACT baseline

Head Injury Training Program
All Coaches, Band Directors, School Nurses, School / Team Physicians, Certified Athletic Trainers, Student Athletes, Marching Band members and any other affiliates of Everett High School Athletics must complete an Interscholastic Head Injury Training Program.

The athletic head injury training program must include, but not be limited to:
• The recognition of the signs and symptoms of head and neck injuries, concussions, risk of secondary injury, including the risk of second impact syndrome
• Description of the protocol for return to sports competition or practice after a head injury is sustained.
* The NFHS online “concussion in sports” must be completed by all coaches, directors, school nurses, marching band members and student athletes.
• Athletic trainers, physicians, and physician assistants involved with the evaluation and clearing of concussions must take the MDPH approved clinical training found at http://www.cdc.gov/concussion/HeadsUp/clinicians/index.html.
• Certified athletic trainers will have a concussion awareness assembly for all coaches, directors, school nurses, and physicians. It is mandatory to attend.
• Instruction to teach coaches proper techniques on how to reduce risk for head injuries will be gone over in training
• Parents and students will be given a copy of the Head Injury and Concussion Policy and the Parent/Athlete Concussion Information Sheet. Both parents and students will have to sign and return Acknowledgement of Receipt for the policy and fact sheets.

Procedures for Attending Staff in the event of injury
• The athletic trainer will remove the injured student athlete from play and contact the parent/guardian to bring to their physician
• The ATC will fill out an accident report which will be sent to the administration building
• The ATC will fill out the Department of Public Health’s Report of Head Injury During a Sports Season Form
• The ATC will notify the AD and school nurse.

Special Circumstances:
• If there is no athletic trainer on duty, the coach will remove the athlete from play, contact the parent/ guardian to bring the student athlete to the hospital, and also contact the AD, ATC, and school nurse and fill out an accident report.
• If the coach or ATC cannot contact the parent/guardian or they cannot get there, a coach or ATC will accompany the student athlete to the hospital.
• The ATC, trainer/coach or attending person will advise the student athlete and parent/guardian that complete physical, cognitive, emotional, and social rest is very important when experiencing signs and symptoms.

Procedures for student athlete and parents:
• The student athlete must see his/her primary physician after suffering a concussion.
• The student athlete will be given a Report of Head Injury Form from the ATC or coach to bring to the physician.
• The physician will then need to give clearance for the student athlete to start the return to play protocol.
• The certified Athletic Trainer for the Everett Public Schools has the final say as to whether an athlete or band member returns to play.

Individualized Return to Play Protocol
The student athlete’s individualized return to play protocol must be supervised by either the physician or ATC. Each student will have the Department of Public Health’s Post Sports Related Head Injury Medical Clearance and Authorization Form filled out by the ATC or physician.

The following steps will be followed:
• completion of a full day of normal cognitive activities (school day, studying for tests, watching practice, interacting with peers) without any return of signs or symptoms. If no symptoms return, the next day advance to:
• light aerobic exercise, which includes walking or stationary cycling, keeping the intensity less than 70% of maximum heart rate and no resistance training. The objective of this step is to slowly raise the heart rate without any return of signs or symptoms. If no signs or symptoms return, advance to:
• sport specific exercise including skating, and/or running, no head impact activities. This step is designed to add movement while continuing to increase heart rate. If no signs or symptoms return, advance to:
• non-contact training drills and the student athlete may initiate progressive resistance training. If no signs or symptoms return, advance to:
• following medical clearance by a physician, the student athlete may participate in normal training activities. Breaks must be given, for rest and for the ATC to monitor. The objective of this step is to assess the functional skills of the student athlete. If there is still no return of any symptoms, the next day advance to:
• return to play involving normal exertion. The athlete must participate in one regular practice at this step before being allowed into a game or competition.

Re-entry to School
The student’s guidance counselor will make a graduated re-entry plan for any student athlete who has had a concussion. ATCs will inform Guidance Counselor, Athletic Director, School Principals and administrators of the injury. Guidance counselors will consult with ATC, teachers, Parents/guardians, and other administration about the student returning to a full academic schedule. If symptoms of the concussion last longer than 10 days, the students guidance counselor again will be notified and the student will be placed on a 504 plan.