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TISD Concussion Policy

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Temple ISD Athletic Department

Guidelines for Concussion Management

Introduction

The Centers for Disease Control (CDC) estimates that there are approximately 300,000 cases of mild traumatic brain injury (MTBI) or concussions annually in the United States as the result of participation in sports. The Sports Concussion Institute estimates that 10 percent of athletes in contact sports suffer a concussion during a season. A 2006 report estimated that there were 92,000 cases of concussions in American high School sports annually, and that these rates seem to be increasing. Also of concern is the risk of repeated concussions and second impact syndrome to our young athletes. These two problems can have long lasting, and even terminal effects, on the individual. In order to have a standard method of managing concussions to Temple ISD athletes, the following guidelines are intended to serve as a written protocol for concussion management.

The UIL has adopted a new mandate voted on and passed by Texas State Legislature House Bill 2038. The bill is found under Chapter 38. Sub Chapter D of the Texas Education Code (TEC)

Definitions

Concussion or Mild Traumatic Brain Injury (MTBI) -A concussion or MTBI is the common result of a blow to the head or body which causes the brain to move rapidly within the skull. This injury causes brain function to change which results in an altered mental state (either temporary or prolonged). Physiologic and/or anatomic disruptions of connections between some nerve cells in the brain occur. Concussions can have serious and long-term health effects, even from a mild bump on the head. Symptoms include, but are not limited to, brief loss of consciousness, headache, amnesia, nausea, dizziness, confusion, blurred vision, ringing in the ears, loss of balance, moodiness, poor concentration or mentally slow, lethargy, photosensitivity, sensitivity to noise, and a change in sleeping patterns. These symptoms may be temporary or long lasting.

Second Impact Syndrome – Second impact syndrome (SIS) refers to catastrophic events which may occur when a second concussion occurs while the athlete is still symptomatic and healing from a previous concussion. The second injury may occur within days or weeks following the first injury. Loss of consciousness is not required. The second impact is more likely to cause brain swelling with other widespread damage to the brain. This can be fatal. Most often SIS occurs when an athlete returns to activity without being symptom free from the previous concussion.

Terms Associated with a Concussion-Bell ringer, Slobber knocker, Dinger, Buzzed, Rattled, Cobwebs, No one’s home but the lights are on. These are terms that can be used to describe or classify a concussion.

What can happen if my child keeps on playing with a concussion?

Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often under report symptoms of injuries. And concussions are no different. As a result, education of administrators, coaches, parents and students is the key for student-athlete’s safety.

Prevention Strategies

1. All headgear must be NOCSAE certified.

2. Make sure the headgear fits the individual.

3. For all sports that require headgear, a coach or appropriate designate should check headgear before use to make sure air bladders work and are appropriately filled. Padding should be checked to make sure they are in proper working condition.

4. Make sure helmets are secured properly at all times.

5. Mouth guards should fit and be used at all times. They also need to be checked throughout the season to maintain their integrity and proper function.

6. Neuro-psychology testing on students that participate in contact sports prior to season to form a baseline.

Evaluation for Concussion/MTBI

1. At time of injury administer one of these assessment tests:

a. Sports Concussion Assessment Tool 2 (SCAT2)

b. Graded Symptom Checklist (GSC)

c. Sideline Functional & Visual Assessments

d. On-field Cognitive Testing

2. Athlete does not return to a game or practice if he/she shows any signs and/or symptoms of a concussion or if a coach, athletic trainer, parent or other health care provider suspects a concussion.

Concussion Management

School modifications

a. Notify school nurse and all classroom teachers of the student that he/she has MTBI

b. Notify teachers of post concussion symptoms

c. Ask teachers to contact you with concerns or observations of abnormal student behavior

d. Student may need special accommodations such as limited computer work, reading activities, testing, assistance to class, etc. until symptoms subside

e. Student may only be able to attend school for half days or may need daily rest periods until symptoms subside

Return to Play Protocol

Activity progressions

  1. No activity for 24 hours after injury and athlete is symptom free
  2. Written clearance from treating physician to begin Return to Play Protocol
  3. Light aerobic exercise with no resistance training
  4. Sport specific activity
  5. Non-contact training drills with resistance training
  6. Full contact training drills
  7. Written Clearance from treating physician to Return to Play
  8. Completed UIL Return to Play form
  9. Return to play
  10. Note – Athlete progression continues as long as athlete is asymptomatic at current level. If the athlete experiences any post concussion symptoms with any step above, athlete will wait 24 hours and continue at the previous step.

Component scores of neurocognitive test, (ImPACT Test), are normal and within normal limits of baseline.

Athletic Trainer clearance per TISD Return to Play concussion guidelines.

 References

1. McCrory, Paul, et al. Summary & Agreement Statement of the 2nd International Conference on Concussion in Sport, Prague 2004; Clinical Journal of Sports Medicine, March 2005

2. Guskiewicz, Kevin M, et al. National Athletic Trainers Association Position Statement: Management of Sport-Related Concussion; Journal of Athletic Training, Sept. 2004

3. www.ImPacttest.com

4. www.healthsystem.virgina.edu/internet/neurogram

5. www.cdc.org

6. www.brainline.org

7. www.uiltexas.org

8. Presbyterian Sports Network, Sports Concussion Management Protocol

9. Mesquite ISD Concussion policy

10. Lake Dallas ISD Concussion policy

11. Round Rock ISD Concussion policy

12. National Athletic Trainers Association

Impact Testing Information

__Temple Independent School District_ is currently implementing an innovative program for our student-athletes.  This program will assist our team physicians/athletic trainers in evaluating and treating head injuries (e.g., concussion).  In order to better manage concussions sustained by our student-athletes, we have acquired a software tool called ImPACT (Immediate Post Concussion Assessment and Cognitive Testing).  ImPACT is a computerized exam utilized in many professional, collegiate, and high school sports programs across the country to successfully diagnose and manage concussions.  If an athlete is believed to have suffered a head injury during competition, ImPACT is used to help determine the severity of head injury and when the injury has fully healed.   

 The computerized exam is given to athletes before beginning contact sport practice or competition.  This non-invasive test is set up in “video-game” type format and takes about 15-20 minutes to complete.  It is simple, and actually many athletes enjoy the challenge of taking the test. Essentially, the ImPACT test is a preseason physical of the brain.  It tracks information such as memory, reaction time, speed, and concentration.  It, however, is not an IQ test.

 If a concussion is suspected, the athlete will be required to re-take the test.  Both the preseason and post-injury test data is given to a local doctor or, to help evaluate the injury.  The information gathered can also be shared with your family doctor.  The test data will enable these health professionals to determine when return-to-play is appropriate and safe for the injured athlete.  If an injury of this nature occurs to your child, you will be promptly contacted with all the details.

 I wish to stress that the ImPACT testing procedures are non-invasive, and they pose no risks to your student-athlete.  We are excited to implement this program given that it provides us the best available information for managing concussions and preventing potential brain damage that can occur with multiple concussions. The ____Temple ISD__administration, coaching, and athletic training staffs are striving to keep your child’s health and safety at the forefront of the student athletic experience.  Please return the attached page with the appropriate signatures. 

For use of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

 I have read the attached information.  I understand its contents.  I have been given an opportunity to ask questions and all questions have been answered to my satisfaction.  I agree to participate in the ImPACT Concussion Management Program.

 

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