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Concussion Management Guidelines

Concussion Management Guidelines

The recognition and treatment of athletes who have suffered a concussion has become a national priority. An increasing number of studies have revealed that concussions, not properly treated, can result in permanent mental difficulties. Other studies suggest that concussions may lead to the development of early dementia. This led to mandates by the National Federation of High Schools (NFHS), NCAA, and the NFL. There is now legislation in place in Indiana that outlines the how schools must handle concussions.

As outlined in Indiana State Law IC-20-34-7 “A high school athlete who is suspected of sustaining a concussion or head injury in a practice or game, shall be removed from play at the time of injury and may not return to play until the student athlete has received a written clearance from a licensed health care provider trained in the evaluation and management of concussions and head injuries, and not less than twenty-four (24) hours have passed since the student athlete was removed from play.”

In compliance with the Indiana Department of Education’s Concussion and Head Injuries Position, PHHS has developed the following guidelines for their schools.

 

***Even if a student athlete has a completed physical on file, they will NOT be eligible to practice or condition until their signed Concussion/Sudden Cardiac Arrest Acknowledgement forms are also on file in the athletic office or training room.

 

Neurocognitive Testing

Neurocognitive testing such as the ImPACT (Immediate Post Concussion Assessment and Cognitive Testing) is a computerized test that documents the athlete’s cognitive and speed skills. The test has been validated as an accurate measure of brain function recovery following a sports concussion (www.impacttest.com).

PHHS has partnered with IU Health and Indiana Sports Concussion Network (www.indianasportsconcussionnetwork.com) to receive baseline ImPACT testing for PHHS middle and high school athletes. The computerized baseline test is conducted at school and administered by the certified athletic trainer. These baseline tests can be used by the ImPACT trained physician to assist in the management and treatment of an athlete who has suffered a concussion.

Athletes should have a baseline test prior to the season. In the event that the athlete sustains a concussion, a repeat test can be performed by a physician and compared to the baseline test. This can help show the degree of injury and help measure when recovery has occurred.

 

 Who gets ImPACT baseline testing?

Baseline testing for athletes begins in 7th grade with retest every 2 years (9th and 11th), as athletic participation continues.  Other students to include in baseline testing include all transfer students, first year players and any other athletes that have not been previously tested.

  • Fall – Football, Soccer, Volleyball, Cheer
  • Winter – Basketball, Wrestling, Diving, Cheer
  • Spring – Baseball, Softball, Track (Hurdlers & Pole Vaulters)

 

ImPACT Testing Procedure

  • Pre-Test set up is approximately 20 minutes, testing takes approximately 20 minutes. Total time investment = 40 minutes
  • The Athletic Trainer will retest anyone who did not pass the initial test.
  • ATC maintains results of ImPACT testing. Parents can contact the ATC if they need baseline data sent to their MD.

 

Return to Play Following a Concussion

Recovery from a concussion requires limitation of physical activity, which includes practice, drills, games, and physical education classes. In significantly symptomatic athletes, mental activity should also be limited to allow the brain to heal. These activities may include limiting assignments, allowing greater time to complete quizzes and tests or assignments and less homework. Also limited should be activities such as watching TV, texting, playing video games and surfing the Internet. The athlete may also have to stay home from school.

Before the concussed athlete can return to action, the most current standard of care for the sports concussion includes the following:

  • The athlete must be symptom-free at rest with a normal neurological exam
  • A neurocognitive test such as the ImPACT test must have returned to baseline, and
  • The athlete must be symptom-free with increased (physical and mental) activity and pass an activity progression protocol.

Taking shortcuts or seeking “favorable” opinions on return to action decisions remains unacceptable when utilizing this most current standard of care for sports concussions.

Current PHHS Guidelines dictate that an athlete who has sustained a concussion may not return to activity until he or she has received written clearance from an ImPACT trained physician. PHHS athletic trainers will assist the family in finding an ImPACT trained physician in their insurance network.

The PHHS administration, coaches, and athletic training staff are striving to keep your child’s health and safety at the forefront of the student athletic experience. If you have any questions regarding concussion management, please feel free to contact your schools’ athletic trainer.

 

General Concussion Information

Quite often the signs of concussion do not appear immediately after trauma, but hours later. The extent of the injury may not be readily observable for hours after the initial trauma. The signs and symptoms listed below may occur several hours after the initial injury.
After an initial injury, be especially observant for the following signs and symptoms;

  • Headache (Especially one that increases in intensity*)
  • Nausea and vomiting*
  • Confusion or disorientation to time, place
  • Loss of memory for events preceding injury
  • Loss of memory for events after injury o Feeling mentally slowed down
  • Feeling mentally “foggy”
  • Dizziness
  • Disruption of balance
  • Sensitivity to light and/or sound o Blurred vision*
  • Difficulty concentrating
  • Loss of consciousness*
  • Seizure activity*
  • Slurred speech*

 

*If these symptoms occur, seek medical attention at the nearest emergency department.

Following a concussion, these general instructions can be followed:

 

It is OK to:

  • Take acetaminophen (Tylenol)
  • Rest (no physical activity)
  • Use ice pack on head and neck as needed for comfort
  • Eat a light diet
  • Return to school
  • Go to sleep

 

There is NO need to:

  • Check eyes with a flashlight
  • Wake up every hour
  • Test reflexes
  • Stay in bed

 

Do NOT:

  • Drive while symptomatic
  • Exercise or lift weights
  • Take Ibuprofen/Aspirin or other Non-Steroidal Anti-Inflammatory
  • medications
  • Eat spicy food
  • Watch TV, text, and play video games