A concussion is a type of traumatic brain injury (mTBI) that is caused by a bump, blow or jolt to the head or that can change the way a brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth. The following are the Greenwich High School guidelines for concussion management.
Immediate Evaluation
- Recognition of possible concussive injury by the athlete, coach, parent, or athletic trainer.
- Removal from athletic participation if a concussion is suspected.
- Immediate evaluation of the athlete by a trained medical professional (physician or athletic trainer) should occur as soon as possible.
- Following a concussion, the athlete should be referred to a physician for IMMEDIATE medical evaluation if there was loss of consciousness, vomiting, motor, sensory, balance deficits or symptoms that worsen. Transportation to the hospital emergency room should occur in the case of pulse or respiration irregularity or decrease, unequal/dilated or un- reactive pupils, lethargy, confusion, or in the event of seizure.
- At the time of injury, the parent/guardian will be given verbal and/or written instructions regarding proper homecare and management following a suspected concussion.
- All concussions MUST be reported as soon as possible to the athletic trainer and school nurse for proper follow-up care.
Removal from Participation
- No adolescent who sustains a concussion will be allowed to play or return to a game/practice. It is a Connecticut state law!
- Athletes continuing to play (including exercise) or receiving multiple blows to the head, after sustaining a concussion, may take longer to recover and are at an increased risk for developing Post-Concussion Syndrome and Second Impact Syndrome.
- If an individual has an increase in symptoms while doing a specific activity of daily living, that activity should be discontinued immediately to maximize healing potential.
***FOLLOW TREATMENT PRESCRIBED BY YOUR PHYSICIAN (REST!)***
Neurocognitive Testing (ImPACT)
- Greenwich HS athletes participating in interscholastic contact sports are encouraged to take a baseline ImPACT test through either their pediatric group or a local concussion care center. Neurocognitive tests are a useful tool and can help greatly in making sound return-to-play decisions.
- Post-injury ImPACT tests will not be conducted at GHS. This type of test needs to be taken with the health professional associated with the baseline test for that specific athlete.
- School/Activities Modified As Needed
- Students who are unable to attend school for an entire day without symptoms may need special accommodations.
- In-school workload and homework may also need to be adjusted.
- Extended periods of accommodations must be made by a physician or neuropsychologist. School nurse and guidance counselors need to be notified of concussion injury as soon as possible by staff and parents. This is especially important if academic/attendance considerations are to be made.
Clearance/Progressive Return to Athletic Participation
- The athlete must be symptom free, and have written clearance to return to play by a physician. ALL academic accommodations must be lifted in order to play.
- Normalized baseline ImPACT scores MUST be achieved prior to resuming activity if a recent valid baseline test is available
- “Return-to-Play” involves gradually increasing the level and intensity of the activity, and closely monitoring the athlete for any return of symptoms.
Example:
Day 1: Biking for 20-30 min.
Day 2: Jogging/Running for 20-30 min.
Day 3: Sport specific non-contact drills for 20-30 min.
Day 4: Full practice (contact allowed)
Day 5: Cleared to return to contact sports
If symptoms return at any point during the progression, the activity should be stopped. The athlete should return to rest and must be symptom free for at least 24 hrs before starting the progression again from the beginning.
Further Information:
- Second Impact Syndrome (RARE): Occurs when an adolescent receives a second blow to the head after they have already sustained a concussion, which results in rapid swelling of the brain and is often fatal.
- Post-Concussion Syndrome: Is characterized by prolonged concussion symptoms greater than 2-3 weeks in length.
- ImPACT Neurocognitive Testing Information: www.impacttest.com
