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Cougar Sports Zone Concussion Management Policy

 

The Cougar Sports Zone has adopted a concussion management policy. Prior to each season, parents must read and electronically acknowledge the policy. The policy will be reviewed and edited as new research, school policy and state/national laws dictate.

A concussion is a brain injury that is characterized by an onset of impairment of cognitive and/or physical functioning, and is caused by a blow to the head, face, neck, or elsewhere on the body with an “impulsive” force transmitted to the head.

Typical short-term symptoms include: headache, nausea, dizziness or balance problems, vision impairment, sensitivity to light or noise, feeling sluggish or drowsy, feeling “mentally foggy”, concentration or memory problems. A concussion can occur with or without loss of consciousness, and proper management is essential to the immediate safety and long-term future of the injured individual. Symptoms of a concussion can last days, weeks or even months.

The long-term effects of concussion are rare but can occur after either a single or repetitive concussive event. Long-term symptoms can include depression, impaired memory, fatigue, sleep disturbances, concentration deficits and balance problems. Most athletes will recover completely as long as they do not return to play prematurely. The effects of repeated concussions can be cumulative, and after a concussion there is a period in which the brain is particularly vulnerable to further injury. If an athlete sustains a second concussion during this period, the risk of permanent brain injury increases significantly and the consequences of a seemingly mild second concussion can be very severe, and even result in death (i.e., “second impact syndrome”). Therefore, it is imperative that athletes report any head injuries and/or concussion-like symptoms immediately to the Athletic Trainer, coach and/or parent.

 

Management

- Any athlete with a suspected concussion will be removed from play, medically assessed and monitored for deterioration.

- The Athletic Trainer will perform a series of tests on the sideline to assess the athlete’s symptoms, orientation, memory, concentration, balance/coordination, and neurologic function.

- An athlete who has been removed from play, evaluated and suspected to have a concussion shall not return to play that same day nor until evaluated by an appropriate licensed health care provider and a clearance note is on file with the Athletic Trainer.

- The Athletic Trainer will notify the athlete’s parents and give written and verbal home instructions.

-An athletes that exhibits any of the following symptoms will be referred the day of the injury to the Emergency Room for further evaluation; any loss of consciousness, post-traumatic amnesia, neurologic deficits, severe or deteriorating symptoms.

-Any athlete with a suspected concussion will be instructed to follow-up with their pediatrician. Due to their age and developing brain of these athletes, the athlete’s parents and pediatrician will have the responsibility of managing these injuries.

 

Neurocognitive testing

It is recommended that all athletes have a baseline neurocognitive test performed prior to the start of the season.  There are many different tests available, none of which should be the sole decision making instrument in the concussion management process.  Families may choose to have out of pocket baseline testing done, but it will not be required to participate in CSZ activities. Please contact our CSZ Athletic Trainer, Jason Engle, for more information regarding local testing options.

 

Return to Learn and Play

The cornerstone of concussion management is physical and cognitive rest until symptoms resolve, and then a graded program of mental and physical exertion and return to play once cleared by a licensed healthcare professional.

 

The athlete must meet all of the following criteria in order to return to full activity:

1. Symptom-free (without medication) at rest and with exertion (see Return to Play Progression below)

2. With-in normal range of baseline on post-concussion neurocognitive testing (if available)

3. Have written clearance from a licensed health care provider (ex. Head Injury Clearance Note)

 

An example of a Return to Play Progression:

1. Light aerobic exercise (stationary bike, swimming, etc. at <70% Max. Heart Rate)

2. Sport-specific training (running, throwing, catching, body weight exercises)

3. Non-contact training drills; weight lifting (non-contact practice)

4. Full-contact practice (controlled contact drills)

5. Game play (no activity restrictions)

*Note: If the athlete experiences post-concussion symptoms during any phase, they should stop activity, rest and resume the progression after 24 hours if symptom-free. All head injuries are unique and should be treated individually.

 

The above information was gathered from the most current research available: The Consensus Statement on Concussion in Sport (4th International Conference on Concussion in Sport, Zurich, November 2012).

 

Please contact Jason Engle, MS, ATC with any questions (jengle@collegiate-va.org).