Table of Contents

Introduction 2

Prairie-Hills Elementary School District 144 – Board Policy 7:305 3

IESA Protocol for Implementation of NFHS Sports Playing Rules for Concussions 5

IESA Return-to-Play Policy 7

Concussion Fact Sheet for Coaches 8

Return-to-Learn before Return-to-Play 13

Most Common “Thinking” Cognitive Problems Post-Concussion and Suggested Accommodations 16

Return-to-Play 17

Heads Up Concussion Action Plan 18

Proper Steps for Return-to-Play 19

Concussion Training 20

Appendixes 21

  1. Concussion Information and Parental Signature
  2. PHESD Student Activity – Agreement to Participate
  3. School Recommendations Following Concussion
  4. Post-Concussion Symptom Score

Contact Information 27

Introduction

On August 3, 2015, Governor Rauner signed into law Senate Bill (SB) 07 (Public Act 99-245). The legislation focuses primarily on concussion management in the middle school/junior high school and high school levels. The legislation amends the school code and is a requirement for all schools. As a result, Prairie Hills Elementary School District 144 created an oversight team to develop a concussion policy and create procedures for all extra-curricular activities at both the junior high school and all elementary schools. These procedures explain the return-to-learn and return-to-play steps for any student that is believed to have suffered a concussion. In addition, all interscholastic coaches will be trained on concussions prior to beginning the season. Training must be completed every two years.

Prairie-Hills Elementary School District 144 – Board Policy 7:305

Student Athlete Concussions and Head Injuries

The Superintendent or designee shall develop and implement a program to manage concussions and head injuries suffered by students. The program shall:

  1. Prepare for full implementation of the Youth Sports Concussion Safety Act, that provides, without limitations, each of the following:
  2. The Board must appoint or approve members of a Concussion Oversight Team for the District.
  3. The Concussion Oversight Team shall establish each of the following based on peer-reviewed scientific evidence consistent with guidelines from the Centers for Disease Control and Prevention:
  4. A return-to-play protocol governing a student’s return to interscholastic athletics practice or competition following a force of impact believed to have caused a concussion. The Superintendent or designee shall supervise an athletic trainer or other person responsible for compliance with the return-to-play protocol.
  5. A return-to-learn protocol governing a student’s return to the classroom following a force of impact believed to have caused a concussion. The Superintendent or designee shall supervise the person responsible for compliance with the return-to-learn protocol.
  6. Each student and the student’s parent/guardian shall be required to sign a concussion information receipt form each school year before participating in athletic activity.
  7. A student shall be removed from an interscholastic athletic practice or competition immediately if any of the following individual believes that the student sustained a concussion during the practice and/or competition: a coach, a physician, a game official, an athletic director, the student’s parent/guardian, the student, or any other person deemed appropriate under the return-to-play protocol.
  8. A student who was removed from interscholastic athletic practice or competition shall be allowed to return only after all statutory prerequisites are completed, including without limitation, the return-to-play and return-to-learn protocols developed by the Concussion Oversight Team. An athletic team coach or assistant coach may not authorize a student’s return-to-play or return-to-learn.
  9. The following individuals must complete concussion training as specified in the Youth Sports Concussion Safety Act: all coaches or assistant coaches (whether volunteer or a district employee) of interscholastic athletic activities; nurses who service on the Concussion Oversight Team: athletic trainers: game officials of the interscholastic athletic activities; and physicians who serve on the Concussion Oversight Team. The Board shall approve school-specific emergency action plans for interscholastic athletic activities to address the serious injuries and acute medical conditions in which a student’s condition may deteriorate rapidly.
  10. Comply with the concussion protocols, policies, and by-laws of the Illinois High School and Elementary School Association, including its Protocol for NFHS Concussion Playing Rules and its Return to Play Policy. These specifically require that:
  11. A student athlete who exhibits signs, symptoms, or behaviors consistent with a concussion in a practice or game shall be removed from participation or competition at that time.
  12. A student athlete who has been removed from an interscholastic contest for a possible concussion or head injury may not return to that contest unless cleared to do so by a physician licensed to practice medicine in all its branches in Illinois, or a certified athletic trainer.
  13. If not cleared to return to that contest, a student athlete may not return to play or practice until the student athlete has provided his or her school with written clearance from a physician licensed to practice medicine in all branches in Illinois or a certified trainer working in conjunction with a physician licensed to practice medicine in all its branches in Illinois.
  14. Require all student athletes to view the Illinois High School Association’s video about concussions.
  15. Inform student athletes and their parents/guardians about this policy in the Agreement to Participate or other written instrument that a student athlete and his or her parent/guardian must sign before the student is allowed to participate in a practice or interscholastic competition.
  16. Provide coaches and student athletes and their parents/guardians with educational materials from the Illinois High School and Elementary School Associations regarding the nature and risk of concussions and head injuries, including the risks inherent in continuing to play after a concussion or head injury.
  17. Include a requirement for staff members to notify the parent/guardian of a student who exhibits symptoms consistent with that of a concussion.

LEGAL REF:105 ILCS 5/10-20.54

105 ILCS 5/22-80 added by P.A. 99-245; if approved by the House and signed by the Governor. SB219 will extend the effective date to the 201602917 school year. 105 ILCS 25/1.15.

CROSS REF:4:170 (Safety), 7:300 (Extracurricular Athletics)

ADOPTED:April 18, 2016.

IESA Protocol for Implementation of NFHS Sports Playing Rules for Concussion

August, 2015

“Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, orbalance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health care professional.”

The above language which first appeared in all National Federation sports rule books for 2010-11 school term, reflects a strengthening of rules regardingthe safety of athletes suspected of having a concussion, but not a revision in primary responsibilities in these areas. Previous rules required officials toremove any athlete from play who was “unconscious or apparently unconscious.” This revised language reflects an increasing focus on safety, given thatthe vast majority of concussions do not involve a loss of consciousness. However, the revised language does not create a duty that officials are expectedto perform a medical diagnosis. The change in rule simply calls for officials to be cognizant of athletes who display signs, symptoms or behaviors of aconcussion from the lists below and remove them from play.

Definition of a Concussion

A concussion is a traumatic brain injury that interferes with normal brain function. An athlete does not have to lose consciousness (be “knocked out”) tohave suffered a concussion.

Behavior or signs observed indicative of a possible concussion / Symptoms reported by a player indicative of a possible concussion
Loss of consciousness / Headache
Appears dazed or stunned / Nausea
Appears confused / Balance problems or dizziness
Forgets plays / Double or fuzzy vision
Unsure of game, score, or opponent / Sensitivity to light or noise
Moves clumsily / Feeling Sluggish
Answers questions slowly / Feeling foggy or groggy
Shows behavior or personality changes / Concentration or memory problems
Can’t recall events prior to or after the injury / Confusion

NOTE: The persons who should be alert for such signs, symptoms, or behaviors consistent with a concussion in an athlete include appropriatehealth-care professionals, coaches, officials, parents, teammates, and, if conscious, the athlete him/herself.

Protocol

Background: This protocol is intended to provide the mechanics to follow during the course of contests/matches/events when an athlete sustains an apparentconcussion. For the purposes of this policy, appropriate health care professionals are defined as: physicians licensed to practice medicine in all itsbranches in Illinois and certified athletic trainers.

Policy:

1. During the pre-game conference of coaches and officials, the official shall remind the head coaches that a school-approved appropriate health careprofessional will need to clear for return-to-play any athlete removed from a contest for an apparent head injury.

2. The officials will have no role in determining concussion other than the obvious situation where a player is unconscious or apparently unconscious as isprovided for under the previous rule. Officials will merely point out to a coach that a player is apparently injured and advise the coach that the player shouldbe examined by the school-approved health care provider.

3. If it is confirmed by the school’s approved health care professional that the student did not sustain a concussion, the head coach may so advise theofficials during an appropriate stoppage of play and the athlete may re-enter competition pursuant to the contest rules.

4. Otherwise, if an athlete cannot be cleared to return to play by a school-approved health care professional as defined in this protocol, that athlete maynot be returned to competition that day and is then subject to the Return-to-Play Policy before the student-athlete can return to practice or competition.

5. Following the contest, a Concussion Special Report must be filed by the contest official(s) with the IESA Office through the Officials Center.

6. In cases where an assigned IESA state finals event medical professional is present, his/her decision to not allow an athlete to return to competition maynot be over-ruled.

Additional information regarding concussions can be accessed on the IESA website:

IESA Protocol for Implementation of NFHS Playing Rules for Concussions

Return-to-Play (RTP) Policy

Background: With the start of the 2010-11 school term, the National Federation of State High School Associations (NFHS)implemented a new national playing rule regarding potential head injuries. The rule requires “any player who exhibits signs,symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, orbalance problems) shall be immediately removed from the game and shall not return to play until cleared by an appropriate health care professional.”In applying that rule in Illinois, it has been determined that only certified athletic trainers and physicians licensed to practice medicine in all itsbranches in Illinois can clear an athlete to return to play the day of a contest in which the athlete has been removed from the contest for a possiblehead injury.

Policy: In cases when an athlete is not cleared to return to play the same day as he/she is removed from a contest following apossible head injury (i.e., concussion), the athlete shall not return to play or practice until the athlete is evaluated by and receives written clearancefrom a licensed health care provider to return to play.

For the purposes of this policy, licensed health care providers consist of physicians licensed to practice medicine in all itsbranches in Illinois and certified athletic trainers working in conjunction with physicians licensed to practice medicine in all itsbranches in Illinois.

Mandatory Concussion Course for Coaches

Senate Bill 7 (Public Act 99-245) amends the School Code and will go in to effect for the 2016-2017 school year. The legislation requires ALL interscholasticathletic coaches to take a training course from an authorized provider at least once every 2 years. The IESA will make the IHSA onlineconcussion awareness and education program available to IESA member schools through the IESA Member Center.

The program includes information on concussion awareness training, concussion recognition, best practices for avoiding concussions, return-to-play guidelines, and sub-concussive trauma. The presentation and other supplementary materials included in the presentation should be reviewed by ALL interscholastic athletic coaches prior to taking a required exam over the curriculum.

CONCUSSION FACT SHEET

FOR COACHES

WHAT IS A CONCUSSION?

Concussion, a type of traumatic brain injury, is caused by a bump, blow, or jolt to the head. Concussions can also occur from a blow to the body that causes the head and brain to move rapidly back and forth-literally causing the brain to bounce around or twist within the skull. This sudden movement of the brain causes stretching and tearing of brain cells, damaging the cells and creating chemical changes in the brain.

HOW CAN I RECOGNIZE A POSSIBLE CONCUSSION?

Concussions can result from a fall or from athletes colliding with each other, the ground, or with an obstacle, such as a goalpost. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. As a coach you are on the front line in identifying an athlete with a suspected concussion. You know your athletes well and can recognize when something is off—even when the athlete doesn’t know it or doesn’t want to admit it. So to help spot a concussion, you should watch for and ask others to report the following two things:

  1. A forceful bump, blow, or jolt to the head or body that results in rapid movement of the head.

AND

  1. Any concussion signs or symptoms, such as a change in the athlete’s behavior, thinking, or physical functioning.

Signs and symptoms of concussion generally show up soon after the injury. But the full effect of the injury may not be noticeable at first. For example, in the first few minutes the athlete might be slightly confused or appear a little bit dazed, but an hour later they can’t recall coming to the practice or game.

You should repeatedly check for signs of concussion and also tell parents what to watch out for at home. Any worsening of concussion signs or symptoms indicates a medical emergency.

SIGNS AND SYMPTOMS

Athletes who experience one or more of the signs and symptoms listed below, or who report that they just “don’t feel right,” after a bump, blow, or jolt to the head or body, may have a concussion.

SYMPTOMS REPORTED BY ATHLETE:

• Headache or “pressure” in head

• Nausea or vomiting

• Balance problems or dizziness

• Double or blurry vision • Sensitivity to light

• Sensitivity to noise • Feeling sluggish, hazy, foggy, or groggy

• Concentration or memory problems

• Confusion

• Just not “feeling right” or is “feeling down”

SIGNS OBSERVED BY COACHING STAFF:

• Appears dazed or stunned

• Is confused about assignment or position

• Forgets an instruction

• Is unsure of game, score, or opponent

• Moves clumsily

• Answers questions slowly

• Loses consciousness (even briefly)

• Shows mood, behavior, or personality changes

• Can’t recall events prior to hit or fall

• Can’t recall events after hit or fall

WHAT ARE CONCUSSION DANGER SIGNS?

In rare cases, a dangerous blood clot may form on the brain in an athlete with a concussion and crowd the brain against the skull. Call 9-1-1 or take the athlete to the emergency department right away if after a bump, blow, or jolt to the head or body the athlete exhibits one or more of the following danger signs:

• One pupil larger than the other

• Is drowsy or cannot be awakened

• A headache that gets worse

• Weakness, numbness, or decreased coordination

• Repeated vomiting or nausea

• Slurred speech

• Convulsions or seizures

• Cannot recognize people or places

• Becomes increasingly confused, restless, or agitated

• Has unusual behavior

• Loses consciousness (even a brief loss of consciousness should be taken seriously)

WHAT SHOULD I DO IF A CONCUSSION IS SUSPECTED?

No matter whether the athlete is a key member of the team or the game is about to end, an athlete with a suspected concussion should be immediately removed from play. To help you know how to respond, follow the Heads Up four-step action plan:

1. REMOVE THE ATHLETE FROM PLAY.

Look for signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head or body. When in doubt, sit them out!

2. ENSURE THAT THE ATHLETE IS EVALUATED BY AN APPROPRIATE HEALTH CARE PROFESSIONAL.

Do not try to judge the severity of the injury yourself. Health care professionals have a number of methods that they can use to assess the severity of concussions. As a coach, recording the following information can help health care professionals in assessing the athlete after the injury:

• Cause of the injury and force of the hit or blow to the head or body

• Any loss of consciousness (passed out/knocked out) and if so, for how long

• Any memory loss immediately following the injury

• Any seizures immediately following the injury

• Number of previous concussions (if any)

  1. INFORM THE ATHLETE’S PARENTS OR GUARDIANS.

Let them know about the possible concussion and give them the Heads Up fact sheet for parents. This fact sheet can help parents monitor the athlete for signs or symptoms that appear or get worse once the athlete is at home or returns to school.

  1. KEEP THE ATHLETE OUT OF PLAY.

An athlete should be removed from play the day of the injury and until an appropriate health care professional says he or she is symptom-free and it’s OK to return to play. After you remove an athlete with a suspected concussion from practice or play, the decision about return to practice or play is a medical decision.

WHY SHOULD I BE CONCERNED ABOUT CONCUSSIONS?

Most athletes with a concussion will recover quickly and fully. But for some athletes, signs and symptoms of concussion can last for days, weeks, or longer.