BRENTWOOD HIGH SCHOOL

Brentwood, NY, 11717

Telephone (631) 434-2204

Richard J. Loeschner Assistant Principals

High School Principal Vincent Autera

Judy Crawford

Matthew Gengler

John Murphy

Linda Pappert

Jeanette Suarez

BRENTWOOD SCHOOL DISTRICT

CONCUSSION PROTOCOL

The following protocol was established in accordance to the National Federation of State High School Associations and the international conference on concussion in sport, Prague 2004. This policy was fabricated from information received from the collaborative effort of concussive experts on Long Island. This information was presented during three conferences for all athletic directors and athletic trainers sponsored by Section XI Athletic Directors. As such, it is imperative to remember the safety of the student-athlete is the primary concern of the Brentwood Union Free School District.

The information contained below should be used as mere guidelines that are implemented in the time following a concussive event. This information is not to be considered as all-inclusive or all encompassing.

It is important to note that the older “grading” system for concussion care is no longer used by the health care community when assessing a student’s level of concussion. All assessments are done on an individual basis and students will not be placed into “Grades” anymore.

CONCUSSION INJURY ACTION PLAN:

When a student athlete shows signs or symptoms of a concussion or is suspected to have sustained a brain/head injury:

  1. The coach should hold student-athlete from continued play and contact the appropriate medical professional (i.e. Athletic Trainer, Nurse, and/or EMT) for an evaluation.
  2. If no medical professional is immediately available, the coach should assess the situation to see if it is a medical emergency or not.
  3. If medical emergency, (i.e. Loss or losing consciousness, seizure, multiple signs and symptoms) contact security (434-2500) and explain that an ambulance is needed.
  4. If not medical emergency, (i.e. some signs and symptoms but student-athlete is stable) release student-athlete to parent and/or guardian and recommend they take him/her to medical doctor within 24 hours of injury.
  5. Student-athlete who sees a medical doctor needs to provide a clearance note from said doctor to begin the process of clearing athlete to return to play.
  6. A Doctor’s clearance note for an athlete to return to play allows a student to participate in the Graduated Return to Play Program. The district’s athletic trainer or appropriate medical professional working as an extension and under the supervision of a Medical Doctor will oversee the student-athlete’s return to competition through this program listed below.

GRADUATED RETURN TO PLAY PROGRAM:

The cornerstone of proper concussion management is rest to all symptoms resolve. After symptoms resolve and a clearance note from personal physician is reviewed by Brentwood’s Chief Medical Officers, the student- athlete can then participate in a graduated return to play program. The program is broken down into six steps in which only one-step is covered per one 24-hour period. The six steps involve the following:

  1. No exertion until asymptomatic.
  2. Light aerobic exercise such as walking or stationary bike. No resistance or strength training.
  3. Sport specific exercise such as jogging, running, jumping, and/or stretching. Light resistance training.
  4. Non-contact training/skills/drills with team. Hard resistance training.
  5. Full contact training in practice setting (if a contact/collision sport) simulating game situations.
  6. Return to full competition/game play.

If any concussion symptoms re-occur, the athlete should drop back to previous level and try to progress after 24 hours of rest. In addition, student-athlete should also be monitored for re-occurrence of symptoms due to mental exertion, such as reading, working on computer, or taking a test.

ASSESSMENT OF INJURY:

A concussion is a mild traumatic brain injury. This disruption in normal brain functioning could be due to a blow or jolt to the body or head, or a trauma induced alteration in mental status that may or may not involve the loss of consciousness.

When a student-athlete has received a blow or jolt to the head or body AND

-Losses consciousness OR

-Appears Dazed and/or Confused OR

-Has Post-traumatic amnesia OR

-Presents with other signs and symptoms listed below……..

Then the individual doing the initial assessment will look for the following:

SIGNS:

-Loss of Consciousness

-Confusion of disorientation

-Wobbly and uncoordinated

-Slurred or Garbled speech

-Mentally or physically slowed

-Memory Problem (Asking the same questions repeatedly or forgetting the play)

SYMPTOMS:

-Headache

-Neck pain

-Dizziness

-Nausea and/or vomiting

-Vision or Hearing Problems

-Feeling “Foggy”

-Feeling tired or sleepy

MEMORY:

-Which period/quarter is it?

-What team are we playing?

-What is the score?

-How did you hurt?

-Focus on recent memory?

COORDINATION/BALANCE:

-Feet together stance

-Feet together eyes closed head tilt back stance

-Single Leg Stance

-Touch finger to nose with eyes closed from out stretched arms

-Heel to Toe Walk

IMMEDIATE CARE:

If any of the signs and/or symptoms listed above are present then the student-athlete should be held from competition. If the coach is with the student, he should notify the athletic trainer as soon as he/she is able. After the initial assessment is performed by the appropriate medical professional a decision to remove the athlete from any further competition could be made. If this is decided, the athlete will not be allowed to return to play without physician clearance. The parent must be notified of the injury and advised. Home care instructions should be provided. It is important to note that the symptoms will be maximal during the 48-72 hour time period after the insult. The symptoms may not present before that 48-72 hour window. Consistent monitoring of the student-athlete is prudent.

While the athlete is still symptomatic, they must avoid re-injury (organized sports, physical education classes, recess, recreational activities). They must also avoid physical and mental over-exertion. Depending on the symptoms, school days may be shortened, no test taken, reading assignments shortened. The school nurse should be the contact person to establish a modified school day for the student-athlete.

The best treatment is rest and removal of as much mental stimulation as possible such as long bouts of reading, TV watching, Video game playing, Texting, and anything else that may provoke concussion like symptoms. Medications, education, and accommodation should also be provided. Resist pressures to return to play too soon. In most cases, concussions during athletic competition fall into the category of full recovery within 7 to 10 days. Risk factors for slow or incomplete recovery are prior brain illness or injury, learning disability, or a psychiatric disorder. Psychological complications such as depression, anxiety, or loss of self-confidence should be considered. The following websites can provide some additional information about concussions: and .