Randolph-Macon Academy Athletic Training Department Concussion Policy and Procedures
What is a Concussion?
A concussion is a violent shaking or jarring action to the brain, usually as a result of impact with an object or the ground. They can range from minor to major, but all concussions temporarily interfere with the way your brain works. Every concussion, no matter how mild, injures your brain. This injury needs time and rest to heal properly.
Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion shall be immediately removed from the event (practice or game) and shall not return to competition until cleared by the school’s Athletic Trainer or the Director of the ImPACT program, or Team Neurologist.
Common Signs and Symptoms of a Concussion:
Concussion signs and symptoms generally fall into four categories: physical symptoms, cognitive symptoms, emotional symptoms, and sleep symptoms, and may include:
|Headache||Feeling mentally “foggy”||Irritability||Drowsiness|
|Nausea||Feeling slowed down||Sadness||Sleeping less than usual|
|Vomiting||Difficulty concentrating||More emotional||Sleeping more than usual|
|Balance||Difficulty remembering||Nervousness||Trouble falling asleep|
|Problems||Forgetful of recent information and conversations||Depression|
|Dizziness||Confused about recent events||Aggressiveness|
|Visual Problems||Answers questions slowly|
|Sensitivity to light||Repeats questions|
|Sensitivity to noise|
|Dazed or stunned|
|Ringing in the ears|
|Loss of consciousness|
‘Why It Is Important to Report Symptoms
Second Impact Syndrome – a condition in which the brain swells rapidly after a person suffers a second concussion before symptoms from an earlier one have resolved. The condition is often fatal.
Make sure to report all signs and symptoms to your athletic trainer/health care professional! Delaying treatment only delays your return to play!
Concussion Assessment and Management
It is the duty of the Athletic Trainer to assess and manage those athletes that have sustained a concussion. This includes a thorough evaluation at the time of injury or at the onset of symptoms. It is also the responsibility of the athlete’s teammates and/or coaches that have seen or have any knowledge of a possible head injury to report such knowledge of what they saw or symptoms to the Athletic Training Staff.
ImPACT testing is available to athletes in sports that are considered to be of high risk for concussion (football, volleyball, lacrosse, wrestling, basketball, soccer, baseball, and softball). ImPACT testing measures baseline neuro-cognitive function and is used as a tool to help determine when it is safe for an athlete to return to competition. ImPACT testing can help to objectively evaluate the concussed athlete’s post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion. It is highly recommended but not required that those athletes be tested at the beginning of their season.
- No athlete with a concussion or with Signs/ Symptoms of a concussion should continue to play or return to a game after sustaining a concussion. They shall be removed from participation and evaluated. A student-athlete diagnosed with a concussion SHALL NOT return to competition that day and will undergo concussion management/monitoring as outlined in this Manual/Protocol by the Randolph-Macon Academy Sports Medicine team. A student-athlete may only return to participation when asymptomatic at rest, with exertion, and when cleared by a Physician and/or the discretion of the Team Physician, Team Neurologist.
- An individual sustaining a concussion should cease doing any activity that causes the symptoms of a concussion to increase (e.g. headaches, dizziness, nausea, etc.). This includes not only physical activity but mental activities such as reading, computer work, texting, loud music (I-Pods) and watching television. Continuing activities, or exercise that increases symptoms, can delay the recovery from the concussion.
- School attendance and activities may need to be modified. While some individuals may be able to attend school without increasing their symptoms, the majority will probably need some modifications depending on the nature of the symptoms. Trial and error may be needed to discover what they can and cannot do.
- If students are unable to attend school for an entire day without symptoms, they may attend for a half day. Some students may only be able to attend for one period, some not at all, due to severe headaches or other symptoms. Frequent breaks with rest periods in the nurse’s office may also be necessary. Often, alternating a class with a rest period may be helpful. As recovery proceeds, gradually, hours spent in school may be be increased.
- They should not participate in physical education or music classes.
- Workload and homework may need to be reduced. Frequent breaks while doing homework may be helpful. Projects and papers should be postponed. Pre-printed class notes and tutors may help to relieve the pressure of schoolwork.
- Tests: If there are concentration and memory problems, quizzes, tests, PSAT tests, SAT tests and final exams should be delayed or postponed. If test results are poor, a note to the school should request that the scores be voided. Extra time (un-timed tests) may be necessary initially when test taking is resumed.
- Neuro-cognitive testing is an important component for the management of concussions. ImPACT testing should only be used as a tool, and should not be the only deciding factor in returning a concussed athlete to play. Generally, the symptoms of a concussion disappear before the neuro-cognitive findings return to normal, although occasionally, this can be reversed. It is for these reasons that symptom evaluation alone can not be used as the sole criteria for return to play.
- No athletes should return to contact competitive sports until they are symptom free, both at rest and with exercise and have normal neuro-cognitive testing. When they have no headaches or other concussion symptoms athletes can begin the return to play protocol developed by the Athletic
- It is important to remember, each concussion should be treated individually. No one guideline will work for every athlete. The coaches, parents, and the athletes themselves, must be educated about the signs, symptoms and treatment of concussions. Many times, the athlete may be unaware that they have actually sustained a
Athletes who are not fully recovered from an initial concussion are significantly vulnerable for recurrent, cumulative, and even catastrophic consequences of a second concussion.
Such difficulties are prevented if the athlete is allowed time to recover from a concussion and return to play decisions are carefully made. No athlete should return to their respective sport or other at-risk activities when symptoms of concussion are present and recovery is ongoing.
In summary, the best way to prevent difficulties with concussion is to manage the injury properly when it does occur.