A copy of the EHS Concussion Policy will be sent home with every athlete along with a CDC concussion information sheet per South Carolina law (copies of both can be found in the appendix). The policy will need to be reviewed and signed by both the parents and the athlete and turned into the athletic trainer.
The Emerald High School Sports Medicine Team is committed to the prevention, identification, evaluation and management of concussions. Per recent concussion recommendations and law, the EHS Sports Medicine Team has developed a plan so any student-athlete who exhibits signs, symptoms or behaviors consistent with a concussion shall be removed from practice or competition and evaluated by an athletics healthcare provider with experience in the evaluation and management of concussions. Those student-athletes diagnosed with a concussion shall not return to activity for the remainder of that day. Medical clearance shall be determined by the certified athletic trainer according to the concussion management plan.
What is a Concussion?
A concussion is a traumatic brain injury that may be caused by a blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head. Concussions can also result from hitting a hard surface as the ground, ice or floor, from players colliding with each other or being hit by a piece of equipment such as a bat or ball. If a second blow is received without the brain healing completely (Second Impact Syndrome), an athlete risks becoming severely impaired or even death.
Signs and Symptoms
Observed by Coaching staff Reported by student athlete
Appears dazed or stunned Headache or “pressure” in head
Confused about assignment or position Nausea or vomiting
Forgets plays Balance problems or dizziness
Unsure of game, score or opponent Double or blurry vision
Moves clumsily Sensitivity to light
Answers questions slowly Sensitivity to noise
Loses consciousness (even briefly) Feeling sluggish, hazy, foggy or groggy
Show behavior or personality changes Concentration or memory problems
Can’t recall events before hit or fall Confusion
Can’t recall events after hit or fall Does not “feel right”
Education and Acknowledgement
Before being allowed to participate in any sport, all EHS student-athletes and their parents must read the concussion policy and CDC concussion fact sheet. They will then be required to sign and return the concussion awareness statement acknowledging that they have read and understand the information and their responsibility to report their injury and illnesses to the staff certified athletic trainer, including signs and symptoms of a concussion.
The staff certified athletic trainer will also come and talk with the teams about concussions and answer any questions before the season starts. The staff certified athletic trainer and coaches will be required to comply with the concussion policy that is in place.
Concussion Management Plan
Any student-athlete experiencing symptoms should report to the staff certified athletic trainer as soon as possible. Any athlete exhibiting signs, symptoms, or behaviors consistent with a concussion shall be removed from athletic activities by the certified athletic trainer (or coach in the absence of the certified athletic trainer) and evaluated by a medical staff member as soon as possible.
The South Carolina High School League has determined the following health care professionals to be the appropriate health-care professionals:
- Certified Athletic Trainer (ATC and/or SCAT)
- Doctor of Medicine (MD)
- Doctor of Osteopathic Medicine (DO)
- Nurse Practitioner
- Physician’s Assistant (PA)
Anyone not fitting one of the above descriptions is not qualified to determine the status of the concussed student/athlete.
No student-athlete will return to play the same day they sustain a concussion or present with ANY concussion symptoms, until cleared by the appropriate medical professional.
When a student-athlete sustains a concussion, his/her parent will be contacted as soon as possible and both parent and student-athlete will be further educated in concussion management.
After the first evaluation and assessment of signs/symptoms by the certified athletic trainer, the student-athlete will be required to report to the certified athletic trainer daily to do a symptom check. The student-athlete will also be required to complete post-concussion testing through Concussion Vital Signs until they are completely asymptomatic (symptom-free):
- 24 hours post-injury
- 72 hours post-injury and every other day after until asymptomatic and Concussion Vital Signs test releases the student-athlete based on pre-season baseline test.
When a student-athlete sustains a concussion, the following people will be notified and will receive instructions on how to take care of that student-athlete:
- Head Coach
- Student-Athlete’s teachers (may have trouble in class)
Graduated Return to Play Protocol for the Concussed Athlete
The student-athlete will begin the graduated return to play protocol when asymptomatic (no symptoms present) as determined by the certified athletic trainer. The graduated return to play protocol will be conducted and supervised by the certified athletic trainer.
- Day One: Light exercise
- Day Two: Intense exercise with sport specific drills
- Day Three: Non-contact drills at practice
- Day Four: Full contact practice
- Day Five: Full return to play
If the student-athlete becomes symptomatic during any stage of the return to play protocol, they will return to day one of the return to play protocol if asymptomatic at least 24 hours after, until completely asymptomatic.
Long-term side effects of Concussion
Concussions are known to be cumulative. That is, each time you have a concussion it is easier to get another concussion in the future. Repeated concussions can lead to long-term memory loss, psychiatric disorders, and other neurologic problems. If you have had a number of concussions, your physician likely will advise you to avoid the activities that may put you at risk for future head injuries and to discontinue contact sports. Professional athletes are particularly prone to the effects of cumulative concussions.
At EHS, when a student-athlete has sustained their second concussion in a single school year, they will be removed from athletics for the rest of the school year. When they sustain their third concussion (total), they will no longer be allowed to participate in any contact sports at the school. This is to protect the student from severe medical complications later on in life. If needed or requested, they will be referred to a neurologist.
The main symptom of post-concussive syndrome is persistent headache for one to two weeks, lasting up to months after the injury. Anywhere from 20-90% of patients develop at least one symptom of post-concussive syndrome within the first month following injury, and about 40% have at least three symptoms by three months post-injury.
Post-concussive syndrome is more common after a serious concussion than after a mild one. Symptoms usually are relieved with mild pain relievers such as acetaminophen (Tylenol).
Sometimes people with post-concussive syndrome will have dizziness, difficulty concentrating, or problems doing certain types of activities such as reading. Nausea and vomiting may also occur.
Post-concussive syndrome usually goes away on its own with time. Some people may have symptoms that do not go away, even after months or years. In this situation, contact a doctor. Sometimes tests (such as an MRI or cognitive function testing) or consultations with a neurologist can better assess this problem. An IEP may need to be developed if the student-athlete is having problems in class as well.
- NATA Position Statement: https://natajournals.org/doi/pdf/10.4085/1062-6050-49.1.07
- SCHL Guidelines for Concussion Management: http://schsl.org/wp-content/uploads/2017/03/SuggestedConcussion.pdf
- Research on Concussions: https://www.aappublications.org/news/2018/11/12/concussion111218