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Watchung Hills Regional High School

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Concussions

CONCUSSIONS IDENTIFICATION
MANAGEMENT AND RETURN -TO- PLAY

In Order to help protect student-athletes of New Jersey, The NJSIAA has mandated that all athletes, parents/guardians and coaches follow the NJSIAA Concussion Policy

ATHLETIC TRAINERS
Terry Marcazo - tmarcazo@whrhs.org
Michelle Armonda - marmonda@whrhs.org
phone: 908-647-4800 ext. 4913

Official NJSIAA Policy Statement
Developed by the Medical Advisory Board
According to The Centers of Disease Control and Prevention, at least 3 million sports and recreation related concussions occur in the United States each year.


Concussions are a serious and growing public health concern, especially for students participating in contact sports. The competitive athletic culture of playing through pain or "toughing it out" puts student-athletes at serious risk of brain injury, disability, and death.

Currently, many student-athletes, school personnel including coaches,parents/guardians, and others involved in interscholastic athletics lack awareness about prevention, identification, and treatment of concussions as well as when it is most appropriate for the student-athlete to return to play.


The effects of concussion, while not all preventable, can be mitigated by prompt recognition and appropriate response. Therefore, the new Jersey State Interscholastic Athletic Association concludes that a viable public education, prevention, and a uniform return-to-play policy is in the best interest of student-athletes throughout the Sate of new Jersey.

A concussion is a type of traumatic brain injury (TBI) caused by a direct or indirect blow to the head. The injury can range from mild to severe, and can disrupt the way the brain normally functions. A student-athlete does not need to lose consciousness to sustain a concussion. You might notice some of the symptoms right away. Other symptoms can show up within hours, days or weeks after the injury.

RETURN-TO PLAY- GUIDELINES
A student-athlete who is suspected of sustaining or who has sustained a concussion and / or has become unconscious during an athletic event shall not return to play until she//he meets all of the following criteria:
  1. Immediate removal from play and no return to play that day.
  2. Medical evaluation to determine the presence / absence of concussion.
  3. It is recommended that the student-athlete diagnosed with a concussion complete a symptom-free week initiated on the first symptomatic day before initiating a graduated return-to play exercise protocol. The student-athlete must be monitored during this time period for any reoccurrence of concussion symptoms.
  4. If a student-athlete exhibits a re-emergence of any post-concussion signs or symptoms once he/she returns to play, he/she will be removed from exertional maneuvers and return to his/her primary care physician or team doctor for reevaluation.
  5. If concussion symptoms reoccur during the graduated return-to-play exercise protocol, the student-athlete will return to the previous level of activity that caused no symptoms and then advance as tolerated.
  6. Utilization of available tools such as symptom checklists, baseline and balance testing are suggested.
GRADUATED RETURN-TO-PLAY EXERCISE PROTOCOL
Step 1: No activity,complete physical and cognitive rest. The objective of this step is recovery.

Step 2: Light aerobic exercise includes walking, swimming or stationary cycling, keeping the intensity <70% maximum percentage heart rate; no resistance training. The objective of this step is increased heart rate.

Step 3: Sport-specific exercise including skating,and/or running drills; no head impact activities. The objective of this step is to add movement..

Step 4: Non-contact training drills involving progression to more complex training drills (e.g. passing drills ). The student-athlete may initiate progressive resistance training.

Step 5: Following medical clearance, participation in normal training activities. The objective of this step is to restore confidence and assess functional skills by the coaching staff.

Step 6: Return to play involving normal exertional or game activity.

Reference: Consensus Statement on Concussion in Sports, 3rd International Conference on Concussion in Sport held in Zurich, November 2008, Clinical Journal of Sports medicine, Volume 19, No. 3 may 2009, pp. 185-200

POSSIBLE SIGNS AND SYMPTOMS OF A CONCUSSION
Signs observed ( by a member of the coaching staff.athletic trainer, and/or physician ) include but are not limited to:
  1. Appears dazed, stunned, or disoriented.
  2. Forgets plays, or demonstrates short-term memory difficulties (e.g. unsure of the game, score, or opponent )
  3. Exhibits difficulties with balance or coordination.
  4. Answers questions slowly or inaccurately.
  5. Loses consciousness.
  6. Demonstrates behavior or personality changes.
  7. Is unable to recall events prior to or after the hit.
Symptoms reported by the student-athlete to a member of the coaching staff, athletic trainer, and/or physician include but are not limited to:
  1. Headache.
  2. Nausea / vomiting.
  3. Balance problems or dizziness.
  4. Double visionor changes in vision.
  5. Sensitivety to light or sound/noise
  6. Feeling of sluggishness or fogginess.
  7. Difficulty with concentration, short-term memory, and /or confussion.
  8. Irritability or agitation.
  9. Depression or anxiety.
  10. Sleep disturbance.