Concussions: The Invisible Injury

Student and Parent Information Sheet

Concussion definition

A concussion is a reaction by the brain to a jolt or force that can be transmitted to the head by an impact or blow occurring anywhere
on the body. Essentially a concussion results from the brain moving back and forth or twisting rapidly inside the skull.

Facts about concussions according to the Symptoms

Center for Disease Control (CDC)
Symptoms of a concussion are the result of a temporary
l An estimated 4 million people under age 19 sustain a head change in the brain’s function. In most cases, the symptoms of a
injury annually. Of these approximately 52,000 die and concussion generally resolve over a short period of time; however,
275,000 are hospitalized. in some cases, symptoms will last for weeks or longer. Children
l An estimated 300,000 sports and recreation related and adolescents are more susceptible to concussions and take
concussions occur each year. longer than adults to recover.
l Students who have had at least one concussion are at
increased risk for another concussion. It is imperative that any student who is suspected of having
a concussion is removed from athletic activity (e.g. recess, PE
In New York State in 2009, approximately 50,500 children class, sports) and remains out of such activities until evaluated and
under the age of 19 visited the emergency room for a traumatic cleared to return to activity by a physician.
brain injury and of those approximately 3,000 were hospitalized.
Symptoms include, but are not limited to:

Requirements of School Districts

l Decreased or absent memory of events prior to or immed-
iately after the injury, or difficulty retaining new information
Confusion or appears dazed
Education:
l

Headache or head pressure

Each school coach, physical education teacher, nurse, and
l

Loss of consciousness
l

athletic trainer will have to complete an approved course on

l

Balance difficulties, dizziness, or clumsy movements

concussion management on a biennial basis, starting with the
l

Double or blurry vision

2012-2013 school year.
l

j School coaches and physical education teachers must

l Sensitivity to light and/or sound
Nausea, vomiting and/or loss of appetite
complete the CDC course.
l

Irritability, sadness or other changes in personality

(www.cdc.gov/concussion/HeadsUp/online_training.html)
l

j School nurses and certified athletic trainers must complete

l Feeling sluggish, foggy or light-headed
Concentration or focusing problems
the concussion course. (http://preventingconcussions.org)
l

l Drowsiness
Fatigue and/or sleep issues – sleeping more or less than usual
Information:
l

Provide concussion management information and sign off

Students who develop any of the following signs, or if signs
l

with any parental permission form.

and symptoms worsen, should be seen and evaluated immediately
The concussion management and awareness information or
at the nearest hospital emergency room.
l

the State Education Department’s web site must be made

available on the school web site, if one exists. l Headaches that worsen
l Seizures
Removal from athletics: l Looks drowsy and/or cannot be awakened
l Require the immediate removal from athletic activities of any l Repeated vomiting
pupil that has or is believed to have sustained a mild l Slurred speech
traumatic brain injury. l Unable to recognize people or places
l No pupils will be allowed to resume athletic activity until l Weakness or numbing in arms or legs, facial drooping
they have been symptom free for 24 hours and have been l Unsteady gait
evaluated by and received written and signed authorization l Change in pupil size in one eye
from a licensed physician. For interscholastic athletics, l Significant irritability
clearance must come from the school medical director. l Any loss of consciousness
j Such authorization must be kept in the pupil’s permanent l Suspicion for skull fracture: blood draining from ear or
heath record. clear fluid from the nose
j Schools shall follow directives issued by the pupil’s

treating physician.
 State Education Department’s Guidance for Concussion Management Team
Concussion Management
Schools may, at their discretion, form a concussion management
Schools are advised to develop a written concussion manage- team to implement and monitor the concussion management policy
ment policy. A sample policy is available on the NYSPHSAA web and program. The team could include, but is not limited to, the
site at www.nysphsaa.org. The policy should include: following:
l A commitment to reduce the risk of head injuries. l Students
l A procedure and treatment plan developed by the district l Parents/Guardians
medical director. l School Administrators
l A procedure to ensure proper education for school nurses, l Medical Director
certified athletic trainers, physical education teachers, l Private Medical Provider
and coaches. l School Nurse
l A procedure for a coordinated communication plan among l Director of Physical Education and/or Athletic Director
appropriate staff. l Certified Athletic Trainer
l A procedure for periodic review of the concussion l Physical Education Teacher and/or Coaches
management program. l Classroom Teachers

Other Resources
Return to Learn and Return to Play
protocols l New York State Education Department
http://www.p12.nysed.gov/sss/schoolhealth/schoolhealthservices
Cognitive Rest: Activities students should avoid include, but are
not limited to, the following: l New York State Department of Health
l Computers and video games http://www.health.ny.gov/prevention/injury_prevention/
l Television viewing concussion/htm
Texting
New York State Public High School Athletic Association
l

Reading or writing
l

www.nysphsaa.org/safety/
l

l Studying or homework
l Taking a test or completing significant projects l Center for Disease Control and Prevention
l Loud music http://cdc.gov/TraumaticBrainInjury
l Bright lights l National Federation of High Schools
Students may only be able to attend school for short periods of www.nfhslearn.com – The FREE Concussion Management course
time. Accommodations may have to be made for missed tests and does not meet education requirement.
assignments. l Child Health Plus
http://www.health.ny.gov/health_care/managed_care/consumer_
Physical Rest: Activities students should avoid include, but are guide/about_child_health_plus.htm
not limited to, the following:
l Contact and collision
l Local Department of Social Services – New York State
l High speed, intense exercise and/or sports Department of Health
l High risk for re-injury or impacts http://www.health.ny.gov/health_care/medicaid/ldss/htm
l Any activity that results in an increased heart rate or l Brain Injury Association of New York State
increased head pressure http://www.bianys.org
Return to Play Protocol once symptom free for 24 hours and l Nationwide Children’s Hospital – Concussions in the
cleared by School Medical Director: Classroom
http://www.nationwidechildrens.org/concussions-in-the-
Day 1: Low impact, non strenuous, light aerobic activity. classroom
Day 2: Higher impact, higher exertion, moderate aerobic activity. l Upstate University Hospital – Concussions in the Classroom
No resistance training. http://www.upstate.edu/pmr/healthcare/programs/concussion/
Day 3: Sport specific non-contact activity. Low resistance weight classroom.php
training with a spotter. l ESPN Video – Life Changed by Concussion
Day 4: Sport specific activity, non-contact drills. Higher resistance http://espn.go.com/video/clip?id=7525526&categoryid=5595394
weight training with a spotter. l SportsConcussions.org
Day 5: Full contact training drills and intense aerobic activity. http://www.sportsconcussions.org/ibaseline/

Day 6: Return to full activities with clearance from School Medical

l American Association of Neurological Surgeons
Director. http://www.aans.org/Patient%20Information/Conditions%20
and%20Treatment/Concussion.aspx
Any return of symptoms during the return to play protocol, the l Consensus Statement on Concussion in Sport – Zurich
student will return to previous day’s activities until symptom free. http://sportconcussions.com/html/Zurich%20Statement.pdf