Davidson College Sports Medicine Concussion Management Policy

Transcription

1 Davidson College Sports Medicine Concussion Management Policy Davidson College practices concussion management care based on the most current research and consensus statements from noted concussion experts. This policy is reviewed and updated on a regular basis to ensure we are instituting best practices and meeting new requirements as dictated by the National Collegiate Athletic Association. The Davidson College Sports Medicine Concussion Management Policy outlines the requirements for student-athlete and staff education in addition to the procedures to be followed in the management of concussion injuries. Within this policy, it will outline pre-season education, baseline testing assessments, evaluation tools and management procedures, and return to play and return to learn guidelines, developed in order to provide for the safety and well-being of those student-athletes participating in Davidson College Athletics. Pre-Participation Education Athlete Education Each athlete will undergo concussion education as part of their annual pre-participation examination. They are required to review the Davidson College Sports Medicine Concussion Management Policy, the NCAA Concussion Fact Sheet, and view the NCAA Concussion Video before participating in any practices or training/conditioning sessions. Each athlete will complete an electronically signed acknowledgement form confirming they read and understand the concussion management policy, concussion fact sheet and have viewed the concussion video. All student-athlete acknowledgement forms will be submitted electronically through The Athletic Trainer System and maintained by the Davidson Sports Medicine Department. Staff Education All Davidson team physicians, certified athletic trainers, and directors of athletics will be supplied with a copy of the Davidson College Sports Medicine Concussion Management Policy and the NCAA Concussion Fact Sheet on a regular basis. All Davidson College staff members who fall under the previously mentioned titles will complete an electronically signed acknowledgement form stating they have read and understand the concussion management policy and fact sheet. All coaches will be required to complete an electronically signed acknowledgement form prior to supervising or participating in any practices or training/conditioning sessions. Non-Davidson employed medical professionals and part-time coaches will undergo the same concussion education and complete a hand signed acknowledgement form. Electronically signed acknowledgement forms will be maintained by the Assistant Director of Athletics/Senior Woman Administrator while hand signed forms will be maintained by the Athletics Health Care Administrator.

2 Pre-Participation Baseline Assessment: Prior to participation in any athletic activities the Davidson Sports Medicine staff will review each student-athlete's concussion history. Every student-athlete will complete a series of baseline tests to use for comparison after a concussion injury. These baseline assessments include the following: Computerized neurocognitive baseline testing utilizing the ImPACT TM concussion management system Balance assessment SCAT3 symptom score assessment After reviewing each athlete s concussion history and baseline testing results, a certified athletic trainer will determine whether any subsequent evaluation is warranted. In those athletes who have an extensive concussion history evaluation by the team physician may be required. Computerized neurocognitive assessments will be repeated every 2 years for every athlete who does not suffer a concussion injury. If an athlete sustains a concussion, they will repeat their baseline assessments before the start of the next academic year. Recognition and Diagnosis An athletic trainer or team physician trained in the diagnosis, treatment, and initial management of acute concussion will be available on campus during all NCAA varsity competitions for the following sports: Men s & Women s Basketball Field Hockey Football Women s Lacrosse Pole Vault Men s & Women s Soccer Wrestling An athletic trainer or team physician trained in the diagnosis, treatment, and initial management of acute concussion will be available during all NCAA varsity practices in those sports listed above via telephone to discuss any suspected concussion injury and to make immediate arrangements for the athlete to be evaluated.

3 A student-athlete who displays concussion-like symptoms will be immediately removed from sports participation and will be evaluated by a member of the Davidson sports medicine staff. If a Davidson sports medicine staff member is not physically present at the time of suspected concussion injury, it is the responsibility of the coach to remove the athlete from participation and immediately contact a member of the Davidson sports medicine staff by phone. No studentathlete will be permitted to return to participation until evaluated by a member of the Davidson sports medicine staff. If the student-athlete is diagnosed with a concussion he/she will not be allowed to return to participation during the same day of the injury. Evaluation: When a concussion is suspected the athlete will undergo a series of tests by a certified athletic trainer and/or team physician to evaluate their current signs and symptoms, neurological and cognitive status, potential balance deficits, vestibulo-ocular function, and a physical exam to assess potentially life-threatening injuries including cervical spine trauma, skull fracture, and intracranial bleeding. Signs and symptoms that are evaluated for include, but are not limited to: 1. Loss of consciousness 11. Drowsiness 2. Amnesia 12. Excess Sleep 3. Nausea/Vomiting 13. Fatigue 4. Headache 14. Poor balance/coordination 5. Feeling in a fog/slowed down 15. Delayed verbal/motor response 6. Ringing in the ears 16. Visual Disturbances 7. Personality changes 17. Sensitivity to light/sound 8. Emotional lability 18. Poor concentration/focus 9. Confusion 19. Slurred/incoherent speech 10. Dizziness 20. Vacant stare/glassy eyed If at any time during the assessment of an athlete with a suspected concussion it is determined that further emergency care is needed, the emergency action plan for that specific venue will be initiated. An athlete presenting with any of the following symptoms will be immediately transported for emergency medical care: Glasgow Come Scale < 13 Prolonged loss of consciousness Focal neurological deficit suggesting intracranial trauma Repetitive emesis Persistently diminished or worsening mental status or other neurological signs & symptoms Potential spinal injury

4 When evaluating an athlete for a suspected acute concussion the Davidson College Sports Medicine staff will utilize the following tools as necessary: SCAT3 Neurological Screen Balance Assessment Vestibulo-Ocular Motor Screen ImPACT TM Neurocognitive Assessment Serial Monitoring After a concussion has been diagnosed the athlete will be monitored throughout the completion of the game or event. Should the athlete develop any of the symptoms mentioned above they will be immediately referred for emergency medical care. Once the athlete has been determined to be medically stable and emergency medical care is not needed the athlete will be released from the supervision of the Davidson Sports Medicine staff. Specific instructions for follow-up care will be given to a teammate, roommate, or family member. Post-Concussion Management Return to Learn No athlete who is diagnosed with a concussion shall be allowed to engage in any classroom activity on the same day of their concussion injury. Any athletes who have protracted or worsening symptoms with class attendance and/or classwork will be re-evaluated by a physician as needed and referred to the Center for Teaching & Learning for consultation and consideration for schedule modifications and/or academic accommodations. In consultation with the Head Athletic Trainer, the Center for Teaching & Learning will communicate any academic accommodations to all academic faculty and staff members including, but not limited to: Dean s Office Professors/Instructors Academic Counselors The athlete s return to learn plan will be determined based on their symptoms while attending class and completing coursework. This plan will be determined in consultation between the managing physician, Davidson Sports Medicine staff and the Center for Teaching & Learning.

5 When an athlete is referred to a physician trained in concussion management, who is not the team physician, their recommendations will be incorporated into the athlete s return to learn plan. Any athlete where schedule modifications and academic accommodations are not sufficient will be referred to the Office of Academic Access and Disability Resources as is consistent with ADAAA. Follow-Up Care All athletes diagnosed with a concussion will be required to follow-up with a member of the Davidson Sports Medicine staff on a regular basis. They will be evaluated using the tools previously specified in the evaluation section as needed. Any athlete with protracted symptoms will be referred to a physician specifically trained in concussion management. Evaluation by this physician will include consideration for alternative diagnosis s including, but not limited to: Post-Concussion Syndrome Sleep dysfunction & disorders Migraine or other headache disorders Mood disorders such as anxiety and depression Ocular or vestibular dysfunction Research has shown athletes recovering from a concussion may benefit from light physical activity (non-sport related submaximal activities, i.e walking or stationary biking) while symptomatic. Beginning light activity may aid in decreasing athlete anxiety and stress as well as helping to improve quality of sleep. In implementing evidence-based practices, an athlete may be cleared to begin light physical activity before beginning the return to play progression. Recovery from concussion is highly individualized from one athlete to another and it is understood that not every athlete will benefit from early physical activity. Athletes will only be cleared to perform physical activity as long as it does not exacerbate physical symptoms or affect their class attendance or ability to complete their coursework. Neurocognitive testing using the ImPACT software will be completed when the athlete is asymptomatic. Once the student-athlete is asymptomatic he/she will begin a return to play progression under the supervision of an athletic trainer that includes the following steps. Stage 1 Light aerobic exercise (20 minutes in duration) Stage 2 Treadmill running (20 minutes in duration) Stage 3 Sport specific activities with no head impact Stage 4 Non-Contact training drills with others, begin resistance training Stage 5 Full contact practice/return to normal training Stage 6 Return to competition

6 In order for the athlete to progress to the next phase they must remain asymptomatic after completion of the previous stage for no less than 1 day. If at any point during the return to play progression post-concussive symptoms return, the student-athlete will complete the previous asymptomatic stage after he/she returns to an asymptomatic state for no less than 1 day. The return to play progression may be shortened depending on the nature of contact for specific sport demands. Due to the individualized recovery from concussion injury, the return to play progression may be extended at the discretion of the sports medicine staff and team physicians. All athletes will be evaluated by a physician before being cleared to return to unrestricted participation. Reducing Exposure to Head Trauma In order to ensure the health and safety of its student-athletes who suffer a concussion, Davidson College promotes evidence-based management of concussions as well as preventative measures to decrease an athlete s exposure to head trauma. Davidson College will implement specific components of the NCAA Inter-Association Consensus: Year-Round Football Practice Contact Guidelines. These include the following: o Elimination of 2-a-day football practices during preseason Davidson College will take a safety first approach to all of our sports. Davidson College will promote taking the head out of contact. Davidson College will provide annual education to all athletes and coaches on signs and symptoms of concussions and the procedures to be followed when an athlete sustains a concussion.