EAGLE CARE A SPORT CLUB CONCUSSION MANAGEMENT MODEL Cncussin awareness has increased significantly in recent years. The Natinal Cllegiate Athletic Assciatin (NCAA), Natinal Athletic Trainers Assciatin (NATA), Centers fr Disease Cntrl and Preventin (CDC), and ther prfessinal and medical rganizatins have established guidelines fr cncussin management. The Department f Campus Recreatin at the University f Mary Washingtn (UMW) recgnizes the imprtance f having an apprpriate cncussin management mdel in place t safeguard the well being f all student athletes participating in the Eagle Sprt Clubs prgram. The Department f Campus Recreatin has partnered with Mary Washingtn Healthcare and its Neurlgical Institute t create and sustain a viable cncussin management prgram that respects the requirements f HIPPA (Health Insurance Prtability Accuntability Act) and FERPA (Family Educatinal Rights and Privacy Act) while guaranteeing the safe return t play f all student athletes fllwing a mild Traumatic Brain Injury (mtbi). The prgram is titled Eagle Care. CARE lays the grundwrk fr and prvides an utline fr the key cmpnents f the prgram. C Cllabrate. UMW Campus Recreatin cllabrated with Mary Washingtn Healthcare t recgnize the need fr better cncussin management fr ur 23 Eagle Sprt Club teams. This cllabratin led t the develpment f the Eagle Care mdel. A Acknwledge. UMW Campus Recreatin and Mary Washingtn Healthcare acknwledge the imprtance f accurate assessment and management f all head injuries and the ptential lngterm effects f this injury n brain functin. Preseasn baseline brain functin assessment is prvided by the ImPACT (Immediate Pst Cncussin Assessment and Cgnitive Testing) prgram. The pst injury assessment and mnitring f all head injuries is perfrmed by apprpriately trained medical persnal f the Mary Washingtn Healthcare system. R Recgnize and Respnd. The Eagle Care mdel allws fr the timely recgnitin and respnse t any mtbi sustained by a student athlete during their participatin in a Department f Campus Recreatin spnsred Sprt Club practice r event. The mdel allws fr the timely recgnitin and respnse f injuries sustained n ur hme venue and well as any away venue. The mdel recgnizes that medical infrmatin is private and cannt be freely shared with third parties withut the expressed written apprval f an individual. E Educate. The Campus Recreatin Prfessinal Staff recgnizes that cmpliance t any initiative requires knwledge f the need and imprtance f the initiative. Therefre, a thrugh educatin cmpnent has been develped and utilized t educate student athletes, caches, parents, staff, and UMW faculty and staff t the etilgy f mtbi and t the apprpriate fllw up management f the injury. This prvides the best guarantee fr the safe return f the student athlete t sprts and academic endeavrs. Eagle Care is the prduct f the cllabrative effrts f the fllwing individuals: Mark Mermelstein, UMW Campus Recreatin Directr Bb Liebau, UMW Campus Recreatin Assciate Directr
Ian Rgl, UMW Head Athletic Trainer fr Intercllegiate Athletics Dianne McKee, Mary Washingtn Healthcare Neurdiagnstics Manager Nicle Hall, Mary Washingtn Healthcare Neurdiagnstics Supervisr The prgram was designed ver the curse f 2010 and 2011 with implementatin f the prgram beginning August 2011. The fllwing is a descriptin f the cmpnents f the prgram. The summary items fr this cmpnent are: EDUCATION AND BASELINE TESTING 1. Cncussin educatin sessin fr all sprt club fficers and caches presented by the Department f Campus Recreatin and UMW Hspital 2. Student athlete signs participatin agreement t include ImPACT baseline testing 3. ImPACT baseline testing fr the fllwing high risk sprts: Cheerleading, Lacrsse, Rugby, Bxing, Field Hckey, Sccer, Pl, Wmen s Vlleyball 4. Many sprt related cncussins d nt result in a lss n cnsciusness Detailed pints fr educatin and baseline testing include the fllwing: Cncussins and ther brain injuries can be serius and ptentially life threatening injuries. Research indicates that these injuries can als have serius cnsequences later in life if nt managed prperly at the time f the initial incident. A cncussin ccurs when there is a direct r indirect insult t the brain. As a result, impairment f mental functins such as memry, balance/equilibrium and visin may ccur. It is imprtant t recgnize that many sprt related cncussins d nt result in a lss f cnsciusness. As a result, all suspected head injuries must be taken seriusly. Caches and teammates are critical in identifying thse student athletes wh may have a cncussin because a cncussed athlete may nt be aware f their cnditin r may be trying t hide their injury t remain in practice r cmpetitin. All Eagle Sprt club fficers and caches will be required t attend the cncussin educatin sessin presented by the Department f Campus Recreatin and Mary Washingtn Healthcare during the first week f fall classes. All Eagle Sprt Club student athletes and caches must read the NCAA Cncussin Fact Sheet prvided by the Department f Campus Recreatin and sign the statement acknwledgement regarding sprt club cncussin management prtcl. Every first year r transfer student athlete in the sprts f bxing, cheerleading, field hckey, lacrsse (men and wmen), pl, rugby (men and wmen), sccer, and wmen s vlleyball will be required t take a supervised pre seasn baseline assessment fr cncussin using the ImPACT (Immediate Pst Cncussin Assessment and Cgnitive Testing)system. Student athletes wh have already had ImPACT testing must prvide a cpy f the test results t the Directr f Campus Recreatin.
ImPACT is a sftware tl utilized t evaluate recvery after cncussin. ImPACT evaluates multiple aspects f neurcgnitive functin; including memry, attentin, and brain prcessing speed, reactin time, and pst cncussin symptms. This data will help physicians evaluate recvery fllwing cncussins and assist in making recmmendatins fr return t play. ImPACT testing will be cnducting by the prfessinal staff f the Department f Campus Recreatin. Each Eagle Sprt Club president will be cntacted with the date and time(s) f their club s testing sessins. The test administratr will cnfirm that all tests are certified as valid. The student athlete will maintain a cpy f the baseline test and the data will be stred in the ImPACT data base. This infrmatin will be available t Mary Washingtn Healthcare staff in the event the student athlete presents t the hspital with a cncussin r ther head trauma. CONCUSSION MANAGEMENT AND ASSESSMENT The summary items fr this cmpnent are: 1. Student athlete is immediately remved frm play 2. Club first respnder r cach will prvide sideline assessment fllwing SCAT guidelines 3. A student athlete that lses cnsciusness r whse cnditin wrsens will immediately be transprted t UMW hspital by ambulance 4. A student athlete wh is cnscius but has exhibited signs and/r symptms f a cncussin is t be referred t UMW hspital fr evaluatin 5. Student athlete will ntify physician upn arrival if ImPACT data is available Detailed pints fr cncussin management and assessment include the fllwing: A student athlete suspected f sustaining a cncussin will immediately be remved frm play. The sprt club s first respnder r cach will prvide sideline assessment fllwing the SCAT guidelines. A student athlete suspected f having a cncussin is nt permitted t return t play n the day f the injury. The fllwing situatins indicate a medical emergency and require immediate activatin f the Emergency Medical System (call UMW Public Safety at 540 654 4444): Any student athlete with a witnessed lss f cnsciusness f any duratin Any student athlete wh has symptms f a cncussin, and wh is nt stable ( i.e. cnditin is wrsening An student athlete wh exhibits any f the fllwing symptms: Deteriratin f neurlgical functin: headaches that wrsen, seizures, fcal neurlgic signs, lks very drwsy r can t be awakened, repeated vmiting,
slurred speech, can t recgnize peple r places, increasing cnfusin r irritability, weakness r numbness in arms r legs, neck pain, unusual behavir change, significant irritability, any lss f cnsciusness greater than 30 secnds r lnger Decreasing level f cnsciusness Decrease r irregular respiratins Any signs r symptms f assciated injuries, spine r skull fracture, r bleeding Mental status changes: lethargy, difficulty maintaining arusal, cnfusin r agitatin Seizure activity A student athlete wh is cnscius but has exhibited signs and/r symptms f a cncussin is t be referred t Mary Washingtn Hspital immediately fr evaluatin. The injured student athlete will ntify the physician upn arrival at the hspital that ImPACT testing data is available. All sprt club presidents are respnsible fr making certain that visiting sprt clubs receive a cpy f ur cncussin plicy prir t travel and fr prviding the same cncussin care fr visiting student athletes. Any sprt club student athlete wh sustains a suspected cncussin at practice r cmpetitin away frm UMW will be treated accrding t the emergency prtcl n site. The summary items fr this cmpnent are: POST CONCUSSION TREATMENT PLAN 1. Return t play is a medical decisin that must be made by a physician 2. Student athlete MAY NOT return t practice r cmpetitin withut the written cnsent f a cncussin specialist r ther physician 3. The Sprt Club President must ensure that the student athlete des nt return t play until the date specified by the physician 4. A fllw up ImPACT test will be given pst cncussin Detailed pints fr the pst cncussin treatment plan include the fllwing: Return t play is a medical decisin that must be made by a cncussin specialist. A student athlete MAY NOT return t practice r cmpetitin withut the written cnsent f a cncussin specialist r ther physician.
Once the physician has cleared the student athlete t return t play, it is strngly recmmended that the athlete is prgressed back t full activity fllwing the step wise prcess detailed belw. Prgressin is individualized, and will be determined n a case by case basis. Factrs that may affect the rate f prgressin include: previus histry f cncussin, duratin and type f symptms, age f the athlete, and sprt in which the athlete participates. An athlete with a prir histry f cncussin, ne wh has had an extended duratin f symptms, r ne wh is participating in a cllisin r cntact sprt may be prgressed mre slwly. Cmplete cgnitive rest. Activities requiring cncentratin and attentin may wrsen symptms and delay recvery. Light exercise. This step shuld nt begin until the athlete is n lnger having cncussin symptms and is cleared by a physician fr further activity. At this pint the athlete may begin walking r riding an exercise bike. N weight lifting. Running withut gear r equipment. Nn cntact training drills in full equipment. Weight training can begin. Full cntact practice r training. Return t cmpetitin. The Sprt Club President must ensure that the student athlete des nt return t play until the date specified by the physician. A fllw up ImPACT test will be given pst cncussin 24 t 48 hurs after the injury. If pst cncussin symptms ccur at any stage, the student athlete shuld stp the activity and the treating physician shuld be cntacted fr additinal evaluatin. RETURN TO PLAY OPTIONS FOR THE PHYSICIAN 1. Cleared t return t play withut restrictin 2. Fllw up ImPACT test required 3. Cleared t return t play with restrictins 4. Cleared t return t play withut restrictin n a specific date 5. Return appintment with physician required Due t FERPA and HIPAA guidelines, the department f Campus Recreatin prfessinal staff des nt have cnsent t view a medical diagnsis withut the expressed written cnsent f the studentathlete. The physician is required t limit return t play ntes with this in understanding. FERPA http://www2.ed.gv/plicy/gen/guid/fpc/ferpa/index.html HIPPA http://www.hhs.gv/cr/privacy/