SCHOOL DISTRICT 308 RETURN TO LEARN (RTL) and RETURN TO PLAY (RTP) PROTOCOL FOR CONCUSSION **The fllwing is required by the State f Illinis as per Public Act 99-0245** OVERSIGHT CONCUSSION MANAGEMENT TEAM Athletic Trainer(s) OR Advanced Practice Nurse, OR Neurpsychlgist OR Physician Assistant Physician Schl Nurse(s) High Schl Athletic Directr(s) High Schl Cunselr(s) Junir High Athletic Directr(s) District Appintee District Appintee PRESEASON A cncussin management tl (test) is used prir t athletic participatin. The test is given t each athlete t establish a baseline scre which can be cmpared t future scres fr an athlete with a head injury. On high schl level this test is given t freshmen, junirs and all new students t District 308 athletics. On the junir high level this test is given t 7 th graders, any athletes new t the district r 6th graders that will participate in crss cuntry and/r wrestling. If an athlete is in multiple sprts, then they will be given the test prir t their first seasn. Any student that des have a cncussin will need a new baseline test cmpleted befre their next sprts seasn. SUSPECTED CONCUSSION If an athlete has a suspected cncussin the fllwing prcedure will be used t determine playing status: On-the-field assessment at time f injury (if athletic trainer is present at event); Athletes suspected f a cncussin will be pulled frm game r practice and must meet minimum requirements t return t participatin which includes release by a physician r athletic trainer wrking under a physician s license/directin t return t play; Cncussed athletes MUST cmplete bth the RTL and RTP prtcl(s) as set frth by SD308. Hwever, RTL must be cmpleted prir t being cleared thrugh RTP; and All athletes must be apprved by a physician as well as the parent(s) t return t athletic participatin (Parent/Student cmplete IHSA frm fr RTP/RTL and submit a dctr release). RETURN TO PLAY/ DISQUALIFICATION GUIDES An athlete able t pass all physical tests (see RTP guidelines) and nt expressing any utward signs r symptms f a head injury, may be allwed t return t play.
If an athlete is allwed t RTP the same day, the athlete will be mnitred by athletic training staff and required t fllw-up with an Athletic Trainer Certified (ATC). If an athlete is remved frm play, and nt allwed t return, the fllwing steps will be taken t care fr the athlete: Athlete mnitred by ATCs while with team; Parents are ntified their athlete has a pssible head injury and prvided warning signs t watch fr, as well as any ther pertinent infrmatin (shuld a dctr be seen, care instructins, etc.); Athlete will be instructed t fllw up with ATCs the next day fr reevaluatin (may include symptms checklist, physical ability test, cncussin management test, etc.) Athlete will be reevaluated n a daily basis until they meet RTL/RTP criteria. DOCTOR VISITS While each case will be handled individually, the fllwing criteria are guidelines which may require the athlete s immediate referral t a physician: Athlete becmes uncnscius; Athlete shws significant signs f head injury r reprts significant symptms; Athlete shws significant change in mental status; It is recmmended that student with head injuries see a physician. RETURN TO LEARN GUIDELINES (RTL must be cmpleted befre RTP) Stage 1: N Schl/Cmplete Cgnitive Rest Symptm Severity: Severe symptms at rest that prevent him r her frm being able t benefit frm being in schl. Symptms may include but are nt limited t: Headache, dizziness, balance difficulties, nausea/vmiting, fatigue, sensitivity t light r nise, visual changes, feeling mentally fggy, feeling slwed dwn, drwsy, difficulty cncentrating/ fcusing, difficulty remembering, unusual changes in md (irritability, sadness, nervusness, mre emtinal than usual) Treatment: Cgnitive and physical rest Academic Interventins: N schl N physical educatin class r participatin in athletics (includes attending practices and games) N tests, quizzes, r hmewrk Prgressin: Readiness t prgress t stage 2 will be determined by: Decrease in verall symptms t manageable level Ability t d cgnitive activities fr very shrt perids f time (15-30 minutes) Stage 2: Part-time schl attendance with accmmdatins
Symptm Severity: Decrease in verall symptms t manageable levels, but may wrsen with physical and mental activity. Treatment: Balance rest with gradual re-intrductin t schl. Avid tasks that prduce, wrsen, r increase symptms. Academic Interventins: Limited schl attendance as symptms warrant. Example: Alternating half-day attendance (mrning classes ne day, afternn classes next day) N PE r athletic participatin (may nt attend practices, games) Avid chir, band, PE areas, r cafeteria if symptms wrsen If symptms wrsen during class, allw students t put head dwn fr 5 minutes. If still symptmatic, allw student t sit in hall fr 5 minutes. If still symptmatic then allw rest in nurse s ffice. Obtain a five minute pass frm the schl nurse, athletic trainer r administratin t avid nisy, crwded hallways between class perids Limit screen time (cmputers, vides/mvies, Smart Bards, prjectrs, cell phnes, ipad, etc.) and reading based n student s symptms Allw sunglasses when viewing Smart Bards, Pwer Pint presentatins, etc. as needed Allw ear plugs as needed Prvide student with cpies f class ntes (may need t be large print) Divide up wrk int smaller prtins (15-20 minutes at a time) Hmewrk reduced r eliminated with n due dates n assignments. This allws students t wrk at a pace that des nt exacerbate symptms and reduces their anxiety abut cmpleting the assignments. N tests r quizzes Prgressin: Readiness t prgress t stage 3 will be determined by: Schl activity des nt increase symptms Overall symptms cntinue t decrease in number and severity Stage 3: Full schl attendance with accmmdatins Symptm Severity: Overall symptms cntinue t decrease in number and severity. Symptms may still be exacerbated by certain activities, but shrt time spans with knwn symptm triggers d nt have drastic effects n symptm levels. Treatment: Gradually increase demands n the brain by increasing the amunt, length f time spent n the wrk, and the type r difficulty f wrk, as lng as it des nt wrsen symptms. Academic Interventins: N PE r athletic participatin (may attend practices, games, r PE class but n participatin) Cntinue with interventins listed in Stage 2 as needed Gradually increase amunt f hmewrk
Limited tests and quizzes. Limit student t ne test per day. May split lnger tests int halves. Accmmdatins are reduced r eliminated as symptms reslve Prgressin: Readiness t prgress t stage 4 will be determined by: Symptm-free with cgnitive activity Stage 4: Full schl attendance withut accmmdatins Symptm Severity: Symptm-free with cgnitive activity. Treatment: Accmmdatins are remved and student can functin fully withut them. Academic Interventins: N physical activity until released by a healthcare prfessinal (such as physician r athletic trainer) Cnstruct a reasnable step-wise plan t cmplete missed wrk while keeping stress levels lw Gradually increase amunt f hmewrk Limited tests and quizzes. Limit student t ne test per day. May split lnger tests int halves. Accmmdatins are reduced r eliminated as symptms reslve Prgressin: Cmplete return-t-play prgressin with athletic trainer in rder t be released t participate in physical activity. RETURN TO PLAY GUIDELINES The fllwing criteria will determine if an athlete may begin the Return t Play Prtcl: Athlete must be symptm free fr a minimum f 72 hurs; and Athlete s pst-injury cncussin management test is 90%+ f pretest scres; and Athlete must be able t pass physical ability testing (vestibulcular testing, etc.). If all criteria are met, athletes begin the Return t Play Prtcl, which is a graduated increase in activity levels ver a series f days. Each injury will be viewed n a case-bycase basis, wrking with each athlete t return t full participatin. When an athlete is seen by a physician (ER r primary care), a written dctr s release MUST be presented prir t RTL and RTP prtcls being cmpleted.
Public Act 99-0245 (Frmerly Senate Bill 7) CONCUSSION MANAGEMENT OVERSIGHT TEAM Each schl shall create a cncussin versight team which shall cnsist f: Physician licensed t practice in all f its branches (Mst chirpractrs are nt included in this definitin); AND Athletic Trainer*; OR Advanced Practice Nurse**; OR Neurpsychlgist; OR Physician Assistant *If a schl district emplys an athletic trainer directly, they must be n the cncussin versight team. **If a schl district emplys ne r mre schl nurse directly, ne f them must be n the cncussin management versight team The rle f the Cncussin Management Oversight Team is t create an evidenced based Return t Play prtcl and an evidenced based Return t Learn prtcl REMOVAL AND RETURN TO PLAY A student can be remved frm play fr a suspected cncussin by a: Cach Physician Licensed Health Care prvider (fr the sake f the law is defined as thse listed under thse allwed n a cncussin versight team) Parent/guardian Once remved frm play fr a cncussin, the athlete may nt return until they have the fllwing: Has been evaluated by a physician
Has successfully cmpleted return t play prtcls Written clearance has been prvided by physician Parent guardian has: Attached is a very imprtant aspect f the new cncussin law. This frm must be filled ut by the parents befre an athlete may Return t Play after a cncussin. This is in additin t a physician clearance. This is als available n the IHSA website: http://www.ihsa.rg/dcuments/frm s/current/pstcncussin%20cnsent%20frm%20( RPT-RTL).pdf Acknwledged that the student has cmpleted the return t play requirements Prvided the written clearance t the apprpriate staff at the schl Sign a cnsent frm stating: Has been infrmed and cnsents t the athlete returning t play Understands the risks f returning t play, and will cmply with nging requirements Cnsents t basic HIPAA disclsures Understands immunity prvisins EDUCATION AND COMPLIANCE On-ging educatin On-ging training n the tpics f cncussin
must be cmpeted every 2 years by: All caches (n less than 2 hurs) Licensed healthcare prviders wh serve n the Cncussin Oversight Cmmittee (vlunteer r staff) Athletic trainer must take an apprved curse, r a BOC accredited curse n the tpic matter f cncussins Physician wh is a part f a Cncussin Oversight Cmmittee Prf f these curses must be submitted t district superintendent r designee Thse nt in cmpliance, may nt be a part f the cncussin versight team All training must be cmpleted by 9/1/16 The IHSA will keep a list f thse wh are eligible t prvide curses fr caches A student may nt partake in interschlastic activity fr a schl year until bth the athlete and parent has signed a frm a cncussin infrmatin frm. This frm must be apprved by the IHSA. If the Superintendent chses a designee t be respnsible fr the versight f the cncussin management prtcl, this persn cannt cach a interschlastic athletics team. The law specifically des nt: Waive immunity frm liability frm a schl r emplyees/agents Create liability against a schl Create liability f thse n the cncussin versight team in the event f a catastrphic event The State Bard f Educatin may adpt rules as necessary t administer this law. EMERGENCY ACTION PLAN Each institutin shall create a venue specific
emergency actin plan fr interschlastic activities. Each plan shall: Be in writing Reviewed by the athletic trainer Apprved by the schl superintendent Distributed t all apprpriate persnnel Psted cnspicuusly at all venues Reviewed annually