Concussion Information

The following Regulation contains the required protocol for a student or athlete with a suspected concussion. It is imperative to acknowledge that concussions can occur in a variety of settings including, but not limited to, interscholastic athletics, Physical Education class, and recess. Because of the possibility of concussions occurring in these different settings, the term “On-Location” is used instead of “On-Field” in an effort to protect all student populations of The Bronxville School District, not just its student athletes.

1. On-Location Evaluation and Management
   1. Loss of Consciousness (LOC) or Cervical Spine Injury (CSI)
      1. Any student that suffers loss of consciousness, no matter how long its duration, is treated as a MEDICAL EMERGENCY and should be transported to the Emergency Room by EMS. The same is required for any student who is suspected to have a CSI (symptoms include paralysis in the arms and/or legs, numbness and/or tingling anywhere in the body). In both cases, EMS should be notified by calling the Bronxville Police at (914) 337-0500. In such cases, the student should not be moved and the head should be stabilized until EMS arrives.
      2. Any student with a concussion that results in a LOC is required to sit out from school activities (recess, PE, sports) for a minimum of seven (7) days before starting the return-to-play protocol. Return-to-play protocol may not begin until these seven (7) days are over and student is symptom free.
   2. All Other Suspected Concussions
      1. Any student suspected of sustaining a concussion must be immediately removed from activity.
      2. Following removal from activity, the attached concussion checklist should be filled out by the appropriate staff member (Certified Athletic Trainer (ATC), School Physician, or nurse, if available. If not available, the responding teacher or coach).
      3. Wait 15 minutes and re-evaluate utilizing the concussion checklist. If the student has any of the symptoms on the checklist present, a concussion is suspected and the student SHALL NOT return to physical activity.
      4. Contact parents/guardian and make them aware of situation. As soon as is practicable, parents should be given the Concussion Packet for Parents, which is also posted to the District’s website and provided to students prior to their participation in school athletics.
      5. Notify a member of the Concussion Management Team (School Physician/Health Office and the ATC and Athletic Director when applicable).
      6. The Health Office will notify the student’s guidance counselor who will disseminate information to the appropriate faculty members, on a need to know basis.
      7. Fill out and submit an accident report to the nurse’s office.
2. Off-Location Management
   1. For all concussions that occur outside of a Bronxville School District sponsored event/activity, the student’s parent or guardian is REQUIRED to alert the nurse’s office and make them aware of the concussion.
   2. The nurse will then notify the Concussion Management Team, and the student will be monitored on a day-by-day basis by either the nurse, School Physician, or certified athletic trainer.
   3. The nurse will fill out a concussion checklist of symptoms present on the student’s first day back to school after concussion.
   4. Parents/guardians will receive a Concussion Packet for Parents, which is also available on the District’s website.
3. Physician Clearance
   1. All students with suspected concussions must be evaluated by a private licensed MD (preferably with a neurological background) for diagnosis and appropriate medical care.
   2. Once the student has been symptom-free for 24 hours, they must be reevaluated by their physician for written clearance to return to athletic activities.
   3. After the student has obtained clearance from a private licensed MD (preferably with a neurological background), they must next be cleared by the School Physician before starting the return-to-play protocol.
4. Return to Play Protocol *It must first be understood that every concussion is different, and concussions must be treated on a case by case basis. **As a guideline, 24 symptom free hours are suggested between every Phase of return-to-play.
   1. Phase 1: Rest and Recovery: Complete physical and cognitive rest is required of the student until he or she is symptom-free.
   2. Phase 2: Light Aerobic Exercise: Walking on treadmill, stationary bike, or light elliptical exercise for 15 minutes.
   3. Phase 3: Moderate Aerobic Exercise and Sport Specific Drills: Jogging for 20 minutes and/or skills necessary for the activity to which the student will return (ex. Passing drills in football)
   4. Phase 4: Non-Contact Practice: Student may participate in drills in practice that require no contact. (Ex. Lay-up drills in basketball as opposed to scrimmaging).
   5. Phase 5: Full-Contact Practice: Student may participate in full contact training drills and intense aerobic activity.
   6. Phase 6: Return-to-Play: Student may return to game-play with no restrictions.
      
      Upon completion of the return-to-play protocol (while remaining symptom free), the student will be referred to the School Physician for final clearance. The certified athletic trainer, the school physician, and the Bronxville School District reserve the right to withhold a student from activity regardless of medical clearance.
5. Multiple Concussions Any student who sustains either a) two (2) concussions in one (1) season; or b) three (3) concussions in a lifetime is recommended to refrain from contact sports. Four (4) or more concussions in a lifetime can predispose the student to longer recovery time and/or lifetime impairments.