Prior:

At the beginning of every school year the athletic director should

set up a meeting with all of the coaches and trainers and educate them
about concussion policy. Every year before the start of the fall season
any student athlete must take the IMPACT test regardless if their sport
is in the fall or the spring.
The IMPACT test is a computerized computer program that
evaluates and documents multiple aspects of neurocognitive
functioning, including verbal and visual memory, attention span, brain
processing speed, reaction time and post-concussive symptoms.
Each team is assigned to a specific date in the computer lab for
testing. The athletic trainer will be in the room with the teams to help
set up the program and make sure everyone knows what to do and
how to do it. Once the athlete has taken the IMPACT test they are
cleared to practice and participate in games.
If the athlete has not taken the IMPACT test they are not allowed
to participate in any kind of practice or game, until they have taken it.
If there is an athlete that joins in later in the season, the coach must
make sure that they have been tested and if not then they must go to
the athletic trainer and get tested. Each coach must be concussion
wise trained and know the definition as well as how to diagnose a
concussion.
The athletic director is in charge of ordering equipment for the
year and they are required to order the equipment that has been
certified to protect against traumatic head injury. They are also in
charge of sending the parents of every student athlete a letter or
packet in the mail that educates them on the schools concussion
policy. They should also set up a meeting for the parents to come in

and ask questions or talk about their concerns they have about the
policy.
The athletic trainer should be aware of any and all relevant
governing bodies and their policies. They should document the
athletes understanding of concussive signs and symptoms. They
should communicate the status of concussed athletes to the managing
physician on a regular basis. They should ensure proper documentation
of the concussion evaluation, management, treatment, return-toparticipation progression, and physician communications.

During Practice or Games:

If at any point during a practice or a game an athlete shows
signs or symptoms of a concussion, they must immediately be
removed from the practice ot game. Once removed a Certified Athletic
Trainer will look at them and test them using the Sport Concussion
Assessment Tool to determine their cognitive and physical symptoms.
Should an athlete experience deterioration of level of
consciousness, decreasing neurological functions, and/or exhibit signs
and symptoms associated with a severe head or neck injury,
consideration for a more serious brain injury such as intracranial
hemorrhage, skull fracture, or cervical spine compromise should be
considered, and the Emergency Action Plan should be activated.

Return to Play:
When an athlete has sustained a concussion the return to play
protocol is very specific. The athlete must stay home until they are 24
hours symptom free, some symptoms being headache, neck pain,
nausea, dizziness, blurred vision, balance disturbance, sensitivity to

light, sensitivity to noise, feeling slowed down, feeling in a fog,

difficulty concentrating, difficulty remembering, fatigue or low energy,
mental confusion, drowsiness, trouble falling asleep, more emotional,
irritability, sadness and being nervous and/or anxious.
Once they are symptom free for 24 hours they are allowed to
come back to school for a half day, if after that half day they are still
24 hour symptom free, they can return to school for a full day, but not
practice. If they are still symptom free they are allowed to go to school
full day and then take the IMPACT test again.
Once the results are in the trainer can identify if they have
scored better or worse than their baseline test. If the score is better
they can proceed to the next step of the return to play, if they have not
scored better they must go home and rest for another two days before
going back to school for the half day.
After the athlete score higher than their baseline test then the
athlete starts the physical workouts before they can participate in
practice.
The first day of workouts is walking on the treadmill for 15
minutes, after walking the trainer tests the athlete on memory,
balance, and vision. If the athlete is symptom free they are free to
continue the workout the net day.
The second day is the same thing as the first day, if they are
symptom free they can return on the third day.
On the third day the athlete jogs for 10 minutes and walks for 10
minutes and is tested by the trainer on the same three things.
The last day of the workouts is 10 minutes of jogging, and then
lifting weights for 10 minutes, if the athlete is symptom free they are
done with workouts.
The final day of the return to play protocol is allowing the athlete
to practice with their team but they are not allowed to participate in

any contact drills, and after that if they are still symptom free they are
allowed to return to play completely.
If at any point during this process they have a symptom the
athlete must stop, tell the trainer, and start the entire process all over
again until they can do it completely symptom free.