Windham High School

Athletic Training Department

Policies and
Emergency Action Plan
Windham High School
Athletic Training Department

Table of Contents
Lighting Page 3
Heat Safety Page 4
Communicable Disease Page 5
Methicillin Resistant Staphylococcus Aureus (MRSA) Page 6
Cervical Spine Injuries Page 8
Football Helmet Removal Page 10
Concussions Page 11
Concussions- Return to High School Sports Page 14
Concussions- Return to Middle School Sports Page 16
Concussions- Roles of the Care Team Page 18
Concussions- Sign and Symptom Check List Page 24
Concussions- Return to School Page 25
Emergency Action Plan Page 26

Map of Campus Page 42

Acknowledgement Form Page 44

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Athletic Training Department

Subject: Lightening

Policy: Severe weather situations can threaten the safety of the athletes, coaches, and spectators.

LIGHTNING
When conditions are favorable for severe weather, especially lightning, the situation will be
assessed and the Certified Athletic Trainer (ATC) will indicate specific action.

LIGHTNING DISTANCE
Lightning distance will be determined using the “Flash-to-bang” method. After a flash of
lightning is spotted the ATC will begin counting until thunder is heard. The number counted will
then be divided by five to determine how far the lightning was, in miles. If the count is 30 or less
(six miles or less), it will be recommended that all persons seek shelter.

SHELTER
The first choice of shelter is a building that is frequently inhabited. Other sources of shelter are
covered structures with a metal roof, such as a vehicle. Baseball and softball dugout are NOT
consider proper shelter.

Visiting team will be asked to return to their school bus. If the school bus is not on campus the
team will go to the same area as the home team.

F1 (Softball Field) High School

F2 (Field Hockey Field)
F3 (Baseball Field)
F4 (JV Baseball, First Soccer)
F5 (JV Softball)
F6 (Football, Baseball)
F7, F8, F9 (Football, Soccer, Lacrosse)
F10 (Soccer, Lacrosse)
Stadium
Tennis Court
High School, Middle School
High School, Middle School
High School, Middle School
High School, Middle School, Concession stand
High School, Middle School, Concession stand
High School, Middle School, Concession stand
High School, Middle School, Concession stand
High School, Middle School, Concession stand
High School

RETURNING TO PLAY
Play should not be resumed until 30 minutes after the last flash of lightning or sound of thunder.

ATC ACTIONS
If the weather becomes unsafe the ATC will recommend to the “director of the activities” that
action be taken. Officials, coaches, and parents will also be informed of the unsafe situation. The
ATC will then go to a specified shelter and will not return to the event until it is safe to do so.

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Athletic Training Department

Subject: Heat Safety

Policy:
The athletic trainer will take the temperature and humidity. The athletic trainer then will
determine the heat/humidity zone.

The athletic trainers and coaches will observe athletes during practice and games for signs and
symptoms of heat illness. Any athlete showing signs of heat illness will be pulled from
practice/game and evaluated. Any athlete who needs physician evaluation will not be allowed to
return to practice until released by that physician.

WBGT Flag Color Level of Risk Comments

>650 F Green Low Risk Risk low but still exists on the basis of risk factors

65°-73°F Yellow Moderate Risk Risk level increases as event progresses through
the day

73°-82°F Red High Everyone should be aware of injury potential;

individuals at risk should not compete

>82°F Black Extreme Consider rescheduling or delaying the event until

safer conditions prevail; if the event must take place,
be on high alert. Take steps to reduce risk factors
(e.g., more and longer rest breaks, reduced practice
time, reduced exercise intensity, access to shade,
minimal clothing and equipment, cold tubs at practice
site, etc.)

Under 82. Normal activities: provide 3 separate rest breaks per hour of minimum duration 3 min each during
workout.
82.0–86.9 F Use discretion for intense or prolonged exercise. Watch at-risk players carefully. Provide 3
separate rest breaks per of minimum duration 4 min each.
87.0 -89.9 F Maximum practice time 2 h. For football: players restricted to helmet, shoulder pads, and shorts
during practice. All protective equipment must be removed for conditioning activities. For all sports: provide
4 separate rest breaks per of minimum duration 4 min each.
90.0–92.0 F Maximum length of practice 1 h. No protective equipment may be worn during practice and
there may be no conditioning activities. There must be 20 min of rest breaks provided during the hour of
practice.
Over 92.1 F No outdoor workouts, cancel exercise, delay practices until a cooler

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Athletic Training Department

Regular practices with full practice gear can be conducted for conditions that plot to
the left of the triangles.
Cancel all practices when the temperature and relative humidity plot is to the right
of the circles; practices may be moved into air-conditioned spaces or held as walk-
through sessions with no conditioning activities.
Conditions that plot between squares and circles: increase rest- to-work ratio with 5-
to 10-minute rest and fluid breaks every 15 to 20 minutes; practice should be in
shorts only with all protective equipment removed.

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Athletic Training Department

Conditions that plot between triangles and squares: increase rest-to-work ratio with
5- to 10-minute rest and fluid breaks every 20 to 30 minutes; practice should be in
shorts with helmets and shoulder pads (not full equipment).

Subject: Communicable Disease

Policy: Windham High School follows the guidelines set forth by the Maine Principals
Association with regards to potential blood-borne pathogens. These guidelines also follow those
of the National Federation of State High School Associations. The guidelines are as follows.

1. The bleeding must be stopped, the open wound covered, and if there is an
excessive amount of blood on the uniform it must be changed before the
athlete may participate.
2. Routinely use gloves or other precautions to prevent skin and mucous
membrane exposure when contact with blood or other body fluids is
anticipated.
3. Immediately wash hands and other skin surfaces if contaminated (in
contact) with blood or body fluids. Wash hands immediately after
removing gloves.
4. Clean all contaminated surfaces and equipment with an appropriate
disinfectant before competition resumes.
5. Practice proper disposal procedures to prevent injuries caused by needles,
scalpels, and other sharp instruments or devices.
6. Although saliva has not been implicated in HIV transmission, to minimize
the need for emergency mouth-to-mouth resuscitation, mouthpieces,
resuscitation bags, or other ventilation devices should be available for use.
7. Athletic Trainers/coaches with bleeding or oozing skin conditions should
refrain from all direct athletic care until the condition resolves.
8. Contaminated towels should be properly disposed of/disinfected.
9. Follow acceptable guidelines in the immediate control of bleeding and
when handling bloody dressings, mouth guards, and other articles
containing body fluids.

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Athletic Training Department

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Athletic Training Department

Subject: Methicillin Resistant Staphylococcus Aureus (CA-MRSA)

Policy: To establish guidelines when Methicillin Resistant Staphylococcus Aureus (CA-MRSA)

in the School Setting.
Definition:
MRSA is a type of Staphylococcus Aureus (S. aureus) resistant to commonly prescribed
antibiotics that are frequently used to treat staph infections. S. aureus, including MRSA, usually
cause mild infections of the skin. MRSA, however can be more difficult to treat and can lead to
life-threatening blood, bone or pulmonary infections. Both the S. aureus and MRSA are found on
the skin or in the nose of healthy people. This is referred to as colonization.
Description:
As a skin infection, S. aureus and MRSA can present as an abscess, impetigo, boil or an open
wound and is often mistaken for a spider bite. Symptoms can include fever, redness, warmth,
swelling, pus and tenderness at the site. Any drainage from the skin lesion should be considered
infectious.
Mode of Transmission:
S. aureus and MRSA are primarily spread through contact with the bacteria, either by direct
person-to-person contact or indirectly through shared equipment, personal articles/objects or
contaminated surfaces. Examples of shared objects include towels, soap, razors, clothing and
athletic equipment.
Incubation Period:
Variable
Infectious Period:
An open wound may contain S.aureus or MRSA bacteria and should be treated as infectious.
Role of School Nurse/Athletic Trainer (sports settings)

Educate staff, coaches, parents and students (especially athletes) about the importance of:
● Frequent hand washing/use of waterless hand sanitizers.
● Being aware of skin lesions/infections among students/staff.
● Reporting/referring persons with skin lesions/infections to the school nurse/athletic trainer as
soon as possible. Parents encouraged referring child to health care provider.
● Referring persons with possible infections to parents for referral to licensed health care provider.
● Report to Maine CDC if a cluster of three or more cases occur in a sport setting (teams using
same locker room) and/or in a single classroom.
● Not sharing personal items (towels, razors, soap, clothing etc.)
● Cleaning or laundering of equipment and clothing between uses.
● Showering thoroughly with liquid soap and water after practices and competitions. (preferably at
school)

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Athletic Training Department

● Fully completing antibiotic treatment as prescribed by health care provider (HCP) for an infected
person.
● Keeping skin infections and wounds covered with clean dry bandages.
● Ensure contact precautions when doing wound care and standard precautions if the potential for
splashing exists.
Control of Spread:
● Student or staff members, who are colonized or infected with MRSA, do not need to routinely be
excluded from school.
● Establishing that persons diagnosed with S.aureus/MRSA infections/lesions may attend school if
lesions are kept consistently covered with a dry dressing taped on 4 sides. Return to school will
meet guidelines of the Windham School District’s Communicable Disease policy.
● Do not place persons with an active MRSA infection in classrooms with anyone who has severe
immune system suppression.
● Reporting possible infections to parents for referral to a licensed health care provider (HCP) for
an evaluation. Student will not participate in contact sports (PE/extracurricular) until evaluated by
HCP and school nurse/athletic trainer receives return to school/sports release in writing from
HCP
● Establishing that persons diagnosed with S.aureus/MRSA infections/lesions may NOT participate
in contact sports (PE/extracurricular) until lesion is healed with no evidence of drainage.
● Encourage athletes to report skin lesions to coaches/athletic trainer/school nurse. Athletes may
be assessed (esp. football players and wrestlers) as needed for skin infections. Parents will be
made aware that athletes may need to be assessed for skin infections in order to participate in
practice and competition
Coordination and Communication
● Coaches will immediately notify athletic trainer/school nurse (whoever is available) of possible
skin infection of an athlete for further evaluation.
● Parent will be notified by either of above for further evaluation by HCP per guidelines described
above.
● Athletic trainer and school nurse will communicate as needed and on a daily basis in the event of
positive findings in an athlete. Athletic Director and school Principal will be notified of a MRSA
diagnosis in an athlete. If a potential outbreak (three or more cases) “in a defined cohort outside
of a single household (e.g., school, athletic team) is identified the Superintendent of Schools and
the local Public Health Department, (Maine CDC) shall be notified.*
● Athletic Director will notify opposing team in the event of an outbreak.
● Athletic trainer and school nurse will coordinate daily assessment results and dressing changes of
infected athletes.

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Athletic Training Department

Subject: Cervical Spine Injuries

Policy: Adhere to the following protocol.

PROTOCOL FOR CERVICAL SPINE INJURIES

Unconscious and Not Breathing

1. ABC’s
2. Activate EMS (call 911) – always transport if loss of conscious occurs.
3. If the athlete is prone, logroll them over to the supine position as a “unit” (4 to 5 people
positioned accordingly on both sides of the body):
a. Head – this person is the team leader or “Captain”. They are responsible for stabilizing
the head and neck in its original position as found on the field no matter how distorted it may
appear. Do not apply traction! The Captain continues to stabilize the athlete until securely
stabilized on the spine board. They do not let go of the head until stabilized on the spine board.
b. Trunk
c. Hips and thighs
d. Lower legs
4. Establish the airway. Remove the face mask as the Captain continues to stabilize the head and
neck. KEEP HELMET ON
5. Cut the shoulder pads strings spreading the pads apart. LEAVE PADS UNDERNEATH
ATHLETE. This keep cervical spine straight because the helmet is on.
6. Perform CPR or rescue breathing, maintaining the airway and stabilizing the head and neck.
Utilize the jaw thrust technique. If you are unable to obtain adequate ventilation, then utilize
head tilt-chin lift technique.
7. Assist the EMT’s when they arrive.

Remember:
Always treat the unconscious athlete as having a cervical spine injury.
Be prepared to calm the athlete if they wake up.
Each emergency situation presents its own set of unique circumstances, so you may have to
deviate from the protocol to a certain degree.

Unconscious but Breathing

1. Check ABC’s
2. Activate EMS (call 911)
3. Captain stabilizes head and neck until secured to spine board.
4. If the athlete is prone, logroll the athlete from a prone position to a supine position making
sure to stabilize the head and neck.

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Athletic Training Department

5. Remove the face mask for the EMT’s – Leave helmet on until EMS arrives. EMS will
determine if helmet and shoulder pads should be removed
6. Maintain airway until EMS arrives.
7. Assist EMT’s with securing the injured athlete on the spine board. (See helmet removal)

Conscious Athlete
1. Check ABC’s
2. Evaluate for cervical spine injury
2. Calm the athlete
3. Take a history of the incident.

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Athletic Training Department

Subject: Football Helmet Removal

Policy: In the case of a suspected cervical spine injury involving an athlete wearing a helmet, the
Athletic Trainer will work in conjunction with Emergency Medical Technicians to administer the
best treatment for the athlete.

1. The Athletic Trainer or physician will assess the injury and decide whether the injury
requires immobilization and transportation to the hospital.
2. If transportation is deemed necessary, Emergency Medical Service will be activated.
(Call 911)
3. If the athlete is unconscious, a cervical injury is always suspected and the athlete is
treated following protocol.
4. If the athlete is not breathing, he/she will be positioned such that access to the athletes’
airway is possible. If the athlete is in the prone position, a log roll maneuver will be
performed while maintaining cervical stabilization.
5. If the athlete is breathing and in the prone position, he/she will be log rolled into the
supine position.
6. Once the athlete is supine, the facemask will be removed regardless of current
respiratory status.
7. If the situation requires the helmet to be removed, the shoulder pads will be
removed as well using the following protocol.
- while maintaining cervical immobilization, the chin strap is cut
- accessible internal helmet padding is removed and air pressure deflated
- the athletes’ head is stabilized by support of the chin and the back of the
neck
- prior to removing the helmet, the shoulder pads are prepared for removal
by cutting all straps and removing any extra padding
- a responder stabilizes the athletes’ head by placing his/her forearms on the
athletes’ chest while holding the maxilla and occiput
- with the help of responders, the athlete is lifted slightly by placing hands
directly on the thoracic region of the back
- the helmet is rotated forward slightly and removed
- slight traction may be applied to the helmet if necessary
- the helmet should NOT be spread apart by the ear holes
- the shoulder pads are removed by spreading the front panels and pulling
them around the head
- the athlete is lowered, stabilized to a spine board and transported to the
hospital

8. Once the Emergency Medical team arrives, the athlete will be immobilized and
transported to the hospital.

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Athletic Training Department

Subject: Concussions

The RSU #14 Board of Directors recognizes that concussions and head injuries are commonly
reported injuries in children and adolescents who participate in sports and other recreational
activities. The Board recognizes the seriousness of concussions, the emerging scientific and
medical understanding of the academic and physical impacts of concussions, and the need for
careful handling of the post-injury healing process.

Faculty Responsibility

By June 30 of each year, the Athletic Director will identify the school-sponsored athletic
activities that pose a risk of concussion or other head injury. A list of these activities will be
distributed to school administrators and coaches.

All coaches in RSU #14, including volunteer coaches, and all school personnel (including
volunteers) identified by the Concussion Policy Management Team will be trained to recognize
the signs and symptoms of a concussion and the management of concussive and other head
injuries. The training must be consistent with such protocols as may be identified or developed
by the Maine Department of Education and include instruction in the use of such forms as the
DOE may develop or require. Coaches are required to immediately remove any athlete with
suspicion of a concussion from all sports until proper clearance is received by a physician
specifically trained in concussion management.

Student & Parent Information

At the beginning of each school year, and/or prior to the beginning of each sports season,
students and parents of students who will be participating in school-sponsored athletic activities
will be provided information regarding:

A. The risk of concussion and other head injuries and the dangers associated with continuing
to participate when a concussion or other head injury is suspected;

B. The signs and symptoms of concussion and other head injuries; and

C. The District’s protocols for (1) removal from the activity when a student is suspected of
having sustained a concussion or other head injury; (2) evaluation; and (3) return to
participation in the activity

The student and his/her parent/guardian must sign a statement acknowledging that they have
received and read this information before the student will be allowed to participate in any school-
sponsored athletic activity.

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Athletic Training Department

Management of Concussive and Other Head Injuries

It is the responsibility of the coach/teacher of the activity to act in accordance with this policy
when the coach/teacher recognizes that a student may be exhibiting signs, symptoms, and
behaviors associated with a concussion or other head injury.

Any student suspected of having sustained a concussion or other head injury during a school-
sponsored athletic activity, including but not limited to competition, practice, or scrimmage, or
during a school learning activity, must be removed from the activity immediately. The student
and his/her parent/ guardian will be informed of the need for an evaluation for brain injury before
the student will be allowed to return to the activity.

No student will be permitted to return to the activity or to participate in any other school-
sponsored athletic activity on the day of the suspected concussion.

Any student who is suspected of having sustained a concussion or other head injury shall be
prohibited from further participation in school-sponsored athletic activities or learning activities
until he/she has been evaluated and received written medical clearance to do so from a licensed
health care provider who is qualified and trained in concussion management. More than one
evaluation by the health care provider may be necessary before the student is cleared for full
participation. Coaches and other school personnel shall comply with the student’s health care
provider’s recommendations.

If a district has concerns or questions about the private medical provider’s orders, the district
concussion specialist should contact that provider to discuss and clarify. Additionally, the
concussion specialist has the final authority to clear students to participate in or return to extra-
class physical activities

Cognitive Considerations

School personnel should be alert to cognitive and academic issues that may be experienced by
students who have suffered a concussion or other head injury, including but not limited to
difficulty with concentration, organization, long-and-short-term memory and sensitivity to bright
lights and sounds, and accommodate a gradual return to full participation in academic activities
as appropriate, based on the recommendations of the student’s health care provider and
appropriate designated school personnel.

Concussion Policy Management Team

The Superintendent will appoint a Concussion Policy Management Team including a school
administrator to be responsible, under the administrative supervision of the Superintendent, to
make recommendations related to the implementation of this policy. The Concussion Policy

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Management Team will include the school nurse and Athletic Administrator and may include
one or more principals or assistant principals, the school physician, and other school personnel or
consultants as the Superintendent deems appropriate.

The Team shall oversee and implement this policy and related protocols for concussive head
injuries based on the generally accepted protocols. This Team will identify the school personnel
who shall be trained in concussion signs and symptoms and the school activities covered by this
policy.

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Athletic Training Department

Subject: Student Concussion and Head Injuries- Return to High School Sports.

Here at RSU #14 we value an athlete’s health in the highest regards and take every
concussion seriously. Windham High School athletes will be providing baseline concussion test
(ImPACT) (free of charge).

Requesting Exemption from Baseline Testing:

Athletes requesting exemption will require written consent from parent/guardian. To request
your athlete be exempt, please contact the athletic office and complete the appropriate forms.
This form must be filled out prior to participation in the school sport.

Faculty Responsibility:
All coaches in RSU #14, including volunteer coaches, will be trained to recognize the signs and
symptoms of a concussion and the management of concussive and other head injuries. The
training must be consistent with such protocols as may be identified or developed by the Maine
Department of Education and include instruction in the use of such forms as the DOE may
develop or require. Coaches are required to immediately remove any athlete with suspicion of a
concussion from all sports until proper clearance is received by a physician specifically trained in
concussion management.

Returning to Sport:
Any student who is suspected of having sustained a concussion or other head injury shall be
prohibited from further participation in school-sponsored athletic activities or learning activities
(classes) until he/she has been evaluated and received written medical clearance to do so from a
licensed health care provider who is qualified and trained in concussion management.

The athlete can either see their primary care physician (if trained in concussion management) or
they can see Orthopedic Associates, concussion specialist, to get clearance to return to class at
school.

NOTE: The initial assessment by the physician clears the athlete to return to school and class.
The athlete still needs to pass ImPACT and follow the return to play protocol before returning
to sports.

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Athletic Training Department

Orthopedic Associates, will read the follow-up ImPACT exam unless another practice is
specifically requested who is trained in reading and interrupting ImPACT. All athletes will also
be required to follow the ‘Return to Play Protocol’ prior to returning to sport.

Return to Play Protocol:

1. Athletes will be required to take and pass the ImPACT test (computerized test that helps to
identifying a concussion), and there must be NO signs or symptoms of a concussion.
2. Athletes are also required to follow the ‘Return to Play Transition Steps’:
Day 1: Athlete will participate in cardio. They athlete will walk, run, or bike for 30
minutes.
Day 2: Athlete will participate in a light practice with the following restriction:
NO heading, NO tackling/hitting, NO stunting
Day 3: Athlete will participate in a full practice with no restriction
Day 4: Athlete may participate in a game

*If any symptoms return during any of the steps above, that athlete will return back to the
previous step before moving forward to full participation.

*These are the minimum standards for an athlete to return to sport. We reserve the right to add
additional steps depending on severity of an individual situation.

Other Concussion Syndromes:

Second-Impact Syndrome
Second-impact syndrome occurs when a second concussion occurs before the previous
concussion fully healed, even if both the injuries were mild. Second-impact syndrome is a rare
event but can cause significant danger for athletes who return too soon after suffering a previous
concussion. Second-impact syndrome is characterized by an auto regulatory dysfunction that
causes rapid and fatal brain swelling, and can result in death in as little as two to five minutes.

Post-Concussion Syndrome
Following a concussion, athlete may suffer a number of lingering symptoms for varying
lengths of time. If this occurs the athlete will be held for sports until the symptoms are gone. The
return to play protocol will be altered according to the symptoms and how long these symptoms
occurred. Orthopedic Associates will be responsible for setting these new standards.

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Athletic Training Department

Subject: Student Concussion and Head Injuries- Return to Middle School Sports

Here at RSU #14 we value an athlete’s health in the highest regards and take every
concussion seriously.

Faculty Responsibility:
All coaches in RSU #14, including volunteer coaches, will be trained to recognize the signs and
symptoms of a concussion and the management of concussive and other head injuries. The
training must be consistent with such protocols as may be identified or developed by the Maine
Department of Education and include instruction in the use of such forms as the DOE may
develop or require. Coaches are required to immediately remove any athlete with suspicion of a
concussion from all sports until proper clearance is received by a physician specifically trained in
concussion management.

Returning to Sport:
Any student who is suspected of having sustained a concussion or other head injury shall be
prohibited from further participation in school-sponsored athletic activities or learning activities
(classes) until he/she has been evaluated and received written medical clearance to do so from a
licensed health care provider who is qualified and trained in concussion management.

The athlete can either see their primary care physician (if trained in concussion management) or
they can see Orthopedic Associates, concussion specialist, to get clearance to return to class at
school.

Note: The letter from the doctor might come in stage. The doctor can clear the athlete for school
and not sports. Therefore, the note must say cleared to return to sport activity.

Return to Play Protocol:

3. Once a note is receive from a physician trained in concussion management and there are NO
signs or symptoms of a concussion.
4. Athletes are also required to follow the ‘Return to Play Transition Steps’:
Day 1: Athlete will participate in cardio. They athlete will walk, run, or bike for 30
minutes.
Day 2: Athlete will participate in a light practice with the following restriction:
NO heading, NO tackling/hitting, NO stunting
Day 3: Athlete will participate in a full practice with no restriction
Day 4: Athlete may participate in a game

*If any symptoms return during any of the steps above, that athlete will return back to the
previous step before moving forward to full participation.

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*These are the minimum standards for an athlete to return to sport. We reserve the right to add
additional steps depending on severity of an individual situation.

Other Concussion Syndromes:

Second-Impact Syndrome
Second-impact syndrome occurs when a second concussion occurs before the previous
concussion fully healed, even if both the injuries were mild. Second-impact syndrome is a rare
event but can cause significant danger for athletes who return too soon after suffering a previous
concussion. Second-impact syndrome is characterized by an auto regulatory dysfunction that
causes rapid and fatal brain swelling, and can result in death in as little as two to five minutes.

Post-Concussion Syndrome
Following a concussion, athlete may suffer a number of lingering symptoms for varying
lengths of time. If this occurs the athlete will be held for sports until the symptoms are gone. The
return to play protocol will be altered according to the symptoms and how long these symptoms
occurred. Orthopedic Associates will be responsible for setting these new standards.

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Subject: Concussion- Roles of the Care Team

Student
Students should be encouraged to communicate any symptoms promptly to
district staff and/or parents/guardians, as a concussion is primarily diagnosed by reported
and/or observed signs and symptoms. It is the information provided by the student about
their signs and symptoms that guide the other members of the team in transitioning the
student back to activities. The amount and type of feedback reported by the student will
be dependent on age and other factors. Therefore it is recommended that students:
▪ Be educated about the prevention of head injuries.
▪ Be familiar with signs and symptoms that must be reported to the coach, certified
athletic trainer, school nurse, parent/guardian, or other staff.
▪ Be made aware of the risk of concussion and be encouraged to tell their coach,
parent/guardian, certified athletic trainer, school nurse or other staff members
about injuries and symptoms they are experiencing.
▪ Be educated about the risk of severe injury, permanent disability, and even death
that can occur with re-injury by resuming normal activities before recovering
from a concussion.
▪ Follow instructions from their private medical provider.
▪ Be encouraged to ask for help and to inform teachers of difficulties they
experience in class and when completing assignments.
▪ Encourage classmates and teammates to report injuries.
▪ Promote an environment where reporting signs and symptoms of a concussion is
considered acceptable.

Parent/Guardian
Parent/guardians play an integral role in assisting their child and are the primary
advocate for their child. When their child is diagnosed with a concussion, it is important
that the parent/guardian communicates with both the medical provider and the school.
Understandably this is a stressful time for the parent/guardian as they are concerned
about their child’s well-being. Therefore, it is recommended that parents/guardians:
▪ Be familiar with the signs and symptoms of concussions. This may be
accomplished by reading pamphlets, Web based resources, and/or attending
▪ meetings prior to their child’s involvement in interscholastic athletics.
▪ Be familiar with any concussion policies or protocols implemented by the school
district. These policies are in the best interest of their child.
▪ Be made aware that concussion symptoms that are not addressed can prolong
concussion recovery.
▪ Provide any forms and written orders from the medical provider to the school in a
timely manner.
▪ Monitor their child’s physical and mental health as they transition back to full
activity after sustaining a concussion.

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▪ Report concerns to their child’s private medical provider and the school as
necessary.
▪ Communicate with the school to assist in transitioning their child back to school
after sustaining a concussion.
▪ Communicate with school staff if their child is experiencing significant fatigue or
other symptoms at the end of the school day.
▪ Follow the private medical provider orders at home for return to activities.

School Administrator
The school administrator and/or their designee should insure that the district’s policies on
concussion management are followed. The administrator may choose to designate a formal
concussion management team to oversee that district policies are enforced and protocols are
implemented. Therefore, administrators should:
▪ Review the district’s concussion management policy with all staff.
▪ Arrange for professional development sessions regarding concussion management
for staff and/or parent meetings.
▪ Provide emergency communication devices for school activities.
▪ Provide guidance to district staff on district wide policies and protocols for
emergency care and transport of students suspected of sustaining a concussion.
▪ Develop plans to meet the needs of individual students diagnosed with a
concussion after consultation with the concussion specialist, school nurse, or
certified athletic trainer.
▪ Enforce district concussion management policies and protocols.
▪ Assign a staff member as a liaison to the parent/guardian. The liaison should
contact the parent/guardian on a regular basis with information about their child’s
progress at school.
▪ Encourage parent/guardian to communicate to appointed district staff if their child
is experiencing significant fatigue or other symptoms at the end of the day.
▪ Invite parent/guardian participation in determining their child’s needs at school.
▪ Encourage parent/guardian to communicate with the private medical provider on
the status of their child and their progress with return to school activity.

Concussion Specialist
The district concussion specialist plays a very important role in setting policies and
procedures related to identifying students who may have sustained a concussion, along with post-
concussion management in school. Therefore, the concussion specialist should:
▪ Collaborate with district administration in developing concussion management
policies and protocols.
▪ Assist district staff by acting as a liaison to the student’s medical provider and
contacting that provider as necessary to discuss or clarify orders and plan of care.
▪ Attend 504 and CSE meetings when requested by 504 or CSE director.
▪ Review all medical providers’ written clearance for students to begin graduated

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physical activity unless the concussion specialist chooses to delegate this to the school
nurse or certified athletic trainer. If this task is delegated, the concussion specialist
should provide concise written protocols for the school nurse or certified athletic
trainer to follow when accepting a private medical provider’s clearance. Such protocols
should specify the type of symptoms, medical history, and concussion severity etc. that the
concussion specialist will need to personally review. This protocol may include
permitting the school nurse or certified athletic trainer to act as the concussion specialist’s
delegate to inform appropriate district staff of the student’s return to activity.
▪ Clear all students returning to extra-class athletic activities. This can be done at the
discretion of the concussion specialist either by reviewing a private medical provider’s
clearance, or personally assessing the student.
▪ Implement district policy on return to activities. Discuss any orders with the
private medical provider as needed.
▪ Work with the Concussion Management Team to monitor the progress of
individual students with protracted recovery, multiple concussions, and atypical
recovery.
▪ Encourage school health personnel (concussion specialist, school nurses, and certified
athletic trainers) to collaborate and communicate with each other about any student who
is suspected of having or is diagnosed with a concussion.

School Nurse
The school nurse (RN) is often the person who communicates with the private medical
provider, concussion specialist, parent/guardian, and district staff. Often, he or she is the district
staff member who collects written documentation and orders from the medical provider. The
school nurse also plays an integral role in identifying a student with a potential concussion.
Additionally, they assess the student’s progress in returning to school activities based on private
medical provider orders or district protocol. Therefore, the school nurse should:
▪ Perform baseline validated neurocognitive computerized tests if permitted by
district policy, and credentialed in their use.
▪ Assess students who have suffered a significant fall or blow to the head or body
for signs and symptoms of a concussion. Observe for late onset of signs and
symptoms, and refer as appropriate.
▪ Assess the student to determine if any signs and symptoms of concussion warrant
emergency transport to the nearest hospital emergency room per district policy.
▪ Refer parents/guardians of students believed to have sustained a concussion to
their medical provider for evaluation.
▪ Provide parents/guardians with oral and/or written instructions (best practice is to
provide both) on observing the student for concussive complications that warrant
immediate emergency care.
▪ Assist in the implementation of the private medical provider’s or other specialist’s
requests for accommodations.
▪ Use the private medical provider’s or other specialist’s orders to develop an

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emergency care plan for staff to follow.

▪ Monitor and assess the student’s return to school activities, assessing the student’s
progress with each step and communicating with the private medical provider or
other specialist, concussion specialist, certified athletic trainer, parent/guardian, and
appropriate district staff when necessary.
▪ Collaborate with the district concussion management team in creating
accommodations as requested by the private medical provider or other specialist if
it is determined that a 504 plan is necessary.
▪ Review a private medical provider’s or other specialist’s written statement to
clear a student to return to activities (if the district’s concussion specialist has written
a policy delegating this to the school nurse). Such protocols should specify the type of
symptoms, medical history, and concussion severity etc. that the concussion specialist will
need to personally review. This protocol may include permitting the school nurse to act as
the concussion specialist’s delegate to inform appropriate district staff of the student’s
return to activity.
▪ Perform post-concussion assessments or use validated neurocognitive
computerized tests or other assessment tools, if credentialed or trained in their
use, and provide the results to the private medical provider and/or district concussion
specialist to aid him/her in determining the student’s status.
▪ Educate students and staff in concussion management and prevention.

Athletic Director
Athletic director must be aware of district policies regarding concussion management.
They should educate PE teachers, coaches, parents/guardians, and students about such policies.
The athletic director often act as the liaison between district staff and coaches. Therefore, the
athletic director should:
▪ Ensure that pre-season consent forms as required by the Concussion Policy information
about the district’s policies and protocols for concussion
management.
▪ Offer educational programs to parents/guardians and student athletes that educate
them about concussions.
▪ Inform the school nurse, certified athletic trainer, or concussion specialist of any
student who is suspected of having a concussion.
▪ Ensure that any student identified as potentially having a concussion is not
permitted to participate in any athletic activities until written clearance is received
from the district concussion specialist.
▪ Ensure that game officials, coaches, PE teachers, or parent/guardian are not
permitted to determine whether a student with a suspected head injury can
continue to play.
▪ Educate coaches on the school district’s policies on concussions and care of
injured students during interscholastic athletics, including when to arrange for
emergency medical transport.

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▪ Support staff implementation of graduated return to athletics protocol.

▪ Enforce district policies on concussions including training requirements for
coaches, PE teachers, and certified athletic trainers.
▪ If the district concussion specialist has authorized the school nurse or certified athletic
trainer to review and accept a private provider’s clearance, that written policy should be
made readily available to the athletic director, PE teachers, and
coaches.

Certified Athletic Trainer

A certified athletic trainer under the supervision of a qualified physician can assist
the concussion specialist and by identifying a student with a potential concussion. The certified
athletic trainer can also evaluate the student diagnosed with a concussion in their progress in
return to athletic activities based on private medical provider orders and/or district protocol.
They also play an integral role in ensuring the student athlete receives appropriate post-
concussion care as directed by the student’s medical provider. Therefore, certified athletic
trainers should:
▪ Oversee student athletes taking baseline validated standardized computerized tests
if permitted by district policy, and credentialed in their use.
▪ Evaluate student athletes who may have suffered a significant fall or blow to the
head or body for signs and symptoms of a concussion when present at athletic
events. Observe for late onset of signs and symptoms, and refer as appropriate.
▪ Evaluate the student to determine if any signs and symptoms of concussion
warrant emergency transport to the nearest hospital emergency room per district
policy.
▪ Refer parents/guardians of student athletes believed to have sustained a
concussion to their medical provider for evaluation.
▪ Provide parents/guardians with oral and/or written instructions (best practice is to
provide both) on observing the student for concussive complications that warrant
immediate emergency care.
▪ Assist in implementation of the private medical provider’s or other specialists’
requests for accommodations.
▪ Monitor the student’s return to school activities, evaluating the student’s progress
with each step, and communicating with the private medical provider or other
specialist, concussion specialist, school nurse, parent/guardian and appropriate district
staff.
▪ Review a private physician’s written statement to clear a student for return to
activities (if the district’s concussion specialist has written a policy delegating this to the
certified athletic trainer). Such protocols should specify the type of symptoms,
medical history, and concussion severity etc. that the concussion specialist will need to
personally review. This protocol may include permitting the school nurse or certified
athletic trainer to act as the concussion specialist’s delegate to inform appropriate district
staff of the student’s return to activity.

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▪ May perform post-concussion observations or oversee student athletes taking

validated standardized computerized tests if credentialed or trained in their use,
and provide the results to the private medical provider and/or district medical
director to aid him/her in determining the student’s status.
▪ Educate students and staff in concussion management and prevention.

Physical Education Teacher/ Coaches

Concussions often occur during athletic activities. Coaches are typically the only
district staff at all interscholastic athletic practices and competitions. It is essential that
coaches and physical education (PE) teachers are familiar with possible causes of
concussions along with the signs and symptoms. Coaches and physical education
teachers should always put the safety of the student first. Therefore, PE teachers and
coaches should:
▪ Remove any student who has taken a significant blow to head or body, or presents
with signs and symptoms of a head injury immediately from play because the
Concussion Management Policy requires immediate removal of any
student believed to have sustained a concussion.
▪ Contact the school nurse or certified athletic trainer (if available) for assistance
with any student injury.
▪ Send any student exhibiting signs and symptoms of a more significant concussion
to the nearest hospital emergency room via emergency medical services (EMS) or
as per district policy.
▪ Inform the parent/guardian of the need for evaluation by their medical provider.
The coach should provide the parent/guardian with written educational materials
on concussions along with the district’s concussion management policy.
▪ Inform the AD, certified athletic trainer, the school nurse and/or medical
director of the student’s potential concussion. This is necessary to ensure that the
student does not engage in activities at school that may complicate the student’s
condition prior to having written clearance by a medical provider.
▪ Ensure that students diagnosed with a concussion do not participate in any athletic
activities until, in conjunction with the student’s physician, the PE teacher/coach
has received written authorization from the concussion specialist or their designee
that the student has been cleared to participate.
▪ Ensure that students diagnosed with a concussion do not substitute mental
activities for physical activities unless medical provider clears the student to do so
(e.g. Due to the need for cognitive rest, a student should not be required to write a
report if they are not permitted to participate in PE class by their medical
provider).

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Subject: Concussion- Sign and Symptom Check List

Student’s Name: __________________________Student’s Grade: _______ Date___________________

Description of Injury: (Be sure to include information about any loss of consciousness and for how long, memory loss,
or seizures following the injury, or previous concussions, if any.
________________________________________________________________________________________

OBSERVED SIGNS
Appears dazed or stunned YES NO
Is confused about events YES NO
Repeats questions YES NO
Answers questions slowly YES NO
Can’t recall events prior to the hit, bump, or fall YES NO
Can’t recall events after the hit, bump, or fall YES NO
Loses consciousness (even briefly) YES NO
Shows behavior or personality changes YES NO
Does not “feel right” YES NO

PHYSICAL SYMPTOMS
Headache or “pressure” in head 0 1 2 3 4 5 6
Nausea or vomiting 0 1 2 3 4 5 6
Balance problems or dizziness 0 1 2 3 4 5 6
Fatigue or feeling tired 0 1 2 3 4 5 6
Blurry or double vision 0 1 2 3 4 5 6
Sensitivity to light 0 1 2 3 4 5 6
Sensitivity to noise 0 1 2 3 4 5 6
Numbness or tingling 0 1 2 3 4 5 6
Does not “feel right” 0 1 2 3 4 5 6

COGNITIVE SYMPTOMS
Difficulty thinking clearly 0 1 2 3 4 5 6
Difficulty concentrating 0 1 2 3 4 5 6
Difficulty remembering 0 1 2 3 4 5 6
Feeling more slowed down 0 1 2 3 4 5 6
Feeling mentally foggy 0 1 2 3 4 5 6

EMOTIONAL SYMPTOMS
Irritable 0 1 2 3 4 5 6
Sad 0 1 2 3 4 5 6
More emotional than usual 0 1 2 3 4 5 6

I ____________ the parent/guardian of____________ have been inform and given the school
policy on concussion. I understand that my child is suspected of having sustained a concussion
and shall be prohibited from further participation in school-sponsored athletic activities or
learning activities (classes) until he/she has been evaluated and received written medical clearance
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to do so from a licensed health care provider who is qualified and trained in concussion
management.

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Windham Raymond School Department
Returning to School with Concussion
Students Name________________
Doctor Name_________________
Good through ________________
School Recommendations
 Patient has no academic restrictions
 Patient is cleared for full activity
 Please note the recommendation
prescribed below
Attendance
 No school for ____________ school
day(s)
 No school until symptom free or
significant decrease in symptoms
 Part time attendance for ______ school
day(s) as tolerated
 Full school day as tolerated
 Tutoring homebound/in school as
tolerated
Visual Stimulus
 Allow student to wear sunglass in school
 Pre-printed notes for class material or
note taker
 No smart board, projector, computer, TV
screens or other bight screens
 Enlarged font when possible
Workload/ Multi-Tasking
 No homework
 Limit homework to ___________
minutes a night
 Reduce overall amount of make-up work,
class work and homework when possible
 Prorate workload when possible
 Graded catch-up for missed work
Physical Execration
Date of Doctor Visit_______________
Date of Concussion________________
 No physical exertion/athletics/gym
 Light aerobic activity only
 Non-contact/non collision activity only
 Begin return to play protocol prior to
returning gym or athletics
Breaks
 Allow students to go to the nurse office if
symptoms increase
 Allow students to go home if symptoms
do not subside
Audible Stimulus
 Allow Student to leave class 5 minutes
early to avoid noise hallways
 Lunch in a quiet place
 Audible learning (discussion, reading out
loud)
Testing/Project
 No testing/Projects
 No more than one test a day
 Extra time to complete tests
 Oral testing
Addition Recommendation:
 See School Nurse Daily_______
 ___________________________
 ___________________________
 ___________________________
Physician Signature: _______________
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Subject: Emergency Action Plan

Policy: To adhere to the following Emergency Action Plan:

SEROUS INJURY IS A CONDITION WHEREBY THE ATHLETE’S LIFE MAY BE IN

DANGER OR RISKS PERMENATN IMPAIRMENT. THESE INJURIES INCLUDE BUT
ARE NOT LIMITED TO: CERVIAL SPINE INJURIES, HEAD INJURIES, LOSS OF LIMB,
SERIOUS BLEEDING, SHOCK, SERIOUS FRACTURES, HEAT STRESS, DIFFICULITY
BREATHING, UNCONSCIOUSNESS, AND CARDIOVASCULAR ARREST.

Emergency Personnel: BOC Certified and Maine Licensed Athletic Trainer(s) and Athletic
Training Student(s) are on site for competition and clinic hours (2:00-6:00). EMS personnel are
available by calling 911. Windham high school athletic trainer must be made aware of any
athletic related emergency or injury that has occurred to a student-athlete.

Athletic Training Room: Is available most days from 2:00-6:00PM to respond to medical
emergencies and provide immediate care of athletic injuries.

AFTER HOURS
If events or practice are outside of the 2:00-6:00 PM Monday- Friday or you have no athletic
trainer coverage, the coach is responsible for responding to the athletes’ health care needs and
emergencies.

Emergency Communication: When using campus phones you must dial 9 to get an outside line,
then number. Local EMS is 911.

Coaches: The medical kits must be stocked and have the appropriate emergency cards. Please let
the athletic trainer know what supplies need to be re-stocked

ROLE OF FIRST RESPONDERS

1. Immediate care of the injured or ill student athlete.
A. Check ABC’s, Severe Bleeding and Level of Consciousness.
B. Notify athletic trainer immediately via phone- 590-1268 cell or 893-1810 ext.
2916. If there is no answer please call Rich Drummond at 893-8050 cell or 893-
2182 office. Rich can reach Casey on the radio. If no answer activate EMS as
needed.
Note: Casey doesn’t have cell reception inside the high school.
C. Begin Rescue Breathing/ CPR if needed or necessary first-aid care.
D. If an ambulance is necessary send a coach to call 911. Stabilize and comfort
athlete until EMS arrives. NOTE: If cervical injury is suspected and individual is

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breathing and/or conscious instructing victim to remain motionless until EMS

personnel arrives.
2. Activation of Emergency Medical system (EMS)
E. Call 911
F. Identify yourself
G. Specify location of emergency. Give athlete field location. (see venue direction,
include street names and how to access sites)
H. Give telephone number where they can call you back at
I. Condition of injured athletes
J. Care being provided
K. Other information as requested
L. Make sure athletic trainer has been called 590-1268 or 893-1810 ext. 2916.

3. Direction of EMS to Scene

M. Open appropriate gates
N. Designated individual to “flag down” EMS and direct to scene.
O. Scene Control: Limit scene to first aid providers and move bystanders away from
area.
4. Transportation of Non-Emergency or Immediate care needs: Transportation should only
be conducted by parent or legal guardian. Every effort should be made to have athletic
trainer evaluate the injury prior to transportation

The athletic trainer and the athletic director must be notified of any athlete that is
transported to the emergency room and/or admitted to the hospital.

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