Radnor High School Concussion Safety Protocol
The health and safety of our Student-Athletes is of the upmost importance to Radnor High School, its Athletic Department, and the Team Physician. To this end, Radnor has adopted the following Concussion Safety Protocol and management practices.
Definition of Sport Related Concussion
The Consensus Statement on Concussion in Sport, which resulted from the 5th international conference on concussion in sport, defines sport-related concussion as follows:
Sport-related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. Several common features that may be utilized to clinically define the nature of a concussion head injury include:
- SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.
- SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms evolve over a number of minutes to hours.
- SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
- SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged.
- The clinical signs and symptoms cannot be explained by drug, alcohol or medication use, other injuries (such as cervical injuries, peripheral vestibular dysfunction, etc.) or other comorbidities (e.g., psychological factors or coexisting medical conditions).
All athletes participating in contact or collision sports (football, basketball, field hockey, soccer, lacrosse, wrestling, volleyball, cheer, baseball, softball, diving, and pole vaulting) will be required to undergo baseline neurocognitive testing (ImPACT) during their preseason prior to competition. Baseline tests will be valid for a period of two years and then athletes will have to be retested prior to their next season. The goal is to use objective testing data to help guide return to play decisions in the event that an athlete sustains a concussion.
Recognition of Concussion
Any athlete suspected of sustaining a concussion will be immediately removed from competition or practice for the remainder of that day's activities. The athlete must then be evaluated by an Athletic Trainer or On-site Physician with concussion experience. If concussion is suspected, the athlete’s parent/guardian will be notified by the athletic trainer or coach. An athlete may only return to play on the same day if the Athletic Trainer or On-site Physician determines that a concussion is no longer suspected.
Initial Evaluation of Suspected Concussion
The Certified Athletic Trainer on On-site Physician will conduct an evaluation of the athlete using established and validated evaluation techniques. This exam will include a clinical assessment for cervical spine trauma, skull fracture, intracranial bleed or other emergent injury. The remainder of the exam will include symptoms assessment, physical and neurologic exam, cognitive assessment, and balance exam. Athletes who have any signs or symptoms of concussion or abnormal cognitive testing may not return to play on the day of the injury.
All concussed athletes must be seen by an MD/DO trained in the evaluation and management of concussion. It is recommended that the athlete be under the care of a MD/DO who is not the parent/guardian or immediate family member. If diagnosed with a concussion, repeat ImPACT testing as well as an in-office evaluation will be performed to help guide the Treating Physician and Athletic Trainer in developing a plan of care for the student-athlete.
Written clearance from the Treating Physician is required to start the "return-to-play" progression.
A student-athlete who has suffered a concussion will return to classroom/studying as tolerated with modification of schedule/academic accommodations, as indicated. A student-athlete will be re-evaluated by the Treating Physician if concussion symptoms worsen with academic challenges.
Athletes who have been diagnosed with concussion will need to advance through a stepwise return to play progression implemented by the Athletic Trainer and the physician before returning to full play. These 5 steps must be completed prior to return to unrestricted activity. If an athlete is participating in light to moderate-level exercise as part of their concussion recovery program, the return to play process may be modified at the discretion of the Athletic Trainer and/or Team Physician. Each step must be at least 24 hours apart. If at any time the symptoms return, the athlete must rest for at least 24 hours and repeat the step. The Athletic Trainer will contact the parent/guardian if the student athlete complains of symptoms.
Unrestricted return to play should not occur prior to unrestricted return to learn for concussions diagnosed while classes are in session. Athletes will require ImPACT scores that are consistent with his/her baseline or with acceptable normative values prior to unrestricted return to play. Any variations to the policy will be left to the discretion of the Team Physician.
Return to play progression is as follows:
Step 1: Light Aerobic Activity-increase heart rate to 100-140 BPM 10-20 min. biking or walking
Step 2: Moderate Aerobic Activity-target HR between 140-170 BPM, 10-30 min. jogging, bike at moderate intensity, agility drills, throwing and catching
Step 3: Moderate Anaerobic Activity-sprints, interval bike and weight training, non-contract Sport Specific Exercises: Close to typical routine without any contact.
Step 4: Full contact practice while monitoring symptoms
Step 5: Full uninhibited return to play
If an athlete who has been placed in the protocol for suspected concussion is given a clearance note by a Treating Physician to return to play and has not met the Return to Play Progression or other health and safety criteria as deemed necessary by the Athletic Trainer and Team Physician, the athlete will not be permitted to participate. The health and safety of our student athletes is of utmost importance to us.