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Bald Eagle Area Jr Sr High School

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Eagle Athletics

Bald Eagle Area Jr Sr High School

Eagle Athletics

Bald Eagle Area Jr Sr High School

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1 month ago @ 9:13AM

B.E.A. Concussion Policy

Bald Eagle Area School District: Concussion Management Plan

XI. Bald Eagle Area School District Concussion Management Plan

In accordance with recommendations by Law in the State of Pennsylvania, in accordance with Senate Bill 200(SB 200), also known as “Safety in Youth Sports Act, the Bald Eagle Area School District has adopted a policy for its student-athletes participating in interscholastic athletics.

The Safety in Youth Sports Act, Pennsylvania Senate Bill 200, (Section 1) Establishes standards in the state of Pennsylvania for managing concussions and traumatic brain injuries to student-athletes.

This policy also includes students involved in an athletic contest or competition that is sponsored by, or associated with the Bald Eagle Area School District, including cheerleading, club sponsored sports activities, and sports activities sponsored by the school district’s affiliated organizations. This includes practices, interschool practices, and scrimmages as outlined in Section 2 under “Athletic Activity” in accordance with this Act.

A copy of Pennsylvania Senate Bill 200 is attached with this Concussion Management Plan.  (Document 1)

  1. Definitions (Section 2)
  1. Appropriate Medical Professional
  1. A Licensed Physician who is trained in the evaluation and management or concussions or a Licensed or Certified Health Care Professional trained in the evaluation and management of concussions and designated by such Licensed Physician. The Licensed Athletic Trainer(s) are the Appropriate Health Care Professional(s) and the Licensed Physician designee, trained to provide concussion evaluation and management under the Standard Operating Procedures.
  2. A Licensed Psychologist neuropsychological trained in the evaluation and management of concussions or who has post-doctoral training in neuropsychology and specific training in the evaluation and management of concussions.

 

  1. Specific Head Injuries
  1. Concussion or Mild Traumatic Brain Injury (MTBI)- A concussion or MTBI is the common result of a blow to the head or body which causes the brain to move rapidly within the skull. This injury causes brain function to change which results in an altered mental state (either temporary or prolonged). Physiologic and/or anatomic disruptions of connections between some nerve cells in the brain occur. Concussions can have serious and long-term health effects, even from a mild bump on the head.                                                      

Symptoms include, but are not limited to: brief loss of consciousness, headache, amnesia, nausea, dizziness, confusion, blurred vision, ringing in the ears, loss of balance, moodiness, poor concentration or mentally slow, lethargy, photosensitivity, sensitivity to noise, and a change in sleeping patterns. These symptoms may be temporary or long lasting.                                                                                                                                                                                      

  1. Second Impact Syndrome-(SIS)- Refers to catastrophic events which may occur when a second concussion occurs while the athlete is still symptomatic and healing from a previous concussion. The second injury may occur within days or weeks following the first injury. Loss of consciousness is not required. The second impact is more likely to cause brain swelling with other widespread damage to the brain. This can be fatal. Most often SIS occurs when an athlete returns to activity without being symptom free from the previous concussion.

 

 

 

 

 

 

 

  1.  Appropriate Health Care Plan For The District
  1. The Bald Eagle Area School District provides an appropriate healthcare plan that includes equitable access to athletics healthcare providers for each sport.
  2. The Bald Eagle Area School District provides healthcare to all student-athletes participating in interscholastic athletics, cheerleading, and club sponsored sports activities. This healthcare is provided by the Licensed Athletic Trainer(s) that provide coverage for after school practices, scrimmages, and scheduled interscholastic athletic events.
  3. The Licensed Athletic Trainer(s) on staff at the Bald Eagle Area School District follow Standard Operating Procedures (SOP), in accordance with the Pennsylvania Board of Medicine and Osteopathic Medicine. This SOP is provided by the Bald Eagle Area School District Team Physician and agreed upon in writing by the district administration.

 

  1. Educational Materials Related to Concussions and Traumatic Brain injuries (Section 3 (a))
  1. The Pennsylvania Department of Health and Department of Education

Shall develop and post on their Internet websites guidelines and other relevant materials to inform and educate students participating in or desiring to participate in an athletic activity, their parents and their coaches, about the nature and risk of concussion and head injury, including the risks associated with continuing to play or practice after a concussion or head injury. In developing the guidelines and materials, the departments shall utilize existing materials developed by the Centers for Disease Control and Prevention.                                                                                                                                                                    

  1. Bald Eagle Area School District policies for Concussion Management Planning In- accordance with SB 200 (Section 3 (a)):
  1. The Bald Eagle Area School District shall require each school year, that student-athletes participating in or desiring to participate in an athletic activity, and the student’s parent/guardian, prior to participation by the student in an athletic activity, sign and return to the district an acknowledgement of receipt and review of a concussion and traumatic brain injury information sheet developed in accordance with the “Safety in Youth Sports Act”.  In signing this information sheet, student-athletes and the parent/guardian accepts the responsibility for reporting their injuries and illnesses to the school district’s medical staff (Staff Licensed Athletic Trainers), including signs and symptoms of concussions. This form is attached as Document 3.
  2. PIAA CIPPE Form (Attached with Pre-Participation Physical Packet)

The Bald Eagle Area School District requires all student-athletes and parent/guardian to review and sign the PIAA Concussion Information Sheet as part of the Comprehensive Initial Pre-Participation Physical Evaluation (CIPPE) required by the PIAA.

  1.  Baseline Testing – Concussion Vital Signs

The Bald Eagle Area School District will record a baseline assessment for each student-athlete prior to the first practice in the sports of baseball, basketball, cheerleading, football, soccer, softball, track and field, volleyball, and wrestling, at a minimum. The same baseline assessment tools should be used post-injury at appropriate time intervals. Baselines will be updated every three years.

  1. The baseline assessment should be considered one or more of the following areas of assessment:

Baseline for All Student-Athletes will include:

  1. Standardized Assessment for Concussion (SAC Evaluation Form)
  2. Graded Symptom Checklist
  3. BESS
  4. VOMS (Vestibular Oculomotor Screen)- VOS Form
  5. VOR – (Visual Ocular Reflex)- Pursuit, Saccades, Accommodation
  6. Concussion Vital Signs Post Injury Test

 

  1. All students who participate in athletics at Bald Eagle Area are eligible for

and required to complete baseline testing prior to participating in their sports season.

  1. Any student athlete who suffers a concussion will be baseline retested before the next academic/athletic year.                                                                                
  2. Additionally, neuropsychological testing (e.g. computerized, standard paper and

            Pencil) has been shown to be effective in the evaluation and management of                         

concussion. The development and implementation of a neuropsychological testing program should be performed in consultation with a neuropsychologist. Ideally, post injury neuropsychological test data should be interpreted by a neuropsychologist.

  1. Informational Meeting on Concussions and Traumatic Brain Injuries

The Bald Eagle Area School District will hold an informational meeting prior to the start of each athletic season for all student-athletes, parents and/or guardians, and coaches regarding concussions and other head injuries, the importance of proper concussion management and how neurocognitive testing can aid in the evaluation, management and recovery process. All members of the district coaching staff, Head and Assistants, are required to attend these informational meetings each school year. Student-athletes and their parent(s)/guardian(s) are required to attend at least one informational meeting per school year.

  1. Removal from Participation in Athletic Activity following Concussions and Traumatic Brain Injuries (Section 3 (c))
  1. Athlete Assessed with Concussion or Traumatic Brain Injury

A student-athlete who, as determined by a licensed or certified health care provider, whose scope of practice includes the management and evaluation of concussions, coach from the student's team, game official or other official designated by the student's school entity, exhibits signs or symptoms of a concussion or head injury while participating in an athletic activity, shall be removed from participation at that time. The student shall not return to participation until they are evaluated and cleared for return to participation in writing by a licensed or certified health care practitioner whose scope of practice includes the management and evaluation of concussions.

 

  1. The Bald Eagle Area School District shall require the immediate removal of the Student-Athlete from athletic activity after sustaining a concussion or traumatic brain injury.

 The athlete may not return to activity until they are evaluated and cleared for Return to Participation (RTP) in practice or competition, in writing, by a Licensed or Certified Health Care Provider who is trained in the evaluation and management or concussions as outlined in Definitions related to SB 200 in Section 2.

  1. Athletes will be provided with written instructions upon discharge (Document 6); preferably with a parent or guardian. A Concussion and Traumatic Brain Injury Information sheet will be provided to the parent/guardian outlining signs and symptoms, further recommendations for care and Licensed Physician Follow up, complications for further injury, removal from play, and return to play guidelines.  
  2. Following evaluation and determination of a concussion or traumatic brain injury, the student-athlete should be further evaluated by a licensed physician. This should be done prior to initiating the phasic return program and return to participation in any activity as outlined within the concussion management plan. A physician form letter, daily symptom checklist, and copy of the phasic return to participation will be provided and brought with the student-athlete to the physician appointment.

 

Evaluation for Concussion and Mild Traumatic Brain Injury

  •  Normal clinical examination must include: factors relating to cognitive, visual, vestibular, cervical, and neurological.
  • All evaluation and guidelines are based upon recommendations from International, National, and Pennsylvania State Law for management of concussion and mild traumatic brain injury.
  1. Student-Athlete does not return to a game or practice if he/she displays and signs or symptoms consistent with a concussion. Athlete also will never be allowed to return to play the day of injury.
  2. Physician Referral,  after the initial injury. (ER, Primary Care Physician, Ophthalmology, Optometry, or Neurology if recommended)
  3. Home Instructions will be provided to student-athlete and parent/guardian prior to departure from the school.
  4. 5 Phase Return-To-Play Program must be completed with the licensed athletic trainers at Bald Eagle Area School District.
  5. Concussion Vital Signs post-injury test is performed after injury and/or after symptoms have resolved. Student-athlete must return to normal level of baseline testing before return to play in athletic activity. Must be passed and completed prior to the 5 Phase Return to play.
  6. Athlete should not return to sport until they can participate to the full extent without symptoms and have no adverse signs/symptoms at rest or following exertion.
  7. Return to sport will not be based solely on Concussion Vital Signs post injury neurocognitive testing results.

 

 Note- In accordance with school district policy: the student-athlete will be referred to a licensed physician and does not return to play until that physician gives a written release for return to sports and after completion of post injury Concussion Vial Signs Testing at Baseline or Normative Level followed by the 5 Phase Testing Program for RTP post-concussion to be performed under the supervision of the licensed athletic trainer(s) in the Bald Eagle Area School District

Evaluation Sequence(s) for Concussion Management

 

  1. On Field Evaluation Sequence (Following removal from play)
  1. Observable signs, Memory Assessment (Maddock’s Questions), Glascow Coma Scale
  2. Graded Symptom Checklist and Vitals
  3. Standardized Assessment for Concussion (SAC Evaluation Form)
  4. Rhombergs Test
  5. BESS- Balance Error Scoring System
  6. VOMS (Vestibular Oculomotor Screen)-King-Devick and VOS Form
  7. VOR – (Visual Ocular Reflex)- Pursuit, Saccades, Accommodation
  • Day of Initial Injury take note of:

Response time to questioning, relying on others to answer, fidgeting, poor eye

Contact, lack of spontaneous responses, level of symptom report, increase in

Symptoms with change in body positioning.

 

 

  1. Off Field Evaluation Sequence
  1. SCAT 5 (Sports Concussion Assessment Tool)
  2. Concussion Vital Signs Neurocognitive Post Injury Test

 

  1. Re-Evaluation following the initial injury of the student-athlete will include:
  1. Graded Symptom Checklist (GSC)
  2. Rhomberg’s Test
  3. BESS
  4. VOMS
  5. VOR

 

  1. Return to Play Criteria (RTP) Post Initial Injury

5 Phase Return to Play (RTP) Program (Attached)

  1. Must be completed with the licensed athletic trainer(s) at the Bald Eagle Area District.
  2. Activity Progressions

1. Student-athlete must be symptom-free

2. Light aerobic exercise with no resistance training  

3. Sports-specific activity

4. Non-contact training drills with resistance training

5. Full contact training drills (must have physician clearance)                                                 

** Note- Athlete progression continues as long as athlete is asymptomatic at current level. If the athlete experiences any post-concussion symptoms, a waiting period of 24 hours is implemented and then begin the progression at the beginning, not the level the symptoms appeared.          

  1. The student-athlete will receive serial monitoring for deterioration and will be assessed daily when attending school utilizing a daily symptom score sheet provided by the Licensed Athletic Trainer(s) on staff. The Symptoms Score Sheet will be continued until symptoms relating to their head injury have resolved.

                    

  1. Return to Participation in Athletic Activity Post Concussion/Traumatic Brain Injury

 (Section 3 (d))

  1. Student-Athlete Return to Play

The coach may not return a student-athlete to play in any athletic activity. The student-athlete may not return to play (RTP) until they have been evaluated and cleared for participation in writing by an appropriate medical professional, as designated in Definitions (A) in Section 1 of SB 200. The governing body of a school entity may designate a specific person or persons, who must be appropriate medical professionals, to provide written clearance for return to participation. In order to help determine whether a student is ready to return to participation and appropriate medical professional may consult any other licensed or certified medical professionals.

 

  1. Bald Eagle Area Return to Participation (RTP) Policy for Student-Athletes relating to Concussions and Traumatic Brain Injury

 

 

  1. An Athlete cannot return to participation in their respective sport or physical activity until:
  1.  Have been evaluated by a Licensed Physician
  2.  Symptom Free
  3.  Successfully Complete a 5 Phase Return to Participation Program with the Licensed Athletic Trainer(s) (LAT) on staff with the Bald Eagle Area School District.
  4. . Return to the level of their Baseline Concussion Testing
  5.  Evaluated and Cleared for RTP in writing, by a Licensed or Certified Health Care Provider (LAT), and Licensed Physician.
  1. Once asymptomatic and post-exertion assessments are within normal baseline limits, return to play should follow a medically supervised stepwise process.

 

  1. As part of the Concussion Management Plan, all student-athletes must

Satisfactorily, complete the 5 Phase RTP exertion program with the Licensed Athletic Trainers at Bald Eagle Area before they can return, along with securing a written release by a Licensed or Certified Health Care Professional trained in the evaluation and management of concussions and traumatic brain injury designated by a Licensed Physician.       

The Licensed Athletic Trainer(s) are the Appropriate Health Care Professional(s) within the Bald Eagle Area School District and the Licensed Physician designee, trained to provide concussion evaluation and management under the Standard Operating Procedures. .

  1. Final authority for Return-to-Play of the student-athlete to athletic activity shall reside with the licensed physician and/or the physician designee, which includes, the Licensed Athletic Trainer(s) on staff within the Bald Eagle Area School District.

 

  1. Documentation of the incident, evaluation, continued management, and clearance of the student-athlete with a concussion.
  1. All reported injuries, including concussions, are documented with SOAP forms, Concussion Management Forms, and kept on file with the individual student-athlete’s records.

                                       

  1. Return to Play Criteria(RTP) post initial injury
  1. Student-Athlete does not return to a game or practice if he/she displays and signs or symptoms consistent with a concussion.
  2. Physician Referral if level or number of symptoms persist, increase, or worsen after the initial injury.
  3. Home Instructions will be provided to student-athlete and parent/guardian prior to departure from the school.
  4. 5 Phase Return-To-Play Program must be completed with the licensed athletic trainers at Bald Eagle Area School District.
  5. C3 post-injury test 48 hours after injury and/or after symptoms have resolved. Student-athlete must return to normal level of baseline testing before return to play in athletic activity.
  6.  
  1. 5 Phase Return to Play (RTP) Program
    1. Must be completed with the licensed athletic trainer(s) at the Bald Eagle Area District.
    2. Activity Progressions

1. Student-athlete must be symptom-free

                2. Light aerobic exercise with no resistance training   

3. Sports-specific activity

4. Non-contact training drills with resistance training

5. Full contact training drills (must have physician clearance)                                                             

** Note- Athlete progression continues as long as athlete is asymptomatic at current level. If the athlete experiences any post-concussion symptoms, a waiting period of 24 hours is implemented and then begin the progression at the beginning, not the level the symptoms appeared.                    

  1. Injury Prevention Strategies to Reduce the incidence of Head Injuries:
  1. All Football headgear must be NOCSAE certified.
  2. All Football headgear should properly fit the student-athlete.
  3.  For all sports that require headgear, a coach or appropriate designate with knowledge of equipment fitting should check headgear before use to make sure air bladders work and are appropriately filled. Padding should be checked to make sure they are in proper working condition.
  4.  Make sure helmets are secured properly at all times.
  5.  Mouth guards should fit and be used at all times for those sports that they are required.
  6. Neuropsychological testing or C3 Testing on student-athletes that participate in varsity, junior varsity, and junior high interscholastic athletic prior to the start of the season.
  1. Emergency Action Plans (EAP)

The Bald Eagle Area School District has separate and specific emergency action plans(EAP) for all indoor and outdoor practice and competition event venues. These EAP’s are posted in each Athletic Training Room on the bulletin board and are provided to and reviewed each member of the coaching staff prior to the start of the season. Attached Document 8

  1. Training and Educational Course for Concussion Management Training

SB 200 Section 3 (e)

During each school year, a coach shall complete the concussion management certification training course offered by the Centers for Disease Control and Prevention, the National Federation of State High School Associations or another provider approved by the Department of Health.A coach shall not coach an athletic activity until they complete the training course outlined under this subsection.

  1. Penalties for Coaches Violating SB 200 Section 3 (f)

 

  1. Any coach found in violation of the requirements under subsection (c), which penalties shall take effect two years following the effective date of this section:
  1. For a first violation, suspension from coaching any athletic activity for the remainder of the season.
  2. For a second violation, suspension from coaching any athletic activity for the remainder of the season and for the next season.                                                                                

(c)  For a third violation, permanent suspension from coaching any athletic activity.

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