Return to Play Participation in a non-medically supervised practice or athletic competition

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1 Information to Students and Parent/Guardians The Health, Physical, and Driver Education Office will provide annually concussion information to both the student-athlete and their parents or guardians to review from a reputable program such as, but not limited to, The Centers for Disease Control, the National Federation of State High School Associations, and the Rocky Mountain Youth Sports Medicine Institute. The student-athlete and the student-athlete s parent or guardian must sign a statement acknowledging that they have reviewed the materials describing the short- and long-term health effects of concussions, criteria for removal from and return to athletic participation, and the risks of not reporting the injury and continuing to play. Each school s activity office will provide the form and maintain a file of the signed forms. Arlington Public Schools staff (coach, athletic trainer, team physician) shall remove a student athlete suspected of sustaining a concussion or brain injury from a practice or a game. No student athlete who has been removed from play, evaluated, and suspected of having a concussion or brain injury shall return to play that same day. No student-athlete who has been removed, and who is suspected of having a concussion shall return to play until he or she has been evaluated by an appropriate licensed health care provider and has received written clearance to return to play from such licensed health care provider. Definitions Appropriate Licensed Health Care Provider A physician, physician assistant, osteopath or athletic trainer licensed by the Virginia Board of Medicine; a neuropsychologist licensed by the Board of Psychology; or a nurse practitioner licensed by the Virginia State Board of Nursing. Concussion A brain injury that is characterized by an onset of impairment of cognitive and/or physical functioning, and is caused by a blow to the head, face or neck, or a blow to the body that causes a sudden jarring of the head (i.e., a helmet to the head, being knocked to the ground). A concussion can occur with or without a loss of consciousness, and proper management is essential to the immediate safety and long-term future of the injured individual. Return to Play Participation in a non-medically supervised practice or athletic competition Second Impact Syndrome The effects of repeated concussions can be cumulative, and after a concussion, there is a period in which the brain is particularly vulnerable to further injury. If an athlete sustains a second concussion during this period, the risk of permanent brain injury increases significantly and the consequences of a seemingly mild second concussion can be very severe, and even result in death. Approved - July1, 2011 Effective July 1, 2011 Page 1 of 5

2 Comprehensive Concussion Management Plan Training The Health, Physical, and Driver Education Office shall annually train secondary school staff, including but not limited to administrators, counselors and teachers, coaches, athletic trainers, team physicians, and volunteers on: how to recognize the signs and symptoms of a concussion strategies to reduce the risk of concussions how to seek proper medical treatment for a person suspected of having a concussion when the athlete may safely return to the event or training current best practice protocols. In providing this training, the Health, Physical, and Driver Education Office shall use concussion management training in accordance with established protocols such as, but not limited to, those identified by: The Centers for Disease Control s (CDC) tools for youth and high school sports coaches, parents, athletes, and health care professionals The Oregon Center for Applied Science (ORCAS) ACTive course The principal or his designee shall maintain a tracking system to document compliance with the annual training for staff. Equipment Management Arlington Public Schools staff will purchase and recondition helmets according to the following guidelines: 1. Helmets used for athletic participation in football, lacrosse, field hockey, softball and baseball must be National Operating Committee on Standards for Athletic Equipment (NOCSAE) certified by the manufacturer at the time of purchase. 2. Football and lacrosse helmets are reconditioned annually 3. Reconditioning of helmets must be performed by NOCSAE recertified companies. 4. Helmets must be fitted properly. Concussion assessment tools The Arlington Public Schools Office of Health, Physical, and Driver Education Office, will coordinate the administration of concussion assessment tools that are aligned to current best practices for identification and/or assessment of a concussion or brain injury. Approved - July1, 2011 Effective July 1, 2011 Page 2 of 5

3 Cognitive Testing Arlington Public Schools will require and provide the opportunity for a baseline cognitive assessment, for the high school student-athletes identified below. Arlington Public Schools will use current best practices for cognitive assessment and management. This assessment will measure multiple aspects of cognitive functioning in athletes, including: attention span, working memory, sustained and selective attention time, response variability, non-verbal problem solving and reaction time. Arlington will baseline test the following student-athletes as provided below: All VHSL rostered student athletes engaged in contact/limited-contact sports VHSL student athletes engaged in contact/limited-contact sports new to Arlington Public Schools VHSL student-athletes with a known concussion history Arlington Public Schools may identify additional athletes who should be given a baseline assessment. Such baseline testing is required for all identified rostered student-athletes. Testing will be administered to most student-athletes after the team is selected and prior to the first contest of the season, except that student athletes participating in football and boys lacrosse will be baseline tested before their first practice with contact. Academic Support If a student with a head injury or a diagnosis of concussion/traumatic brain injury (TBI) comes to the attention of any APS or School Health staff, the student is referred to the public health nurse in the clinic who will obtain the authorization (including for School TBI team members) from the parent to have the Concussion Care Plan completed by the parent and health providers. The School TBI team includes at a minimum, the following: the student (as appropriate), parent/guardian, public health nurse, counselor, athletic trainer (as appropriate), and other school staff as invited and appropriate. Based on the Care Plan, team members determine their roles in the student's school day. These roles include: communication with parents and health providers, the performance of any symptom assessments, medication dispensing, modification of academic activities, and return to play (physical education, athletics). Referral for 504 screening should be considered when the need for accommodations continues beyond three weeks or at the request of the parent. Approved - July1, 2011 Effective July 1, 2011 Page 3 of 5

4 Monitoring of the Care Plan should occur regularly with input from parents and health provider and should be modified, if warranted. This will be done until the student is symptom free and able to resume normal academic and physical activities. Protocol for Return to Play for Student-Athletes The following protocol is designed to minimize the potential impact of a concussion and should be conducted under the supervision of the high school athletic trainer who has the final authority in deciding if the student-athlete is eligible to return to play. Day of Injury No member of a school athletic team shall participate in any athletic event or practice the same day he or she is injured and: exhibits signs, symptoms or behaviors attributable to a concussion; or has been diagnosed with a concussion. Days Following Injury No member of a school athletic team shall return to participate in an athletic event or training on the days after he/she experiences a concussion unless and until all of the following conditions have been met: the student no longer exhibits signs, symptoms or behaviors consistent with a concussion, either at rest or with exertion; the student is asymptomatic during, or following, periods of supervised exercise that is gradually intensifying; and the student receives a written medical release from a licensed health care provider. Graduated Return to Play Protocol* When a student has met the criteria for returning to play, the following steps will be followed for gradually returning the student to playing: Rehabilitation Stage: Functional Exercise at Each Stage of Rehabilitation: 1. No Activity Complete physical and cognitive rest 2. Light aerobic Walking, swimming or stationary cycling keeping intensity exercise <,70% maximum predicted heart rate No resistance training 3. Sport-Specific Skating drills in ice hockey or running drills in soccer. Exercise No head impact activities 4. Non-contact training drills Progression to more complex training drills, eg passing drills in football and ice hockey May start progressive resistance training 5. Full contact practice Following medical clearance participate in normal training activities 6. Return to play Normal game play Approved - July1, 2011 Effective July 1, 2011 Page 4 of 5

5 *Consensus Statement on Concussion in Sport: the 3 rd International Conference on Concussion in Sport held in Zurich, November Community Involvement The Health, Physical, and Driver Education Office will provide guidelines, training and materials to Arlington s Parks, Recreation and Cultural Resources for the community youth organizations that use school property for athletic purposes and will post and maintain said materials for public use via the school system website. Evaluation The Supervisor, Health, Physical and Driver Education and Athletics will assemble a concussion policy team that will annually refine and review the concussion policy and its procedures. This team will include, at a minimum, the following: a high school administrator a middle school administrator an athletic administrator an appropriate licensed health care provider an athletic trainer a coach a parent a student Evaluation results and recommendations will be forwarded to the Superintendent, or designee. Reference The Code of Virginia Approved - July1, 2011 Effective July 1, 2011 Page 5 of 5

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