These guidelines are being published to clarify the Athletic Training Program’s Policy & Protocol regarding mild traumatic brain injuries (MTBI), or more informally known as concussions. Data and information is based on the most up-to-date research on MTBIs, the Consensus Statement on Concussion in Sport, 4th International Conference on Concussion in Sport, Zurich, 2012. It is our obligation that all athletes, parents, coaches, athletic department personnel, school nurse and health clerk, and team physician become familiar with the following Concussion Management Policy.
Definition of Sports Concussion
A sports concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Further defined by:
· A direct blow with force transmitted to the head
· Rapid onset of short lived impairments
· Neuropathological changes and functional disturbance
· A graded set of clinical syndromes that may or may not involve LOC; resolution follows a sequential course
· Grossly normal neuroimaging studies
Education and Compliance
Parents/Guardians & Athletes
California AB2127, Cooley (Ed. Code 49475), passed January 1, 2015 mandates that all parents/guardians and athletes receive in writing a fact sheet pertaining to concussion signs & symptoms, the danger of returning too soon, and what to do if a concussion is suspected. Parents/guardians of all athletes will receive, on an annual basis, a copy of the Diamond Bar High School Concussion Fact Sheet (included in Sports Physical packet). Written verification of receiving and reading this form must be returned to the athletic department. Athletes will not be allowed to practice, condition, weightlift, or compete in any amount without this form on file in the athletics office.
A baseline test of the SCAT3 (Sideline Concussion Assessment Tool 3) will be administered by the certified athletic trainer and athletic training students to each athlete at the beginning of the season for athletes who participate in: football, wrestling, basketball, and soccer. Athletes will not be allowed to practice, condition, weightlift, or compete in any amount without a completed baseline test on file. Athletes who participate in these sports will also be required to complete a concussion awareness program consisting of video lectures to be given by the certified athletic trainer, prior to the start of each season.
Coaches and Athletic Department Personnel
In accordance with CIF Bylaw 22.9.f all coaches shall complete the free NFHS course: Concussion in Sport on an annual basis.
In the event an athlete suffers a concussion, the following steps will be taken to ensure the highest level of care possible:
4. The grade level coordinator (GLC), health office & school nurse will be notified via email, and a letter will be sent to the athlete’s teachers.
CIF Bylaw 503.H and Ed. Code 49475
“A student-athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time for the remainder of the day. A student-athlete who has been removed from play may not return to play until the athlete is evaluated by a licensed health care provider trained in education and management of concussion and receives written clearance to return to play from that health care provider. If a licensed health care provider, trained in education and management of concussion determines that the athlete sustained a concussion or a head injury, the athlete is required to complete a graduated return-to-play protocol of no less than seven (7) full days from the time of diagnosis under the supervision of a licensed health care provider. On a yearly basis, a concussion and head injury information sheet shall be signed and returned by all athletes and the athlete’s parent or guardian before the athlete’s initial practice or competition.”
Question: What is meant by “licensed health care provider?”
Answer: The “scope of practice” for licensed healthcare providers and medical professionals is defined by
In accordance with Ed. Code 49475 and CIF Bylaw 503.H: the REBRAIN program is designed to be completed over the course of a minimum of seven (7) days with no less than 24 hours between each stage. The athlete cannot progress onto the next stage while still displaying symptoms. Each stage must be carefully supervised by the diagnosing licensed healthcare provider, or the certified athletic trainer, if authorized by the diagnosing licensed healthcare provider.
See the photo to the right for the REBRAIN program.
Clearance to Participate
In accordance with Ed. Code 49475 and CIF Bylaw 503.H: “A student-athlete who has been removed from play may not return to play until the athlete is evaluated by a licensed health care provider trained in education and management of concussion and receives written clearance to return to play from that health care provider.” (MD or DO only)
Written clearance will be documented in the Concussion Clearance Packet under the “Licensed Health Care Professional Clearance” section. If written clearance was obtained by a separate physician’s note, the following must be clearly stated in order to return to full participation:
THE CERTIFIED ATHLETIC TRAINER RESERVES THE RIGHT TO HAVE THE FINAL SAY IN ALL RETURN TO PLAY DECISIONS. IN THE EVENT THE CERTIFIED ATHLETIC TRAINER IS ABSENT, THE LICENSED HEALTHCARE PROVIDER’S NOTE WILL STAND AS IS.
AT NO TIME WILL A COACH MAKE A RETURN TO PLAY DECISION.
THIS CONCUSSION MANAGEMENT POLICY IS NOT ALL-INCLUSIVE, AND THE CERTIFIED ATHLETIC TRAINER RESERVES THE RIGHT TO ALTER THE POLICY AT ANY TIME AS THEY BEST SEE FIT TO PROTECT THE ATHLETE.