Catherine Cat Marr - MEd, ATC/L Klein Collins High School Defines - - PowerPoint PPT Presentation

Catherine “Cat” Marr- MEd, ATC/L Klein Collins High School



Defines Concussion



Immediate Removal from Play



Concussion Oversight Committee



New paperwork/ documentation

• UIL Concussion Acknowledgement Form (PRIOR to play)
• Concussion injury paperwork:

▪ Medical info release (HIPAA/FERPA) ) ▪ Notice of Immunity ▪ Signs/ Symptoms & management information (school & home) ▪ Notification of School Personnel ▪ MD referrals & notes

• RTP protocol

▪ Management during the RTP ▪ MD release form after completing RTP

• UIL RTP Form

▪ Informed & consented

▪ RTP guidelines ▪ Risks



Training/ Education

 This bill applies to interscholastic athletic

activity, including practice and competition, sponsored or sanctioned by a school district, a public school, including a charter school,

• r the University Interscholastic League

(UIL).

 does not apply to private schools that are

members of TAPPS

• Or Club sports

 Immediate Removal of student-athlete from athletics

practice or competition if a head injury is suspected by:

• a coach;
• a physician;
• a licensed health care professional; or
• the student's parent or guardian or another person with legal

authority to make medical decisions for the student.

 Have the student-athlete evaluated by an appropriate

health care professional as soon as practicable.

• Call the student athlete over to the sideline so that the athlete may be

evaluated- The act of calling a player over to the sideline does not by itself constitute a belief that the student athlete might have sustained a concussion.

 If it is determined that a concussion has occurred,

the student-athlete shall:

• NOT be allowed to return to participation that day

regardless of how quickly the signs or symptoms of the concussion resolve

• Be kept from activity until a physician indicates they are

symptom free and gives clearance to return to activity.

• Must complete the District’s RTP Protocol
• A coach of an interscholastic athletics team may not authorize a student’s

return to play.

 Inform the student-athletes parent/guardian about

the possible concussion and give them information

• n concussion. (PAPERWORK-Packet!)



Concussion Oversight Team (COT)

• Appointed & Approved by each school district or charter school
• Headed by at least one physician with concussion management training.
• To the greatest extent possible, COT must also include one or more:

▪ An athletic trainer; If the school district employs an athletic trainer they must be a member ▪ An advanced practice nurse; ▪ A neuropsychologist; or ▪ A physician assistant

▪ Administrators, coaches or other school officials can not serve on the COT

• All COT need to show proof of Concussion Training

▪ Physicians are not required to take specific training or submit proof however they shall to the greatest extent practicable, periodically take an appropriate continuing education course in concussions 

Establish a Return to Play Protocol

• based on peer-reviewed scientific evidence

 In developing a RTP Protocol,

• at a minimum- adopt the UIL Concussion Management

Protocol

▪ http://www.uiltexas.org/health/info/concussions

• If the local COT wishes to be more restrictive than the UIL

Concussion Management Protocol, that is within their local discretion.

 Each Athlete MUST complete the districts’

approved RTP protocol prior to being able to participate.

• Examples:

DISD- also progresses in 24 hr/ increments & utilizes ImPact Testing

ImPact Testing

Friendswood ISD

*The St. John Concussion Center puts together a binder of RTP for each sport*

http://www.christusstjohn.org/body.cfm?id=26&eformid=8

Must be symptom free for 48-72 hours:

• Days 1 and 2
• no more than 15 minutes of cardio work
• Days 2-4
• no more than 25 minutes of cardio work
• Days 3-5
• Continue Cardio but add in strength training
• r any non contact individual drills
• Days 4-6
• Progress to non-contact drills
• Days 5-7
• Progress to controlled contact
• Days 6-8
• Full play

Lufkin ISD Klein ISD

 If the school district or charter school employs an

athletic trainer, he/she is responsible for the compliance of the athlete with the return to play protocol.

• A coach of an interscholastic athletics team may not authorize a student’s

return to play.

 AT not available:

• a supervising adult approved by the school district with appropriate

training in the recognition of the signs and symptoms of a concussion in athletes could serve in that capacity. ▪ This person is also then responsible for creating the appropriate documentation related to the injury event

 UIL approved continuing concussion education

required for coaches, licensed health care professionals and recommended for physicians

• Must be at least 2 hours, every 2 years.
• Must be done by Sept, 1, 2012

▪ This CME event qualifies

 Concussion education

• Parent
• Student-Athlete
• Teachers/ School Personnel

▪ In-service prior to school

• And even to other Medical Professionals

 Prior to Athletic Participation

• UIL Concussion information and acknowledgement

form (April 15th)

▪ written information about concussions and relevant safety policies was received and read (signature required) ▪ Complete a new form each academic year .

 Post Head Injury

• the student athlete, parent/guardian, and other

appropriate school employees must receive a written copy of the concussion oversight team’s RTP protocol.

• Post concussion Instructions / Management Plan

 School/Academic Adjustments & Modification

Following Concussion

• Notify all school personnel regarding the student-athlete’s

condition

▪ Advise teachers of post concussion symptoms & modifications

▪ Examples of modifications

• Academic restrictions

▪ Difficulties

▪ Sandbagging and faking symptoms ▪ What to do?

▪ Teachers Reactions

▪ Compliance

 4 Basic Steps Involved are:

(1) The student has been evaluated by Physician

• using established medical protocols based on

peer-reviewed scientific evidence

• chosen by the student/parent/ guardian

▪ KISD- “a physician skilled in Concussion Management” ▪ ImPact/ Cognitive Testing

(2) The student has successfully completed each requirement

• f the RTP protocol
• Previous Examples
• Varies per athlete
• Pitfalls

▪ Many things cause headaches ▪ handle each student-athlete individually (see KISD Questionnaire)

 S/S Questionnaire

• Completed by student
• Reviewed/ Discussion

by LAT

 Compliance/

Supervision

• Responsible party

signature (LAT)

• Fax to MD
• MD clearance signature

▪ See also #3

(3) The treating physician has provided a written statement indicating that, in the physician's professional judgment, it is safe for the student to return to play

▪ (Example- see KISD Questionnaire)

(4) the student and parent/guardian:

• (A) Acknowledgement form stating they completed the

requirements of the RTP protocol;

• (B) provide the AT with the MD note
• (C) have signed a consent form indicating (UIL Form):

▪ informed about the RTP protocol; ▪ understands the risks of athletic participation ▪ will comply with any ongoing requirements of the RTP protocol; ▪ consents to the disclosure to appropriate persons (HIPAA/ FERPA) ▪ understands the immunity provisions

 Compliance

• Club Sports
• Social life

▪ Movies, texting, etc...

 Isolation issues

• Care of the whole athlete

▪ Practice time

 Hiding or inflation of S/S

• Education (everyone!)
• Knowing your athletes

 “Doctor said that my MRI is clear so I don’t have a

Concussion!”

• CT or MRI- not diagnostic tool for a concussion
• ImPact/ Cognitive Testing

 Athlete evaluated on sidelines & has S/S of a

concussion, they may not present with those same S/S when they see the MD several days later

• Doesn’t mean they do not have a concussion
• They still need to go through RTP

 Athlete plays club sport, ER diagnosis with a

Concussion- doesn’t let the AT or HS coach know.

• We can only do the best we can with the info we have
• UIL Yearly Acknowledgement form

 This is the law - not an option

• Many are unaware of the new protocols

 RTP Protocol

• Can’t be circumvented regardless
• Each District’s RTP will differ
• An athlete must complete a school district’s RTP protocol

even if the physician writes a clearance note

• The athlete must then have a final written clearance note

after they have completed the RTP protocol clearing them for a full release back to practice and game

• UIL Form with parent signature for full release

 We need to be proactive

• Education & Good communication =  difficulties

Thank you 