Annapolis High Concussion Protocol

Jake Snakenberg DOB -April 19,1990 In the fall of 2004, Jake Snakenberg was a freshman football player at Grandview High School. He likely sustained a concussion in a game the week prior, however, he did not fully understand that he had experienced a concussion and he did not report his symptoms to anyone. One week later, Jake took a typical hit in a game, collapsed on the field and never regained consciousness. Jake passed away from “Second Impact Syndrome” on September 19, 2004.

What is a Concussion? A concussion is an injury to the brain caused by a direct or indirect blow to the head, face, neck or elsewhere on the body that causes the head and brain to move rapidly back and forth. A concussion results in the onset of impaired brain function, producing a set of clinical signs and symptoms (physical, cognitive, emotional, sleep) that may or may not involve loss of consciousness. A concussion is an injury to the brain caused by either direct or indirect force that causes the head and brain to move rapidly back and forth. A concussion can cause problems physically, cognitively, emotionaly and with sleep.

The facts A concussion is a brain injury. All concussions are serious. Concussions can occur without loss of consciousness. Concussions can occur in any sport. Recognition and proper management of concussions when they first occur can help prevent further injury or even death. A concussion is a brain injury All concussions should be considered serious Concussions can occur without loss of consciousness They can occur in any sport or not related to sports at all. Recognition and treatment is important immediately to help prevent further injury.

RECOGNIZING A POSSIBLE CONCUSSION To help recognize a concussion, you should watch for the following two things among your children: A forceful blow to the head or body that results in rapid movement of the head.                                      Any change in the child’s behavior, thinking, or physical functioning. Recognizing a concussion First watch for any type of forceful blow to the head or anything that causes the head to have rapid movement Secondly, for a student who already has been identified with a concussion watch for any changes in behavior, thinking or physical functioning.

Multi-Disciplinary Team Approach Medical Systems Family Pre-Hospital (EMS) Emergency Urgent Primary Care Specialty Care Child/ Teen (Student, Athlete, Son/Daughter, Friend) Certified Athletic Trainer Certified Athletic Trainer School It takes a team approach to support a student with a concussion Athletic/ Recreational Administrators Teachers Certified Athletic Trainer Administrators Coaches Officials Parents Teammates School Nurse/ Counselor Psychologist

Cognitive Demands of School Worsen Symptoms It is important to note that the cognitive demands of school worsen the symptoms N= 72 Gioia et al., 2010

The REAP Model came out from the Rocky Mountain Hospital REAP stands for: Reduce – potential for further injury or stress to brain Educate – know the symptoms Accommodate – accommodations at school Pace – graduated return to academics and play

Link to short video on effects of concussions http://www.kjrh.com/news/segment-2/concussions-having-impact-beyond-the-field-for-oklahoma-student-athletes#Sports%20concussions%20taking%20a%20toll%20in%20the%20classroom

What Parents/Guardians Need to Do Should seek proper diagnosis and treatment by a licensed medical provider. Enforce strict limits on your child’s use of electronics and screen time. Communication to School Nurse/School Counselor within 24 to 48 hours of diagnosis. Any academic accommodations must be written on AHS Concussion Management Form (Form can be downloaded from www.annapolishighschool.org or Athletic Trainer will send home). NO academic accommodations will be made without a form submitted to the school nurse and signed by a licensed physician. Updates from the doctor on the student’s condition should be received weekly from parent/guardian to the Nurse until student is released to full academic and extracurricular activities. If there is no follow-up accommodations will stop! A Medical Release form must be signed by Parent so School Nurse can speak to doctor to better serve student’s needs.

AHS CONCUSSION MANAGEMENT Copy of the Concussion Manangement Plan that is on our website and given to parents if the concussion happens during sports or at school.

What your child needs to do To clearly and honestly communicate their symptoms, academic difficulties, and feelings. To follow up on treatment. Students need to let us know if they are having difficulties honestly.

School Nurse/Counselor are responsible To be liaison between teachers, student, parents, and medical staff. To disseminate academic accommodations to the student’s teachers. To help student as needed.

How a person may feel physically   Know the Symptoms How a person may feel physically Physical Headache/ Pressure Nausea Blurred vision Vomiting Dizziness Numbness/Tingling Poor balance Sensitivity to Light Ringing in ears Sensitivity to Noise Seeing “stars” Disorientation Vacant stare/Glassy eyes  Neck Pain

Difficulty remembering Difficulty concentrating/easily distracted   Know the Symptoms How a Person Thinks   Cognitive Feel in a “fog” Feel “slowed down” Difficulty remembering Difficulty concentrating/easily distracted Slowed speech Easily confused

How a Person Feels Emotionally   Know the Symptoms How a Person Feels Emotionally   Emotional Inappropriate emotions Personality change Nervousness/Anxiety Feeling more “emotional” Irritability Sadness Lack of motivation

How a Person Experiences Their Energy Level and /or Sleep Patterns   Know the Symptoms How a Person Experiences Their Energy Level and /or Sleep Patterns   Maintenance Fatigue Excess sleep Trouble falling asleep Drowsiness Sleeping less than usual

Return to School

Return to Sports

Summary Concussions can have a significant effect on a student’s cognitive ability School learning can have impact on recovery School’s play a significant role in the student’s recovery by understanding & monitoring symptoms Assisting by reducing demands both physical and cognitive. Gradual increase in academic demands Student returning fully to sports or PE needs clearance from the concussion team.

Our Thanks to the following resources Children’s National Medical Center Heads Up on Concussion Kent School District Concussion Management Training Sports Concussion Institute