1. Annapolis High Concussion Protocol

2. 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.

3. 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.

4. 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.

5. 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.

6. 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

7. 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

8. 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

10. Link to short video on effects of concussions

11. 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 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.

12. 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.

13. 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.

14. 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.

15. 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

16. 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

17. 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

18. 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

19. Return to School

20. Return to Sports

21. 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.

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