1. Oxbridge Health and Wellness Clinic
Concussions
Oxbridge Health and Wellness Clinic

2. What is a Concussion?
A concussion is a traumatic brain injury that is caused by a blow to the head or body, a fall, or any other injury that causes the brain to shake inside the skull that may result in improper brain functioning.

3. Symptoms
Each concussion, as well as each person’s brain, is unique and individualized. Symptoms will vary among people and it may take anywhere from hours for symptoms to appear.
Appearing dazed
Fatigue
Difficulty with concentration and/or memory
Irritability
Personality changes
Changes in sleep patterns
Headache or a feeling of pressure in the head
Neck pain
Confusion or feeling as if in a fog
Sensitivity to noise and light
Dizziness, balance problems
Nausea
Blurred, double or fuzzy vision
Vomiting
Drowsiness
Slurred speech
In accordance with state and federal practice acts, current research, the FHSAA regulations, the 2016 Berlin Consensus Statement on Concussion in Sports, the National Athletic Training Association position statement, and collaboration with local neurologists, the Oxbridge Health and Wellness Clinic has created a comprehensive concussion management protocol.

4. Oxbridge Concussion Management
Oxbridge Concussion Management Team
Doctor of physical therapy
Athletic trainers
School psychologist
Several local physicians that specialize in concussions, typically a neurologist.
Oxbridge Academy’s preferred local neurologist is Dr. Francis Conidi. He is a sports concussion specialist, is the team neurologist for the NHL Florida Panthers and has consulted with the Florida High School Athletic Association (FHSAA) to create a concussion policy.
The team helps facilitate doctor’s visits, monitors progress and recovery following a concussion, facilitates academic accommodations as needed, communicates with parents and teachers, and supervises the return to physical activity procedure.

5. Oxbridge Concussion Management
Baseline Testing
Baseline testing provides a record of subjective and objective data for a student that can be used as a comparison should they sustain a concussion.
The baseline testing is conducted by the medical professionals of the Health and Wellness Clinic and will consist of concussion tests including but not limited to:
SCAT 5
Dual-Task Timed Tandem
King Devick test (K-D test).

6. Oxbridge Concussion Management
If a student is exhibiting signs and symptoms consistent with a concussion, they will be immediately removed from participation in physical activity for evaluation by the Oxbridge medical staff.
Following evaluation, if the Oxbridge medical staff suspects that the student has a concussion, they will not be allowed to return to participation in any physical activity until cleared by an appropriate health care provider (AHCP).
Physical activity includes, but is not limited to, PE class, club sports, competitive sports, dance class, weight training and drama classes that involve physical activity.
Should your child sustain a concussion, a member of the Oxbridge medical staff will contact you with more information, including physician referral information, warning signs of a worsening condition and an overview of the return to learn and return to play procedures.

7. Oxbridge Concussion Management
If a student is diagnosed with a concussion by an appropriate health care provider, please follow all recommendations.
The physician may feel that the student would benefit from staying home from school for several days. If this happens, do not worry, it is a normal step in the process that helps the brain heal.
Once a student returns to school, they are required to check into the Health and Wellness Clinic each day prior to class in order to complete a symptom checklist. This will allow the Oxbridge medical staff to track their progress and help make appropriate classroom accommodations.

8. Oxbridge Concussion Management
Returning to the Classroom
It is just as important to allow cognitive rest for the brain to heal as it is to rest from physical activity. Some classroom accommodations a student may receive include, but are not limited to:
Shortened homework assignments
Extra time to complete assignments
Give access to lecture notes/outlines from teachers
No assessments or tests until symptom free
Allow student to take tests in less distracting environment
Allow rest breaks as needed and at the sign of increasing symptoms
Provide written record of all assignments and task instruction to avoid taxing student’s working memory

9. Oxbridge Concussion Management
Returning to Physical Activity
Once a student is symptom free, has been fully reintegrated into the classroom and the physician involved in the student’s medical care gives clearance to begin, the student will start the following six-step return process with stage two.
Stage One: Complete physical and cognitive rest
Stage Two: Light aerobic activity to increase the heart rate to no more than 70% max heart rate, no resistance training
Stage Three: Sport-specific exercise (Aerobic + Strength training)
Stage Four: Non-contact practice and/or drills (Non-contact sport specific drills)
Stage Five: Full contact practice
Stage Six: Return to full activity
It is mandatory that there be at least 24 hours between each stage. If the student begins to experience symptoms at any stage, that stage is over and they will return to the previous stage. Once all stages are completed, the doctor has to give final clearance to return to all activity and sign the FHSAA required concussion forms.

10. Concussion Management at Home
Follow all physician recommendations for rest, school attendance, restrictions and medication use.
Avoid bright light, and noisy rooms or events.
Allow for both cognitive and physical rest to avoid overstimulating the brain during the healing process.
Avoid use of electronics including, cell phones, iPads, computers, music and decreased television time.
Avoid driving if symptoms are still present, especially if the symptoms include dizziness, impaired vision and impaired balance.

11. Concussion Management
Misconceptions
Only participants in contact sports can get a concussion
Anybody can get a concussion, at any time and the force at which the head is hit does not have to be large. Over the past two school years, there have been just as many Oxbridge students treated for concussions sustained during a non-athletic incident as those treated for sports related concussions.
A CT Scan or an MRI can diagnose a concussion
A concussion can not be seen on a CT Scan, MRI or other imaging study.
There needs to be a loss of consciousness to sustain a concussion
There does not have to be a loss of consciousness to sustain a concussion. If there is a loss of consciousness, it usually is indicative of a more serious condition and is an emergency situation.
Every athlete who suffers a concussion playing sports is at risk for CTE
Currently, there is no evidence that suggests CTE is caused by one concussion. CTE is caused by repetitive brain trauma including asymptomatic sub-concussive blows and symptomatic concussions sustained over years.

12. Consequences of Improper Concussion Management
Second Impact Syndrome
This can occur when a second injury to the brain happens before the patient is fully recovered from the first concussion.
It can result in immediate and rapid swelling of the brain that will result in an emergency situation.
Post Concussion Syndrome
A disorder where concussion symptoms can last weeks to months after the initial injury.
The most common symptoms reported to linger are headaches and dizziness.

13. Additional Information and Resources
Heads Up
Youth Sports Concussion Safety Center
Brain Injury Association of America
Children’s National Health System
NATA Concussion Position Statement
FHSAA Concussion Policy
The Berlin Consensus Statement on Concussion in Sports