2. Concussions in High School Athletics Concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. McCrory, P., Meeuwisse, W., Johnston, K. (2009). Consensus Statement on Concussion in Sport: The 3 rd International Conference on Concussion in Sport Held in Zurich, November 2008. Journal of Athletic Training. 44(4):434–448

3. Campolindo Sports Medicine Identification/Management of Concussions A process that ensures a student-athlete who exhibits signs, symptoms or behaviors consistent with a concussion shall be removed from athletics activities (e.g., competition, practice, conditioning sessions) and evaluated by a medical staff member (e.g., sports medicine staff, team physician) with experience in the evaluation and management of concussions; A policy that precludes a student-athlete diagnosed with a concussion from returning to athletics activity (e.g., competition, practice, conditioning sessions) for at least the remainder of that calendar day; and A policy that requires medical clearance for a student-athlete diagnosed with a concussion to return to the athletics activity (e.g., competition, practice, conditioning sessions) as determined by a healthcare professional with specific training and experience in the assessment and management of a concussion.

4. Concussion; Signs & Symptoms Selected acute & delayed signs & symptoms suggestive of concussion CognitiveSomaticAffectiveSleep Disturbances Confusion Anterograde amnesia Retrograde amnesia Loss of consciousness Disorientation Feeling in a fog, zoned out Vacant stare Inability to focus Delayed verbal & motor responses Slurred/incoherent speech Excessive drowsiness Headache Dizziness Balance disruption Nausea/vomiting Visual disturbances (photophobia, blurry/double vision) Phonophobia Emotional lability Irritability Fatigue Anxiety Sadness Trouble falling asleep Sleeping more than usual Sleeping less than usual Nata.org

5. Concussion Education Any athlete suspected of having a concussion should be removed from play and assessed by a licensed healthcare provider trained in the evaluation and management of concussion. Recognition and initial assessment of concussion should be guided by a symptom checklist, cognitive evaluation (including orientation, past and immediate memory, new learning, and concentration), balance tests, and further neurologic physical examination. While standardized tests are a useful framework for examination, the sensitivity, specificity, validity, and reliability of these tests among different age groups, cultural groups, and settings is largely undefined. Their practical usefulness with or without an individual baseline test is also largely unknown.

6. High School Athletics: Coaching Education Program AB 1451 (Hayashi) – January 1, 2013 This bill would require each high school sports coach taking or renewing his or her first aid certification to take additional training that includes a basic understanding of the signs, symptoms, and appropriate emergency action steps regarding potentially catastrophic injuries, including, but not limited to, head and neck injuries, concussions, second impact syndrome, asthma attacks, heat stroke, and cardiac arrest. By requiring high school sports coaches to complete this additional training, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions

7. Concussion Management Progression of Return to Play Should be gradual and the time spent at each stage should be individualized and monitored by a healthcare professional (from Vienna Guidelines 01, Zurich 09)

8. Concussion Overview Presentation Center for Disease Control: Heads Up Concussion in High School Sports (10 min)

9. Concussion Management Home Care Guidelines Following a Concussion The Center for Disease Control provides information for Caregivers dealing with concussions www.cdc.gov/concussion

10. Additional Resources Consensus Statement on Concussion in Sport http://www.nata.org/sites/default/files/attr-44-04-434.pdf Management of Sport Related Concussion http://www.nata.org/sites/default/files/MgmtOfSportRelatedConcussion.pdf http://www.nata.org/sites/default/files/MgmtOfSportRelatedConcussion.pdf American Medical Society for Sports Medicine Position Statement: Concussion in Sport http://journals.lww.com/cjsportsmed/Fulltext/2013/01000/American_Medic al_Society_for_Sports_Medicine.1.aspx Websites: American Academy of Neurology www.aan.com National Athletic Training Association www.nata.org Center for Disease Control www.cdc.gov