POLICY REGARDING CONCUSSIONS, CONCUSSED ATHLETES AND RETURN TO PLAY PROTOCOL
It is important for all adults involved in youth athletics to recognize the potential for catastrophic injury and even death from concussions. Thus it is extremely important that each coach, parent, athletic trainers, and any medical support personnel review their responsibilities in protecting young athletes.
It has always been the ultimate responsibility of the coaching staff, in all sports, to ensure that players are only put into practice or contests if they are physically capable of performing. However, all adults involved in the conduct of youth sports competition have responsibilities in this endeavor.
Our policy shall follow the regulations adopted by USA Hockey:
Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion or balance problems) shall be immediately removed from the practice or contest and shall not return to practice or play until cleared with written authorization by an appropriate health care professional. In New Jersey, an ‘appropriate health care professional’ shall be a physician, and includes both doctors of medicine (M.D.) and doctors of osteopathy (D.O.) and an athletic trainer (A.T.), licensed under applicable state law.
The following parameters shall guide coaches, parents, athletic trainers and medical personnel in implementing this policy.
1. What are the signs, symptoms, or behaviors consistent with a concussion?
The U.S. Department of Human Services, Centers for Disease Control and Prevention has published the following lists of signs, symptoms and behaviors that are consistent with a concussion:
SIGNS OBSERVED BY OTHERS:
- Appears dazed or stunned
- Is confused about assignment
- Forgets plays
- Is unsure of game, score or opponent
- Moves clumsily
- Answers questions slowly
- Loses consciousness
- Shows behavior or personality changes
- Cannot recall events prior to hit
- Cannot recall events after hit
SYMPTOMS REPORTED BY ATHLETE:
- Balance problems or dizziness
- Double or fuzzy vision
- Sensitivity to light or noise
- Feeling sluggish
- Feeling foggy or groggy
- Concentration or memory problems
2. Who is responsible for administering this policy?
All adults who have responsibilities and duties in the youth athletics environment are responsible: coaches, parents, trainers and medical personnel.
3. What is the role of coaches in administering this policy?
- Coaches are to review and know the signs and symptoms of concussion and to prohibit any athlete who displays these signs or symptoms from participating in a practice or a contest
- Note that coaches are not medical professionals and have no authority to determine whether or not an athlete has sustained a concussion. The coach is responsible for removing a player when he or she observes signs and symptoms that may indicate an athlete is concussed and ensuring that the athlete’s parents are notified and the athlete is referred to a medical professional.
4. Who decides if an athlete has not been concussed and/or who has recovered from a concussion?
- Only an M.D. (Medical Doctor), D.O. (Doctor of Osteopathy), or A.T. (Athletic Trainer) is empowered to make the determination that an athlete has not received a concussion.
- If any one of these individuals has answered that “yes” there has been a concussion, that decision is final.
5. Can an athlete return to play on the same day as he/she receives a concussion?
- No, under no circumstances can that athlete return to play that day. When in doubt, hold them out.
- If the event continues over multiple days, then a health care professional has ultimate authority over return to play decisions.
- However, if a health care professional (M.D, D.O. or A.T.) has evaluated the athlete, who has been removed from competition due to exhibiting the signs and symptoms of a concussion, and has determined that the athlete did not sustain a concussion, that athlete may return to play with the submission of the written authorization by the health care professional.
- The written authorization shall be submitted to the coach who shall forward a copy of the written authorization form within 48 hours to the Flyers Elite Hockey office, retaining a copy for the team manager.
6. Once the day has concluded, who can issue authorization to return to practice / competition in the sport?
- Once a concussion has been diagnosed, only an M.D., D.O. or A.T. can authorize subsequent return to play (RTP), and such authorization shall be in writing. This written RTP authorization shall be kept with the team manager.
- With receipt of the written authorization, the coach has the permission to return the athlete to practice or play. 7. What should be done after the athlete is cleared by an appropriate health care professional?
- After a clearance has been issued, the athlete’s actual return to practice and play should follow a protocol established by an appropriate health care professional.
- The following graduated protocol is simply a suggested protocol. The appropriate health care professional who issues the clearance may establish a different graduated protocol.
7. Suggested Medical Clearance Return To Play Protocol (per USA Hockey Policy):
1. No exertional activity until asymptomatic.
2. When the athlete appears clear, begin low-impact activity such as walking, stationary bike, etc.
3. Initiate aerobic activity fundamental to specific sport such as skating, and may also begin progressive strength training activities.
4. Begin non-contact skill drills specific to sport such as stick-handling, etc.
5. Full contact in practice setting.
6. Game play/competition.
7. Athlete must remain asymptomatic to progress to the next level. (It is often suggested that an athlete not be allowed to progress more than one level per day.)
– If symptoms recur, athlete must return to previous level and should be reevaluated by an appropriate health care professional.
– Medical check should occur before contact. (Final written clearance from the medical professional shall be obtained before the athlete engages in any unrestricted or full contact activity.)
8. USA Hockey Insurance Coverage: As a member of USA Hockey, treatment for injuries occurring during ‘sanctioned USA Hockey events’ (i.e. games and practices) are covered by the USA Hockey Insurance. To review a description of the benefits, visit the USA Hockey website.
9. Other Resources
Coach fact sheet: http://www.cdc.gov/concussion/pdf/coaches_Engl.pdf
Parent fact sheet: http://www.cdc.gov/concussion/pdf/parents_Eng.pdf
Athlete fact sheet: http://www.cdc.gov/concussion/pdf/athletes_Eng.pdf
ImPACT Testing website: http://impacttest.com/
USA Hockey Insurance and Risk Management: http://www.usahockey.com/page/show/837074-insurance-and-risk-management
For current and up-to-date information on concussions you can go to: http://www.cdc.gov/ConcussionInYouthSports/