Chicago Public Schools Concussion Protocol

 

Illinois has recently enacted a law expanding school and district obligations to protect students from concussion injuries. The requirements in these guidelines are in addition to the rules established by Chicago Public Schools Policy 704.9, “Concussion Management Policy.” Accordingly, these guidelines apply to all athletic play occurring in sports programs provided by elementary, middle and high schools including but not limited to intramural, interscholastic, afterschool or summer sport activities.

Immediately, schools should update the practices associated with how to promote concussion awareness, monitor instances of concussions, and help assimilate students that have suffered a concussion back to the classroom as well as the playing field/court. These practices must include the following mandates:

Consent & Acknowledgement Form In accordance with previous communications from Sports Administration, each parent/guardian and student athlete shall annually receive the “IHSA Sports Medicine Acknowledgement & Consent Form.”

  1. Description of concussions symptoms;
  2. Explanation of concussion prevention;
  3. Description of concussion treatment; and
  4. Guidelines for safely resuming participation in an athletic even following a concussion.

Parents/guardians and students must complete, sign, and return the Acknowledgement and Consent form to the Athletic Director at the school before the student participates in any interscholastic athletic activities including but not limited to practice, scrimmages, or competition.

The IHSA Sports Medicine Acknowledgement & Consent Form also serves as a “Concussion Fact Sheet” to promote concussion awareness in students, coaches as well as parents.

Signs and symptoms of a concussion include the following:

 

Signs Observed

 

Symptoms Reported

Appears dazed or stunned

Headache or “pressure in head’

Appears confused

Nausea Balance problems or dizziness Sensitivity to

Forgets sports plays

 

light or noise

Is unsure of game, score, opponent

Double or fuzzy vision

Moves clumsily

Feeling sluggish or slowed down

Answers questions slowly

Feeling foggy or groggy

Loses consciousness (even briefly)

Does not “feel right”

Shows behavior or personality changes

Concentration or memory problems

Can’t recall events prior to hit or fall

Confusion

Can’t recall events after hit or fall

 

 

 

Emergency Action Plan : Each school that hosts interscholastic activities must complete a venue specific Emergency Action Plans (EAP) to be executed in case of a serious medical injury suffered by at the venue including concussions. The EAP must be submitted and reviewed by the Chicago Public Schools’ Office of Safety and Security for approval. EAP forms can be found at the IHSA web site: http://ihsa.org/documents/forms/current/Emergency_Action_Plan_Form.pdf. At minimum, EAP’s must include a delegation of roles; method of communication; list of emergency equipment and their location; and a plan for emergency transport.

Emergency Action Plans must be posted prominently at all venues used by the school for interscholastic athletic activities and reviewed annually by athletic trainers, first responders, coaches, school nurses, athletic directors and all volunteers for athletic activities.

Coaches Training. All AD’s, Coaches and volunteers must complete a concussion awareness and certification test every two (2) years training program prior to the beginning of each sport season in accordance with the requirements specified by the Executive Director of Sports Administration. The test is administered on­line through the (IHSA) Illinois High Schools Association. All Elementary School coaches and volunteers must produce a certificate of completion of the “Concussion in Sports” course offered either by the National Federation of High Schools or the CDC.

Removal From Play : Per the requirements of the CPS Concussion Management Policy, “any student who exhibits signs, symptoms or behaviors consistent with a concussion shall be immediately removed from the game or practice.” Students must be immediately removed from practice or competition if a student, coach, physician, game official, athletic trainer, parent/guardian, or person legally authorized to make medical decisions on behalf of the student believes the student might have sustained a concussion.

A student that is suspected of suffering a concussion must not be allowed to return to play until there is medical clearance issued by a treating physician, or an athletic trainer working under the supervision of a physician for the student to both return­to­learn and return to play . The incident resulting in the “suspected” injury must be reported to the Office of Sports Administration by email within 24 hours of the event to sportsad@cps.edu , and likewise submitted as an incident report to VERIFY in Oracle.

Return to Classroom : Please be advised that coaches MAY NOT authorize athletes to return to classroom.

Students are encouraged to get medical clearance before returning to class. When a student who is believed to have suffered a concussion returns to school school personnel are required to take certain steps to ensure that students receive appropriate services and accommodations. Schools should follow the guidance provided by the Center for Disease Control and Prevention at http://www.cdc.gov/headsup/basics/return_to_school.html and attached to this memo. Most students will only require informal academic accommodations when recovering from a concussion.

CDC recommended accommodations for these students include:

  • Rest breaks as needed;
  • Fewer hours at school;
  • Being given more time to take tests or complete assignments;
  • Receiving assistance with schoolwork; and/or
  • Reduce time spent on the computer, reading or writing.
 

If a student has ongoing symptoms of a concussion and has been approved to return to the classroom through the measures discussed above, it may be appropriate for an Eligibility Determination Meeting to be called.

CDC recommended services and accommodations for students with ongoing symptoms include:

  • Speech ­language therapy;
  • Environmental adaptations;
  • Curriculum modifications; and
  • And behavioral strategies.

The student’s parent/guardian and coaches should monitor the student for concussion symptoms when he/she returns to the classroom. If any of the student’s concussion symptoms return, or if the student exhibits any new symptoms, the student should seek medical attention. Special attention should be given to students that have previously suffered a concussion.

Once a student has been cleared to Return to Learn by the treating physician or trainer, the school representative must indicate the date that the student was cleared on the Post­ concussion Consent Form submitted on behalf of the student.

The school should additionally follow Return to Play guidelines for students returning to Physical Education classes.

Return to Play : Please be advised that coaches MAY NOT authorize student­ athletes to Return to Learn or Return to Play. Students believed to have suffered a concussion may not return to athletic activities until they have successfully resumed classroom activities.

Students are only allowed to Return to Play after providing medical clearance. Students who are believed to have suffered a concussion must be evaluated by a treating physician, or an athletic trainer working under the supervision of a physician, chosen by the student’s parent/guardian. The treating physician or trainer must provide a written statement demonstrating that in their professional judgment it is safe for the student to return to learn and return to play before the student is allowed to resume athletic activity. In the event that a student athlete has been formally diagnosed with a concussion by the treating physician or trainer, a school representative (primarily the Athletic Director) must collect the Post­concussion Consent Form issued by the IHSA http://ihsa.org/documents/forms/current/Post­concussion%20Consent%20Form%20(RPT­RTL).pdf completed by the student and parent/guardian, and keep it on file at the school prior to the student resuming classroom attendance.

Once a student has been cleared to play by the treating physician or trainer, the school representative must indicate the date that the student was cleared on the Post­concussion Consent Form submitted on behalf of the student. For students returning to play after suffering a concussion, schools should follow the guidance provided by the Center for Disease Control and Prevention at http://www.cdc.gov/headsup/basics/return_to_sports.html and attached to this memo. Students should return to athletic activity progressively. Until CPS distributes formal Return to Play protocol, schools should follow the progression of activities recommended by the CDC:

Baseline: Back to School ­ Student has returned to normal school activities, is no longer suffering concussion symptoms and has been approved by the medical provider to begin sporting activities.
Step 1: Light Aerobic Activity ­ Student should do light aerobic exercise to increase heart rate. This activity should consist of 5­10 minutes on an exercise bike, light jogging, or walking. STUDENTS SHOULD NOT BE WEIGHTLIFTING AT THIS POINT.
Step 2: Moderate Activity ­ Student should progress with activities that increase heart rate and include head and body movement. This includes jogging, brief running, moderate­intensity stationary biking, moderate­intensity weightlifting. Student should limit weightlifting activities to less weight than typical and/or less time than typical.
Step 3: Heavy, Non­Contact Activity ­ Begin heavy non­contact activity including sprinting/running, high­intensity stationary biking, non­contact sport­specific drills.
Step 4: Practice and Full Contact ­ Student returns to controlled practice and full contact activities.
Step 5: Competition – Student returns to competition.

The student’s parent/guardian and coaches should monitor the student for concussion symptoms throughout their re­entry into sports activities. If any of the student’s concussion symptoms return, or if they exhibit any new symptoms, the student should stop athletic activity and a medical provider should be contacted.

Supervision : Each school is responsible for identifying a Concussion Supervisor that will report any concussion related events to the Office of Sports Administration by completing the Google Form available here: http://goo.gl/forms/mdkzKTkAW6 . The Concussion Supervisor is responsible for monitoring student Return to Play and Return to Learn to ensure that all proper protocols are being followed.

Contact: For questions or concerns please contact the Office of Sports Administration at (773) 534 – 0700.