Quincy Public Schools

Quincy Public Schools Concussion Policy
Grades 6-12

The purpose of this policy and accompanying protocols is to provide information and standardized procedures for persons involved in the prevention, training, management and return to activity decisions regarding student athletes who incur head injuries during the school day or while involved in school sponsored extracurricular activities including, but not limited to, interscholastic sports in order to protect their health and safety, pursuant to the requirements of the Massachusetts Department of Public Health (MDPH) at 105 CMR 201. ImPACT testing is mandatory for students in grades 9 to 12 who participate in an extracurricular athletic activity, in advance of their first season of participation and every two years thereafter.

The Superintendent or Designee will review the policy at least every two years. The protocols will be reviewed annually by the athletic department, the nursing staff and the school physician. The Athletic Director or other school personnel, designated by the superintendent, is responsible for the implementation of this policy and protocols.

This policy and protocols shall be made available to the MDPH and to the Department of Elementary and Secondary Education (DESE) upon request or in connection with any inspection or program review.

The Superintendent or Designee shall ensure the following records are collected, verified, documented and maintained for three years or, at a minimum, until the student graduates, unless state or federal law requires a longer retention period:

Documentation of annual training of persons specified in 105 CMR 201.007 in the prevention and recognition of a sports-related head injury, and associated health risks including second impact syndrome, utilizing Department-approved training materials or program.
Documentation of physical examination prior to a student’s participation in extracurricular athletic activities on an annual basis, consistent with 105 CMR 200.100(B)(3): Physical Examination of School Children.
Documentation of current information regarding a student athlete’s history of head injuries and concussions using the Department Preparticipation Head Injury/Concussion Reporting Form For Extracurricular Activities (Pre-participation Form), or District approved form.
DPH Medical Clearance and Authorization Forms or equivalents; and
Graduated reentry plans for return to full academic and extracurricular athletic activities.

An accurate synopsis of this policy and protocols shall be placed in the school handbook, in the Health Office and on the District website.

Resource: Quincy Public Schools Concussion Protocol
LEGAL REFS.: M.G.L. 111:222; 105 CMR 201.000

Quincy Public Schools Concussion Protocol Grades 6-12

The Quincy Public Schools will provide standardized protocols for persons involved in the prevention, training, management and return-to-activity decisions regarding students who incur a head injury or suspected concussion in order to protect their health and safety. The protocols have been adopted to be in compliance with the law and will be reviewed annually by the Athletic Director, the Licensed Athletic trainer and the nursing staff.

What is a Concussion?

A concussion is defined as a transient alteration in brain function without structural damage, but with other potentially serious long-term ramifications. In the event of a concussion, the brain sustains damage at a microscopic level in which cells and cell membranes are torn and stretched. The damage to these cells also disrupts the brain at a chemical level, as well as causing restricted blood flow to the damaged areas of the brain, thereby disrupting brain function. A concussion, therefore, is a disruption in how the brain works; it is not a structural injury. Concussions are difficult to diagnose because the damage cannot be seen. A MRI or CT Scan cannot diagnose a concussion, but they can help rule out a more serious brain injury to a student athlete. Because concussions are difficult to detect, student athletes must obtain medical approval before returning to athletics following a concussion.

Signs and Symptoms:

Signs (what you see):

Confusion
Forgets plays
Unsure about game, score, opponent
Altered coordination
Balance problems
Personality change
Slow response to questions
Forgets events prior to injury (retrograde amnesia)
Forgets events after injury (anterograde amnesia)
Loss of consciousness (any duration)

Symptoms (reported by athlete):

Headache
Fatigue
Nausea or vomiting
Double vision/ blurry vision
Sensitivity to light (photophobia)
Sensitivity to noise (tinnitus)
Feels sluggish
Feels foggy
Problems concentrating
Problems remembering
Trouble with sleeping/ excess sleep
Dizziness
Sadness
Seeing stars
Vacant stare/ glassy eyed
Nervousness
Irritability
Inappropriate emotions

If any of the above signs or symptoms are observed after a suspected blow to the head, jaw, spine or body, they may be indicative of a concussion and the student athlete must be removed from play immediately and not allowed to return until cleared by an appropriate allied health professional.

Training

Concussion training is a pre-participation requirement for all students and must be completed prior to practice or competition. The following persons annually shall complete one of the head injury safety training programs approved by the Quincy Public Schools (QPS):

Coaches and Advisors
Certified athletic trainers
Volunteers
School and team physicians
School nurses
Athletic Director
Directors responsible for a school marching band, whether employed by a school or school district or serving in such capacity as a volunteer
Parents of a student who participates in an extracurricular athletic activity
Students who participate in an extracurricular athletic activity

The required training applies to one school year and must be repeated for every subsequent year.

Each school shall maintain a record of completion of annual training for all persons specified by 105 CMR 201.007(A) through:

A certification of completion for any DPH-approved on-line course; or
A signed acknowledgement that the individual has read and understands DPH-approved written materials required by 105 CMR 201.008(A)(1); or
An attendance roster from a session using DPH-approved training.

Game officials shall complete one of the training programs approved by the DPH as specified on the DPH’s website annually and shall provide independent verification of completion of the training requirements to schools or the district upon request.

Approved trainings can be found on the Massachusetts DPH sports concussion website at: mass.gov/sportsconcussion

Participation Requirements for Students and Parents (Differentiated by level)

Middle School Level:

All students who plan to participate in extracurricular athletic activities and their parents must fulfill the following pre-participation requirements regarding head injuries and concussions:

Complete a DPH-approved training regarding head injuries and concussions in extracurricular athletic activities; and
Provide the school with a certification of completion for any DPH-approved on-line course or a signed acknowledgement that they have read and understand DPH-approved written materials, unless they have attended a school-sponsored training at which attendance is recorded.
Before the start of every sports season, the student and parent/guardian must complete and submit the Sports Permit and Medical Questionnaire. This Google form will be sent out electronically and is specific to each middle school for Athletics. The questionnaire will be reviewed by the school nurse prior to athletic participation. The school nurse will provide appropriate follow-up when necessary.
Annually, students are also required to provide a physical exam to the school nurses’ office. No student shall be medically cleared for extracurricular athletic activities until the school nurse has reviewed both the questionnaire and physical exam. The school nurse shall consult with the student’s primary care physician or the QPS school physician advisor as necessary regarding a student’s medical history and/or eligibility.
Prior to the start of participation in high school sports students will be offered a baseline “ImPACT Test” at the end of their 8th grade year. ImPACT testing is mandatory for students in grades 9 to 12 who participate in an extracurricular athletic activity, in advance of their first season of participation and every two years thereafter. The Athletic Director or designee will coordinate scheduling of baseline ImPact testing for students with coaches and middle school health educators.

Additional parental requirement:

If a student sustains a head injury or concussion during the season, but not while participating in an extracurricular school athletic activity, the parent shall complete the Report of Head Injury During Sports Season Form and submit the form to the school nurse and to the Athletic Director.

High School Level:

All students who plan to participate in extracurricular athletic activities and their parents must fulfill the following pre-participation requirements regarding head injuries and concussions:

Complete a DPH-approved training regarding head injuries and concussions in extracurricular athletic activities; and
Provide the school with a certification of completion for any DPH-approved on-line course or a signed acknowledgement that they have read and understand DPH-approved written materials, unless they have attended a school-sponsored training at which attendance is recorded.
Before the start of every sports season, the student and parent/guardian must complete and submit the Sports Permit and Medical Questionnaire using Family ID. The questionnaire will be electronically distributed through the athletic department. The questionnaire will be reviewed by the school nurse prior to athletic participation. The school nurse will provide appropriate follow-up when necessary.
Annually, students are also required to provide a physical exam to the school nurses’ office. No student shall be medically cleared for extracurricular athletic activities until the school nurse has reviewed both the questionnaire and physical exam. The school nurse shall consult with the student’s primary care physician or the QPS school physician advisor as necessary regarding a student’s medical history and/or eligibility.
High school student athletes will be required to take a baseline “ImPACT Test” prior to the start of their participation in sports. ImPACT testing is mandatory for students in grades 9 to 12 who participate in an extracurricular athletic activity, in advance of their first season of participation and every two years thereafter. At the high school level, prior to the start of every sports season, ImPACT Baseline Screening will be offered under the guidance of the Athletic Department. The Athletic Director or designee will coordinate scheduling of baseline ImPact testing for students with coaches and middle school health educators.

Additional parental requirement:

Documentation and Review of Head Injury and Concussion History Forms

Prior to the start of the season, the Pre-participation Form or district equivalent will be reviewed by the Athletic Director, the Licensed Athletic Trainer and coaches to identify students who may be at greater risk for repeated head injuries.

Prior to the start of the season, all Pre-participation Form or district equivalent indicating a history of head injury, must be reviewed by the school nurse or school physician and the Licensed Athletic Trainer.

If an athlete sustains a head injury or concussion during the season, but not while participating in an extracurricular athletic activity, the parent/guardian shall complete the Report of Head Injury Form and submit it to the school nurse, Athletic Director, or coach.

When an athlete is identified as sustaining a head injury or suspected concussion during an extracurricular athletic event, the athlete must be removed from practice or competition, the Report of Head Injury Form must be completed immediately, by Licensed Athletic Trainer, coach or designee, and the student referred for medical evaluation. The form must be submitted to the school nurse or Athletic Director.

If evaluated by a Licensed Athletic Trainer they will complete the Report of Head Injury Form.
If evaluated by other medical personnel, the coach will complete the Report of Head Injury Form.
If the coach removes a student from play due to suspected head injury, the coach will complete the Report of Head Injury Form.

The Report of Head Injury Form must be reviewed by the school nurse and the Licensed Athletic Trainer (if any), within 24 hours of injury.

The school may use a student's history of head injury or concussion as a factor to determine whether to allow the student to participate in an extracurricular athletic activity or whether to allow such participation under specific conditions or modifications.

Exclusion from Play (differentiated by level)

Middle School Level Exclusion from Play and Medical Clearance:

Any student, who during a practice or competition, sustains a head injury or suspected concussion, or exhibits signs and symptoms of a concussion or loses consciousness, even briefly, shall be removed from the practice or competition immediately and may not return to the practice or competition that day.

The coach shall communicate the nature of the injury directly to the parent in person or by phone immediately after the practice or competition in which a student has been removed from play due to a head injury, suspected concussion, or loss of consciousness. The coach also must provide this information to the parent in writing, whether paper or electronic format, “QPS Head Injury Information Sheet”, by the end of the next business day.

The coach or his or her designee shall communicate, by the end of the next business day, with the Athletic Director, and the school nurse that the student has been removed from practice or competition for a head injury, suspected concussion, or loss of consciousness. The coach will also complete a “QPS Accident Form”
and Report of Head Injury Form and send it to the School Nurse and the Athletic Director.

The student shall not return to practice or competition unless and until the student provides medical clearance. The coach shall provide the necessary forms for the student to take to their medical provider. DPH Medical Clearance and Authorization Form | Mass.gov This Form must be completed by one of the following individuals who has received DPH-approved training in post traumatic head injury assessment and management or have received equivalent training as part of their licensure or continuing education:

A duly licensed physician
A duly licensed athletic trainer in consultation with a licensed physician
A duly licensed nurse practitioner in consultation with a licensed physician
A duly licensed physician assistant under the supervision of a licensed physician
A duly licensed neuropsychologist in coordination with the physician managing the student’s recovery.

Athletic Reentry:

Students must be symptom free and medically cleared (by one of the above providers) in order to return to full athletic and extracurricular activities.

Academic Reentry:

A QPS multidisciplinary team will develop a plan for the student’s return to academics if needed. This team may consist of the student's teachers, the student's guidance counselor, school nurse, parent, members of the building-based student support team and in consultation with the student's primary care provider or the physician who made the diagnosis or who is managing the
student's recovery.
The plan shall include the academic recovery plan recommendations from the physician.

High School Level Exclusion from Play, Graduated Return to Play Protocol and Medical Clearance:

Any student, who during a practice or competition, sustains a head injury, suspected concussion, or exhibits signs and symptoms of a concussion or loses consciousness, even briefly, shall be removed from the practice or competition immediately and may not return to the practice or competition that day.

The coach shall communicate the nature of the injury directly to the parent and the Athletic Trainer in person or by phone immediately after the practice or competition in which a student has been removed from play due to a head injury, suspected concussion, or having any loss of consciousness. The coach also must provide this information to the parent in writing, whether paper or electronic format, “QPS Head Injury Information Sheet ”, by the end of the next business day.

The coach or his or her designee shall communicate, by the end of the next business day, with the Athletic Director, the school nurse, and the Licensed Athletic Trainer that the student has been removed from practice or competition for a head injury, suspected concussion, or loss of consciousness. The coach will also complete a “QPS Accident Form” and Report of Head Injury Form and send it to the School Nurse, Athletic Trainer, and the Athletic Director.

The student shall begin a gradual return to play with light cardiovascular exercise, as soon as 24 - 48 hours following a concussion. The best available evidence shows that recommending strict rest until the complete resolution of concussion-related symptoms is not beneficial following a Sports Related Concussion. Relative (not strict) rest, which includes activities of daily living and reduced screen time, is indicated immediately and for up to the first 2 days after injury. The student may return to light-intensity physical activity, such as walking that does not more than mildly exacerbate symptoms, during the initial 24 - 48 hours following a concussion.

The Athletic Trainer shall provide the necessary forms for the student to take to their medical provider. DPH Medical Clearance and Authorization Form | Mass.gov

The following individuals may authorize a return to play:
- A duly licensed physician
- A duly licensed certified athletic trainer in consultation with a licensed physician
- A duly licensed nurse practitioner in consultation with a licensed physician, or
- A duly licensed neuropsychologist in coordination with the physician managing the student’s recovery

Each student who is removed from practice or competition and subsequently diagnosed with a concussion shall have a written graduated reentry plan for return to full academic and extracurricular athletic activities.

For a student to begin a gradual return to play protocol, the student must be back in the classroom full-time.

Repeat ImPACT testing must be completed under the direction of the Athletic Department, after the student has decreased symptoms and is able to complete a whole day at school. Prior to medical clearance, a copy of the ImPACT testing will be provided to the parent/guardian, by the Athletic Department, to be shared with
the licensed care provider.

Implementation of the return to play protocol in the Quincy Public Schools requires the supervision of the athletic trainer.

Gradual Return To Play Protocol for High School Level

It is important for an athlete’s parent(s) and coach(es) to watch for concussion symptoms after each day’s return to play progression activity. An athlete should only move to the next step if they do not have any new symptoms at the current step. If an athlete’s symptoms come back or if he or she gets new symptoms, this is a sign that the athlete is pushing too hard. The athlete should stop these activities and the athlete’s medical provider should be contacted. After more rest and no concussion symptoms, the athlete can start at the previous step.

During an athlete’s sports season, the gradual return to play protocol must be completed under the supervision of the Licensed Athletic Trainer on the school grounds.

Stages of Healing	Activity allowed	Examples of sports	Examples of other activities	Goal
1	No activity Complete cognitive and physical rest	Complete physical rest	Quiet time with rest Avoid groups, videos, reading, computers, video games, cell phones, noisy places	Brain rest BECOME FREE OF SYMPTOMS
2	Light aerobic Activity after 24-48 hours	10-15 minutes of walking or stationary bike Light sweat on the brow Slight increase in breathing rate	Walk in park or neighborhood Avoid group activities	Increase heart rate to 30 to 40% at most
3	Moderate Aerobic activity Light resistance training	20-30 minutes of jogging or stationary bike Arm curls, shoulder raises, or leg lifts with weights that can be comfortably lifted One set of 10 repetitions for each activity	Supervised play Low risk activities such as dribbling a ball, playing catch, changing directions, jumping, side-to-side slides, chasing a ball or catching a ball on the run	Increase heart rate to 40 to 60% max Add resistance Use eyes to track objects
4	Intense aerobic activity Moderate resistance training Sport-specific exercise	40-60 minutes of running or stationary bike Same resistance exercises with weight for three sets of 10 reps Pre-competition warm-up such as passing a soccer ball, throwing a football or doing ladder drills	Supervised play Moderate-risk activities, such as balance and agility drills No head contact activities Can sweat and breathe heavy	Increase heart rate to 60 to 80% max Increase resistance Mimic the sport
5	Controlled contact training drills	60-90 minutes of time on the field, court or mat for specific drills Take part in normal practice session Contact that is normally part of the sport—only use items that "do not hit back" such as a sled in football Recheck for symptoms or problems often	Free play Run and jump as able Full return to PE Recheck for symptoms or problems often	Mimic the sport or free play without the risk of head injury
6	Full-contact practice	After medical clearance, may take part in normal training activities	With parent or adult supervision, may take part in normal activities	Build confidence Assess skills
7	Return to play	Normal game play	Normal playtime and activities	No restrictions

***If there are no symptoms, the athlete can advance to the next stage of the gradual return to play protocol, under the supervision of the Licensed Athletic Trainer, on the subsequent day. If symptoms return or persist, the athlete should go back to the previous asymptomatic level/stage and attempt to progress again after being free of concussion-related symptoms for a further 24-hour period at the lower level.

Post Concussion Syndrome

Post Concussion Syndrome is a poorly understood condition that occurs after a student athlete receives a concussion. Student athletes who receive concussions can have symptoms that last a few days to a few months, and even up to a full year, until their neurocognitive function returns to normal. Therefore, all school personnel must pay attention to and closely observe all student athletes for post concussion syndrome and its symptoms. Student athletes who are still suffering from concussion symptoms are not ready to return to play. The signs and symptoms of post concussion syndrome are:

Dizziness
Headache with exertion
Tinnitus (ringing in the ears)
Fatigue
Irritability
Frustration
Difficulty in coping with daily stress
Impaired memory or concentration
Eating and sleeping disorders
Behavioral changes
Alcohol intolerance
Decreases in academic performance
Depression
Visual disturbances

Second Impact Syndrome:

Second impact syndrome is a serious medical emergency and a result of an athlete returning to play and competition too soon following a concussion. Second impact syndrome occurs because of rapid brain swelling and herniation of the brain after a second head injury that occurs before the symptoms of a previous head injury have been resolved. The second impact that a student athlete may receive may only be a minor blow to the head or it may not even involve a hit to the head. A blow to the chest or back may create enough force to snap the athlete's head and send acceleration/deceleration forces to an already compromised brain. The resulting symptoms occur because of a disruption of the brain's blood autoregulatory system which leads to swelling of the brain, increasing intracranial pressure and herniation.

After a second impact a student athlete usually does not become unconscious, but appears to be dazed. The student athlete may remain standing and be able to leave the field under their own power. Within fifteen seconds to several minutes, the athlete's condition worsens rapidly, with dilated pupils, loss of eye movement, loss of consciousness leading to coma and respiratory failure. The best way to handle second impact syndrome is to prevent it from occurring altogether. All student athletes who incur a concussion must not return to play until they are asymptomatic and cleared by an appropriate health care professional.

Athletic Director Responsibilities:

The Athletic Director participates in the development and biannual review and revision of the policy and protocol for the prevention and management of sports-related head injuries.

The Athletic Director shall:
- Complete an annual training
- Ensure the training of coaches, staff, parents, volunteers and students.
- Maintain certificates of completion, attendance rosters, and signed affidavits.
- Maintain records of annual trainings, completions, affidavits, and/or attendance rosters for three years.
- Ensure that the medically cleared list is provided to all coaches, assistants, and volunteers and that no student participates without this clearance.
- Ensuring all students meet the physical examination requirements prior to participation in any extracurricular athletic activity;
- Ensuring all students participating in extracurricular athletic activities have completed and submitted the Pre-Participation Form or district equivalent prior to the start of each season;
- Ensuring all Pre-Participation Form are reviewed;
- Ensure the “Report of Head Injury Forms are completed by parents or coaches and reviewed by the school nurse.
- Ensure that athletes are prohibited from engaging in any unreasonably dangerous athletic technique that endangers the health or safety of an athlete, including using a helmet or any other sports equipment as a weapon.
- Report annual statistics to the Department of Public Health:
  - The total number of Head Injury Reports received from both coaches and parents.
  - The total number of students who incur head injuries and suspected concussions when engaged
    in any extracurricular athletic activities.

Coach & Band Instructor Responsibilities:

The coach and band instructor completes the annual training and provides the Athletic Director with a certificate of completion.

The coach shall:
- Review the pre-participation information provided by Family ID for High school or google form for middle school or from the school nurse regarding a student’s history and/or risk of head injury.
- Ensure that all student athletes are offered ImPACT baseline testing (High school) prior to participation.
- Ensure that all student athletes are on the medically cleared list prior to participation.
- Identify athletes with head injuries or suspected concussions that occur in practice or competition and remove them from play.
- Complete a “QPS Accident Form” and Report of Head Injury Form upon identification of a student with a head injury or suspected concussion that occurs during practice or competition when the Licensed Athletic Trainer is not on site;
- Communicate the nature of the injury directly to the parent/guardian in person or by phone immediately during or after the practice or competition in which a student has been removed from play due to a head injury, suspected concussion signs and symptoms of a concussion, or loss of consciousness and provide them with a “QPS Head Injury Information Sheet” and DPH MedicalClearance and Authorization Form
- Promptly notify the Athletic Director and school nurse of any student removed from practice or competition by the end of the next business day.
- Teach techniques aimed at minimizing sports-related head injury.
- Discourage and prohibit athletes from engaging in any unreasonably dangerous athletic technique that endangers the health or safety of an athlete, including using a helmet or any other sports equipment as a weapon.

Licensed Athletic Trainer Responsibilities:

Licensed Athletic Trainer, if on staff, shall be responsible for:

Participating in the development and biannual review of the policies and protocols for the prevention and management of sports-related head injuries;
Completing the annual training;
Reviewing information from Pre-Participation Forms which indicate a history of head injury and from Report of Head Injury Forms to identify students who are at greater risk for repeated head injuries;
Ensuring completion of initial ImPACT screening for applicable student-athletes according to guidelines.
Identifying athletes with head injuries or suspected concussions that occur in practice or competition and removing them from play;
Completing Head Injury Forms for athletes that sustain a head injury during practice or competition;
Reviewing Report of Head Injury Forms completed by others and follow up with the coach, student, parent/guardian and School Nurse;
Ensuring a copy of the completed Report of Head Injury Forms are given to the School Nurse and sent to parent/guardian;
Ensuring parent/guardian receives a copy of ImPACT screening when student has a suspected concussion;
Participating, if available, in the graduated reentry planning and implementation for students who have been diagnosed with a concussion;
Communicating with students, parents/guardians, coaches and school nurses regarding diagnosis of potential concussion and gradual return to play protocol and anticipated dates;
If there are any setbacks during the gradual return to play protocol, all parties should be made aware of the setback, the new plan and new anticipated dates;
Ensuring repeat ImPACT testing is completed after the student is symptom free for at least 24 hours and providing parent/guardian with a copy of the repeat ImPACT testing, to be shared with the licensed care provider.
Following up with coach, parent/guardian, student and school nurse as needed;
Forwarding any medical documentation received to the School Nurse; and
Monitoring recuperating students with head injuries in collaboration with teachers to ensure that the graduated reentry plan for return to full academic and extracurricular activities is being followed.

School Nurse Responsibilities:

The school nurse shall:
- Complete the annual training
- Participate in the biannual review and revision of the policy.
- Review all pre-participation questionnaires.
- Review all annual physical exams.
- Review all Report of Head Injury Forms that indicate a history of head injury and following up with the parent/guardian as needed prior to the student’s participation in extracurricular athletic activities;
- Maintain all questionnaires, physical exams, Report of Head Injury Forms, QPS Accident Form and any other pertinent medical information in the student health record.
- Share on a need to know basis any head injury information regarding a student that may impact their ability to participate in extracurricular athletic activities or places a student at greater risk for repeated head injuries.
- Participate in the graduated reentry planning for students to discuss any necessary accommodations or modifications with respect to academics, course requirements, homework, testing scheduling and other aspects of school activities consistent with a graduated reentry plan for return to full academic and extracurricular athletic activities after a head injury and revising the health care plan as needed.
- Monitor recuperating students with head injuries in collaboration with Student SupportTeam Members and teachers to ensure that the graduated reentry plan is being followed.
- Provide annual and ongoing educational materials on head injury and concussion to teachers, staff and students.

Guidance Counselor Responsibilities:

Be designated as the contact or “point person” once informed by the school nurse that a student has been diagnosed with a concussion.
Work with the student on organizing work assignments, making up work and giving time for assignments and tests/quizzes.
Assist teachers in following the recovery stage and academic accommodations for the student.
Convene meetings and develop rehabilitative plans as needed.
Notify teachers to decrease workload if symptoms reappear.
Educate staff on the educational impact concussions may have on students.
Communicate with the school nurse and any concerns or report of students’ progress and give any medical reports to the school nurse.

Classroom Teacher/Specialist Responsibilities:

Classroom Teacher/Specialist will be offered the annual concussion training. The Classroom Teacher/ Specialist shall:

Follow the academic guidelines set forth in the Academic Expectations During Post Concussion Recovery Plan.
Work in conjunction with the guidance counselor to follow the recommendations and accommodations.
Communicate with guidance counselor and/or school nurse student’s progress, academic needs, and/or any issues or concerns.

Parent/Guardian Responsibilities:

The Parent/Guardian shall:

Complete the annual concussion training and provide the Athletic Director with accompanying documentation.
Complete and submit the Family ID (high school)/Google form(middle school) electronic forms online and submit the physical exam form to the school nurse.
Inform the coach or school nurse if your child sustains a concussion outside of school hours and complete the Report of Head Injury Form and give it to the coach or school nurse.
Watch for changes in your child that may indicate that your child does have a concussion or that your child’s concussion may be worsening. Report to a physician:
a. Loss of consciousness
b. Headache
c. Dizziness
d. Lethargy
e. Difficulty concentrating
f. Balance problems
g. Answering questions slowly
h. Difficulty recalling events
i. Repeating questions
j. Irritability
k. Sadness
l. Emotionality
m. Nervousness
n. Difficulty with sleeping
Encourage your child to follow concussion protocol.
Enforce restrictions on rest, electronics and screen time.
Reinforce academic accommodations and gradual return to play plan.
Communicate about your child’s progress, academic needs or concerns with their guidance counselor.
Observe and monitor your child for any physical or emotional changes.
Recognize that your child will be excluded from participation in any extracurricular athletic event if all forms are not completed and on file with the athletic department.

Student and Student Athlete Responsibilities:

Student Athletes or students participating in the Marching Band will complete the annual concussion training and provide the Athletic Director or Band Director with a certificate of completion. The Student Athlete shall:

Return to coach, athletic trainer (at high school) or school nurse the Registration/Permission/Medical Forms, Pre-participation Head Injury/Concussion Reporting forms, and annual physical form prior to participation in athletics
Recommended completion of Baseline ImPACT Test(high school) prior to participation in athletics
Report all symptoms to the coach and/or school nurse, or athletic trainer if applicable.
Follow academic accommodations and return to play recovery plan
Rest for up to the first 2 days after injury.
No athletics
Be honest
Keep strict limits on screen time and electronics for up to the first 2 days after injury.
Don’t carry books or backpacks that are too heavy
Tell your teachers and guidance counselor if you are having difficulty with your class work
See the school nurse for pain management
Return Medical Clearance Form to coach prior to beginning gradual return to play protocol or the athletic trainer at the high school level.
Return to sports only when cleared by:
- A duly licensed physician
- A duly licensed certified athletic trainer in consultation with a licensed physician
- A duly licensed nurse practitioner in consultation with a licensed physician, or
- A duly licensed neuropsychologist in coordination with the physician managing the student’s recovery.
Report any symptoms to the coach and/or school nurse and parent(s)/guardian(s) if any occur after return to play
Students who do not complete and return all required training, testing and forms will not be allowed to participate in sports.

Record Maintenance

QPS shall maintain the following record for three years or at a minimum until the student graduates:

Verifications of completion of annual trainings
Pre-participation Questionnaires
Annual physical exams
Report of Head Injury Forms
DPH Medical Clearance and Authorization Forms or equivalent; and
Graduated reentry plans for return to full academic and extracurricular activities.