Background
Grasslands School Division recognizes the importance of the health, safety and overall well-being of its students and is committed to taking steps to reduce the risk of injury. Research demonstrates that a concussion can have a significant impact on a student – cognitively, physically, emotionally, and socially. In fact, research shows that activities that require concentration can cause a student's concussion symptoms to reappear or worsen. Without identification and proper management, a concussion can result in permanent brain damage and in rare occasions, even death. Research also suggests that a child or youth who suffers a second concussion before he or she is symptom-free from the first concussion is susceptible to a prolonged period of recovery, and possibly Second Impact Syndrome – a rare condition that causes rapid and severe brain swelling with often catastrophic results. It is equally important to help students as they "Return to Learn" in the classroom as it is to help them "Return to Physical Activity".
Grasslands School Division recognizes children and adolescents are among those at greatest risk for concussions and that while there is potential for a concussion any time there is body trauma, the risk is greatest during activities where collisions can occur, such as during physical education classes, playground time, school-based sports activities, or field trips. Educators and school staff play a crucial role in the identification of a suspected concussion as well as the ongoing monitoring and management of a student with a concussion. Awareness of the signs and symptoms of concussion and knowledge of how to properly manage a diagnosed concussion is critical in a student's recovery and is essential in helping to prevent the student from returning to learning or physical activities too soon and risking further complications. Ultimately, the awareness and knowledge could help contribute to the student's long-term health and academic success.
These procedures which are based on current research evidence and knowledge contain information on concussion prevention, symptoms and signs or a concussion, response procedures for a suspected concussion, and management procedures for a diagnosed concussion, including a plan to help a student return to learning and to physical activity.
Definition
A concussion:
- Is a brain injury that causes changes in how the brain functions, leading to symptoms that can be physical (e.g. headache, dizziness), cognitive (e.g. difficulty concentrating or remembering), emotional/behavioural (e.g. depression, irritability) and/or related to sleep (e.g. drowsiness, difficulty falling asleep);
- May be caused either by a direct blow to the head, face or neck, or a blow to the body that transmits a force to the head that causes the brain to move rapidly within the skull;
- Can occur even if there has been no loss of consciousness (in fact most concussions occur without a loss of consciousness); and
- Cannot normally be seen on x-rays, standard CT scans or MRIs.
Procedures
- The Division will convey the seriousness of concussions to staff, students, parents/guardians, and other stakeholders.
- Prevention will be at the fore of concussion awareness.
- Schools must ensure that they follow the Safety Guidelines for Physical Activities in Alberta Schools as well as the ASBIE Off-Site Guidelines and Procedures Manual
- Teachers and coaches are expected to work with students to follow safety guidelines to reduce the risk of serious injury, including concussions.
- Staff, students, parents, coaches, and volunteers should familiarize themselves with the information in Appendices 2 through 10, as appropriate. Coaches and school personnel who are in contact with students who participate in activities that may have athletic injuries including concussions are required to complete the free concussion courser at Coaching Association of Canada – Making Headway Concussion eLearning Series. A copy of the certificate of completion must be supplied to the Administrator.
- Supervision must be provided in any activity that has a risk of concussions to provide vigilant oversight of the activity.
- It is the responsibility of the coaches, officials, parents/guardians, and student athletes to adhere to the minimum required standards for safety equipment.
- Medical Information Forms must be completed for all students participating in school sports/athletic programs. (Appendix 1)
- If an employee or coach has reason to believe that a student is exhibiting signs and symptoms of a concussion, the employee must remove the student from the activity immediately. Please refer to Appendix 3 – Concussion Recognition Tool.
- Concussions can only be diagnosed by a medical doctor or a nurse practitioner. Since a medical doctor or nurse practitioners are the only health professionals able to diagnose concussions, educators, school staff or volunteers cannot make the diagnosis of concussion. In the best interest of the child, it is critical that a medical doctor or a nurse practitioner examine a student with a suspected concussion.
- To return to a sport or activity after a concussion, the student must be re-examined by a medical doctor. The athlete will not be permitted to return until he or she has received written medical clearance from a doctor. After permission has been granted to return to a sport or activity, the Return to Sport Guidelines must be followed. (Appendix 2 and 2a)
Responsibilities
The Superintendent or designate will:
- Perform a regular review of the Administrative Procedure for Concussion to ensure guidelines align with current best practice recommendations.
- Share concussion prevention, identification, and management information with school administration.
The Principal will:
- Abide by the Administrative Procedure for Identification and Management of Concussions;
- Ensure staff, volunteers, parents/guardians, and students are aware of the Administrative Procedure for Identification and Management of Concussions;
- Ensure the Administrative Procedure for Identification and Management of Concussions is followed by all school staff (including occasional staff/support staff), parents/guardians, students and volunteers;
- Facilitate attendance and/or completion of concussion training for staff and coaching volunteers as required, and repeat as necessary;
- Ensure that the Safety Guidelines for Physical Activity in Alberta Schools are followed.
- Oversee that the Medical Information Form is distributed to all parents/guardians, collected by the school and remind all staff the form must be completed prior to student participation in school sports/athletic programs;
- Ensure that all incidents are recorded, reported and filed as appropriate to the Associate Superintendent, Business Services;
- Ensure that a Return to Learn/Return to Sport plan is developed for a student with a confirmed concussion;
- Alert appropriate staff about students with a suspected or diagnosed concussion;
- Work as closely as possible with students, parents/guardians, staff, volunteers and health professionals to support concussed students with their recovery and academic success;
- For students who are experiencing difficulty in their learning environment as a result of a concussion, coordinate the development of a plan and approve any adjustments to the student's schedule as required; and
- Attempt to obtain parental/guardian cooperation in reporting all non-school related concussions.
The School Staff (includes administration staff, teaching staff, support staff, coaches, volunteers) will:
- Understand and follow the Administrative Procedure for Identification and Management of Concussions;
- Complete concussion training, as required;
- Prior to student's participation is school intramural or interschool athletics ensure the Medical Information Form has been completed (Appendix 1);
- Ensure that the Safety Guidelines for Physical Activity in Alberta Schools are followed and implement risk management and injury prevention strategies specific to each sport/activity;
- Provide concussion educational materials to students and athletes;
- Be able to recognize signs, symptoms and respond appropriately in the event of a suspected concussion;
- Be familiar with the resources:
- Concussion Recognition Tool (Appendix 3)
- Concussion Guidelines for Teachers (Appendix 5)
- Concussion Guidelines for Coaches (Appendix 6)
- Safety Guidelines for Physical Activity (Appendix 8)
- Be able to use the Concussion Recognition Tool;
- When a student concussion is diagnosed, work with the Principal and parents/guardians to develop a return to learn/return to sport plan; and
- Provide the following resources to parents and students as educational and treatment information as required:
- Concussion Recognition Tool (Appendix 3)
- Concussion Guidelines for Athletes (Appendix 4)
- Concussion Guidelines for Parents (Appendix 7)
Parents/Guardians will:
- Reinforce concussion prevention strategies with their child (e.g. following rules of fair play, playground safety rules, wearing properly fitting helmets, using equipment safely);
- Understand and follow parent/guardian roles and responsibilities in the Administrative Procedure for Identification and Management of Concussions;
- In the event of a suspected concussion, ensure child is assessed as soon as possible by a medical doctor/nurse practitioner;
- Be responsible for completion of all required documentation;
- Collaborate with school staff to manage suspected or diagnosed concussions appropriately and support their child's progress through the Return to Learn/Return to Sport Plan (Appendix 2 an 2a);
- Follow medical doctor/nurse practitioner recommendations to promote recovery;
- Report non-school related concussions to the principal
Students will:
- Learn about concussions, including prevention strategies, signs and symptoms, concussion management and student roles and responsibilities, through applicable curriculum and safety lessons connected to personal safety and injury prevention;
- Immediately inform school staff of suspected or diagnosed concussions occurring during or outside of school;
- Inform school staff if they experience any concussion related symptoms (immediate, delayed or reoccurring);
- Remain on school premises until parent/guardian arrives if concussion is suspected;
- Follow concussion management strategies as per medical doctor/nurse practitioner direction and the Return to Learn/Return to Sport plan (Appendix 2 and 2a); and
- Communicate concerns and challenges during the recovery with school staff, parents/guardians, and health care providers.
Appendices/Links
1 – Medical Information Form
2 – Return to Learn/Return to Sport Plan Summary
2a. Return to Sport Strategy Tool
3 – Concussion Recognition Tool
4 – Concussion Guidelines for the Athlete
5 – Concussion Guidelines for Teachers
6 – Concussion Guidelines for Coaches
7 – Concussion Guidelines for Parents and Caregivers
8 - Safety Guidelines for Physical Activity
9 – Parachute – Canadian Guideline on Concussion in Sport
10 – CATT – Concussion Awareness Training Tool
Appendix 1
Medical Information Form — School Sports/Athletics
| Field | |
|---|---|
| Student's Name: | |
| Home Address: | |
| Parent/Guardian Names: | |
| Home Phone #: | |
| Cell Phone #1: | |
| Physician Name: | |
| Physician Phone #: | |
| Health Card # (optional): | |
| Emergency Contact Name: | |
| Emergency Contact Phone #: |
NOTE: An annual medical examination is recommended.
MEDICAL INFORMATION
Date of last complete examination: _________________________________________________________________
Date of last tetanus immunization: _________________________________________________________________
Is your son/daughter/ward allergic to any drugs, food or medication/other? YES NO
Does your son/daughter/ward wear a medical alert bracelet, neck chain, or carry a medical alert card? YES NO
- If yes, provide details. ___________________________________________________________________________
Has your son/daughter/ward been identified as being anaphylactic? YES NO
If yes, does he/she carry an EpiPen? YES NO
Does your son/daughter/ward take any prescription drugs? YES NO
- If yes, provide details ____________________________________________________________________________
- What medication(s) should the participant (son/daughter/ward) have available during the sport activity? ________________________________________________________________________________
- Who should administer the medication? _______________________________________________________
Does your son/daughter/ward wear eyeglasses? YES NO
- Orthodontic appliances? YES / NO Crowns YES / NO Bridges? YES / NO
Please indicate if your son/daughter/ward has been subject to any of the following and provide pertinent details:
- Epilepsy, diabetes, orthopaedic problems, hearing loss, asthma, allergies, heart disorder
- Head or back conditions or injuries
- Diagnosed concussion (in the past three years)
- Arthritis or rheumatism, chronic nosebleeds, dizziness, fainting, headaches, dislocated shoulder, hernia, swollen or hyper mobile or painful joints, trick or lock knee, etc.
Please indicate any other medical condition that will limit participation or require modification to the activity program:
NOTE:
If a concussion has been diagnosed over the summer break, the student must have written medical clearance from a physician before the student returns to school sports/athletic activities.
_________________________ _________________________
(Printed name of parent/guardian) (Parent/guardian signature)
_________________________
(Date)
Appendix 2
Summary of Plan for Return to Learn/Return to Sport Strategy
- The Return to Learn / Return to Sport Plan is a collaborative effort between home and school to support the student's progress through the plan following a diagnosed concussion. The 6 Step Plan is necessary and identifies the sequence of supporting return to normal learning and physical activity.
- A minimum of 24 hours is necessary for EACH step.
- Please contact the school if you have any questions about the following.
SUMMARY OF STEPS
Return to Learn/Return to Physical Activity – Step 1
- Completed at home; student requires cognitive and physical rest
- If symptom free, student may go directly to Return to Learn Step 2b and Return to Physical Activity Step 2
Return to Learn – Step 2a
- Symptoms improving
- Return to school with monitored re-integration to classroom and cognitive effort; and Physical Rest
Return to Learn – Step 2b
Note: Return to Learn Step 2b and Return to Physical Activity Step 2 may occur concurrently
- Symptom free
- Return to regular school routine and learning activities
Return to Physical Activity – Step 2
- A doctor's note is required to start STEP 2 – Return to Physical Activity
- Light aerobic physical activity and regular learning activities
Return to Physical Activity – Step 3
- Begin sport specific type of physical activities
Return to Physical Activity – Step 4
- Greater range of physical activity options permitted, but no body contact
Return to Physical Activity – Step 5
- Full participation in all non-contact type physical activities, and return to training in contact sports
Return to Physical Activity – Step 6
- Full participation, no restrictions
BUT
If after Return to Learn Step 2a, concussion symptoms return, the student will return to the designated step as directed by the physician – this may include return to step 1.