University Concussion Policy
Policy Number: #700
Responsible Executive(s):
- Student Affairs Vice President
Responsible Office(s):
- Athletics
Date Revised: 12-01-2020
A. Purpose
B. Scope
C. The Policy
1. What is a Concussion?
- A concussion is a complex patho-physiologic process affecting the brain, induced by traumatic biomechanical forces secondary to direct or indirect forces to the head. A concussion is caused by a blow or jolt to the head that disrupts the function of the brain. A concussion results in a wide range of physical, cognitive, emotional and/or sleep related symptoms. Symptoms include but are not limited to: headache, nausea, sensitivity to light/noise, fatigue, drowsiness, irritability, and feeling slowed down and/or foggy. Duration of symptoms is highly variable and may last from several minutes to days, weeks, months, or even longer in some cases.
- Second Impact Syndrome (SIS) occurs when an athlete, who has already sustained a head injury, sustains a second head injury prior to complete resolution of symptoms. This often occurs because a person has returned to participation too soon. Most persons do not realize that it may take days and weeks for concussion symptoms to resolve. Second Impact Syndrome most likely affects young athletes (Junior High, High School, and College), however, any athlete who returns to play too soon is a possible candidate. Second Impact Syndrome is a very serious condition that has been linked to permanent brain damage or even death.
3. What is Neurocognitive Testing?
- Given these outlined concerns and inherent difficulties in managing concussion, individualized and comprehensive management of concussion is optimal. At the forefront of proper concussion management is the implementation of baseline and/or post-injury neurocognitive testing. Such evaluation can help to objectively evaluate the concussed athlete’s post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion. In fact, neurocognitive testing has recently been called the “cornerstone” of proper concussion management by an international panel of sports medicine experts.
- The Sport Concussion Assessment Tool 5 (SCAT5) and Balance Error Scoring System (BESS) are standardized tools for evaluating injured athletes for concussion and can be used in athletes aged from 13 years and older. SCAT5 supersedes the original SCAT and the SCAT2 published in 2005 and 2009, respectively. The SCAT5 is a screening evaluation tool designed for use only by qualified first responders or medical professionals. The SCAT5 score does not independently determine the diagnosis of a concussion, nor does it independently determine the injured athlete’s recovery or return to play status. Such determination can only be made by a medical professional who has experience in the treatment of sport concussion.
- In order to provide Regis University Student-Athletes the best possible care and prevention of multiple concussions and second impact syndrome, all Regis University Student-Athletes will undergo pre-season baseline testing. These baseline scores will be saved in an on-line database only accessible to the Regis Sports Medicine Staff. If an athlete sustains a concussion we will administer a post-concussion follow-up test. These scores will be compared to their baseline scores and/or the national average for their respective sport. A return to play plan will then be determined by the Regis Sports Medicine Staff.
- Regis University shall ensure that medical personnel with training in diagnosis, treatment and management of concussion are present at all Contact Sports games and practices. If an athletic trainer suspects a possible head injury the athletic trainer will remove the athlete from activity for further evaluation. If a coach or athletic administrator remotely suspects a possible head injury the athlete is to be removed from activity and must see a Regis athletic trainer prior to returning to any athletic activity. Coaches and athletic administrators must report any suspected concussions to the Regis Sports Medicine staff. This will include a neurological and motor function assessment. The Athletic Trainer will then decide, based on present symptoms and their assessment, if the student athlete needs immediate referral to the ER. If no immediate referral is necessary the student athlete will be sent home with care instructions to be given to the student-athlete and followed by a roommate if possible. The athlete will follow up with a team physician in the athletic training room or in the physician’s office.
- Home care instructions will include the following list of signs and symptoms. An athlete should be taken to the emergency room if any of the following signs or symptoms are severe or worsening:
- Signs (Things Others See)
- Appears to be dazed or stunned
- Confused about assignment
- Unable to remember plays
- Unsure of game, score, opponent
- Slow to answer questions
- Moves clumsily
- Loses consciousness
- Vomiting
- Show behavior or personality change
- Can’t recall events before the impact
- Can’t recall events after the impact
- Symptoms (Things You Feel)
- Headache
- Nausea
- Dizziness or balance problems
- Double or fuzzy vision or any other visual alteration
- Sensitivity to light and/or noise
- Feeling sluggish or slow
- Feeling “foggy” or groggy
- Concentration or memory problems, confusion
- Extreme fatigue
- Signs (Things Others See)
- The student athlete will check in with the athletic training staff daily to fill out a symptom score checklist (appendix A) as well as post-injury SCAT5 and BESS. If the athlete’s post injury score is similar to the baseline score and/or national average, they can begin the return to play progression once clearance is provided by a physician. If the athlete’s post injury score shows a deficit, they will follow up with the team physician for further evaluation. An athlete who has been diagnosed with a concussion will be prohibited from returning to play or participating in any practice or game on the same day on which s/he sustained such concussion.
5. What is the return to play protocol after a student athlete has been diagnosed with a concussion?
- The return to play progression is a multi-step process. It will begin once the athlete is symptom free for 24 hours and has an adequate score on a post injury SCAT5 test as compared to the baseline. Completing one step and moving on to the next is contingent upon finishing the prior day’s activity with no return of symptoms.
- Day 1: 30 minute bike workout
- Day 2: 30 minute running/cardio workout
- Day 3: Return to non-contact sport specific activities
- Day 4: Return to contact activities
6. Education
- Regis University will provide concussion education and training approved by the NCAA to all Regis University Student-Athletes, coaches and athletic trainers before every season. At the beginning of each academic year, Regis University will provide NCAA education materials to faculty regarding academic accommodations that may be advisable to accommodate NCAA Student-Athletes who have sustained concussions.
7. Reporting
- Regis University will report to the NCAA instances of diagnosed concussions in NCAA Student-Athletes and the concussion resolution.
D. Definitions
E. Related Policies, Procedures, Forms and Other Resources (Optional)
1. Appendix A
- Concussion Symptom Score Checklist
F. End Notes
- References
- Cantu, R.C. (1996). Head injuries in sport. British Journal of Sports Medicine, 30, 289-296. Guskiewicz, K.M. et al. (2004). National athletic trainers’ association position statement: management of sports related concussion. Journal of Athletic Training, 39, (3): 280-297 NATA Position Statements: https://www.nata.org/position-statements
- NCAA – Concussions in Sports https://www.ncaa.org/sport-science-institute/concussion
Appendix A