LAFAYETTE SPORTS MEDICINE - CBSSports.comgrfx.cstv.com/photos/schools/lafa/sports/sports-med/auto_pdf/2015... · lafayette college sports medicine concussion protocol 1 ... supplement

LAFAYETTE SPORTS MEDICINE

LAFAYETTE COLLEGE SPORTS MEDICINE CONCUSSION PROTOCOL

1 | P a g e

CONTENTS

SECTION A. STATEMENT & PURPOSE PAGE 2

SECTION B. EDUCATION, PRESEASON, & BASELINE PAGE 2

SECTION C. INITIAL EVALUATION & CARE PAGE 3

SECTION D. FOLLOW UP & RETURN TO PLAY PAGE 4

SECTION E. RETURN TO LEARN PAGE 5

SECTION F. PROLONGED RECOVERY PAGE 5

SECTION G.

HEAD TRAUMA EXPOSURE PLAN PAGE 5

SECTION I. FORMS PAGE 6 +

SUPPLEMENT 1. NCAA CONCUSSION FACT SHEET PAGE 6

SUPPLEMENT 2. FACT SHEET ACKNOWLEDGEMENT PAGE 7

SUPPLEMENT 3. SIDELINE CONCUSSION ASSESSMENT TOOL PAGE 8

SUPPLEMENT 4 KING-DEVICK SCORE SHEET PAGE 9

SUPPLEMENT 5. CONCUSSION MANAGEMENT PLAN FORM PAGE 10

SUPPLEMENT 6. CONCUSSION PROCESS FLOW CHART PAGE 11

SUPPLEMENT 7. CERVICAL SPINE INJURY PROTOCOL PAGE 12

SUPPLEMENT 8. HEAD INJURY INFO TAKE HOME SHEET PAGE 17

SUPPLEMENT 9. ATHLETIC FACILITY EMERGENCY ACTION PLANS PAGE 18

SUPPLEMENT 10. CERTIFICATE OF COMPLIANCE PAGE 26


2 | P a g e

SECTION A.

Policy Statement

This document outlines guidelines to aid in the management of concussions and the safe return-to-play

for athletes at Lafayette College. This is a multifaceted approach to concussion management. The information

included in this protocol and the tools referenced are to be taken into consideration on an individual case-by

case basis. Modifications may be implemented as deemed appropriate by Lafayette College sports medicine

staff.

Purpose To develop a concussion management procedure in accordance with NCAA bylaw 3.2.4.17 (Concussion

Management Plan) that creates a consistent and objective method for the recognition, evaluation, and

management of student-athletes who have sustained a concussion, in keeping with the National Athletic

Trainers’ Association Position Statement on Management of Sport-Related Concussion (Journal of Athletic

Training 2004;39(3): 280-297.) Specifically, to:

a. Ensure proper diagnosis and management of concussions;

b. Monitor student-athletes’ recovery;

c. Prevent short and long term consequences of concussive injury.

SECTION B.

Concussion Education Plan

Concussion education will be provided annually to educate what a concussion is, how it can be

prevented, and what signs and symptoms are consistent of a concussion. Coaches, team physicians, athletic

trainers, and directors of athletics will be provided the NCAA’s Concussion Fact Sheet (See Supplement 1)

and/or applicable educational information on concussion. After reviewing the material provided, individuals

will sign a form of acknowledgement (See Supplement 2). It is required that every varsity athlete completes

annual Concussion Management Education, including signed documentation.

Pre-Participation Exam and Baseline Testing Every varsity athlete is required to have a pre-participation exam by a physician or mid-level provider

through the Bailey Health Center. The provider will review the medical history with the student-athlete and

conduct an exam. Risk factors/modifiers for concussion, including previous concussions, migraine headaches,

ADHD, depression/anxiety will be noted on the medical history form. Additional consultation and testing is at

the discretion of the team physician to determine pre-participation clearance.

Every first year (or transfer) student-athlete that participates in a sport will receive baseline assessment

for concussion by the staff athletic trainers prior to their initial pre-participation exam at Bailey Health Center

and prior to the start of their respective sport:

1.) Computerized neurocognitive exam – ImPACT testing

2.) Modified SCAT2 with Balance Error Scoring System (BESS)

3.) King-Devick Test (K-D)

(See Supplement 3 & 4).


3 | P a g e

Results and documentation regarding the completion of the above baseline exams are stored and tracked

by the athletic trainers.

Every varsity athlete will complete the Concussion Management Plan form during annual pre-

participation screenings (See Supplement 5).

(See Supplement 6 for the Flow Chart diagraming the concussion process.)

SECTION C.

Initial Evaluation and Care The initial assessment will include an evaluation for cervical spine injury, level of consciousness, skull

fracture, and intracranial bleed. A student-athlete with significant altered mental status, suspected spine injury

suspected skull fracture, or suspected intracranial bleed will be immobilized and transported to St. Luke’s

Trauma Center, Bethlehem, PA. (See Supplement 7 for Cervical Spine Injury Protocol).

Any student-athletes who exhibit signs, symptoms, or behaviors consistent with a concussion shall be

removed from practice/competition immediately and evaluated by a staff athletic trainer. Sideline evaluation

consists of SCAT2, BESS, and King-Devick testing.

Any student-athlete diagnosed with a concussion shall be excluded from all athletic activity for the

remainder of that day. If no staff athletic trainer is present (i.e. away competitions) host site medical personnel

should be contacted for evaluation. Coaches should contact their Lafayette Staff Athletic Trainer to alert them

to the student-athlete’s condition and facilitate follow-up with team physicians.

Symptomatic student-athletes should be given a “Head Injury Info Take Home Sheet” and be monitored

by a responsible party (See Supplement 8). Symptomatic student-athletes should also be verbally informed of

concerning signs and symptoms, and the interaction of drugs and alcohol.

In the event where symptoms worsen significantly, where as any of the following occur, Public Safety

should be contacted immediately at extension 4444 from an on campus landline, or dial 911 when off campus.

(See Supplement 9 for concise On Campus Emergency Action Plans. Full descriptions of

Athletics’ Emergency Action Plans are found in each of the three athletic training facilities).

Vomiting more than twice

Severe headache that won’t ease up or go away, even after a dose of acetaminophen (Tylenol)

Confusion

Restlessness or irritability

Pupils of different sizes

Convulsions or seizures

Trouble using arms or legs

Temperature above 100.5 F, with or without stiffness of the neck

Garbled speech

Bleeding from the nose or ears

Unusual sleepiness or decreasing alertness


4 | P a g e

SECTION D.

Follow Up & Return to Play The follow up and return to play protocol is as follows.

1. Every student-athlete that has sustained a concussion or concussive symptoms must be re-evaluated by a

healthcare professional within 24 hours. The symptom checklist must be documented.

2. Every student-athlete that has sustained a concussion or concussive symptoms must be evaluated by the

Team Physician or designee at Bailey Health Center within 48 hours. Said healthcare professional must

communicate patient symptom presentation to the Team Physician in the event of falling outside

physician availability.

3. The student-athlete can begin neurological testing for return to play (SCAT2, ImPACT, K-D) no sooner

than 24 hours asymptomatic. A follow-up appointment with the physician at Bailey Health Center is to

be made.

4. A follow up appointment with the team physician is to occur no less than once a week for the duration of

the symptoms. During these appointments, best management options and additional diagnoses for

prolonged recovery will be considered to treat post-concussion syndrome, sleep dysfunction, headache

disorders, behavioral disorders, ocular/vestibular issues, as well as others.

5. The Team Physician must clear the student-athlete to begin return to play progressions.

6. A graduated exertional testing requires:

Phase 1: Low Exertion: Twenty minutes of stationary exercise bike with heart rate less than 70%

of max; followed by cool down. (Heart rate is calculated as 220 minus Age, times .70)

Phase 2: High Exertion: Twenty minutes of running. Heart rate is greater than 70% of max;

followed by cool down.

Phase 3: High Exertion: Squats, push-ups, sit-ups, sprinting and resistance training. No contact.

Phase 4: Sport Specific Drills / Non-Contact Practice

Phase 5: Full participation practice with contact following at competition tempo. The

supervising healthcare provider can determine content of this activity in the event of

not having a full team activity.

The phases are not to be performed all on the same day, and no more than two steps complete on

any given day. If at any point during the process the athlete becomes symptomatic, no further activity is

allowed and the athlete will be re-evaluated.

Final return to play decisions will be made solely by the Lafayette College Team Physician in

conjunction with the Sports Medicine staff, based upon the individual athlete and his/her rate of

recovery. The steps in this functional progression may be modified as needed by the Team Physician on

a case-by-case position.

.


5 | P a g e

SECTION E.

Return-to-learn The athlete is encouraged to limit cognitive activities during the period of recovery. Coordination of

cognitive recovery and return-to-learn will be administered by the Lafayette College Team Physician.

Professors will be notified by the Dean of the College, via the Lafayette College Team Physician, that a student

has been diagnosed with a concussion and may require additional time to complete assignments.

Within the return-to-learn process, the Lafayette College Team Physician’s role is defined, but not

limited to:

1. Restriction of academic activity the same day as the injury.

2. Managing a multi-disciplinary team that includes Lafayette Sports Medicine staff,

psychologist/counselor(s), sports psychologists, neuropsychologists, vestibular/ocular therapists, faculty-

athletic representatives, academic advisors, instructors, administrators, Disability Services, coaches and

other additional resources, for a duration at the Lafayette College Team Physician’s discretion.

3. Compliance with the ADA Amendments Act of 2008.

4. Individualizing a patient-centered plan for activities of daily living, including off-campus

accommodations for a duration, at the Lafayette College Team Physician’s discretion.

5. Scheduling regular appointments for follow-up throughout return-to-learn process to monitor symptoms

with academic challenges.

SECTION F.

Prolonged Recovery Student-Athletes with prolonged recovery will be managed by the Lafayette College Team Physician in

order to consider additional diagnosis and other best management options. Student-Athletes not progressing

within a normal and ordinary timeframe or individuals struggling with progressions beyond two weeks post-

injury will be referred for additional treatment.

Referral options are dependent on symptoms and patient history. Referral options include, but are not

limited to: Good Shepherd Rehabilitation Hospital, Lafayette Counseling Services, Mind of the Athlete,

behavioral specialists, and neuro-specialists.

SECTION G.

Head Trauma Exposure Management Plan Reducing exposure begins through the education of all participants in athletics, including coaches,

athletic staff and medical staff, and appropriate into practice. Head trauma exposure is twofold; interactive

annual educational sessions, and symptom development and recognition.

Through annual teaching sessions, concussion etiology and strategies to minimize risk exposure are to

be discussed. This includes risk exposure and development of topics such as ‘head’s up’ tackling and pre-

planning for less contact practices.

Annual education will also include symptom and injury education with awareness to prevent further

injury / secondary concussion syndrome.

All medical personnel are responsible for presenting new evidence-based concussion data and its

practical application to the setting.


6 | P a g e

SECTION I.

Forms

Supplement 1. NCAA CONCUSSION FACT SHEET


7 | P a g e

Supplement 2.


8 | P a g e

Supplement 3.


9 | P a g e

Supplement 4.


10 | P a g e

Supplement 5.

Name ________________________________________ Date________________________

A concussion or Mild Traumatic Brain Injury (MTBI) is defined as a blow, impact, collision, or any trauma

causing disruption in cerebral function or alteration in mental status.

Student athletes are responsible for reporting their injuries and illnesses to the medical staff; including signs and

symptoms of concussions (MTBI’s). Signs and symptoms include, but are not limited to:

Vomiting Sensitivity to light Sadness

Imbalance Sensitivity to noise Fatigue

Dizziness Numbness/tingling Difficulty remembering

Nervousness Headache Difficulty concentrating

Nausea Drowsiness Loss of consciousness

Signs and symptoms must be reported to the Lafayette College Sports Medicine staff immediately upon onset,

before the continuation of any activity. Return to any activity will be determined by the Lafayette College Sports

Medicine staff after proper evaluation.

This is to certify that I have carefully read, fully understand, and that I am aware of the signs/ symptoms of

concussions. I have received education on the signs/symptoms associated with concussions. I acknowledge that

all signs and symptoms of concussions must be reported to the Lafayette College Sports Medicine staff

immediately upon onset.

Student-Athlete’s Signature Date

Parent or Guardian’s Signature Date (Parent Signature is required if Athlete is under 18 Years of Age)


11 | P a g e

Supplement 6.

Lafayette Sports Medicine Concussion Flow-Chart

1. Baseline Testing

-SCAT2, modified BESS, King Devick -Impact

-Concussion Management Form signed

2. Sideline Evaluation -Pocket SCAT 2

-Symptom Checklist (y/n) -Take home signed head injury info form

3. Follow Up Within 24 hours

-Verbal F/U with ATC within 6-12 hours

-F/U in person for re-eval with Dr. Goldstein, if possible

-F/U with ATC 24 hours if unable to see Dr. Goldstein

- Symptom checklist

4. Follow Up 24-48 hours asymptomatic

-SCAT 2, modified BESS, King-Devick

-Impact

-Make appointment with Dr. Goldstein

5. Return to Play

- Must be cleared by Dr. Goldstein to initiate the RTP protocol.

6. Return to Learn

- Recommendations for RTL will be provided at the discretion of

Dr. Goldstein


12 | P a g e

Supplement 7.


13 | P a g e

Supplement 7. Continued…


14 | P a g e



15 | P a g e



16 | P a g e



17 | P a g e

Supplement 8. HEAD INJURY INFORMATION

TAKE HOME SHEET

*PLEASE GIVE THIS SHEET TO THE ADULT WHO WILL BE STAYING WITH YOU You have just suffered a head injury that has resulted in a concussion. You may return to your home under supervision of a responsible adult because it appears at this time that your concussion has stabilized. It is possible that your head injury may become progressively worse in the next 24 hours. There are several danger signals that indicate your concussion needs IMMEDIATE medical attention. These signals include the following:

-Vomiting more than twice -Severe headache that won’t ease up or go away, even after a dose of acetaminophen (Tylenol) -Confusion -Restlessness or irritability -Pupils of different sizes -Convulsions or seizures -Trouble using arms or legs -Temperature above 100.5 F, with or without stiffness of the neck -Garbled speech -Bleeding from the nose or ears -Unusual sleepiness or decreasing alertness

If ANY of these signals occur, the responsible adult who is monitoring you must contact public safety IMMEDIATELY at

x4444 and tell them you need an ambulance. They will transport you to Easton hospital, and security will contact Dr.

Goldstein.

In the next twenty hour hours, you must:

1) Take ONLY acetaminophen (Tylenol) as directed on the bottle for pain with food; do not overdose or

take ANY other medication unless directed to do so by a physician

2) Call the health center to set up an appointment with Dr. Goldstein within 48 hours of sustaining the

concussion. Dr. Goldstein will have final clearance on return to play.

3) Rest as much as possible both cognitively and physically. Avoid texting, video games, bright lights,

reading a computer screen, and activity to raise your blood pressure.

4) Do not consume any alcohol, tobacco, or caffeine.

REMEMBER, WHEN IN DOUBT, IT IS BETTER TO BE SAFE THAN SORRY!! HAVE ANY UNUSAL SIGNALS CHECKED OUT

IMMEDIATELY BY A DOCTOR!!

____________________________________ ___________ SIGNATURE OF ATHLETE DATE _____________________________________ ___________ SIGNATURE OF MEDICAL PERSONNEL DATE NAME OF PERSON WHO WILL BE WATCHING YOU _________________________


18 | P a g e

Supplement 9.

Emergency Call & Transportation Procedure:

A.P KIRBY SPORTS CENTER 700 W. Pierce St., Easton, PA 18042

IF YOU NEED AN AMBULANCE:

1. Call Public Safety in case of an emergency at 610-330-4444.

Identify yourself and your location

YOUR LOCATION IS THE A.P. KIRBY SPORTS CENTER AT LAFAYETTE

COLLEGE

Request an ambulance

Describe the nature of the injury. BE AS SPECIFIC AS POSSIBLE, including what is

being done, who is with the person, etc.

Inform the Dispatcher a designated individual will meet the ambulance at the Pierce Street

Doors.

WAIT FOR THE OTHER PERSON TO HANG UP FIRST.

2. Public Safety will dispatch the ambulance and help with scene control.

3. Have someone wait for the ambulance at the Pierce St. front doors; then lead them to the injured

individual.

4. Call a staff Athletic Trainer ASAP.

EMERGENCY PHONE NUMBERS

PUBLIC SAFETY 610-330-4444

Non-emergency 610-330-5330

Bailey Health Center 610-330-5001

Kirby Training Room 610-330-5491

Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692

Tiffany Nish (c) 484-357-6796

Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158

Nicole Perdue (c) 720-231-4736

Hali Aussems (c) 973-255-0578

Dr. Jeff Goldstein (w) 610-330-5001

If you call an Ambulance and/or Dr. Goldstein for any reason, you must call a staff athletic trainer immediately.

Easton Ambulance __ 911 Easton Emergency Room 610-250-4002 St. Luke’s (Fountain Hill) Emergency Room 484-526-4000


19 | P a g e



BOURGER VARSITY HOUSE 826 W. Pierce Street, Easton, PA 18042


1. Call Public Safety in case of an emergency at 610-330-4444


YOUR LOCATION IS THE BOURGER VARSITY HOUSE ON LAFAYETTE

COLLEGE CAMPUS




Inform the Dispatcher you will meet the ambulance at the bottom of the Pierce Street

driveway into Fisher Stadium.



3. Have someone wait for the ambulance at the bottom of the Pierce St. driveway; then lead them to the injured

individual.







Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692


Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158







20 | P a g e



FISHER FIELD & KIRCHHOFF FIELD AT FISHER STADIUM 826 W. Pierce Street, Easton, PA 18042




YOUR LOCATION IS FISHER FIELD AT FISHER STADIUM ON LAFAYETTE

COLLEGE CAMPUS




Inform the Dispatcher you will meet the ambulance at the bottom of the Pierce Street

driveway into Fisher Stadium.



3. Have someone wait for the ambulance at the bottom of the Pierce St. driveway; then lead them to the injured

individual.


EMERGENCY PHONE NUMBERS PUBLIC SAFETY 610-330-4444




Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692


Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158







21 | P a g e



KAMINE GYMNASIUM 700 W. Pierce St., Easton, PA 18042




YOUR LOCATION IS THE KAMINE GYMNASIUM AT LAFAYETTE COLLEGE




Inform the Dispatcher a designated individual will meet the ambulance at the Hamilton

Street Doors (Door #255).



3. Have someone wait for the ambulance at the Hamilton St. side doors; then lead them to the injured

individual.


EMERGENCY PHONE NUMBERS PUBLIC SAFETY 610-330-4444




Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692


Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158







22 | P a g e



MAROON CLUB WEIGHT ROOM 826 W. Pierce Street, Easton, PA 18042




YOUR LOCATION IS THE MAROON CLUB STRENGTH CENTER ON LAFAYETTE

COLLEGE CAMPUS




Inform the Dispatcher someone will meet the ambulance at the Pierce Street driveway into

Fisher Stadium.



3. Have someone wait for the ambulance at the bottom of Pierce St. driveway; then lead them to the injured

individual.







Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692


Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158







23 | P a g e



METZGAR FIELDS COMPLEX 3416 Sullivan Trail, Easton, PA 18040


1. Call 911 in case of an emergency


YOUR LOCATION IS THE METZGAR FIELDS COMPLEX, LAFAYETTE COLLEGE;

SPECIFY YOUR FIELD.




Inform the Dispatcher you will meet the ambulance in the parking lot.


2. Call Public Safety at 610-330-4444 for help with scene control- tell them an ambulance has already been

called.

3. Have someone wait for the ambulance at the gate KNOW THE CURRENT GATE CODE; then lead them

to the injured individual.







Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692


Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158







24 | P a g e


Emergency Call & Transportation Procedure: SULLIVAN TENNIS COURTS

730 Sullivan Road, Easton, PA 18042




YOUR LOCATION IS THE SULLIVAN TENNIS COURTS ON LAFAYETTE

COLLEGE CAMPUS




Inform the Dispatcher you will meet the ambulance at the driveway entrance on Sullivan

Road.



3. Have someone wait for the ambulance at the driveway entrance to tennis courts; then lead them to the

injured individual.







Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692


Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158





Easton Ambulance __ 911 Easton Emergency Room 610-250-4002


25 | P a g e



WEINSTEIN NATATORIUM 700 W. Pierce St, Easton, PA 18042




YOUR LOCATION IS THE WEINSTEIN NATATORIUM IN A.P. KIRBY SPORTS

CENTER AT LAFAYETTE COLLEGE




Inform the Dispatcher a designated individual will meet the ambulance at the Hamilton St.

entrance to the pool.



3. Have someone wait for the ambulance at the Hamilton St. entrance to the pool; then lead them to the

injured individual.







Matt Bayly (w) 610-330-5766

Dawn Comp (c) 610-248-6692


Matt Frantz (c) 484-357-6797

Jon Edwards (c) 518-578-4158







26 | P a g e

Supplement 10.

Documents

LAFAYETTE SPORTS MEDICINE - CBSSports.comgrfx.cstv.com/photos/schools/lafa/sports/sports-med/auto_pdf/2015... · lafayette college sports medicine concussion protocol 1 ... supplement