Mission CISD

Concussion Management Protocol Manual

NOTE: The Mission CISD Concussion Management Protocol Manual will be updated by the MCISD Concussion Oversight Team on a minimum yearly basis or as Texas State Legislation requires maintenance of HB 2038. Revised May 2017

Mission CISD High School sports include baseball, basketball, cross country, football, golf, powerlifting, soccer, softball, swimming & diving, tennis, track & field, volleyball, and wrestling. Junior high (7th & 8th) sports include baseball, basketball, cross country, football, golf, soccer, softball, swimming & diving, tennis, track & field, and volleyball. Students participating in cheerleading must comply with Chapter 38, subchapter D of the Texas Education Code related to the prevention, treatment and oversight of concussions. PURPOSE This protocol is intended to meet all policy requirements set forth by Texas Law Subchapter D, Chapter 38, Education Code, “Natasha’s Law” applied during 2011-2012 school year regarding the safety of our student -athletes and concussions. HB 2038 relates to prevention, treatment, and oversight of concussions affecting public school students participating in interscholastic athletics. The UIL summary of HB 2038 is attached in full below (Attachment 1). CONCUSSION OVERSIGHT TEAM (COT) HB 2038 stipulates a concussion oversight team must include at least one physician and if a school district or open-enrollment charter school employs an athletic trainer, the athletic trainer must be a member of the district or charter school COT. If the school district or charter school employs an athletic trainer, he or she is responsible for the athlete’s compliance with the Return-to-Play protocol. Each member of the COT must have training in the evaluation, treatment, and oversight of concussions at the time of appointment or approval as a member of the COT team. The COT shall establish a return-to-play protocol, based on peer-reviewed scientific evidence, for a student’s return to interscholastic athletics practice or competition following the force or impact believed to have caused a concussion. The members of the COT must take a training course in accordance with Subsection (e) from an authorized training provider at least once every two years:

1) Licensed health care professional who serves as a member of a concussion oversight team and is an employee, representative, or agent of a school district.

2) Licensed health care professional who serves on a volunteer basis as a member of a concussion oversight team for a school district.

3) A physician who serves as a member of a concussion oversight team shall, to the greatest extent practicable, periodically take an appropriate continuing medical education course in the subject matter of concussions.

This Mission CISD Concussion Oversight Team (COT) are listed below. MEDICAL ADVISORS Kaye “Kip” Owen MD Owen Orthopedic Sports Medicine Center ATHLETIC TRAINERS Irving Alday LAT, ATC Mission High School Lori Armendariz LAT, ATC Mission High School Kim C Reynolds MAT, LAT, ATC Kenneth White & Alton Memorial Junior Highs Tim Ferren LAT, ATC Mission Veterans Memorial High School Amanda Leal LAT, ATC Mission Veterans Memorial High School Anthony Saenz LAT Rafael Cantu Jr. & Mission Junior Highs

CONCUSSION DEFINITION A concussion means a complex pathophysiological process affecting the brain caused by a traumatic physical force or impact to the head or body, which may include temporary or prolonged altered brain function resulting in physical, cognitive, or emotional symptoms. A concussion does not have to include the loss of consciousness. A concussion may also be defined as a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head that can change the way the brain normally functions. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth or twist in the skull. This sudden movement may create chemical changes in the brain. What may appear to be only a mild jolt or blow to the head or body can result in a concussion. Concussions can have serious and long-term health effects, even from a mild bump on the head. A concussion typically results in the rapid onset of short lived impairment(s) of neurologic function that resolves spontaneously. In some cases, signs and symptoms may evolve over a number of minutes, hours and even days. Acute symptoms can largely reflect functional disturbances rather than structural brain injuries, therefore no abnormality may be seen on the standard structural neuro-imaging studies, i.e. X-ray, CT Scan or MRI to name a few. It is crucial to allow enough healing and recovery time following a concussion to prevent further damage. Most athletes who experience an initial concussion can recover completely as long as they do not return to play too soon. Following a concussion, there is a period of change in the function of the brain that can last from 24 hours to days, weeks, or even months. During this time, the brain is susceptible to more severe and/or permanent injury. Second Impact Syndrome refers to a catastrophic series of events which may occur when a second concussion occurs while the athlete is still symptomatic and healing from a previous concussion. The second injury may occur within days or weeks following the first injury. Loss of consciousness is not required. The second impact is more likely not as severe as the first, however, more likely to cause brain swelling with other widespread damage to the brain which can be fatal. Most often, second impact syndrome occurs when an athlete returns to activity without being symptom-free from the previous concussion. Student-athletes diagnosed ADD/ADHD or learning disabilities, migraines, or other chronic headache conditions may complicate recovery and may require other special considerations. CONCUSSION SIGNS & SYMPTOMS Symptoms of a concussion can be emotional, cognitive, and / or physical in nature. Symptoms may include but are not limited to those listed below. A person who suffers from a concussion may have one or multiple symptoms. These symptoms may be temporary or long lasting.

PHYSICAL / MOTOR COGNITIVE EMOTIONAL / BEHAVIORAL Headache Retrograde Amnesia (Events prior to) Irritable / Moodiness Dazed / Stunned / Blank stare Anterograde Amnesia (Events after) Explosive behavior Weakness / Numbness In limbs Slow verbal response Depressed Excessive fatigue Simple memory lapses Sleep patterns disrupted Slowed reactions Decreased attention span Emotionally unstable Ringing in the ears Poor concentration Anxious Unsteadiness / Loss of balance Inability to focus Lack of interest Nausea / Vomiting Forgets easily Blurred vision Confused Sensitivity to noise & light Disoriented Slurred or incoherent speech Any loss of consciousness

According to HB 2038, Sec. 38.156: A student-athlete shall be removed from an interscholastic athletics practice or competition immediately if one of the following persons believes the student might have sustained a concussion during the practice or competition:

1) Coach 2) Physician 3) Licensed health care professional (Athletic Trainer, Physician Assistant, Advanced Practice

Nurse, or Neuropsychologist). 4) Student’s parent / guardian or another person with legal authority to make medical decisions

for the student Any student-athlete removed from a workout, practice or competition due to the recognition of concussion related signs and / or symptoms will not be allowed to return to any participation for the remainder of that day. If the student-athlete is deemed to have a signs & symptoms resembling a concussion by the attending athletic trainer or on-site health care professional, he / she must be cleared to resume participation by a licensed healthcare professional. The student suspected of sustaining a concussion must be evaluated by a physician of his or her choosing. The licensed healthcare professionals allowed to clear a concussed MCISD Student-Athlete are as follows:

1) Medical Doctor – MD 2) Doctor of Osteopathy – DO 3) Physician Assistant – PA 4) Advanced Practice Nurse - NP

Details of the UIL HB 2038 summary (Attachment 1), identification (Attachment 2, 3, 4,), evaluation (Attachment 7-14), Return-to-Learn (Attachment 19), and Return-to-Play procedures (Attachment 5, 18), are attached below. UIL ANNUAL PARENT / GUARDIAN FORMS According to Section 38.155, an annual concussion acknowledgement form signed by the student-athlete’s parent / guardian is required each school year before that student may participate in interscholastic athletics. By signing the UIL Concussion Acknowledgement Form, the parent / guardian acknowledges that they have received and read written information that explains concussion prevention, symptoms, treatment, and oversight. That information includes guidelines for safely resuming participation in an athletic activity following a concussion.

Other MCISD / UIL forms required yearly prior to participation: All forms except for Pre Participation Physical (PPE) & Medical History (MH) are currently online UIL / MCISD Pre Participation Physical & Medical History UIL Acknowledgement of Rules, General Information & General Eligibility Rules UIL Concussion Acknowledgement Form (Attachment 17) UIL Parent Information Handbook & SB 82 Safety Training Manual UIL Parent and Student Steroid Agreement UIL Sudden Cardiac Awareness Agreement MCISD Bullying, Harassment & Hazing Agreement MCISD Drug Testing Policy & Consent MCISD Extracurricular Code of Conduct MCISD Helmet Agreement

PLAN OF ACTION FOR CONCUSSED ATHLETE: If a student-athlete demonstrates signs and/or symptoms consistent with a concussion, or if one of the persons listed above believes the student- athlete suffered a concussion, the Mission CISD Athletic Trainer will:

1) The student-athlete will be immediately removed from athletic activity / period / practice / game. 2) The student-athlete will be evaluated and concussion tested by one of the Mission CISD Licensed

Athletic Trainers (LAT). a) The MCISD LAT may use one of many concussion tests readily available, including but not

limited to the SCAT5 (Sport Concussion Assessment Tool) (Attachment 13), SCAT3 – Child (Attachment 14), SAC (Standard Assessment of Concussion) (Attachment 10), BESS (Balance Error Scoring System) (Attachment 9), and VOMS (Vestibular / Ocular Motor Screening) (Attachment 11 & 12).

b) If the MCISD Athletic Trainer does not suspect a concussion following their initial concussion testing, the MCISD Student-Athlete will follow the PLAN OF ACTION FOR AN ATHLETE SUFFERING HEAD OR FACE INJURY / TRAUMA

3) The student-athlete suspected of sustaining a concussion must be evaluated by a physician of his or her choosing from one of the licensed healthcare professionals allowed to clear a concussed MCISD Student-Athlete listed above.

4) The student-athlete’s parent / guardian will be informed about the possible concussion and shall be given a condensed version of the Mission CISD Concussion Management Protocol (Attachment 2); The CDC Head Ups Concussion Fact Sheet for Parents (English & Spanish) (Attachment 3 & 4); the Mission CISD Physician’s Return to Play Clearance Consent & RTP Step Protocol (Attachment 5); and the UIL Return to Play Form & UIL Parental / Guardian HIPPA & Immunity Provisions Signature Sheet(Attachment 6). These forms make up the Coaches Team Travel Concussion Packet.

5) If it is determined that a concussion has occurred, the student-athlete will not be allowed to return to participation that day regardless of how quickly the signs or symptoms of the concussion resolve. The student-athlete shall be kept from all activity until a physician provides written clearance to return to activity and start the MCISD RTP Protocol.

6) All UIL / MCISD concussion signature forms must be completed prior to starting the RTP Protocol. These signatures include the Physician’s Return to Play Clearance Consent (Attachment 5), & the UIL Parental / Guardian HIPPA & Immunity Provisions Signature Sheet (Attachment 6),

7) After a successful completion of the MCISD Return to Play Protocol, the MCISD Athletic Trainer will have final approval of the student-athlete returning to full activity.

PLAN OF ACTION FOR AN ATHLETE SUFFERING HEAD OR FACE INJURY / TRAUMA If a student-athlete suffers a head injury or head trauma, the Mission CISD Licensed Athletic Trainer (LAT) will:

1) The student-athlete will be immediately removed from athletic activity /period / practice / game. 2) The student-athlete will be evaluated by one of the Mission CISD LATs. 3) The student-athlete’s parent / guardian will be informed about the head or face injury / trauma and

shall be given information regarding such injury. This information may include but not limited to the Coach Team Travel Concussion Packet (Attachments 1 – 8), and Head or Face Injury / Trauma Care (Attachment 21).

4) The MCISD LAT will render a prognosis regarding the head or face injury / head trauma concerning the student-athletes ability to return to play that day. A Non-Concussed prognosis may be deferred at the athletic trainer’s discretion. The student-athlete MUST remain inactive until the prognosis of Concussed or Non-Concussed is completed by the MCISD Athletic Trainer.

5) The student-athlete will be re-evaluated at the earliest possible convenience. At that time, the MCISD Athletic Trainer must render a prognosis of Concussed or Non-Concussed.

6) Even with a Non-Concussed Prognosis, the MCISD LAT may proceed with a more conservative approach to the head or face injury / trauma without labeling the student-athlete with a concussion.

7) If the MCISD LAT renders a Concussed prognosis, the student-athlete must follow the Plan of Action for Concussed Athlete listed above.

SAME DAY RETURN TO PLAY GUIDELINES FOLLOWING HEAD OR FACE INJURY/ TRAUMA WITHOUT A CONCUSSION 1) Following a head or face injury / trauma, any student-athlete with normal testing results indicating a

NON-CONCUSSED injury, will be allowed to return to play and be monitored closely. The possibility of return-to-play is left solely to the team physician or medically qualified designee (i.e. licensed/certified athletic trainer {LAT, ATC}).

2) The parent / guardian of the MCISD Student-Athlete will be notified any time there is head or face injury / trauma.

3) The team physician or medically qualified designee reserves the right to re-evaluate / test the student-athlete and change their diagnosis / prognosis at any time.

HIGH SCHOOL & JUNIOR HIGH ATHLETES

I) PREVENTION STRATEGIES FOR HELMETED ATHLETES A) Helmets, headgear, and mouth guards do not prevent all concussions.

1) All headgear must be NOCSAE certified AND up to date. 2) Make sure the headgear fits the individual. 3) For all sports that require headgear: The MCISD Student-Athlete should

report damage or ill-fitting equipment after the initial fitting. The padding should be checked daily to make sure they are in proper working condition.

4) Make sure helmets are secured properly at all times. 5) Mouth guards should fit and be used at all times 6) CDC Heads Up Helmet Safety (Attachment 16),

7) Riddell Fitting Instructions and Helmet Care (Attachment (15) 8) CDC Heads Up Batters Helmet Safety (Attachment 22) 9) CDC Heads Up Catchers Helmet Safety (Attachment 23)

II) IMMEDIATE ASSESSMENT OF A POTENTIAL CONCUSSION A) The team physician and licensed athletic trainers will complete an on the field assessment to

rule out the initiation of the emergency action plan (EAP) and emergency transportation. If the athlete is unable to stand on their own without aid following a hit, collision or fall, it may be assumed that the athlete lost consciousness and may have sustained a cervical spine injury. The athlete should be stabilized and transported immediately to the ER via ambulance. It will be assumed that the athlete suffered a concussion and will be required to be evaluated by the appropriate health care professional listed that is approved to evaluate concussions.

B) If no emergency transport is required, the conscious athlete is assisted to the sideline / bench, allowed to calm down and then the MCISD Athletic Trainer will administer a concussion management evaluation on the athlete.

C) If the athlete exhibits signs, symptoms or behaviors consistent with a concussion, it may be assumed that the athlete has sustained a concussion and further appropriate evaluation by the athletic trainer or health care professional is required.

D) The athlete will be monitored and re-assessed in a timely manner looking for any signs of deterioration. If the athlete demonstrates any deterioration, the athlete will be transported via ambulance to the local ER. If the parents are present, they make elect to transport any non-emergency injury if deemed safe by the MCISD Athletic Trainer.

E) The Mission CISD Athletic Trainer will make the final decision regarding the athlete following the Plan of Action for Concussed Athlete or the Plan of Action for a Head or Face Injury / Trauma.

III) RETURN TO LEARN – POST CONCUSSION MANAGEMENT AT SCHOOL A) Notify appropriate school personnel through the Rank One Sport Injury Report 1) Nurse 2) Assistant Principal 3) Campus Athletic Coordinator

4) Head Coach 5) Assistant Coach B) Return to Learn (RTL) Post Concussion Signature Sheet (Attachment (19), 1) Nurse 2) Counselor 3) Teachers 4) Coaches 5) Assistant Principal

CONCUSSION RETURN TO LEARN RECOMMENDATIONS

STAGE STAGE DESCRIPTION PROCEDURES / ACTIVITIES

1 Cannot tolerate cognitive activity. Shows symptoms at rest.

Remain at home & avoid classroom work for at least one day, avoid school work, video games, reading, texting, watching television, and no team or social activities. Notification sent to Administration, Counselors & Teachers of concussion and accommodations required. As symptoms resolve, progress to Stage 2 as tolerated. If symptoms exceed two weeks, initiate additional examination by attending MD with possibility of neurological exam and testing.

2

Ability to perform cognitive activities for up to 1 hour with no increase in symptoms. Allow for cognitive rest periods and reduce rest periods as tolerated.

Monitor symptoms and make appropriate adjustments to exposure to cognitive and social activities. May return to cognitive and social activities as tolerated. If athlete cannot attend school, they also cannot attend team or social functions.

3 Return to all activities of daily living Return to all cognitive, social activities including classes, team meetings, and traveling to games. Report any re-occurrence of symptoms.

EXAMPLES OF POTENTIAL ACCOMMODATIONS / RECOMMENDATIONS BASED ON SYMPTOM TYPE

SYMPTOMS POTENTIAL ACCOMMODATIONS

Headaches Allow frequent breaks Identify triggers of headaches and avoid triggers.

Sensitivity to Noise (Phonophobia)

No physical activity in or around loud areas Avoid lunch room – eat in quiet room Avoid attending athletics events Refrain from using headphones / earbuds

Sensitivity to Light (Photophobia)

Wear sunglasses or cap to shield eyes Utilize low lighting or dimly lit room Minimize use of computer screens or bright projected images.

Other Visual Problems

Limit computer use and / or increase font size on screen Reduce / shorten assignments Refrain from texting, video gaming Refrain from watching TV, Videos

Concentration or Memory (Cognitive) Problem

Keep main focus on essential academics Postpone testing or standardized testing Allow extra time for assignments & quizzes Allow extra time for test, projects, assignments & homework.

Sleep Difficulties Allow frequent breaks.

IV) PROLONGED RECOVERY GUIDELINES

A majority of the student-athletes who are concussed fully recover in 7-10 days and can be managed daily based on resolution of symptoms. Any student-athlete who has prolonged recovery and symptoms lasting longer than two weeks will return for a full evaluation by an MD and possible referral to a local Neurologists / Neurophysiologist. Academic accommodations will remain in place until the student-athlete is released to start and successfully completes the Mission CISD RTP Protocol.

V) STARTING THE RETURN TO PLAY PROTOCOL REQUIREMENTS

The following forms must be complete and on file with the respective MCISD Athletic Trainer prior to starting the MCISD RTP Protocol.

A) MCISD / UIL Concussion Management Protocol RTP Form (Top of Attachment 6) B) Physician’s Return to Play Clearance Consent (Attachment 5),

C) UIL Parent / Guardian HIPPA & Immunity Provisions Signature Sheet (Bottom of Attachment 6)

VI) RETURN TO PLAY PROTOCOL FOR MCISD ATHLETES:

The RTP protocol does not progress more than one step per day for both the high school and junior high school aged student-athletes. Only proceed to the next step if asymptomatic during the recovery period. Progression of steps will not occur during a Sunday or a Holiday. If the athlete shows any signs or complains of any post-concussion symptoms during these progressive steps, the athlete will return to Step 1. If any post-concussion signs or symptoms linger, the athlete may be required to return to the MD for further evaluation. The MCISD Athletic Trainer may follow a more restrictive or conservative RTP at their discretion, but must follow the minimum guidelines outlined by the State of Texas Law HB 2038.

High School – 24 hours symptom free prior to starting the RTP Junior High School – 48 hours symptom free prior to starting the RTP

6 step Return to Play Protocol Step 1 – Symptom Free Rest for 24 – 48 hours after MD Clearance Step 2 – Light Aerobic Exercise Step 3 – Moderate Aerobic Exercise Step 4 – Sport Specific Light Contact Step 5 – Sport Specific Full Contact Step 6 - Return to Full Sports / Participation

*In the absence of competition, an off-season student-athlete must complete an additional day(s) of Step 5 in lieu of Step 6 to fulfill RTP requirements at the MCISD Athletic Trainers discretion*

STEPS OF RTP PROGRESSION

FUNCTIONAL EXERCISE AT EACH STEP STAGE OBJECTIVE

STEP 1 REST

Rest. Symptom free for 24 – 48 hours

Recovery

STEP 2 LIGHT AEROBIC EXERCISE

Walking or stationary bike keeping intensity <70% Maximum heart rate for 10-15 Minutes. NO resistance / weight training.

Increase heart rate Once daily

STEP 3 MODERATE AEROBIC EXERCISE

Stationary bike, elliptical, outdoor jogging keeping intensity <85% Maximum heart rate for 20-40 minutes. Begin LIGHT resistance / weight Training.

Further increase heart rate. Add movement & cardiac endurance Once daily / practice

STEP 4 SPORT SPECIFIC LIGHT CONTACT

Progression to more complex, light contact sport-specific drills. 1 on 1 skills drills w/ no take down in football and wrestling. Sleds and individual passing drills - OK. No tackling / wrestling dummies. No heading in soccer. Hand toss batting cages & passes-OK No JUGS machine work outs. Progressive return to normal resistance / weight training. NO Live / Team drills or Scrimmages Football players in shells only.

Exercise, coordination and cognitive load while participating in LIGHT contact Multiple practices allowed

STEP 5 SPORT SPECIFIC FULL CONTACT

Progress to participate in normal training activities including scrimmages and live play.

Restore confidence and assess functional skills Multiple practices allowed

STEP 6 RETURN TO FULL SPORTS

PARTICIPATION / COMPETITION

Return to FULL sports participation. Normal game play as tolerated, monitor for symptoms.

VII) GUIDELINES FOR MULTIPLE CONCUSSIONS

A) Mission CISD High School Athlete in a School Year 1) 1st Concussion

Student-athlete follows the MCISD Concussion Protocol 2) 2nd concussion in a school year a) Physician’s Return to Play Clearance Consent (Attachment 5) b) Minimum of 15 continuous day’s symptom free rest prior to starting of RTP

Protocol 3) 3rd concussion in a school year

a) Physician’s Return to Play Clearance Consent b) Mandatory Neurologist / Neuropsychologist referral for evaluation

c) Minimum of 30 continuous day’s symptom free rest prior to starting of RTP Protocol

B) Mission CISD High School Athlete in a Lifetime 1) 1st concussion in a lifetime

Student-athlete follows the MCISD Concussion Protocol 2) 2nd concussion in a lifetime Student-athlete follows the MCISD Protocol if concussions are one calendar year

apart. If concussions are not one calendar year apart: a) Physician’s Return to Play Clearance Consent b) Minimum of 15 continuous day’s symptom free rest prior to starting of RTP

Protocol 3) 3rd or more concussion in a lifetime Student-athlete follows the MCISD Protocol if concussions are one calendar year

apart. If concussions are not one calendar year apart: a) Physician’s Return to Play Clearance Consent b) Mandatory Neurologist / Neuropsychologist referral for evaluation c) Minimum of 30 continuous day’s symptom free rest prior to starting of RTP

Protocol C) Mission CISD Junior High School Athlete in a School Year

1) 1st Concussion in a school year Student-athlete follows the MCISD Concussion Protocol

2) 2nd concussion in a school year a) Physician’s Return to Play Clearance Consent b) Minimum 30 continuous day’s symptom free rest prior to starting of RTP

Protocol 3) 3rd concussion in a school year a) Physician’s Return to Play Clearance Consent b) Mandatory Neurologist / Neuropsychologist referral for evaluation c) Minimum of 45 continuous day’s symptom free rest prior to starting of RTP

Protocol

D) Mission CISD Junior High School Athlete in a Lifetime 1) 1st concussion in a lifetime Student-athlete follows the MCISD Concussion Protocol 2) 2nd concussion in a lifetime Student-athlete follows the MCISD Protocol if concussions are one calendar year

apart. If concussions are not one calendar year apart: a) Physician’s Return to Play Clearance Consent b) Minimum of 30 continuous day’s symptom free rest prior to starting of RTP

Protocol 3) 3rd or more concussion in lifetime Student-athlete follows the MCISD Protocol if concussions are one calendar year

apart. If concussions are not one calendar year apart: a) Physician’s Return to Play Clearance Consent b) Mandatory Neurologist / Neuropsychologist referral for evaluation c) Minimum 45 continuous day’s symptom free rest prior to starting of RTP

Protocol NOTE: The attending physician, neurologist or neurophysiologist may require a longer cognitive & athletic rest / recovery period. This may include the student-athlete missing a partial or full sport season as well as an entire athletic year. Attachments

Attachment 1 UIL Summary of HB 2038 Attachment 2 MCISD Condensed Concussion Management Protocol ** Attachment 3 Heads Up CDC English Fact Sheet for Parent ** Attachment 4 Heads Up CDC Spanish Fact Sheet for Parent** Attachment 5 Mission CISD Physician’s Return to Play Clearance Consent & RTP Step Protocol ** Attachment 6 UIL Concussion Management Protocol RTP Form & Parent HIPPA Signature ** Attachment 7 Heads Up CDC Concussion Signs & Symptoms Checklist ** Attachment 8 Graded Symptom Scale Checklist Attachment 9 BESS – Balance Error Scoring System Concussion Test Attachment 10 SAC - Standard Assessment of Concussion Test Attachment 11 VOMS - Vestibular / Ocular Motor Screening Diagram Attachment 12 VOMS – Vestibular / Ocular Motor Screening Instructions & Scoring Attachment 13 SCAT 5 – Sport Concussion Assessment Tool Attachment 14 SCAT 5 Child – Sport Concussion Assessment Tool for ages 5-12 Child Attachment 15 Riddell Fitting Instructions and Helmet Care Attachment 16 Heads Up Football Helmet Safety Attachment 17 UIL Concussion Acknowledgement Form Attachment 18 Mission CISD Return to Play Protocol Coach’s Note Attachment 19 Mission CISD Return to Learn Post-Concussion Form Attachment 20 Mission CISD Concussion Clearance, Testing & Signature Check List Attachment 21 Mission CISD Head or Facial Trauma / Injury Contusion Care** Attachment 22 Heads Up Batters Helmet Safety Attachment 23 Heads Up Catchers Helmet Safety **Denotes MCISD Coaches Concussion Team Travel Packet

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RESOURCES

CDC Heads Up Web Page Harlingen ISD Concussion Policy Iowa State University Concussion Policy Mesquite ISD Concussion Policy NATA Research and Education Foundation Natasha’s Law - HB 2038 NCAA Student Athlete Fact Sheet Spring Branch ISD Concussion Policy Sharyland ISD Concussion Policy UIL Athletics Web page

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