Concussion Care

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Community High School District 117 has developed a concussion protocol for students, staff, and parents, supported by current research and evidence-based practice, on the care of concussions and management of the post-concussion recovery period.  This protocol is divided into 4 general stages of recovery.  Although each concussion injury presents with its own unique symptoms, these stages represent average concussion recovery phases and interventions.   We recognize that not every student with a concussion will follow the stages of recovery and healing as presented.  This protocol will serve as a guide to support the student in the academic and athletic setting at District 117 schools during his/her individual recovery.

General Information:

A student’s best chance of full recovery from a concussion involves two critical components: cognitive and physical rest. Continued research has shown cognitive rest to be essential in the quick resolution of concussion symptoms. Cognitive stimulation includes: driving, playing video games, computer use, text messaging, cell phone use, loud and/or bright environments, watching television, reading, and studying.  These stimuli must be limited, and in most cases, completely avoided for a brief period of time during recovery.  Physical activity such as physical education, athletics, strength or cardiovascular conditioning, and fine arts practices/performances must be completely avoided or regulated while recovering from a concussion.

It is recommended that this protocol is shared with the student’s primary care physician (MD/DO licensed to practice medicine in all its branches) during the initial visit.

Stages of Concussion Recovery and Academic/Athletic Participation:

1.       Complete Rest
2.       Return to School
3.       Full Day of School Attendance
4.       Full Academic and Athletic Participation
Return to Learn:  Process to return to full cognitive/academic activities.
Return to Play:  Process to return to full sports participation.

Points of Emphasis:

• It is important to note that the recovery from a concussion is a very individualized process. Caution must be taken not to compare students with concussions as they progress through the recovery process.

• For the concussion care protocol to be initiated the student must be initially evaluated by a primary care physician, MD/DO (licensed to practice medicine in all of its branches) and documentation must be provided to the school nurse or athletic trainer.  An emergency room/acute care note is only temporary until seen by the student’s primary care physician within one week.  A student may be referred to a physician specializing in concussion care for further recommendations and eventual clearance for full return to learn (RTL-academics) and return to play (RTP-athletics).   

• The student’s missed academic work will be reviewed and granted extra time to complete, in conjunction with the physician recommendations, ATC, and school nurse guidance.

• As the student’s recovery progresses through Stages 1-3, teachers should identify essential academic work in each subject and collaborate with department supervisors, as needed, to determine potential reduction in course workload. This will promote healing, and help reduce the student’s anxiety level related to the perceived volume of work that will be required once the student is medically cleared to resume a full academic load.

• The teacher has the option of assigning the student a grade of incomplete for the progress mark, final exam, and/or semester grade.

• For the student athlete:  It is important, upon return to school, that the student report to the athletic trainer to monitor symptoms and determine progression to the next stage within the concussion care protocol.  The student may also check in with the school nurse as needed.

• For the non-athlete student: The student may check in with the school nurse as needed.

For additional questions - please contact the student’s school counselor, the school nurse, or the athletic trainer.

ACHS - Wanda Sobczak, school nurse:  847-838-7799
wanda.sobczak@chsd117.org

ACHS – Ryan Naes & Bryn Nottoli, athletic trainers:  847-838-7769
ryan.naes@chsd117.org    bryn.nottoli@chsd117.org

LCHS – Michele Miller, school nurse:  847-838-7117
michele.miller@chsd117.org

LCHS – Mike Gedville & Jacqueline Bair, athletic trainers:  847-838-7121
mike.gedville@chsd117.org    jacquelyne.bair@chsd117.org

 

Stage 1

Complete Rest

(Usually lasts 2-4 days, could last more than 1 week per individual case)

  • Characteristics may include:

  • Severe symptoms at rest
  • Symptoms may include but are not limited to:

  • Headache or pressure in head, dizziness, nausea, photosensitivity, auditory sensitivity, inability to focus/concentrate, memory/lack of recall, feeling mentally foggy, unusual changes in mood, fatigue
  • Students may complain of intense and continuous/frequent headaches
  • Students may not be able to read for more than 10 minutes without an increase in symptoms
  • Initial evaluation by primary care physician (not ER)

  • No PE or athletic participation (includes practices and attending events)
  • Interventions may include:

  • No school attendance for at least one full day - emphasize cognitive and physical rest
  • Sports: does not attend practice/games
  • ATC or school nurse will notify student’s teachers and appropriate staff
  • *Progress to stage 2 when:

  • Decreased sensitivity to light or noise
  • Decreased intensity and frequency of headaches and dizziness
  • Ability to do light reading for 10 minutes without increased symptoms
  • Decreased feeling of fogginess or confusion

 

Stage 2

Return to School

(Options for altered daily class schedule)

  • Characteristics

  • Mild symptoms at rest, but increasing with physical and mental activity
  • Modified class schedule

  • limited attendance for 1-2 weeks.  Example: alternate afternoon classes and morning classes, repeat as symptoms warrant
  • No PE or athletic participation
  • No Behind the Wheel (Driver’s Ed.) until cleared by primary physician
  • No participation in Fine Arts practices/performances until cleared by primary physician
  • For the student athlete:  report daily to the athletic trainer; may check in with the school nurse as needed.
  • For the non-student athlete:  may check in with the school nurse as needed.
  • Interventions may include:

  • Avoid choir, band, PE areas, cafeteria
  • Rest in nurse’s office to offer breaks between academic classes
  • Obtain a “five minute pass” from the school nurse to avoid noisy, crowded hallways between class periods
  • Limit computer work, videos/movies in class
  • Divide up work into smaller portions (15-20 mins. at a time)
  • Tests, quizzes or homework modified per physician order
  • *Progress to stage 3 when:

  • School activity does not increase symptoms
  • Overall symptoms continue to decrease 
  •  

Stage 3

Full Day of School Attendance

  • Characteristics

  • Symptom-free at rest
  • Mild to moderate symptoms with cognitive and school day activity
  • No PE, athletics, Behind the Wheel (Driver’s Ed.), or Fine Arts participation (may attend practices, events or classes, but no participation).
  • For the student athlete:  report daily to athletic trainer; may check in with the school nurse as needed.
  • For the non-athlete student:  may check in with the school nurse as needed.
  • Continue with interventions listed in Stage 2 as needed
  • *Progress to stage 4 when:

  • Symptom free with cognitive and physical activity
  • Student should report any return of symptoms with cognitive or school day activity
  • Written clearance by primary care physician or concussion specialist for return to physical and cognitive/academic activities.
  • Some students are cleared by primary care physician for full cognitive/academic activities before receiving clearance for full physical activities.
  •  

    Stage 4

    Full Academic and Physical Participation

  • Characteristics: 

  • Asymptomatic with academic/cognitive and physical activities as cleared by physician (MD/DO)
  • For the student-athlete:  report daily to the athletic trainer; may check in with the school nurse as needed.  Student will begin the Illinois High School Association’s (IHSA) required Return to Play Protocol with the athletic trainer.
  • For the non-athlete student:  may check in with the school nurse as needed.
  • Interventions may include:

  • Resumption of full academic responsibilities once symptoms have resolved completely as determined by primary care physician.  ATC or school nurse will notify teachers.  
  • Create plan for possible modification and gradual completion of required make-up work (school counselor, teacher, department supervisor).
  • Teachers have the discretion to identify essential academic work  for their course.
  • For the non-athlete student:  written clearance to full participation from primary care physician will be required for return to Fine Arts, Behind the Wheel, and PE participation.
  • For the student athlete: required to follow the IHSA Return to Play Protocol under the direction of the athletic trainer upon written clearance from the primary care physician to begin physical activity (including Fine Arts, Behind the Wheel, and PE/athletic participation).
  • Follow Up:

  • The athletic trainer will conduct a follow-up assessment with the student one week after he/she returns to full academic and athletic activity.
  • The student is encouraged to meet with school counselor regularly to discuss progress, grades, and status of make-up work.
  • The student is encouraged to meet with the athletic trainer or school nurse to assess any recurring symptoms.
  • If at any point a student does not progress in a timely manner, the student will be referred to the primary physician/concussion specialist for further evaluation and accommodations.  The presence of significant symptoms/accommodations beyond one month will result in the initiation of the evaluation process for a 504 Plan.
  •  

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