Concussion Protocol Detail
A concussion is considered a mild traumatic brain injury (mTBI) caused by a blow or jolt to the head or body that causes the brain to shake inside the skull. This shaking of the brain can cause a metabolic event producing some serious symptoms.
The first 24 hours after a concussion are considered a critical healing phase for the brain, since concussions are a considered a metabolic “mismatch” in the brain neurons. The brain needs rest at this time, and the “cognitive rest” guidelines are the prescribed treatment.
PC Concussion Management Team (CMT)
The concussion management team is responsible for transitioning your child’s safe return to the school learning environment and athletic participation.
Debra Foley, RN, CRNP - Coordinator of Health Services/School Nurse (pre-K to 12)
Jessica Rawlings, MSN ATC - Athletic Trainer (grades 6-12)
Karen Campbell and Heather Larrabee - Divisional Learning Resource Specialist (grades 6-12)
When can my child return to school?
Each child’s injury is unique and requires careful observation from both parents and your concussion management team. You can promote recovery and prevent ongoing symptoms by following a “return to learn” plan. Academics and school attendance are the first priority. A return to sports is initiated once the child is fully tolerating school and an academic make-up plan is in place.
Step 1: Home- Total Rest
After a confirmed concussion, your child should remain at home on the “cognitive rest” guidelines until the symptoms subside or do not increase with light cognitive exertion.
- Cognitive rest = No homework, no reading, no screen time (including computer/video games), no texting, no noisy environments
- Light cognitive activities can include watching TV, listening to audio books, drawing and cooking. If symptoms increase, cease the activity and rest.
- Graded Symptom Checklist (GSC) - This useful parent tool allows the student to grade symptoms on a discomfort scale of 0-10. The GSC gives specific feedback to parents on your child’s progress.
Step 2: Home: Light Cognitive Activity
Once your child’s symptoms have significantly improved, your child may resume some light cognitive activities that do not cause symptoms to get worse.
- Initially, your child may only tolerate 5-15 minutes of light cognitive work, such as reading. The time of cognitive activity is increased as long as symptoms do not worsen significantly.
- Once your child can accomplish 2-3 hours of school-specific work at home with breaks without a significant increase in symptoms, they may return to school for a half-day.
Although recovery times can vary, the majority of students will remain at home for no longer than one week.
Step 3: Half Day of School with Accommodations
- Student reports directly to Health Office (D. Foley) for evaluation and management plan.
- Academic accommodations in place to ease transition to school as facilitated by divisional learning resource specialist and D. Foley.
- Missed work is NOT expected to be made up immediately upon return to school.
- Student remains at school unless a significant escalation of symptoms occurs.
- Student may take breaks or rest in health office as needed throughout the day for minor elevation of symptoms.
Step 4: Full Day School with Accommodations
- Symptoms continue to be monitored during school, students may take rest breaks as necessary
- Students may be initially excused from band/chorus and cafeteria as advised by CMT.
- No physical education, intramurals or athletic participation until the Return-To-Play protocol completed and cleared by physician.
Step 5: Return-To-Play (RTP)
- The RTP protocol is facilitated by the athletic trainer once the student tolerates a full symptom-free day of school and has progressed forward in the academic make-up plan.
- Students are required by PA state law to be evaluated and cleared by an appropriate medical professional before athletic participation.