Concussions and SportsSports-related concussions are common in the following sports: soccer; football; ice hockey; baseball and softball; lacrosse; skiing and snowboarding; wrestling and martial arts; and bicycling.
As mandated by the Commonwealth, the Lincoln Public Schools has adopted the following policy:HEAD INJURIES AND CONCUSSIONS IN EXTRACURRICULAR ATHLETIC ACTIVITIES POLICYPurpose
This policy provides the procedures and protocols for the Lincoln Public Schools (LPS) in the prevention, training, management and return to activity decisions ofsports-related head injuries for all middle school students who participate inany extracurricular athletic activity as required by MA 105 CMR 201.000. The district will provide DPH with an affirmation that this policy is updated by September 2013 and every two years thereafter upon review or revision of its policies.
Concussion means a complex disturbance in brain function, due to direct or indirect trauma to the head, related to neurometabolic dysfunction, rather than structural injury.
Head injury means direct blow to the head or indirect trauma to the head including a concussion or traumatic brain injury. Scalp or facial laceration alone is not a head injury for purposes of 105 CMR 201.000.
Pre-Participation Requirements and Training:
The following persons shall complete annually one of the head injury safety training programs approved by the Department of Public Health (DPH) as specified on the Department’s website:
(2) School Nurses;
(3) School Physicians;
(4) Athletic Director;
(5) Parent(s)of a student who participates in an extracurricular athletic activity;
(6) Students who participate in an extracurricular athletic activity. Students must complete the training prior to any participation including try-outs, practice and competition.
This requirement may be met by:
Coaches, Athletic Director, School Nurses, School Physician: Completing an approved online program and providing a certificate of completion to the Athletic Director. (http://www.cdc.gov/concussion/HeadsUp/online_training.html)Parents and Students:Signing an acknowledgement that they have read and understand written materials provided to them by the Athletic Director, or have completed an approved online program.(http://www.cdc.gov/concussion/HeadsUp/online_training.html)
The training applies to one school year and must be repeated every subsequent year.
The Athletic Director will keep all certificates and signed acknowledgments on file for four years.
Additional participation requirements for Parents and Students:
A student and his/her parent(s) must complete and sign the pre-participation Extracurricular Activities Medical Questionnaire prior to each season of participation. The questionnaire will be distributed by the athletic director and will also be available on the district’s website. The questionnaire will be reviewed by the School Nurse prior to the athlete’s participation and will provide appropriate follow-up when needed. The School Nurse will notify coaches and the Athletic Director of any history of concussion and head/neck injuries.
Students must provide a copy of a physical exam that is dated within 13 months prior to participation. Students with physical exams that expire during the season are eligible to complete the season. The school nurse shall review a student’s pre-participation history and physical exam prior to participation. The school nurse shall consult with the school physician as necessary regarding a student’s medical history or eligibility.
If a student sustains a concussion or head injury during the season of play, but not while participating in an extracurricular athletic activity, the parent is required to submit the Report of Head Injury Form to the school nurse. The School Nurse will notify the Athletic Director.
All student athletes involved in contact sports must wear a mouth guard during play.
All coaches must be certified in CPR with AED and First Aid.
Exclusion from Play:
Any student, who during a practice or competition, sustains a head injury or suspected concussion, or exhibits signs and symptoms of a concussion, or loses consciousness, even briefly, shall be removed form play immediately and may not return to practice or competition that day.
The coach shall communicate the nature of the injury directly to the parent in person or by phone immediately after the practice or competition in which a student has been removed from play for a head injury,suspected concussion, signs and symptoms of a concussion, or loss of consciousness. The coach must provide this information to the parent in writing, whether paper or electronic format, by the end of the next business day.
The coach shall notify, by the end of the next school day,the Athletic Director and School Nurse that the student has been removed from practice or competition for a head injury, suspected concussion, signs and symptoms of a concussion, or loss of consciousness.
Student Reentry Plan:
Each student who is removed from play and subsequently diagnosed with a concussion shall have a written graduated reentry plan for return to full academic and extracurricular activities.
The plan shall be developed by the student’s teachers,school nurse, neuropsychologist if involved, parent and members of the individualized education program team as appropriate and in consultation with the student’s primary care provider or the physician who diagnosed the head injury or who is managing the student’s recovery.
The written plan shall include instructions for students,parents and school personnel addressing:
- Physical and cognitive rest as appropriate;
- Graduated return to extracurricular athletic activities and classroom studies as appropriate, including accommodations or modifications as needed;
- Estimated time intervals for resumption of activities;
- Frequency of assessments, as appropriate, by the school nurse, physician or neuropsychologist, if available, until full return to classroom activities and extracurricular athletic activities are authorized; and
- A plan for communication and coordination between and among school personnel and between the school, parent, and the student’s physician.
Medical Clearance and Authorization to Return to Play:
A student who has sustained a head injury shall not return to practice or competition unless and until the student provides medical clearance and authorization by submitting the Post Sports-Related Head Injury Medical Clearance and Authorization Form prior to resuming the athletic activity. A physician, a nurse practitioner in consultation with a licensed physician, or a neuropsychologist in coordination with the physician managing the student’s recovery must sign the form.
Responsibilities of the Athletic Director:
The Athletic Director shall be responsible for:
- Coordinate the biannual review of this policy.
- Completing the required annual training.
- Ensuring that the training requirements for staff, coaches, parents, and students are met, recorded and records are maintained.
- Ensuring that all students meet the physical examination requirements prior to any participation;
- Ensuring that all students participating in extracurricular athletic activities have completed and submitted the required pre-participation forms;
- Ensuring that student pre-participation forms are reviewed by the School Nurse;
- Ensuring that Report of Head Injury Forms are completed by the parent or coach and reviewed by the coach, school nurse and school physician;
- Ensuring that athletes are prohibited from engaging in any unreasonably dangerous athletic technique that endangers the health or safety of an athlete.
- Reporting annual statistics to MDPH.
Responsibilities of Coaches:
Coaches shall be responsible for:
- Completing the required annual training;
- Completing a Report of Head Injury Form upon identification of a student with a head injury or suspected concussion that occurs during practice or competition;
- Teaching techniques aimed at minimizing sports-related head injury;
- Discouraging and prohibiting athletes from engaging in any unreasonably dangerous athletic techniques that endangers the health or safety of an athlete, including using a helmet or any other sports equipment as a weapon;
- Identifying athletes with head injuries or suspected concussions that occur in practice or competition;
- Communicating promptly with the parent of any student removed from play and with the School Nurse and Athletic Director.
Responsibilities of the School Nurse:
The School Nurse shall be responsible for:
- Participating in the biannual review of this policy;
- Completing the required annual training;
- Reviewing completed pre-participation forms that indicate a history of head injury and following up with parents and coaches as needed prior to the student’s participation in extracurricular athletic activities.
- Reviewing Report of Head Injury Forms and following up with the coach and parent as needed.
- Maintaining Pre-participation forms and Report of Head Injury Forms in the student’s health record;
- Participating in the graduated reentry planning for students who have been diagnosed with a concussion to discuss any necessary academic accommodations or school activities’ modifications;
- Monitoring recuperating students with head injuries and collaborating with teachers to ensure that the graduated reentry plan for return to full academic and extracurricular athletic activities is being followed;
- Providing ongoing educational materials on head injury and concussion to teachers, staff, and students.
The district shall maintain the following records for four years:
- Verifications of completion of annual trainings
- Pre-participation Forms
- Report of Head Injury Forms
- Medical Clearance and Authorization Forms
- Graduated reentry plans for return to full academic and
The district shall make these records available to the Massachusetts Department of Public Health andthe Department of Elementary and Secondary Education, upon request or in connection with any inspection or program review.
The district shall be responsible for maintaining and reporting annual statistics that report:
- The number of Report of Head Injury Forms received by the school; and
- The total number of students who incur head injuries and suspected concussions when engaged in any extracurricular athletic activities.
The Athletic Director will assemble a head injury policy team that will biannually review this policy. This team will include, at a minimum, the following:
- A middle school administrator
- Athletic Director
- School Nurse
- A coach
- A parent
- A student
Evaluation results and recommendations will be forwarded to the Superintendent, or designee.