What you need to know. A type of brain injury that changes how the brain normally works. Kids and Teens are at greatest risk.

Concussion In the School Setting

Concussion In the School SettingWhat you need to know

What is a concussionA type of brain injury that changes how the brain normally works.

Kids and Teens are at greatest risk

The FactsAll Concussions are SeriousMost Concussions occur without loss of consciousnessRecognition and Response when they first occur aid recovery or further injury

Signs and Symptoms: Observed by teachers or school staffAppears dazed or stunnedConfused about eventsAnswers questions slowlyRepeats questionsCant recall events prior to injuryCant recall evens after injuryLoses ConsciousnessShows behavior or personality changesForgets class schedule or assignments

Cognitive Symptoms Reported by StudentThinkingDifficulty thinking clearlyDifficulty concentratingDifficulty rememberingFeeling more slowed downFeeling sluggish, hazy, foggy or groggy

Cognitive Symptoms Reported by StudentEmotional/sleepIrritableSadMore emotional than usualNervous

SleepDrowsySleep more or less than usualHaving trouble falling asleep

Physical symptoms Reported by the StudentHeadache or pressure in headNausea and/or vomitingBalance problems/dizzinessFatigueChanges in visionSensitivity to light or noiseNumbness or tingling

Danger Signs of ConcussionSymptoms worsen over timeEye pupils not equal Drowsiness or cannot be awakenedPersistent Headache- does not go awayWeakness, numbness or decreased coordinationRepeated vomiting and nauseaSlurred speech

Danger Signs ContinuedDifficulty recognizing people/placesIncreasing confusion, agitationUnusual behaviorLoss of consciousness

Teachers RoleTeachers may be the first to recognize symptoms Send to school nurse if:Any kind of forceful blow to head or event that results in rapid movement of the head. Any Change in Students behavior, thinking, or physical functioning

Returning to School, Play and ActivityNever return to sports or rec activity same day injury occurred. Needs evaluated by health care professionalNeeds to be symptom free before returning to activities which means no p.e., sports practices, games or physical activity at recess.

Returning to School May need 504 plan, team discussionSome possible accommodationsPrioritize assignments, both make-up and new workAllow extra time to complete assignmentsNo tests, quizzes or assessments first week returned to classroomLimit to 1 test per dayGo to clinic as neededLimit participation in p.e., recess, and sports per dr. recommendations

Potential AccommodationsReceive help with school workShortened school dayReduce time on computer, reading or writingAllow breaks as neededContact guidance or school nurse with concerns in classroom or recovery.

Return to Play ProgressionGeared toward student athletes, but can be for overall students Day 1: Light Aerobic Exercise 30 min. totalGoal is to increase heart rateDay 2: Increase duration & intensity exercise Goal is to increase heart rate and add movements

Return to Play ProgressionDay 3: Increase ExerciseGoal increase heart rate, add movement, no potential head contact activities

Day 4: Continual increase activityGoal to increase heart rate, involve coordination, and cognitive load to some exertion as long as symptom freeDay 5: Continue to Full Activity If no symptoms on exertion. Can resume full activity

Return to Play ProgressionIf Symptoms return must, fall back to previous day/level.

Things to RememberEach concussion is different Typical recovery is 2-3 weeks, some symptoms may last longerTreatment is cognitive rest for the brain and body

What to do if increasing cognitive demand worsens symptomsIncrease cognitive demandSymptoms worsen- Discontinue activity for 20 min. If symptom improve with rest-re-start activity at or below same levelIf symptom does not improve after 20 min. rest- discontinue activity and resume when symptoms have lessened. ConclusionIf in doubt, sit it out! Listen to student symptomsRefer to athletic trainer or school nurse with questions. Recourses and ReferencesCenter for Disease Control: http://www.cdc.gov/concussion

Heads Up Youth sports: Online Training for coaches.

www.nationwide childrens.org/concussions