High School Concussion Protocol :

The immediate symptoms of concussion include dizziness, blurred vision, memory loss, headache, nausea and difficulty concentrating.  After the initial injury, a post-concussion syndrome often occurs in high school athletes.  The symptoms of this include a prolonged period of days to weeks whereby the athlete experiences chronic headaches, difficulty concentrating in school, sensitivity to light and noise, sleep disturbances and short-term memory deficits. 

It is during this period of recovery that the brain is the most susceptible to another injury.  Studies have shown that students who have a history of concussion are more likely to suffer another one and that the symptom severity usually increases with more brain injuries.  If the student has not fully recovered from a concussion and then suffers another traumatic brain injury, he/she may experience the Second-Impact Syndrome.  This devastating injury can cause irreversible brain damage or even death.  Thus, it is important to know when an athlete has recovered and is safe to return to competition. 

Serial clinical exams by certified athletic trainers and/or physicians are important to track an athlete’s recovery.  Recent research has demonstrated that even when students pass clinical tests and are apparently symptom-free, they often still suffer cognitive deficits and are not fully recovered.  Thus, standardized tests given on computers have been developed to assist the athletic trainer and team physician in determining when a child is considered safe to return to play. 

One such study that has been verified and widely used in the high school through professional levels is the Immediate Post-Concussive and Cognitive Testing tool (ImPACT).  This is a 20-minute computerized test that is given to all athletes before participating in contact sports to determine a baseline level.  If an athlete suffers a concussion, he or she will take the ImPACT test at various intervals after their injury to help determine when their brain has fully recovered.  When done in conjunction with serial clinical exams by the athletic trainer or physician, the degree of certainty for full recovery is significantly increased. 

Guidelines for return to play have been outlined by various medical societies including the American Orthopedic Society for Sports Medicine.  It is generally accepted that high school athletes who have suffered a concussion should not be allowed to return to competition that day, no matter how mild the injury appears.  After that, the athlete is monitored for symptom recovery.  Once the athlete has achieved complete symptom recovery, he or she must remain symptom-free for 7 days prior to consideration of return to activity.  It has been advocated that the child be removed from as much stimulus as possible during that time.  This includes limiting television and computer time and even time watching practice.  At the end of the 7 days, the athletic trainer then puts the athlete through a series of physical challenges in order to determine if he or she can truly remain symptom-free.  If the athlete passes all of these tests and has shown complete recovery on ImPACT studies, then he or she can be considered safe to return to play.