1. Concussion Management
Todd Nelson
Assistant Director, NYSPHSAA

2. NYSPHSAA Concussion Initiative
Dennis Fries
Concussion Management Coordinator
Lloyd Mott, Asst Director
Safety Committee Chair
Senator Kemp Hannon
NYS Senate Health Committee

3. NYSPHSAA Concussion Team
NYSPHSAA Safety Committee Chair
NYSAAA Representative
Physicians
Psychologists & Neuropsychologists
Athletic Trainers
Athletic Directors
Parent
Section CMT formed

4. Principles of Concussion Management
Avoid re-injury until recovered
Avoid over-exertion during recovery
Early education and reassurance improves outcome
Return to school gradually with accommodations as needed
Return to play must follow a medically supervised process

5. 3rd International Conference on Concussion in Sport
Zurich 2008 Guidelines
No grading of injury
Treat every concussion seriously
Recovery may take longer in children and adolescents
3rd International Conference on Concussion in Sport
FIFA IOC IIHF 5

6. Zurich Return to Play Guidelines
Any athlete who show ANY symptoms or signs of a concussion:
Athlete should not return-to-play in the current game or practice
Athlete should be monitored for deterioration for 24 hours
return-to-play must follow a medically supervised stepwise process
athlete must be symptom-free at rest and after exertion 6

7. Medical Protocol
Any athlete who suffers a concussion should undergo medical evaluation within 24 hours
Anyone with LOC should be evaluated that day
If confused or not fully conscious, transport by EMS with immobilization
Follow athlete until asymptomatic
First medical clearance is to begin RTP progression
If no return of symptoms with exertion, then final clearance for game play 7

8. Zurich Return to Play Progression
No activity, complete rest
Light aerobic exercise but no resistance training
Sport specific exercise and progressive addition of resistance training
Non-contact training drills
Full contact training and scrimmage after medical clearance
Game play
Also should be symptom-free after mental exertion
and have normal neruocognitive test results 8

9. NYSPHSAA Concussion Initiative
$145K in 3 phases over 3 years
Presentations at athletic director meetings in all 11 sections
Webcast, DVD, and website
CME credit for school physicians
List of identified resources state-wide
Partnership with ImPACT – 220 member schools
Dick’s Sporting Goods – FREE base line testing
Concussion team in every section & every school
Sideline cards – distributed to all schools

10. NYSPHSAA Resources NYSPHSAA Sample Concussion Policy
Modeled on policies, procedures, and protocols already in use in some schools
Approved by NYSPHSAA Executive, available on website
Concussion Checklist
Completed by coach or trainer on the sideline
Follows athlete until cleared to RTP
Reviewed by school ATC and MD after clearance
Improves communication and helps enforce policy

11. Other Resources Free Educational Materials
CDC Heads up in High School Sports kits
NFHS – Concussion Management Course
CDC web based training video for coaches
SED Required First Aid for Coaches outline
NCAA web-based education video
SUNY Upstate Concussion in the Classroom video and brochure on-line

12. Lessons Learned
Coaches and athletic directors will attend if required
Athletic trainers and school nurses are good advocates
Parents rely on advice of physicians
Primary complaint from trainers and nurses is lack of knowledge among physicians
Little awareness of academic consequences

13. National Federation of High Schools Concussion Guidelines 2010 - 2011
Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health care professional

14. Concussion Management Awareness Act – July 1, 2012
NYSPHSAA met with many legislators on potential Bills.
Fully supports the Bill passed by both the Senate and Assembly
NYSPHSAA named as a stakeholder in the Law

15. Steps to Success
Form a school Concussion Team to oversee education and protocols
Educate athletes, parents, coaches, teachers, administrators and school health professionals including the medical officer
Develop and implement a concussion management policy and protocol (use of concussion checklist recommended)
Consider other steps such as hiring an athletic trainer or using a computerized testing program

16. It’s the right thing to do !
Summary
NFHS, CDC, NYSPHSAA and NYS legislature now recognize sports concussion as a significant health concern
Proper recognition and management of concussion can prevent serious problems
Athletes must avoid re-injury and over-exertion until recovered
Every school should have a concussion management policy and a concussion management team
It’s the right thing to do ! 16

17. Todd Nelson, Assistant Director
Contact information
Todd Nelson, Assistant Director
Phone: (518) 17