NYIT Concussion Protocol Policy
February 7, 2018 Version
In order to continually maintain compliance with NCAA guidelines and International Consensus on Sport Related Concussion Statement Guidelines, this protocol will be reviewed annually and updated accordingly. Any attempts by an NYIT staff member to circumvent this policy shall be grounds for discipline, including but not limited to immediate termination.
All coaches, team-physicians, athletic trainers, and the director of athletics will participate in pre-participation concussion education and will be provided with NCAA-issued concussion education materials (Appendix A).
Each party will be required to provide signed acknowledgement (Appendix B) that he/she has read and understands the concussion material.
All incoming (i.e., first year and transfer) student-athletes will undergo baseline concussion testing including:
- Computerized Cognitive Testing: ImPACT® Testing
- Symptom Evaluation
- Vision Testing: King-Devick Assessment
- Balance Testing: Balance Error Scoring System
- A comprehensive intake on prior history of concussion or other neurological conditions
- Assessment for concussion vulnerability (history of migraines, learning disabilities, attention deficit, family history of Alzheimer's, or previous history of concussion)
Note: The team physician determines pre-participation clearance and/or the need for additional consultation of testing.
RECOGNITION AND DIAGNOSIS
Medical personnel, from either team, with training in the diagnosis, treatment, and initial management of concussion must be on site for the following NCAA varsity competitions at NYIT: basketball, lacrosse, and soccer.
Medical personnel, from either team, with training in the diagnosis, treatment, and initial management of concussion must be available via telephone, messaging, email, beeper, or other immediate communication for the following NCAA varsity practices at NYIT: basketball, lacrosse, and soccer.
Any student-athlete* with signs, symptoms, or behaviors consistent with concussion including but not limited to headache, confusion, dizziness:
- Must be removed from practice or competition
- Must be evaluated by an athletic trainer or team physician with concussion experience
- Must be removed from practice/play for that calendar day if concussion is suspected or confirmed
*Visiting sport team members evaluated by NYIT sports medicine staff will be managed in the same manner as NYIT athletes.
POST CONCUSSION MANAGEMENT
In addition to serial monitoring by the medical team, the Evaluation of Initial Suspected Concussion (Appendix C) will include the following sideline assessments:
- SCAT 5
- Symptom assessment (SCAT)
- Cognitive assessment (SAC)
- Balance exam (BESS)
- Clinical assessment for cervical spine trauma, skull fracture, and intracranial bleed
Student-athletes should be referred to a physician within 24–48 hours if not emergent. If emergent, student-athletes should be transported to the closest emergency department by calling 911. NYIT will utilize an emergency action plan for head injuries including transportation for further medical care for any of the following:
- Loss of consciousness for more than 2 minutes
- Neurological deficits (loss of sensation or motor function)
- Deteriorating mental status
- Glasgow coma scale less than 15
- Potential spinal injury
- Repetitive emesis (vomiting)
- Focal neurological deficit suggesting intracranial trauma
Care instructions will be provided to the student-athlete and the student's emergency contact will be notified if necessary.
Post Concussion Management: Precursor to Return to Sports
As indicated by the most recent guidelines published by the International Consensus Statements, light sub-symptom threshold aerobic exercise is indicated 24–48 hours following the initial injury.
At the discretion of the NYIT sports medicine physician and athletic trainer, the student-athlete will be instructed in light sub-symptom threshold aerobic exercise 24–48 hours following the initial injury.
RETURN TO PLAY
The final determination for return to play is made by the team physician(s) from the Center for Sports Medicine. Each student-athlete with a concussion will follow an individualized, graduated return to play protocol following the guidelines listed below.
Graduated Return-to-Sport (RTS) Strategy
|Stage||Aim||Activity||Goal of each step|
|1||Symptom-limited activity||Daily activities that do not provoke symptoms||Gradual reintroduction of work/school activities|
|2||Light aerobic exercise||Walking or stationary cycling at slow to medium pace; No resistance training||Increase heart rate|
|3||Sport-specific exercise||Running or skating drills; No head impact activities||Add movement|
|4||Non-contact training drills||Harder training drills (e.g., passing drills); May start progressive resistance training||Exercise, coordination, and increased thinking|
|5||Full contact practice||Following medical clearance, participate in normal training activities||Restore confidence and assess functional skills by coaching staff|
|6||Return to sport||Normal game play|
Note: An initial period of 24–48 hours of both relative physical rest and cognitive rest is recommended before beginning the RTS progression. At the determination of the medical team, student-athletes may begin light aerobic exercise prior to the formalized return to play protocol. As a result, if the student-athlete has completed light aerobic exercise without symptoms, they may be advanced to stage three at the initiation of the return to play protocol.
There should be at least 24 hours (or longer) for each step of the progression. If any symptoms worsen during exercise, the athlete should go back to the previous step. Resistance training should be added only in the later stages (stage three or four at the earliest). If symptoms are persistent (e.g., more than 10–14 days in adults, or more than one month in children), the athlete should be referred to a healthcare professional who is an expert in the management of concussion.
—Consensus statement on concussion in sport. The 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838. doi:10.1136/bjsports-2017-097699.
RETURN TO LEARN
The student-athlete will be referred to a designated athletic department representative who will guide them through the return to learn protocol.
- Multidisciplinary team members including Office of Counseling and Wellness representatives, team physicians, coaches, athletic trainers, academic advisors, college administrators, and Office of Accessibility Services representatives will collaboratively navigate more complex cases of return to learn.
- Student-athletes will not participate in classroom activity on the same day as concussion incident.
- Each student-athlete will receive an individualized initial plan based on their clinical presentation that includes directions regarding:
- Remaining at home/dorm if the student cannot tolerate light activity
- Gradual return to classroom/study as tolerated
Academic accommodations will be determined collaboratively based on the recommendations of the physician, occupational therapist, physical therapist, instructor, academic advisor, and Office of Counseling and Wellness representatives.
- Student-athletes will be re-evaluated by the team physician(s) if concussion symptoms worsen with academic challenges.
- Modification of schedule/academic accommodations may be made for up to two weeks, as indicated, with help from a designated athletic department representative.
- Student-athletes will be re-evaluated by their team physician(s), and members of the multi-disciplinary team, as appropriate, if symptoms persist longer than two weeks following the injury.
- Campus resources such as Office of Accessibility Services will be utilized for cases that cannot be managed through schedule modification/academic accommodations.
REDUCING HEAD EXPOSURE TO TRAUMA
Efforts to minimizing head trauma exposure will include the following:
- Adherence to Inter-association Consensus: Independent Medical Care for College Student-Athletes Best Practices
- Reducing gratuitous contact during practice
- Taking a safety-first approach to sport
- Taking the head out of contact
- Coaching and student-athlete education regarding safe play and proper technique
- An institutional plan will be submitted to the NCAA Concussion Safety Protocol Committee by May 1 of each year.
- Written certificate of compliance signed by the NYIT Athletics Director of Compliance will accompany the submitted plan.