Concussion Management Protocol

Concussion Prevention | Begin Return to Play Process

What is a concussion?

A concussion is a reaction by the brain to a jolt or force that can be transmitted to the head by an impact or blow occurring anywhere on the body. Essentially a concussion results from the brain moving back and forth or twisting rapidly inside the skull.


Symptoms of a concussion are the result of a temporary change in the brain’s function. In most cases, the symptoms of a concussion generally resolve over a short period of time, however in some cases, symptoms will last for weeks or longer. Children and adolescents are more susceptible to concussions and take longer than adults to recover.

Symptoms include, but are not limited to:

  • Decreased or absent memory of events prior to or immediately
  • Double or blurry vision after the injury, or difficulty retaining new information
  • Nausea, vomiting and/or loss of appetite
  • Confusion or appears dazed
  • Irritability, sadness or other changes in personality
  • Headache or head pressure
  • Feeling sluggish, foggy or light-headed
  • Loss of consciousness
  • Concentration or focusing problems
  • Balance difficulties, dizziness, or clumsy movements
  • Drowsiness
  • Fatigue and/or sleep issues – sleeping more or less than usual

Students who develop any of the following signs, or if signs and symptoms worsen, should be seen and evaluated immediately at the nearest hospital emergency room.

  • Headaches that worsen
  • Weakness or numbing in arms or legs, facial drooping
  • Seizures
  • Unsteady gait
  • Looks drowsy and/or cannot be awakened
  • Change in pupil size in one eye
  • Repeated vomiting
  • Significant irritability
  • Slurred speech
  • Any loss of consciousness
  • Unable to recognize people or places
  • Suspicion for skull fracture: blood or clear fluid draining from ear


Concussion Prevention

Along with educational training for coaches and athletes, the following guidelines will be used to prevent a concussion when one is suspected:
The student will not be allowed to return to play/activity in the current game or practice.

  1. The student should not be left alone and regular monitoring for deterioration is essential over the next 24 hours following injury.
  2. Following the initial injury, the student must follow up with their primary care physician, Athletic Trainer or with an Urgent Care/Emergency Care Facility within the first 24 hours.   It is recommended that a student see a health care professional who has had proper training in evaluation and management of sports concussions.
  3. The student must have the “Student Concussion Checklist” on file with the school nurse and a Physician Checklist form signed by the physician.  These forms must be returned to the school nurse.
  4. Return to play must follow a medical clearance and successful completion of the “Return to Play Protocol”. The Athletic Trainer or nurse will supervise and document the student-athlete’s progress.

The cornerstone of proper concussion management is rest until all symptoms resolve and then a graded program of exertion before return to a sport/activity.

Begin Return to Play Process

If at any point during RTP the athlete has concussion symptoms, PCP will be contacted and athletes will restart RTP on last step is completed.

Step 1

  • Low/Light activity
  • 3 x 10 minutes
  • No contact
  • Jog, bike, elliptical, fast walk

Step 2

  • Moderate activity
  • 2 x 15 minutes
  • No contact
  • Sport specific work

Step 3

  • Heavy activity
  • < 45 minutes
  • No contact
  • Resistance training
  • Complete / Pass Impact Test

Step 4

  • Heavy activity
  • Full practice
  • Light contact
  • No live scrimmaging
  • Complete / Pass Impact Test

Step 5

  • Full practice
  • Full contact
  • No game play
  • Full clearance.

No restrictions. Release.

Download a PDF of the Concussion Management Protocol.