Haverford’s certified athletic trainers work collaboratively with Haverford’s Health Services staff and the department’s sports medicine consultants to manage concussions according to the most recent recommendations and guidelines. All varsity athletes are baseline tested using ImPACT software and all involved parties work to stay abreast of the latest research concerning these types of injuries.
CONCUSSION/HEAD INJURY IN SPORTS PROTOCOL
Definition: Direct blow or jolt to head, face, neck or body blow with force transmitted to the head that result in rapid onset of short-lived impairment of neurological function that spontaneously resolves. The injury may result in neurological changes with acute clinical symptoms reflecting functional disturbances not structural injury that may result in clinical symptoms that may or may not include LOC. Resolution of clinical and cognitive symptoms follows a sequential course.
Baseline Testing – ImPACT
ImPACT software will be used by the Athletic Training staff to baseline test all athletes who participate on a varsity team as part of their clearance to participate. ImPACT testing will be used as appropriate by the athletic trainers to document return to play/ baseline status after athlete is asymptomatic for at least 24 hours and given Health Service staff clearance .
Immediate Post-Concussion Assessment and Cognitive
Athletic Trainers will administer immediate field/sideline standardized assessment tool. A copy of the assessment will be sent to Health Service and athletes will be given head injury care plan handout. Athletes will not be returned to play the same day of injury. Any positive neurological screening abnormality necessitates formal neurological or hospital assessment. If severe head trauma, athlete will be transported to BMHER or nearest hospital immediately.
Any athlete who suffers a concussion will not be allowed to return to play on the same day. The Athletic Trainer will notify Health Service following the injury. The Athletic Trainer will advise the athlete to rest (physical and cognitive) and give athlete handout on care after concussion. The athlete will report to Haverford College Health Services within the first 24-48 hours after the injury. They will be withheld from participation in sports and other training until they have been cleared by the college physician, orthopedic/sports medicine physician or nurse practitioner. This clearance will not occur until the athlete has been asymptomatic for 24 hours and their neurological/cognitive function has returned to baseline levels. Once cleared, they will be released to the Athletic Training staff, which will progress them through a stepwise return to play progression. This progression will be as follows:
Step 1 – light aerobic exercise
Step 2 – sport specific training
Step 3 – non-contact drills
Step 4 – Full contact practice
Step 5 – Game play
Completion of each step without a reoccurrence of symptoms is required to move to the next step. If symptoms return during any of these steps, the athlete must cease activity and again meet the criteria of being asymptomatic for 24 hours and being cleared by Health Services staff prior to any activity.
Any athlete receiving academic accommodations of any form will not return to practice or play until all academic work is up to date.
Athletes whose symptoms are persistent or recurring will be managed by the College Physician, Orthopedic/Sports Medicine Physician or Nurse Practitioner in consultation with a Neurologist. Once the athlete has remained asymptomatic for an appropriate amount of time and neurological/cognitive function has returned to baseline levels they will be released to the Athletic Training staff, who will administer a step wise return to play progression. In these cases, the athlete will be required to spend multiple days at each step during a gradual progression back to activity. Any reoccurrence of symptoms will result in all activity being stopped until again asymptomatic and cleared by Health Services staff.
Freshmen/new athletes with histories of multiple concussions may be asked to provide medical records with full neurological/psychological/neuroimaging to Health Services and/or the Athletic Trainers.
Consensus statement on concussion in sport [PDF]