Head injuries should never be taken lightly because they don’t have to be severe before having temporary or permanent negative effects on the brain. The brain as we all know controls everything in our bodies, and even the slightest damage to it could have terrible repercussions.

What is a concussion?
A concussion is defined as a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head. Concussions can also occur from a fall or blow to the body that causes the head and brain to move quickly back and forth. In school-aged children, many of these brain injuries can occur during a sports practice or event. (“Head injury and concussion information for schools, school staff, coaches, athletic trainers, and volunteers”, n.d.)
 

How do concussions occur?
Head injuries and concussions can occur in many settings and circumstances. They can be a sports-related injury OR NOT. Whether they occur on school grounds, at a different school, or at home, the school nurses need to be notified. If the injury is sports-related the school athletic Trainor, Molly Awiszus, needs to be aware as well. BVT follows the school’s Athletic Concussion Policy as well as the MA Department of Public Health regulation for head injuries/concussions related to Athletics. 

When a head injuries/concussions related to athletics occurs on our campus, our athletic trainer will evaluate the situation. The Sport Concussion Assessment Tool is used to evaluate for signs and symptoms of concussion. The trainer may deem it necessary for a student-athlete to be evaluated by a health care professional (physician, nurse practitioner, etc.). Because athletics is after school, students are typically evaluated at either urgent care or an emergency room. If a concussion is diagnosed the student will need to follow up with their doctor as soon as possible. Accommodations for the concussion need to be written. We like the ACE (Acute Concussion Evaluation) Care Plan, however, your doctor may write his/her own plan. This plan puts restrictions and limitations in place so that while your child is at school, they can participate at a modified pace based on their concussion symptoms and how they are feeling. 

Our Nurse’s Office will evaluate any reported, suspected head injuries/concussions as necessary. They may be alerted from a parent/guardian, the athletic trainer, and student themself. Based on nurse assessment and discussion of the injury with the student, the student may need to be evaluated by their doctor. If the student is diagnosed with a concussion, accommodations need to be written as stated in the above paragraph. Our goal is to work collaboratively with the student’s doctor, guidance counselor, teachers, and athletic trainer (if applicable) to support the student and give guidance while they are recovering from a concussion.

Do I have a concussion?
Diagnosing a concussion could be tricky at times. This is because many victims of concussions may not feel or show any pain or symptoms of a concussion immediately when it happens. It is important to know that concussion signs and symptoms typically occur hours or days after an injury rather than immediately and only 9% of concussions result in loss of consciousness. For adolescents (13 to 18-years) concussion signs and symptoms may last up to 28 days, whereas adults for 10 to 14 days.  Also, individuals with a previous medical history of migraines or mental health problems may take longer to recover. (McCrory et al. Br J Sport Med. 2017).

What is BVT's Return to Play Protocol?
A student cannot return to previous activity or sports until they have been medically cleared from the concussion by their doctor and a note is on file in the nurse’s office. Our school nurse will notify the student’s guidance counselor and teachers. If the injury is sports-related, the student will work with our athletic trainer in order to return to sports. To do so, the student needs to complete the Return to Play Protocol described below:

• Symptom limiting activity after initial 24-48 hours rest
• Light aerobic exercise (walking, biking, etc.)
• Sport-Specific Activity (non-contact, removed from normal practice, allows for skill)
• Non-Contact Practice (no defender, no contact, controlled)
• Impact testing compared to baseline then contact practice
• Full participation/Game

CONCUSSION RESOURCES
The following resources might be helpful if you or a loved one is dealing with persisting concussion symptoms.