• Concussion Policy 

  • Concussion Information

    Concussion are a hot topic in the news and secondary school sports. Secondary school athletes are particularly secceptible to concussions and their effects as adoloecent brains are still in developmental stages. Information on this page is intended to help educate parents and athetes about concussions. If parents or athletes have any questions about concussion or think they (or their child) may have sustained a concussion, they should report this to Head Athletic Trainer, Candace Morales, MA, LAT, ATC

    Basic Information

    - A concussion is a mild traumatic brain injury (mTBI) that can change the way a person's brain normally works.

    - A concussion is caused by a bump, blow, or jolt to the head or body. that may or may not involve physical contact. 

    - Concussions can occur with or with out loss of concousness. 

    Common Myths

    - If you dont get knocked out its not a concussion

    - If you didnt get hit in the head it cant be a concussion

    - If you have a concussion a parent must wake you up every two hours during the night. 

    - You just got your bell rung, youre fine. 


    Concussion is defined as, a trauma-induced alteration in mental status that may or may not involve loss of consciousness, per the National Athletic Trainers' Association position statement. The Gfeller-Waller Concussion Awareness Act was drafted and implemented to protect the safety of student-athletes in North Carolina and was signed into law on June 16, 2011 by Governor Beverly Purdue. There are three major areas of focus in the law and these include: education, emergency action and post-concussion protocol implementation, and clearance/return to play or practice following concussion. In October 2015, the NC State Board of Education approved policy HRS-E-001, titled Return-to-Learn After Concussion. This education policy includes guidelines for safe and appropriate return to the educational environment for ALL students’ post-concussion. Although, this policy includes student-athletes protected under the Gfeller-Waller Concussion Awareness Act, it is further reaching. HRS-E-001 includes requirements for safe return to school for any student in NC public schools who sustains a mild Traumatic Brain Injury (mTBI), more


    What is a concussion? 

    A concussion is a mild form of traumatic brain injury (mTBI) that changes the way a person’s brain normally works. A concussion is caused by a bump, blow, and/or a jolt to the head that may not involve physical contact. Concussions can occur with or without loss of consciousness. Signs and symptoms of a concussion can show up right after an injury or may not appear or be noticed until hours or days after the injury. The physical symptoms that are common following a concussion may include headaches, double vision, light sensitivity, dizziness, fatigue and/or sensitivity to noise. Learning difficulties that may be present include those associated with light and noise sensitivity, cognitive fatigue, slippages in attention, problems with memory, and/or slower processing speed. Any of these symptoms may negatively impact a student’s learning, emotion regulation, or behavioral functioning in the school setting. These symptoms usually resolve in 1-2 weeks in the majority of cases, but in many cases they can linger for months. Consequently, there is a need for guidelines to support all students in their return to the educational environment after sustaining a concussion.


    Second impact syndrome

    Second Impact Syndrome (SIS) consists of two events. Typically, it involves an athlete suffering post-concussive symptoms following a head injury.If, within several weeks, the athlete returns to play and sustains a second head injury, diffuse cerebral swelling, brain herniation, and death can occur. SIS can occur with any two events involving head trauma. While rare, it is devastating in that young, healthy patients may die within a few minutes. Emergency physicians should be aware of this syndrome and counsel patients and their parents concerning when to allow an athlete to return to play. ny athlete who still shows signs of concussion should not be allowed to return to play. Such signs include fatigue, headache, disorientation, nausea, vomiting, feeling “in a fog” or “slowed down,” as well as other differences from a patient’s baseline.

  • Concussion Management

    • No athlete with a suspected concussion is allowed return to practice or play the same day that his or her head injury occurred.
    • Athletes should never return to play or practice if they still have ANY symptoms.
    • A concussion is a traumatic brain injury that can present in several ways and with a variety of signs, symptoms, and neurologic deficits that can present immediately or evolve over time.
    • Both academic and cognitive considerations should be addressed when managing a student-athlete with a concussion.
    • The NC Dept. of Public Instruction now requires a “Return to Learn” plan for students with suspected head injury. Also, consider guidance on proper sleep hygiene, nutrition, and hydration.
    • More than one evaluation is typically necessary for medical clearance for concussion. Due to the need to monitor concussions for recurrence of signs and symptoms with cognitive or physical stress, Emergency Room and Urgent Care physicians typically should not make clearance decisions at the time of first visit.
    • In order to clear an athlete to return to sport without restriction, an athlete should be completely symptom-free both at rest AND with cognitive stress, then with full physical exertion (i.e. has completed Return to Play Protocol).
    • It is not feasible for a provider to diagnosis an acute concussion and provides clearance on the same day.

    NCHSAA specific requirements regarding the Gfeller-Waller Concussion Awareness Law

    • All member school student-athletes must have a Licensed Physician’s (MD/DO) signature on the RETURN TO PLAY FORM and/or Medical Provider Concussion Evaluation Form. If the physician has signed the Medical Provider Concussion Evaluation Form both the Return to Play Protocol and decision to release of the student athlete to full participation in athletics may be delegated to the Licensed Athletic Trainer.
    • The physician signing the RETURN TO PLAY FORM and/or the Medical Provider Concussion Evaluation Medical Recommendation Form is licensed under Article 1 of Chapter 90 of the General Statutes and has training in concussion management.
    • Physicians may choose to delegate aspects of the student-athlete’s care to a licensed athletic trainer, licensed nurse practitioner or licensed physician assistant who is working under that physician’s supervision, and may work in collaboration with a licensed neuropsychologist in compliance with the Gfeller-Waller Concussion Law for RTP clearance.
  • Concussion Forms

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