Concussion Protocol
You are receiving this information sheet about concussions because of California state law AB 25 (effective January 1,
2012), now Education Code § 49475:

1. The law requires a student athlete who may have a concussion during a practice or game to be removed from the
activity for the remainder of the day.
2. Any athlete removed for this reason must receive a written note from a medical doctor trained in the management
of concussion before returning to practice.
3. Before an athlete can start the season and begin practice in a sport, a concussion information sheet must be
signed and returned to the school by the athlete and the parent or guardian.
Every 2 years all coaches are required to receive training about concussions (AB 1451), as well as certification in First Aid
training, CPR, and AEDs (life-saving electrical devices that can be used during CPR).

What is a concussion and how would I recognize one?
A concussion is a kind of brain injury. It can be caused by a bump or hit to the head, or by a blow to another part of the
body with the force that shakes the head. Concussions can appear in any sport, and can look differently in each person.
Most concussions get better with rest and over 90% of athletes fully recover. However, all concussions should be
considered serious. If not recognized and managed the right way, they may result in problems including brain damage
and even death.

Most concussions occur without being knocked out. Signs and symptoms of concussion (see back of this page) may show up right after the injury or can take hours to appear. If your child reports any symptoms of concussion or if you notice some symptoms and signs, seek medical evaluation from your team’s athletic trainer and a medical doctor trained in the evaluation and management of concussion. If your child is vomiting, has a severe headache, or is having difficulty staying awake or answering simple questions, call 911 to take him or her immediately to the emergency department of your local hospital.

On the CIF website is a Graded Concussion Symptom Checklist. If your child fills this out after having had a
concussion, it helps the doctor, athletic trainer or coach understand how he or she is feeling and hopefully shows
improvement. We ask that you have your child fill out the checklist at the start of the season even before a concussion
has occurred so that we can understand if some symptoms such as headache might be a part of his or her everyday life.
We call this a “baseline” so that we know what symptoms are normal and common for your child. Keep a copy for your
records, and turn in the original. If a concussion occurs, he or she should fill out this checklist daily. This Graded
Symptom Checklist provides a list of symptoms to compare over time to make sure the athlete is recovering from the
concussion.

What can happen if my child keeps playing with concussion symptoms or returns too soon after getting a
concussion?
Athletes with the signs and symptoms of concussion should be removed from play immediately. There is NO same day
return to play for a youth with a suspected concussion. Youth athletes may take more time to recover from concussion
and are more prone to long-term serious problems from a concussion. Even though a traditional brain scan (e.g., MRI or CT) may be “normal”, the brain has still been injured. Animal and
human research studies show that a second blow before the brain has recovered can result in serious damage to the
brain. If your athlete suffers another concussion before completely recovering from the first one, this can lead to
prolonged recovery (weeks to months), or even to severe brain swelling (Second Impact Syndrome) with devastating
consequences.

There is an increasing concern that head impact exposure and recurrent concussions may contribute to long-term
neurological problems. One goal of this concussion program is to prevent a too early return to play so that serious brain
damage can be prevented.
Signs observed by teammates, parents and coaches include:
 Looks dizzy  Slurred speech
 Looks spaced out  Shows a change in personality or way of acting
 Confused about plays  Can’t recall events before or after the injury
 Forgets plays  Seizures or has a fit
 Is unsure of game, score, or opponent  Any change in typical behavior or personality
 Moves clumsily or awkwardly  Passes out
 Answers questions slowly
Symptoms may include one or more of the following:
 Headaches  Loss of memory
 “Pressure in head”  “Don’t feel right”
 Nausea or throws up  Tired or low energy
 Neck pain  Sadness
 Has trouble standing or walking  Nervousness or feeling on edge
 Blurred, double, or fuzzy vision  Irritability
 Bothered by light or noise  More emotional
 Feeling sluggish or slowed down  Confused
 Feeling foggy or groggy  Concentration or memory problems
 Drowsiness  Repeating the same question/comment
 Change in sleep patterns

What is Return to Learn?
Following a concussion, student athletes may have difficulties with short- and long-term memory, concentration and
organization. They will require rest while recovering from injury (e.g., avoid reading, texting, video games, loud movies),
and may even need to stay home from school for a few days. As they return to school, the schedule might need to start
with a few classes or a half-day depending on how they feel. If recovery from a concussion is taking longer than
expected, they may also benefit from a reduced class schedule and/or limited homework; a formal school assessment
may also be necessary. Your school or doctor can help suggest and make these changes. Student athletes should
complete the Return to Learn guidelines and return to complete school before beginning any sports or physical activities,
unless your doctor makes other recommendations. Go to the CIF website (cifstate.org) for more information on Return to
Learn.

How is Return to Play (RTP) determined?
Concussion symptoms should be completely gone before returning to competition. A RTP progression involves a gradual,
step-wise increase in physical effort, sports-specific activities and the risk for contact. If symptoms occur with activity, the
progression should be stopped. If there are no symptoms the next day, exercise can be restarted at the previous stage.
RTP after concussion should occur only with medical clearance from a medical doctor trained in the evaluation and
management of concussions, and a step-wise progression program monitored by an athletic trainer, coach, or other
identified school administrator. Please see cifstate.org for a graduated return to play plan. [AB 2127, a California state
law effective 1/1/15, states that return to play (i.e., full competition) must be no sooner than 7 days after the concussion
diagnosis has been made by a physician.]

Final Thoughts for Parents and Guardians:
It is well known that high school athletes will often not talk about signs of concussions, which is why this information sheet
is so important to review with them. Teach your child to tell the coaching staff if he or she experiences such symptoms, or
if he or she suspects that a teammate has had a concussion. You should also feel comfortable talking to the coaches or
athletic trainer about possible concussion signs and symptoms that you may be seeing in your child.
References:
 American Medical Society for Sports Medicine position statement: concussion in sport (2013)
 Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012
http://www.cdc.gov/concussion/HeadsUp/youth.html
CIFSTATE.ORG 05/2015 CIF

School: RALSTON MIDDLE SCHOOL

CIF Concussion Information Sheet
You are receiving this information sheet about concussions because of California state law AB 25 (effective January 1,
2012), now Education Code § 49475:
1. The law requires a student athlete who may have a concussion during a practice or game to be removed from the
activity for the remainder of the day.
2. Any athlete removed for this reason must receive a written note from a medical doctor trained in the management
of concussion before returning to practice.
3. Before an athlete can start the season and begin practice in a sport, a concussion information sheet must be
signed and returned to the school by the athlete and the parent or guardian.
Every 2 years all coaches are required to receive training about concussions (AB 1451), as well as certification in First Aid
training, CPR, and AEDs (life-saving electrical devices that can be used during CPR).
For current and up-to-date information on concussions you can visit:
http://www.cdc.gov/concussion/HeadsUp/youth.html

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