Ferris State Bulldogs



Ferris State University Athletic DepartmentConcussion Management PlanIntroduction/ Purpose:Ferris State University is committed to ensuring the health and safety of its student-athletes. To this end, and in accordance with NCAA legislation [Division I Constitution 3.2.4.18; Division II Constitution 3.3.4.16], Ferris State University has adopted the following Concussion Safety Protocol for all student-athletes. This protocol establishes and/or identifies: a sport-related concussion definition; concussion safety protocol personnel; independent medical care; preseason education; pre-participation assessment; recognition and diagnosis of concussion; post-concussion management; return to activity, including both return-to-learn and return-to-play; reducing exposure to head trauma; and written certificate of compliance signed by the athletics health care administrator.Concussion DefinitionThe 5th international conference on concussion in sport defines concussion as follows:Sport-related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. Several common features that may be utilized to clinically define the nature of a concussion head injury include:SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms evolve over a number of minutes to hours.SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged.The clinical signs and symptoms cannot be explained by drug, alcohol or medication use, other injuries (such as cervical injuries, peripheral vestibular dysfunction, etc.) or other comorbidities (e.g., psychological factors or coexisting medical conditions).Independent Medical CareAs required by NCAA Independent Medical Care legislation, Ferris State University team physicians and athletic trainers shall have unchallengeable autonomous authority to determine concussion management and return-to-activity decisions for all student-athletes. Further, the athletics health care administrator shall ensure that the concussion safety protocol is available for all athletics personnel.Preseason Education:All student-athletes will be provided the NCAA Concussion Fact Sheet (or similar applicable material) and be required to sign an acknowledgement, on an annual basis that they have been provided, allowed an opportunity to discuss and reviewed the concussion education material. This signed acknowledgement will be filed in the student-athlete's medical record.All coaches, team physicians, athletic trainers, directors of athletics and other athletics personnel involved in NCAA student-athlete health and safety decision making will be provided and allowed an opportunity to discuss the NCAA Concussion Fact Sheet (or similar applicable material) and be required to sign an acknowledgement, on an annual basis, that they have been provided, and reviewed the concussion education material. This signed acknowledgement will be filed in a secure location.In accordance with the Medical Monitoring Class Settlement Agreement: Arrington v. NCAA, annually the NCAA will provide institutions with educational materials for faculty regarding academic accommodations that may be advisable to accommodate the NCAA student-athletes who have sustained concussions.Pre-participation AssessmentAll NCAA student-athletes will undergo a pre-participation baseline concussion assessment. This pre-participation assessment will, at a minimum, include assessment for the following: brain injury, concussion history, neurologic disorder, mental health symptoms and disorders, symptom evaluation, cognitive assessment and balance evaluation. The team physician determines pre-participation clearance and any need for additional consultation or testing. A new baseline concussion assessment six months or beyond, will be considered for NCAA student-athletes who have suffered a concussion or who have a complicated concussion history.Recognition and Diagnosis of ConcussionA member of the Ferris State University Sports Medicine staff with training in the diagnosis, treatment and initial management of acute concussion will be present at all NCAA competitions in the following contact/collision sports: basketball; football; ice hockey; soccer.A member of the Ferris State University Sports Medicine staff with training in the diagnosis, treatment and initial management of acute concussion will be available at all NCAA practices in the following contact/collision sports: basketball; football; ice hockey; soccer.NOTE: To be available means that, at a minimum, medical personnel can be contacted at any time during the practice via telephone, messaging, email, beeper or other immediate communication means. Further, the case can be discussed through such communication, and immediate arrangements can be made for the athlete to be evaluated.Symptoms of concussion include, but are not limited to: (1) physical symptoms of headache, nausea, balance problems, dizziness, visual difficulty, fatigue, sensitivity to light, sensitivity to noise, headache, feeling "out of it" or "foggy," vision changes, feeling dazed or stunned; (2) cognitive symptoms of feeling mentally foggy or slowed down, difficulty concentrating, difficulty remembering, forgetfulness, confusion, feeling slow; (3) emotional symptoms of irritability, sadness, nervousness, feeling more emotional; (4) sleep symptoms of drowsiness, sleeping more or less than usual, difficulty falling asleep. Visible signs of concussion include but are not limited to: lying motionless; unconsciousness; vomiting; vacant look; slow to get up; balance difficulty or incoordination; clutching the head. If an athlete, teammate, coach, official or member of medical staff identifies signs, symptoms or behaviors consistent with concussion, the following will take place immediately:The athlete must be removed from practice or competition for evaluation.The athlete must be evaluated by a member of the medical team with concussion experience.The athlete must be removed from practice/play for that calendar day if concussion is confirmed or suspected.The initial assessment will include symptom assessment, a focused assessment of the student-athlete’s neurological status, testing to assess neurocognitive function and balance.Post-Concussion ManagementActivation of emergency action plan, including immediate assessment for any of the following scenarios. A clinical assessment for neck trauma or other head trauma including skull fracture, intracranial bleed and catastrophic injury. If the student-athlete manifests any of the signs and symptoms that are considered to be severe or their clinical status is deteriorating (e.g. Glasgow Coma Scale <13 on initial assessment, or GCS <15 at 2 hours or more post-initial assessment; prolonged loss of consciousness; focal neurological deficit suggesting intracranial trauma; repetitive emesis; persistently diminished / worsening mental status or other neurological signs / symptoms; spine injury; other) that student-athlete will be referred to a medical facility for more immediate follow-up care as per the FSU Emergency Action Plan.A FSU student-athlete diagnosed with a concussion will be serially evaluated and monitored as necessary following the injury by the FSU Sports Medicine staff. FSU Sports Medicine staff will also provide verbal and/ or written care instructions to the student-athlete and/ or other appropriate personnel. Any NCAA student-athlete with atypical presentation or persistent symptoms will be re-evaluated by an FSU team physician in order to consider additional diagnosis, and best management options. Additional diagnoses may include, among others: fatigue, and/or sleep disorder; migraine or other headache disorders; mental health symptoms and disorders; ocular dysfunction; vestibular dysfunction; cognitive impairment and autonomic dysfunction. In these cases, referrals to relevant specialties may occur.Return to ActivityReturn-to-LearnFollowing assessment/evaluation of concussion the treating FSU athletic trainer will serve as the point person to help aide the student-athlete as they return-to-learn. In the event the student-athlete has class on the same day following the injury it will be recommended to the student-athlete that they refrain from class for the remainder of that day. During the home care education the student-athlete and treating FSU athletic trainer will complete the application for Medical Leave (this is short term) and submit the application along with a letter from the ATC or physician supporting the request for the leave. The director of the Birkam Health Center will review the request and upon approving the medical leave notification will be sent out to the student-athletes professors. During the serial evaluations the treating FSU athletic trainer should discuss the student-athletes ability to tolerate light cognitive activity as well as other activities of daily living. Early on relative rest in a controlled environment may be best such as at home or dorm room. Gradual return to classroom activity and completion of assignments as tolerated should be discussed with the student-athlete to allow for more of a progressive approach to return to academics. In more complex cases where the student-athlete is experiencing a prolonged recovery or having symptoms worsen with academic challenges the student-athlete will be referred back to the FSU team physician for further evaluation. In complex cases where a more prolonged return to learn may occur a multidisciplinary team will work together to aide in the care and accommodation of the student-athlete. This group may include but is not limited to the team physician, athletic trainer, neuropsychologist consult, faculty athletics representative, athletic director of compliance, and office of disability services. This team will work together to navigate these complex cases in the event of needing longer return-to-learn accommodations. With more complex cases where schedule and academic modification are not successful the athletic trainer will contact the FSU Disability Services office to see what resources and support could be offered. Return-to-Sport ProtocolIt is important to recognize each return-to-sport plan will be individualized and supervised by a FSU Sports Medicine staff member with expertise in concussion management. Final determination of unrestricted return-to-sport will be made by the FSU team physician. Unrestricted return-to-sport should not occur prior to unrestricted return-to-learn for concussions diagnosed while the student-athlete is enrolled in classes. The initial treatment for all athletes following concussion is at least 1-2 days of relative physical and cognitive rest. Relative rest should continue until the athlete has returned to his/her pre-concussion baseline status. Discretion can be used by the health care provider to introduce mild aerobic activity during the transition period of returning to pre-concussion baseline status, so long as such activity does not exacerbate post-concussion symptoms or signs.Once the athlete has returned to his/her baseline status, a stepwise progression return-to-sport protocol will take place. Progression from one step in the protocol to the next can take place when the stepwise activity does not lead to worsening or new symptoms. The stepwise progression includes: Symptom-limited activityLight aerobic exercise such as walking, swimming or riding a stationary bike for at least15 minutes. No resistance training is permitted3.Sport-specific activity (mode, duration and intensity specific) exercise with no headimpact4. Non-contact practice with progressive resistance training5.Unrestricted training6.Unrestricted return-to-sport NOTE: If at any point the student-athlete becomes symptomatic (more symptomatic than baseline), he/she will be withheld from exercising for the rest of that day and adjustments will be made to the return-to-sport progression. It is typical for progression of each step to take at least 24 hours. Reducing Exposure to Head TraumaFerris State University is committed to student-athlete health and safety and providing a safe environment for each of its participating NCAA student-athletes. To this end and in accordance with the NCAA association-wide policy, Ferris State University will limit student-athlete head trauma exposure in a manner consistent with the Interassociation Recommendations: Preventing Catastrophic Injury and Death in Collegiate Athletes. For example:Ferris State University teams will adhere to existing ethical standards in all practices and competitions.Using playing or protective equipment (including the helmet) as a weapon will be prohibited during all practices and competitions.Deliberately inflicting injury on another player will be prohibited in all practices and competitions.All playing and protective equipment (including helmets), as applicable, will meet relevant equipment safety standards and related certification requirements.Ferris State University will keep the head out of blocking and tackling in contact/collision, helmeted practices and competitions. NCAA Concussion ReportingFerris State University will follow the NCAA reporting process and report annually to the NCAA instances of diagnosed concussion in NCAA student-athletes and their resolution.Ferris State UniversityConcussion Management PlanBy signing and dating this form, you acknowledge, on behalf of your institution, that for the 2019-2020 academic year:The Concussion Management Plan fulfills the requirements of NCAA Concussion Management Legislation (Division I Constitution 3.2.4.18; Division II 3.3.4.16; Division III Constitution 3.2.4.16).The Concussion Safety Protocol is consistent with Inter-Association Consensus: Diagnosis and Management of Sport-Related Concussion Best Practices and also meets the requirements of Division I Constitution 3.2.4.18.1.Required SignatureAthletics Health Care AdministratorFSU Team Physician Print Name:Printed Name:Sign:Sign:Date:Date: ................
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