A concussion, also called mild traumatic brain injury (mTBI), is an injury sustained to the brain resulting from a direct blow to the head or a jolt of the head or body that causes the brain to move rapidly inside the skull. Following a concussion, the brain’s cells undergo chemical and metabolic changes which irritate and interrupt normal brain function including physical and cognitive abilities. It may or may not include loss of consciousness; however, typically there is no loss of consciousness. Children and adolescents are at greatest risk for concussions, they may take longer to recover from a brain injury than adults, and may experience increased symptoms due to the academic environment. Students may report diminished mental energy and cognitive fatigue. Any student reporting a blow to the head, face, nose or forceful body jolt will be evaluated by the Health Services nurse or athletic trainer for signs and symptoms of a concussion and the student’s parent/guardian will be notified
Signs and Symptoms of Concussion: (Could be observed by coaches, certified athletic trainers, Health Services nurse, school physician, teacher, school counselor, administrator)
- Appears dazed, stunned, disoriented or demonstrates decreased alertness
- Demonstrates short term memory difficulty
- Answers questions slowly or inaccurately
- Slurred speech
- Seizures, loss of consciousness or changing level of consciousness
- Headache/feels “pressure” in the head
- Nausea or vomiting
- Dizziness or balance problems
- Sensitivity to light or sounds/noise
- Irritability or changes in personality and behavior
- Uneven pupillary findings
- Blurry or double vision
- Student “just doesn’t feel right”
- Feels confused or “foggy”
- Fatigue, drowsiness
- Numbness or tingling
- Feels slowed down
- Disturbance in sleep pattern
The Health Services nurse will assess the student for signs and symptoms of a concussion and emergency medical treatment will be pursued if there is a deterioration of symptoms including a seizure, altered level of consciousness, vomiting, altered pupillary findings, severe headache, significant confusion or direct, severe neck pain associated with the injury.
The Health Services nurse will contact the injured student’s parent/guardian to make them aware of head injury incident and possible concussion. If the student’s symptoms do not require emergency medical treatment, the Health Services nurse will conduct a concussion symptom check. If the presented symptoms and/or mechanism of injury warrants, the Health Services nurse will evaluate the student regularly throughout the day or until symptoms escalate which require further medical evaluation. Should the student not undergo a recommended medical evaluation, the injured student will be regularly monitored for ongoing symptoms by the Health Services nurse. The parent/guardian will be notified of need for medical evaluation should symptoms not resolve.
Head Injury Information Concussion Guidelines for Educators form or packet will be sent home with a student who suffers any head trauma while at school. For reference please see the Muhlenberg School District Concussion Management found at Schools Policy No 210.3. Additional concussion information from the CDC is available in English & Spanish
Return to Learn
Students with concussions do not have to be 100% symptom-free to return to learn.
Rest, cognitive and physical, is the best "medicine" for healing concussions or other head injuries. It is important during the initial (acute) time period, that a concussed student does not push through school work with high cognitive activity levels.
The concussed brain is affected in many functional aspects as a result of the injury. Memory, attention span, concentration and speed of processing significantly impact learning.
Further, exposing the concussed student to the stimulating school environment may exacerbate symptoms and delay the resolution of symptoms needed for a full recovery.
Striking a balance between the need for rest and keeping up with academic content is the biggest struggle for districts and students.
All students with a concussion need to be academically managed during the school day to promote faster and complete recovery.
Return to school progression must be individualized to meet each concussed student's symptom-based needs.
It is best practice that all students who experience a possible concussion are medically evaluated by a health care provider.
All academic adjustment decisions following a concussion are the responsibility of the school's BrainSTEPs team, which include the Certified School Nurse and School Counselors.
When available, the health care provider input will be taken into consideration. The Muhlenberg School Final decisions are determined by the school, based on the student need and the presenting school-day symptoms.
Common return to learn adjustments for a student with a concussion may include some of the following:
- Take rest breaks as needed throughout the school day.
- Shortened school day
- No or modified testing and/or quizes, such as untimed assessments and reduction to only the most essential assessments
- No or limited computer/screen time with a decrease in brightness and frequent eye rest breaks
- No or modified physical education class/physical activity/sports, especially activities that involve or put the student at risk of direct contact.
- No or limited Band, Chorus, Orchestra, and/or materials shop class(es)
- No, reduce or modified homework, projects and/or classwork
- Extra time to complete assignments without penalty
- Assistantce with note taking or use of teachers' notes
- Early dismissal from class to avoice noidy, crowded hallways
- Use of earplugs
- Use of sunglasses if lights or smart boad increase the student's symptoms
- Carrying a water bottle to keep hydrated throughout the school day.
- The Health Services nurse, School Counselor, teachers and family will closely monitor the performance of the student until the student is released back to full physical and academic activities.
- The Health Services nurse will monitor the concussed student's physical symptoms and provide pain medication as needed.
- The Health Services nurse and/or School Counselor will keep the appropriate staff informed of the student's progress then change activity adjustments depended on the student's symptoms.
- As the student recovers and concussion symptoms decrease, activity adjustments in school will gradually decrease until the student is released to perform full physical and academic activities during the school day.
- A student with ongoing concussion symptoms will be referred to a health care provider for medical reevaluation, monitoring and care.