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Summary of NCAA Recommended Best Practices for a Concussion Management Plan

(adopted from the NCAA Memorandum April 29, 2010)

Sports-related concussions have generated a great deal of media attention and public concern in the past few years.  Between 1.6 and 3.8 million such injuries occur each year in the United States.  As a member of the NCAA, Occidental College Department of Athletics is dedicated to the prevention, identification, evaluation, and management of concussions.

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS) instituted a concussion management plan across all three divisions.  The following is a summary of the committee’s recommendations.

“Institutions shall have a concussion management plan on file such that a student-athlete who exhibits signs, symptoms or behaviors consistent with a concussion shall be removed from practice or competition and evaluated by an athletics healthcare provider with experience in the evaluation and management of concussion.  Student-athletes diagnosed with a concussion shall not return to activity for the remainder of that day.  Medical clearance shall be determined by the team physician or their designee according to the concussion management plan.

In addition, student-athletes must sign a statement in which they accept the responsibility for reporting their injuries and illnesses to the institutional medical staff, including signs and symptoms of concussions.  During the review and signing process student-athletes should be presented with educational material on concussions.”

1. Institutions shall require student-athletes to sign a statement in which student- athletes accept the responsibility for reporting their signs and symptoms to the institutional medical staff, including signs and symptoms of concussion.

2. Athletics healthcare providers should be empowered to have the unchallengeable authority to determine management and return-to-play of any ill or injured student- athlete, as he or she deems appropriate.

3. Institutions shall have on file a written team physician-directed concussion management plan that specifically outlines the roles of athletics healthcare staff.

a. Institutions should ensure coaches have acknowledged they understand the concussion management plan.

  b. Institutions should record a baseline assessment for each student-athlete prior to the first practice in the sports of baseball, basketball, diving, football, lacrosse, pole vaulting, soccer, softball, and water polo, at a minimum.
 
i. At a minimum, baseline assessment should consist of the use of a symptoms checklist and standard cognitive and balance assessments (Standardized Assessment of Concussion (SAC); Balance Error Scoring System (BESS); Immediate Post-Concussion and Cognitive Testing (ImPACT))

c. When a student-athlete shows any signs, symptoms or behaviors consistent with a concussion, the athlete shall be removed from practice or competition and evaluated by an athletics healthcare provider with experience in the evaluation and management of concussion.

d. A student-athlete diagnosed with a concussion shall be withheld from the competition or practice and not return to activity for the remainder of that day.

e. The student-athlete should receive serial monitoring for deterioration.  Athletes should be provided with written instructions upon discharge; preferably with a roommate, guardian, or someone that can follow the instructions.

f. The student-athlete should be evaluated by a team physician as outlined within the concussion management plan. Once asymptomatic and post-exertion assessments are within normal baseline limits, return to play should follow a medically supervised stepwise process.

  g. Final authority for Return-to-Play shall reside with the team physician or the physician’s designee.