Lake Zurich Cmmunity Unit Schl District #95 Cncussin Care Prtcl General Infrmatin: A student s best chance f full recvery frm a cncussin invlves tw critical cmpnents: cgnitive and physical rest. Cntinued research has shwn cgnitive rest t be essential in the quick reslutin f cncussin symptms. Cgnitive stimulatin includes: driving, playing vide games, cmputer use, text messaging, cell phne use, lud and/r bright envirnments, watching televisin, reading, and studying. These stimuli must be limited, and in mst cases, cmpletely avided fr a perid f time during recvery. Physical activity such as physical educatin, athletics, and strength r cardivascular cnditining must be cmpletely avided r regulated while recvering frm a cncussin. It is recmmended that this prtcl is shared with the student s primary care physician r specialist treating the cncussin (licensed t practice medicine in all its branches). Stages f Cncussin Recvery and Academic/Athletic Participatin: 1. Cmplete Rest 2. Return t Schl 3. Full Day f Schl Attendance 4. Full Academic and Athletic Participatin Pints f Emphasis: It is imprtant t nte that the recvery frm a cncussin is a very individualized prcess. Cautin must be taken nt t cmpare students with cncussins as they prgress thrugh the recvery prcess. Fr the cncussin care prtcl t be initiated, the student must be initially evaluated by a primary care physician r specialist treating the cncussin (licensed t practice medicine in all f its branches) and dcumentatin f a diagnsed cncussin must be prvided t the schl nurse and athletic trainer. An emergency rm/acute care nte is nly temprary until seen by the student s primary care physician (licensed t practice medicine in all f its branches) within ne week. The student s missed academic wrk will be reviewed and the student will be granted extra time t cmplete, in cnjunctin with the physician recmmendatins, Student Services Team (SST), and schl nurse guidance. As the student s recvery prgresses thrugh Stages 1-3, teachers shuld priritize academic wrk in each subject and cllabrate with department supervisrs/administratrs, as needed, t determine ptential reductin in curse wrklad and ther accmmdatins. This will prmte healing, and help reduce the student s anxiety level related t the perceived vlume f wrk that will be required nce the student is medically cleared t resume a full academic lad. The teacher has the ptin f assigning the student a grade f incmplete fr the prgress mark, final exam, and/r semester grade.
Fr the high schl student athlete : It is imprtant upn return t schl the student reprt t the athletic trainer and schl nurse daily t mnitr symptms and determine prgressin t the next stage within the cncussin care prtcl. Fr the high schl nn-athlete student : reprt nly t the schl nurse daily. Fr the middle/elementary schl student : It is imprtant upn return t schl the student reprt t the schl nurse daily t mnitr symptms and, in cnjunctin with the primary care physician r specialist treating the cncussin, determine prgressin t the next stage within the cncussin care prtcl. The schl s nurse will cnsult with the treating primary care physician after btaining release f infrmatin fr any additinal, recmmended interventins and fr input int the student s prgressin thrugh steps. Fur Stage Prgressin t Full Return t Academic and Athletic Activity Stage 1: Cmplete Rest (Usually lasts 2-4 days, culd last mre than 1 week per individual case) Severe symptms at rest Symptms may include but are nt limited t: Headache r pressure in head, dizziness, nausea, phtsensitivity, auditry sensitivity, inability t fcus/cncentrate, memry/lack f recall, feeling mentally fggy, unusual changes in md, fatigue Students may cmplain f intense and cntinuus/frequent headaches Students may nt be able t read fr mre than 10 minutes withut an increase in symptms Evaluatin by primary care physician r specialist (licensed t practice medicine in all f its branches) within ne week (nt Emergency Rm) with dcumentatin f diagnsed cncussin and medical clearance t return t schl. N PE/recess r athletic participatin (includes practices and attending events) Interventins: Pssibility f n schl attendance fr at least ne full day - emphasize cgnitive and physical rest Sprts: des nt attend practice/games/pe N tests, quizzes r hmewrk (SST/teachers may begin t cllect hmewrk/assignments) * Prgress t stage 2 when: Parent and student receive cpy f District 95 Cncussin Care Prtcl Schl nurse will ntify student s teachers and apprpriate staff f diagnsis and accmmdatins Decreased sensitivity t light r nise Decreased intensity and frequency f headaches and dizziness Ability t d light reading fr 10 minutes withut increased symptms Decreased feeling f fgginess r cnfusin *If the student remains in Stage 1 lnger than 2 weeks, the Student Services Team will present the student s case t the Assistant Superintendent f Student Services fr review and pssible need fr
further assistance. The schl nurse will cnsult with the primary care physician r specialist (licensed t practice medicine in all f its branches). Stage 2: Return t Schl ( Optins fr altered daily class schedule) Mild symptms at rest, but increasing with physical and mental activity Mdified class schedule Limited attendance pssible fr 1-2 weeks. Example: alternate afternn classes and mrning classes, repeat as symptms warrant N PE/recess r athletic participatin (may attend practices r PE class but n participatin) Fr the high schl student athlete : reprt daily t the athletic trainer and schl nurse fr assessment. Fr the high schl nn-student athlete : reprt daily t the schl nurse fr the assessment Fr the middle/elementary schl student : It is imprtant upn return t schl the student reprt t the schl nurse daily t mnitr symptms and, in cnjunctin with the primary care physician r specialist, determine prgressin t the next stage within the cncussin care prtcl. Pssible Interventins: Avid nisy areas i.e. chir, band, rchestra, PE areas, cafeteria Rest in nurse s ffice t ffer breaks between academic classes Reduce weight f backpack r prvide secnd set f textbks (teachers) Obtain a five minute pass frm the schl nurse t avid nisy, crwded hallways between class perids Limit screen time, cmputer, vides/mvies in class Divide up wrk int smaller prtins (15-20 minutes at a time) Wear sunglasses when viewing Smart Bards, PwerPint presentatins as needed Mdify tests, quizzes, r hmewrk Prvide extended time fr assignments/assessments Prvide student with cpies f class ntes (teacher r student generated) Prvide audi bks as needed and if available fr students struggling with visual prcessing *Prgress t stage 3 when: Schl activity des nt increase symptms Overall symptms cntinue t decrease The determinatin t prgress t Stage 3 is evidence based and made by cllabratin with parents, athletic trainer, nurse and primary care physician r specialist treating the cncussin. Stage 3 : Full Day f Schl Attendance Symptm free at rest r decrease in bth number and severity f symptms
Mild t mderate symptms with cgnitive and schl day activity N PE/recess r athletic participatin (may attend practices/events r PE class, but n participatin) Fr the high schl student athlete : reprt daily t athletic trainer and schl nurse. Fr the high schl nn-athlete student : reprt daily t the schl nurse fr assessment Fr the middle/elementary schl student : reprt daily t the schl nurse fr assessment Interventins: Cntinue with interventins listed in Stage 2 as needed If unable t prgress t Stage 4 after 3 weeks, and it is unlikely the student will be able t make up required wrk, the Student Services Team, Assistant Superintendent f Student Services, and parents will cnsider pssible curse level changes, r class withdrawal. Cnsider a 504 Plan after 6 weeks f residual symptms with educatinal impact. *Prgress t stage 4 when: Symptm free with cgnitive and physical activity Student shuld reprt any return f symptms with cgnitive r schl day activity Written clearance by primary care physician r specialist fr return t physical and full academic activities. Stage 4: Full Academic and Athletic Participatin : Asymptmatic with academic/cgnitive and physical activities Fr the high schl student-athlete : reprt daily t the athletic trainer and schl nurse. Student will begin the Illinis High Schl Assciatin s (IHSA) required Return t Play Prtcl with the athletic trainer. Fr the high schl nn-athlete student : reprt daily t the schl nurse fr assessment Fr the middle/elementary student : reprt daily t the schl nurse fr assessment Interventins: Resumptin f full academic respnsibilities nce symptms have reslved cmpletely as determined by primary care physician r specialist. Schl nurse will ntify teachers. Create plan fr pssible mdificatin and gradual cmpletin f required make-up wrk (schl cunselr, teacher, department supervisr,administratr) Teachers have the discretin t identify essential academic wrk fr their curse. Students are nt required t makeup missed PE classes due t a cncussin. Fr the nn-athlete student : written clearance t full participatin frm primary care physician/ specialist treating the cncussin will be required fr return t PE participatin. Upn receipt f clearance, schl nurse will cnsult with PE teacher/physician (if needed) regarding apprpriate return t full participatin within current activity (n frmal gradual return t physical activity). Fr the student athlete : required t fllw the IHSA/IESA Return t Play Prtcl under the directin f the athletic trainer/nurse/cach.
IHSA/IESA Return t Play Prtcl (required) Written clearance frm the primary care physician/specialist is required t begin physical activity The IHSA Return t Play Prtcl includes 5 phases f activity with increasing intensity. Each phase will take place 24 hurs fllwing the previus step. If symptms return during any phase, a 24 hur perid f rest is required befre repeating that phase. Fr the student athlete : This prtcl will be perfrmed under the supervisin f the athletic trainer/nurse/cach. Stage 1: Light aerbic activity (i.e. walk, bike, swim, <70 % maximum heart rate fr 24 hur minimum) Stage 2: Increased aerbic activity (increased intensity f abve exercises fr 24 hur minimum) Stage 3: Nn-cntact activity related t specific sprt/skill (i.e. shting drill, running drill) Stage 4: Full cntact activity (participate in nrmal training activities, full exertin fr 24 hurs minimum) Stage 5: Return t cmpetitin Fllw Up The athletic trainer and/r schl nurse will cnduct a fllw-up assessment with the student ne week after he/she returns t full academic and athletic activity. The student is encuraged t meet with schl cunselr regularly t discuss prgress, grades, and status f make-up wrk. The student is encuraged t meet with the athletic trainer r schl nurse t assess any recurring symptms. Fr additinal questins, please cntact the student s schl nurse, cunselr r the athletic trainer. LZHS Cncussin Task Frce: Physician- Dr. Philip Skiba District Head Nurse-Karen Presutti Athletic Directr-Rlly Vazquez Head Trainer-Andrew Rdzk (Athletic Trainer) Assistant Principal High Schl-Melissa Pikul Assistant Principal Middle Schl Nrth-McKenna Serwka Assistant Principal Middle Schl Suth-Jhn Walsh March 2016 Rev. Aug 2016, Nv 2016