Locust Valley Central School District
Concussion Management Procedures
Mark J. Dantuono
District Director of Health, Physical Education & Athletics
Tony Marra- M.S., ATC, P/E
Assistant Athletic Trainer
School District TBI Consultant
Concussion Management
Awareness Act
NYS created and implemented this new law
effective July 1, 2012.
 As a result, all school coaches, physical
education teachers, nurses and athletic
trainers must on a biennial basis complete
the training certification program.
 This program will include recognizing the
symptoms pertaining to traumatic brain
injuries and the monitoring and seeking the
proper treatment for students who
experience mild traumatic brain injuries.

Definition of a Concussion
What is a concussion?- Is a brain injury that
is caused by a bump or blow to the head.
How can it occur?- May occur from a fall or
blow to the body that causes the head to
move rapidly back and forth.
Definition of Second Impact
Syndrome

A potential catastrophic medical emergency
where a 2nd concussion is sustained while
symptomatic from the initial concussion.
Both injuries can occur within a same event,
very common to people under 20 years of
age.
 As a result may create massive pressure to
the brain which can lead to brain damage
and or death.

Post -Traumatic Concussion
Syndrome
Persistent post-concussion symptoms
lasting weeks, months or even years after a
concussion.
How Concussions May Occur in
a School Setting
Classroom- Desk(top or bottom), door,
trip/fall and or collision with another person
or object.
 PE Class- Collision with another student
or non-moving object (wall), moving
objects such as basketball or soccer balls.
 Recess- Outdoor equipment which will
include swings, slides, monkey bars, rings
and climbing ropes.

Signs and Symptoms
Signs observed by school professionals:
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Appears dazed or stunned
Is confused about events
Answers questions slowly
Repeats questions
Can’t recall events after hit, bump or fall
Loses consciousness (even briefly)
Signs and Symptoms (cont.)
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Symptoms reported by students
Thinking/Remembering
Difficulty thinking clearly
Difficulty concentrating or remembering
Feeling sluggish, foggy or groggy
Physical
Headache or “pressure” in head
Nausea or vomiting
Balance problems or dizziness
Fatigue or feeling tired
Blurry or double vision
Sensitivity to light or noise
Emergency Procedures
1. Observe body position of the child:
face up/down, sitting, or standing
unbalanced
2. Radio or contact school nurse
immediately.
3. Do not move or have anyone else move
student.
(If student is unconscious call 911)
Responsibilities of Parent and School
Staff dealing with a concussed
child/student
ParentsObserve daily child behavior
Observe sleeping/eating behaviors and physical
symptoms (dizziness and headaches)
Eliminate the use of all electronic devices (TV,
computer, IPAD/gaming devices and cell phone
usage)
Observe emotional behavior (irritability,
sadness/crying and nervousness)
Responsibilities of Parent and School Staff
dealing with a concussed child/student-cont.
School StaffObserve academic performance (difficulty
concentrating, remembering or thinking
clearly)
Observe light and noise sensitivity,
headaches and dizziness.
Observe emotional behavior (irritability,
sadness/crying and nervousness)
NYS Return to Play Protocol

In the event a child is concussed, he or she may
not return to physical activities and physical
education class until the 6-stage return to play
protocol is administered and completed by the
school nurse and physical education teacher.
Elementary Return to Play Protocol
Locust Valley School District
T.B.I. Primary/Intermediate Level Return To Play Protocol
Name:_____________________D.O.I.:
AGE:
, Max HR:____
, Dx. Date:
STAGE 1: Very Light Aerobic Activities (30-40% max effort)
10-15 minutes of cardio exercise in a low stimulus environment; limiting
head movement and concentration activities. Example: walking stationary bike.
STAGE 2: Moderate Aerobic Activities (40-60% max effort)
20-30 minutes of cardio exercise and light strengthening in a gym environment,
allowing some positional changes and head movement: low level concentration
activities. Example: light jogging or stationary bike, light weight training, and
.
balance training with limited hand/eye coordination
Elementary Return to Play
Protocol (cont.)
STAGE 3: Moderately Aggressive Aerobic Activities (60-80% max effort)
Balance and strength training at 80% effort.
Proprioceptive activities to incorporate concentration activities. Example:
running/sprinting, stationary bike, and plyometrics,
STAGE 4: Sports Performance Training (80-90% max effort)
Training in sports specific activities, increasing hand/eye coordination.
Example: student may increase training with multiple head, hand, and eye
coordination skills.
STAGE 5: Full Unrestricted Performance Training
Student may return to ALL school related activities. Example: full unrestricted
participation in P.E. classes ONLY. NO outside activities
Elementary Return to Play
Protocol (cont.)
STAGE 6: Full Unrestricted Activities
Return to full activities, BOTH in and out of school environment.
Approved and authorized by LVCSD Physicians, the above stages
must be implemented by School Nurse and Physical Education
Teacher.