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Conroe ISD Pre-Participation Concussion Information During the 82nd legislative session, a new state law was passed providing for the prevention, treatment, and oversight of concussions affecting students involved in interscholastic activities. This law requires that each school district in the state create one or more Concussion Oversight Teams. The law requires that any student suspected of suffering a concussion be immediately removed from practice or competition until the student is seen by a physician of their parent/guardian’s choice. The law requires that before a student may return to play the student must complete a five-day Return-to-Play Protocol. The law also requires that parents acknowledge in writing that they have received information regarding concussion prevention, symptoms, treatment and oversight, and that parents separately grant permission in writing for their child to return to ful participation. The purpose of this document is to provide you the information required by law relating to concussions. If you have any questions, please contact, CISD Athletic A concussion is defined as a type of traumatic brain injury
The State’s protocol for managing concussions includes a (TBI) caused by a bump, blow, or jolt to the head that can multi-disciplinary approach involving licensed athletic trainer change the way the brain normally works. Concussions can or school nurse clearance, physician referral and clearance, also occur from a blow to the body that causes the head to and successful completion of activity progressions related to move rapidly back and forth. Even a “ding”, “getting your your child’s sport. Below is an outline of this procedure which bell rung”, or what seems to be a mild bump on the head can is referred to as the “Return-to-Play Protocol”.
Before your son/daughter can return to his/her sport/activity
The following are signs and symptoms of a concussion:
after having sustained a concussion, he/she must:
• Headache that increases in intensity* • Be evaluated by a physician chosen by you. The physician must complete the District form indicating a normal physical • Difference in pupil size from right to left eye, dilated pupils* and neurological exam. Without this acknowledgment from • Mental confusion/behavior changes, dizziness, memory your physician, your child wil not be permitted to begin the • Be monitored daily at school by the licensed athletic trainer and/or school nurse. His/her teachers may be notified of the • Noticeable changes in level of consciousness (dif iculty injury and what to expect. Accommodations may be given awakening or loss of consciousness suddenly)* depending on recommendations made by your physician.
• Be asymptomatic at rest and exertion at each step of the • Decreased or irregular pulse or respirations* progression through the Return-to-Play Protocol.
* Seek medical attention at the nearest emergency room
• Complete the Return-to-Play Protocol after being cleared by The best guideline is to note symptoms that worsen, and his/her physician. The Protocol is a progressive step-by-step behaviors that seem to represent a change in your child. If procedure that advances at the rate of one step per day. The you have any question or concern about the symptoms that you are observing, contact your family physician or go to the • No exertional physical activity until student-athlete is emergency room. The following chart may be helpful in symptom free for 24 hours and receives written clearance knowing what to do if your child is suspected of having from a physician and submission of the required documentation fol owing the concussion injury.
Step 1: Light aerobic exercise with no resistance training
It is OK to:
as outlined in the UIL Implementation Guide • Use acetaminophen (Tylenol) for headaches • Use ice pack on head & neck as needed for comfort • Step 2: Moderate aerobic exercise as outlined in the UIL
Step 3: Non-contact training dril s with resistance
• Rest (no strenuous activity or sports) _______________________________________________________
training as outlined in the UIL Implementation Guide There is NO need to:
Step 4: Ful contact practice or training dril s as outlined
Step 5: Ful game play as outlined in the UIL
Implementation Guide after the parent has _______________________________________________________
signed/completed the UIL Return-to-Play Form • Athlete progression continues as long as athlete is asymptomatic at current activity level. If the athlete experiences any post concussion symptoms, he/she wil wait 24 hours and start the progressions again at the • Take ibuprofen, aspirin, naproxen or other non-steroidal anti- _______________________________________________________
• Return the signed UIL Return-to-Play Form to your child’s The Conroe Independent School District does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. The fol owing persons have been designated to handle inquiries regarding these non-discrimination policies: Title IX Coordinator, 3205 W. Davis, Conroe, Texas 77304; (936)-709-7700 and the Section 504/ADA Coordinator, 3205 W. Davis, Conroe, Texas 77304; (936) 709-7670.
Conroe Independent School District
Pre-Participation Concussion Information Acknowledgement
My child and I have received and read the information provided by the District explaining concussion prevention, symptoms, treatment, oversight, and guidelines for safely returning to play after a concussion. Athlete’s name (print): _______________________________________________________________________________________________________________________ ___________________________________________________________________ Parent/Guardian’s name (print): _____________________________________________________________________________________________________ ___________________________________________________________________ Date: __________________________________________________________________



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