Iowa Administrative Code 641—54

Concussion or Other Brain Injury Return-to-Play Protocol

Iowa Code 280.13C

Brain Injury Policies

Effective date:            July 1, 2019

This Concussion Management Plan is adopted in accordance with Iowa law to help ensure the safety of all students in the Urbandale Community School District.  This plan will be implemented throughout the District on three different levels as further outlined below.

Iowa Code § 280.13C(1)(b) states that “Concussions are one of the most commonly reported injuries in children and adolescents who participate in sports and recreational activities… Concussions are a type of brain injury that can range from mild to severe and can disrupt the way the brain normally works. Concussions can occur in an organized or unorganized sport or recreational activity and can result from a fall or from players colliding with each other, with the ground, or with obstacles. Concussions can occur with or without loss of consciousness, but the vast majority of concussions occur without loss of consciousness.”

“Interscholastic Athletics” as used throughout this Plan shall have the same meaning as “extracurricular interscholastic activity” as defined by Iowa Code § 280.13C(2)(d): “any dance or cheerleading activity or extracurricular interscholastic activity, contest, or practice governed by the Iowa high school athletic association or the Iowa girls high school athletic union that is a contact or limited contact activity as identified by the American academy of pediatrics.” 

This plan addresses:

• Students in Grades PK – 12, who do not participate in Interscholastic Athletics
• Students in Grades 7-12, who participate in Interscholastic Athletics when classes are in session
• Students in Grades 7-12, who participate in Interscholastic Athletics when classes are not in session

• Injury occurs
• Evaluation of brain injury
• Mandatory evaluation by a “licensed health care provider” (defined in IAC 641—54.2(280) and Iowa Code § 280.13C(2)(e))  as a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board designated under Iowa Code section 147.13.)
• Return to Learn (RTL) begins

• RTL Steps as outlined by School Nurse
• • The RTL team will consist of the school nurse, teachers involved in the student’s daily learning, with input from the student’s parents or guardians and the student’s licensed health care provider. 
  • REAP Guidelines will serve as basis
  • School nurse will receive daily updates on RTL progress from teachers
  • Students will visit with the School Nurse daily until the RTL process is complete
• Released by nurse following collaboration with parent

• Injury occurs or a student’s coach, contest official, or licensed health care provider or an emergency medical care provider observe signs, symptoms, or behaviors consistent with a concussion or brain injury in Interscholastic Athletics.
• Student is removed from participation in Interscholastic Athletics. 
• Evaluation of brain injury
• Mandatory evaluation by a “licensed health care provider” (defined in IAC 641—54.2(280) and Iowa Code § 280.13C(2)(e))  as a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board designated under Iowa Code section 147.13. 
• Return to Learn begins

• RTL Steps as outlined by School Nurse
• • The RTL team will consist of the school nurse, teachers involved in the student’s daily learning, with input from the student’s parents or guardians and the student’s licensed health care provider. 
  • REAP Guidelines will serve as basis
  • School nurse will receive daily updates on RTL progress from teachers
  • Students will visit with the School Nurse daily until the RTL process is complete
• Released by School Nurse to begin Return to Play with the Athletic Trainer
• RTP is managed by the Athletic Trainer and includes the following steps, mandated by Iowa Administrative Code 641-54.3(2)
• • Athlete has received written medical clearance from a licensed health care provider to begin the return-to-play process, AND the athlete is back to regular activities, including school, without experiencing any concussion signs, symptoms, or behaviors for a minimum of 24 hours.
  • Low impact, light aerobic exercise. Walking or stationary cycling at slow to medium pace. No resistance/weight training
  • Basic exercise, such as running in the gym or on the field. No helmet or other equipment.
  • Noncontact, sport-specific training drills (dribbling, ball handling, batting, fielding, running drills) in full equipment.  Resistance/weight training may begin.
  • Full contact practice and participation in normal training activities.
  • URBANDALE HIGH SCHOOL STUDENTS will take the ImPACT post-test at this time.
  • Contest participation.
• If the student shows signs, symptoms, or behaviors consistent with a concussion or other brain injury at any step of the return-to-play protocol, the student must stop the activity and the student’s licensed health care provider and parent or guardian shall be contacted.
• If the student shows signs, symptoms, or behaviors consistent with a concussion or other brain injury during this process, an additional 24-hour period of rest shall take place. After the 24-hour period of rest, the student shall drop back to the previous level when the student showed no signs, symptoms, or behaviors consistent with a concussion or other brain injury and begin the progression again.
• Students involved in Band, Drama, and Show Choir will have their individual case analyzed as it relates to a safe return to participate in their respective activity which could include a modified RTP plan established by the School Nurse and/or Athletic Trainer.

• Injury occurs (classes are NOT in session) or a student’s coach, contest official, or licensed health care provider or an emergency medical care provider observe signs, symptoms, or behaviors consistent with a concussion or brain injury in Interscholastic Athletics.
• Student is removed from participation in Interscholastic Athletics. 
• Evaluation of brain injury
• Mandatory evaluation by a “licensed health care provider” (defined in IAC 641—54.2(280) Iowa Code § 280.13C(2)(e))  as a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board designated under Iowa Code section 147.13. 

• Return to Play begins, if applicable RTP is managed by the Athletic Trainer and includes the following steps, mandated by Iowa Administrative Code 641-54.3(2)
• • Athlete has received written medical clearance from a licensed health care provider to begin the return-to-play process, AND the athlete is back to regular activities, including school, without experiencing any concussion signs, symptoms, or behaviors for a minimum of 24 hours.
  • Low impact, light aerobic exercise. Walking or stationary cycling at slow to medium pace. No resistance/weight training
  • Basic exercise, such as running in the gym or on the field. No helmet or other equipment.
  • Noncontact, sport-specific training drills (dribbling, ball handling, batting, fielding, running drills) in full equipment.  Resistance/weight training may begin.
  • Full contact practice and participation in normal training activities.
  • URBANDALE HIGH SCHOOL STUDENTS will take the ImPACT post-test at this time.
  • Contest participation.
• If the student shows signs, symptoms, or behaviors consistent with a concussion or other brain injury at any step of the return-to-play protocol, the student must stop the activity and the student’s licensed health care provider and parent or guardian shall be contacted.
• If the student shows signs, symptoms, or behaviors consistent with a concussion or other brain injury during this process, an additional 24-hour period of rest shall take place. After the 24-hour period of rest, the student shall drop back to the previous level when the student showed no signs, symptoms, or behaviors consistent with a concussion or other brain injury and begin the progression again.
• Students involved in Band, Drama, and Show Choir will have their individual case analyzed as it relates to a safe return to participate in their respective activity which could include a modified RTP plan established by the School Nurse and/or Athletic Trainer.

• Each School Nurse, in cooperation with the Building Administration, will conduct an overview of the severity of brain injuries and the practice of Return to Learn at their particular level.

• All Interscholastic Athletic Coaches are required to view the National Federation of High Schools (NFHS) Concussion Training video annually.  This is managed by the Activities Director.
• All students in grades 7-12 that are involved in  Interscholastic Athletics are required to review and sign, along with a parent or guardian, a document provided by the Department of Public Health titled: “Heads Up: Concussions in High School Sports” prior to beginning participation.  This is an annual requirement and is managed by the Activities Director.
• The Urbandale Board of Directors, in action on April 1, 2013, approved the ImPACT test as a requirement for Interscholastic Athletics participation at the high school. Parents do have the ability to opt-out of this test if they elect to not participate.  This test is given annually after July 1.
• Teachers will receive recommendations from the School Nurse, post-concussion, regarding accommodations in the classroom.
• Coaches will receive directions from the Athletic Trainer, post-concussion, regarding Return to Play practice activities and restrictions.
• In April, 2013, the Urbandale Board of Directors approved a policy stating that any athlete sustaining a concussion may not return to action without having been evaluated by a physician, in addition to completing the Return to Play Protocol recommended by the IHSAA / IGHSAU.  This has now been superseded by the requirement that a mandatory evaluation be conducted by a “licensed health care provider” (defined in IAC 641—54.2(280) Iowa Code § 280.13C(2)(e))  as a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board designated under Iowa Code section 147.13.

View this plan as a PDF document.

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