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Concussion Management Protocol & ImPACT Testing

A Concussion is a Mild Traumatic Brain Injury (MTBI) resulting from a blow, violent jarring or rotational force to the head.The injury involves an acceleration-deceleration mechanism in which a blow to the head or the head striking an object results in 1 or more of the following conditions: headache, nausea, vomiting, dizziness, balance problems, feeling ‘‘slowed down,’’ fatigue, trouble sleeping, drowsiness, sensitivity to light or noise, Loss Of Consciousness, blurred vision, difficulty remembering, or difficulty concentrating. Symptoms may last from several days to several months and both the presentation and length of symptoms is highly individualized.

At Holliston High School, we utilize the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) neurocognitive test battery and formally consult with athletes' primary care doctor. Note that the ImPACT test is just one tool to assist the AT with diagnosing a concussion. 

What an athlete can expect when a concussion occurs:
  • Upon assessment of concussion, the student-athlete is removed from the contest and is not allowed to return under any circumstances. Assessment of concussion in made by a Certified Athletic Trainer or Physician covering the contest.
  • Within 24-72 hours of concussion assessment, an initial Post-Injury ImPACT test is administered by the Athletic Trainer.
  • The School Nurse is alerted in the case that academic accommodations are necessary.
  • One or more RESTING Post-Injury ImPACT tests will be administered until neurocognitive scores return to baseline (if baselined for collision/contact sports) or fall into age-appropriate average range. 
    • The 1st benchmark the student-athlete must achieve is resolution of symptoms, at rest. 
    • The 2nd benchmark the student-athlete must achieve is the ability to perform light exertion, without recurrence of symptoms.
  • Once benchmarks 1 and 2 have been achieved, one or more POST-EXERTION ImPACT tests may be administered. 
  • The 3rd benchmark the student-athlete must achieve is for neurocognitive scores to remain in normal range after Post-Exertion ImPACT testing, in combination with the absence of symptom recurrence.
  • Finally, as a guiding rule, all collision/contact athletes must be at least 1 week asymptomatic before returning to potential contact.
  • Student must have completed missed homework and tests in order to be eligible for return to play
Dialogue between the Athletic Trainer, the School Nurse, the student-athlete and his/her coach is on-going throughout the concussion management process. Additional dialogue with parents, guidance counselors, pediatricians and others may be necessary. Only after all of these benchmarks have been met, will a student-athlete be able to Return to Play after sustaining a concussion.