Concussion Management Policy

The Nightingale-Bamford School recognizes that concussions and head injuries are commonly reported injuries in children and adolescents who participate in sports and recreational activity; they can have serious consequences if not managed carefully. The Nightingale-Bamford School has adopted the following policy to support the proper evaluation and management of head injuries.

Concussion is a mild traumatic brain injury. Concussion occurs when normal brain functioning is disrupted by a blow or jolt to the head. Recovery from concussion will vary. Avoiding re‐injury and overexertion until fully recovered is critical to proper concussion management. While school staff will exercise reasonable care to protect students, head injuries may still occur. Physical education teachers, coaches, and nurses will receive training to recognize the signs, symptoms, and behaviors consistent with a concussion. As an additional tool, all athletes in Classes VII–XII will take the baseline ImPACT test prior to the start of an athletic season. In the event of a possible concussion, the athlete will retake the test and those results may be shared with a health care professional. To learn more about ImPACT, click here.

Any student exhibiting the signs, symptoms, or behaviors of concussion while participating in a school-sponsored class, extracurricular activity, or interscholastic athletic activity shall be removed from the game or activity and should be evaluated as soon as possible by an appropriate health care provider if symptoms continue. The school nurse or athletic trainer will notify the student’s parents or guardians and recommend appropriate action if there is a suspected concussion.

If a student sustains a concussion at a time other than when engaged in a school‐sponsored activity, the school expects the parent/guardian to report the condition to the school nurse so that the school can support the appropriate management of the condition.  

If the student is treated by a health care professional for a suspected concussion, the student shall not return to physical activity until authorized by the health care provider in a written note provided to the school. The school nurse, athletic trainer, or concussion team coordinator will then follow the recommended protocols to guide the student through the steps to return to physical activity. Any student returning to physical activity following a diagnosis of concussion must follow the “return to play” protocol below, slowly introducing exercise prior to resuming full activity. If a student is recommended by a medical professional to receive academic accommodations, the student should not be participating in extracurricular activities during that time. Limiting screen time, reading and study time, or other academic assignments should not be limited to in-school hours; rest is needed to facilitate healing.  

Return to Play Protocol

Return to play following a concussion involves a stepwise progression once the student is symptom free and has been cleared by a doctor. There are many risks to premature return to play, including: a greater risk for a second concussion because of a lower concussion threshold, second impact syndrome, exacerbation of any current symptoms and possibly increased risk for additional injury due to alteration in balance. The current NYSPHAA return to play recommendations are based on the most recent international expert opinion. No student-athlete should return to play while symptomatic. Students are prohibited from returning to play the day the concussion is sustained. Once the student-athlete is symptom free at rest for 24 hours and has a signed release by the treating clinician, she may begin the return to play progression below (provided there are no other mitigating circumstances).

  • Day 1: Light aerobic activity
  • Day 2: Sport-specific activity
  • Day 3: Non-contact training drills
  • Day 4: Full contact practice
  • Day 5: Return to play

Each step should take 24 hours. Once the athlete is asymptomatic after introducing all steps of exercise listed above, she can return to play. If any post-concussion symptoms occur while in the stepwise program, then the student should drop back to the previous asymptomatic level and try to progress again after a further 24-hour period of rest has passed.

For further information about concussions, visit the CDC's "HEADS UP" webpage.

 Updated February 15, 2016
The Nightingale-Bamford School
20 East 92nd Street New York NY 10128
T: 212 289 5020
F: 212 876 1045
info@nightingale.org
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