AUBURN UNIVERSITY CONCUSSION MANAGEMENT PLAN

Purpose: To provide guidelines for the prevention and treatment of concussions in collegiate athletics atAuburn University.

1. Auburn University shall require student-athletes to sign a statement in which the student-athlete accepts the responsibility for immediately reporting any acute head trauma / headinjury (concussion) and illness to the institutional medical staff, including signs and symptoms ofconcussions.

2. Auburn University shall also require student-athletes and their parents / legal guardian

to complete and sign a concussion history sheet, reporting any prior head trauma / headinjury (concussion) and illness to the institutional medical staff, including signs and symptoms ofconcussions.

3. All student-athletes will be presented with educational materials on concussions before eachcompetitive season after all medical documents have been reviewed by the team physician.

4. Auburn University will have on file and annually update an EAP(emergency action plan) for eachathletics venue to respond to student-athlete catastrophic injuries and illnesses, including butnot limited to concussions, heat illness, spine injury, cardiac arrest, respiratory distress(asthma), and sickle cell trait collapses.

5. Auburn University's healthcare model includes equitable equal access to the same

healthcare providers/ care for each sport.6. Auburn University's healthcare providers are empowered to have the authority to

determine status, management and return-to-play of any ill or injured student-athlete

with a concussion, as he or she deems appropriate.

7. Auburn University's concussion management plan is team physician directed. The teamphysician or another designated physician who has expertise in the management of

sports related concussion will have the final authority to determine status, managementand return-to-play of any concussed student-athlete.

8. Any member of the healthcare team, i.e., physicians, certified athletic trainer, nurse

practitioner, physician's assistant, clinical psychologist, sports psychologist or Graduate

Assistant athletic trainer may identify an athlete with concussive type symptoms and

remove them from play. After a student athlete is identified as having concussive

symptoms they will be assessed by the team physician or his designated substitute who

will then determine appropriate status, management and return-to-play issues.

9. Auburn University will ensure coaches have acknowledged they understand the

concussion management plan, their role within the plan and that they received

education about concussions.

10. Auburn University's athletic healthcare providers will practice within the scope of their

professional practice as outlined by the State of Alabama. This includes physicians,certified athletic trainers, physician assistants, nurse practitioner, clinical psychologists,and referral physicians or neuropsychologist.

11. Auburn University will record a baseline computer-based concussion assessment test

called Impact Testing for each student-athlete prior to first practice in the sports of

baseball, basketball, diving, equestrian, football, gymnastics, pole vaulting, soccer,

volleyball and softball. In addition student-athletes in any sport who have a significant

concussion history will also obtain a baseline assessment prior to the first practice,

including a computer-based concussion assessment test called Impact Testing.

12. The same baseline assessment tools will be used post injury at the appropriate time

intervals. The baseline assessment tools will consist of:

a. The use of symptom check list and standardized cognitive assessmenttest (such as SCAT) and balance testing ( such as balance error scoringsystem: BESS).

b. The student-athletes will also undergo a computer-based concussion

assessment test called Impact Testing.13. When an Auburn University student-athlete shows any signs, symptoms, or behaviors

consistent with concussion, the athlete shall be removed from practice or competitionand be evaluated by an athletics healthcare provider with experience in the evaJuation

and management of concussion.

14. A student-athlete diagnosed with a concussion shall be withheld from competition orpractice and not return to activity for the remainder of that day.

15. The student-athlete should receive serial monitoring for deterioration. Athletes should

be provided with oral and preferably written instructions upon discharge: preferably

with a roommate, parent/guardian, or someone that can follow the instructions.16. The student-athlete will be evaluated by team physician as outlined within the

concussion management plan. Once asymptomatic, return-to-play will follow a teamphysician prescribed, supervised stepwise protocol.

17. Final authority for return-to-play shall reside with the team physician.18. Auburn University will document the incident, evaluation, continued management, and

clearance of the student-athlete with a concussion. At minimum, the Sports Concussion

Assessment Tool 2 (SCAT2) will be utilized for concussion documentation.

19. Although sports currently have rules in place, athletics staff, student-athletes and

officials should continue to emphasize that purposeful or flagrant head or neck contact

in any sport should not be permitted and current rules of play should be strictly

enforced.

Jan 02 13 04:36p AUBURN SPORTS MEDICINE 334-844-0932

NAME: OOB: DATE: SPORT:

Concussion follow up

Date of Concussion: _

Date of last headache: _

Rate headaches 1-10 scale: _

Post Concussion Symptom Scale

None Moderate SevereHeadache 0 1 2 3 4 5 6"Pressure in head" 0 1 2 3 4 5 6Neck Pain 0 1 2 3 4 5 6Balance problems/dizzy 0 1 2 3 4 5 6Nausea or vomiting 0 1 2 3 4 5 6Vision problems a 1 2 3 4 5 6Hearing problems/ringing 0 1 2 3 4 5 6"Don't feel right" a 1 2 3 4 5 6Feeling "dinged"f'dazed" a 1 2 3 4 5 6Confusion a 1 2 3 4 5 6Feeling slowed down a 1 2 3 4 5 6Feeling like "in a fog" 0 1 2 3 4 5 6Drowsiness a 1 2 3 4 5 6Fatigue or low energy 0 1 2 3 4 5 6More than emotional 0 1 2 3 4 5 6Irritability 0 1 2 3 4 5 6Difficulty concentrating 0 1 2 3 4 5 6Difficulty remembering 0 1 2 3 4 5 6Trouble falling asleep a 1 2 3 4 5 6Sleeping more than usual 0 1 2 3 4 5 6Sleeping less than usual 0 1 2 3 4 5 6Sensitivity to light 0 1 2 3 4 5 6Sensitivity to noise 0 1 2 3 4 5 6Sadness 0 1 2 3 4 5 6Nervousness 0 1 2 3 4 5 6Numbness or tingling a 1 2 3 4 5 6

Athlete Signature: Date: _

p.1

Jan 02 13 04:36p AUBURN SPORTS MEDICINE 334-844-0932 p.2

NAME: OOB: DATE: SPORT:

Concussion follow up

Date of Concussion: _

Headaches since last visit: _

Rate headaches 1-10 _

Memory

At what venue are we? __ Which half is it? __ Who scored last? __ What team did we play last? __ : Did we winlast game? __

Cognitive

Five word recallImmediate Delayed

Word 1 catWord 2 penWord 3 shoe _Word 4 book _Word 5 car

Months in reverse order:Jun-May-Apr-Mar-Feb-Jan-Oec-Nov-Od-Sep-Aug-Jul

Digits backwards

Alphabet backwards

GeographyBalance

One leg stork stand