Concussion and Mild Traumatic Brain Injury (mTBI)

NYSED Guidelines for Concussion Management in Schools have been revised to reflect the current recommendations on managing concussions. Emerging research suggests that some symptoms may be acceptable during the return to activities.  The updated guidelines reflect this practice along with emphasizing that schools follow the guidance of the student’s health care provider on what symptoms are acceptable for return to activities. A gradual return to physical activity typically is done by progressing a student through levels of activity that increase in duration and/or intensity. Gradual return to activity should occur with the introduction of a new activity level every 24 hours.  If any post-concussion symptoms return, the student should stop the activity and drop back to the previous level of activity. Current research suggests that some level of symptoms with activity is acceptable. Therefore, schools will need to follow provider orders on return to activities. Students should be monitored by district staff daily following each progressive level of physical activity, for any return of signs and symptoms of a concussion. A gradual progression should be followed based on the private healthcare provider’s or other specialist’s orders and recommendations.

Research: Consensus Statement On Concussion in Sport (5th International Conference On Concussion in Sport, Berlin, October 2016) can be viewed here. Fifth Berlin Concussion Statement

The law requires that students who sustained, or are suspected to have sustained, a concussion during Athletic Activities (interscholastic sports) are to be immediately removed from such activities. Such students may not return to athletic activities (interscholastic sports) until they have been symptom-free for a minimum of 24 hours and have been evaluated by and receive written and signed authorization to return to activities from a duly licensed physician.

Concussion FAQs 

NYSED Laws, Regulations, Guidelines, and Practice Memos Regarding Concussions

Concussion Management and Awareness Law Section 136.5.

Regulations of the Commissioner 135.1 Health and Physical Education

NYSED Guidelines for Concussion Management In Schools (Revised 6/2018)

NYSED Coaching Update on the NFHS Concussion Rule for Officials (October 2010) -"Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headaches, dizziness, confusion or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health-care professional".

NYSED Memo: Athletic Trainer Scope of Practice Memo (7/2011)

NYSED Approved Concussion Training Courses

The webinars listed below are national training videos.  NYS  scope of practice may differ from what is described in the training. RNs, LPNs, and ATCs practicing in NYS must follow NYS laws in regards to licensing and scope of practice.

School nurses at all levels and certified athletic trainers in secondary schools must complete NYSED approved courses every 2 years. NYSED has approved the free CDC course: Heads Up to Clinicians for these professions (45 minutes). This training must be completed at one time and cannot be saved. Do not refresh the program while watching, or it will reset to the beginning.
Coaches and PE teachers- Must complete a NYSED approved course every 2 years. NYSED has approved the free CDC course Heads Up, Concussion in Youth Sports for both of these professions.

In addition, Coaches may meet the mandatory training requirement by taking the approved free CDC/NFHS course Concussion in Sports from the National Federation of State High School Associations - also available in Spanish (4/18)

Assessment Tools 

Baseline and post-injury concussion assessment tools such as the ACE (Acute Concussion Evaluation), ImPact, Scat 3, and FAQs on Baseline Testing (who can perform)

Care Plans

ACE (Acute Concussion Evaluation) Care Plan-This form is part of the "Heads Up: Brain Injury in Your Practice" tool-kit developed by the CDC. It provides a referral plan by the private provider containing information on current symptoms and recommendations for return to learn and return to play.

NYSCSH Sample Acute Concussion Care Plan and Parent Information Sheet-This template can be customized for your needs. It includes a care plan and information sheet for parents and students.

NYSCSH Sample TBI Return Monitoring
Sample tracking tool schools may use to track student's symptoms for Return To Learn (RTL), Return To Play (RTP) (11/2017) 

Concussion Incident Tracking and Reporting Forms

NYSCSH TBI Return Monitoring-Sample tracking tool schools may use to track student's symptoms for Return To Learn (RTL), Return To Play (RTP) (11/2017) 

NYSCSH Voluntary Data Reporting -Allows the Center to track NYS concussions sustained in school.  

Heads Up Concussion Resources-CDC

Heads Up Resource Center-CDC:  Provides online, print, and video materials order forms, signs and symptoms checklist, Heads Up Head Injury Concussion Resources for physicians, coaches, school nurses, teachers, and counselors.

Heads Up for School Sports: Assists coaches, parents, and athletes properly identify and respond to a concussion, CDC, in partnership with leading experts and organizations, developed the HEADS UP: Concussion in School Sports initiative and materials.

Online Concussion Training Course for High School Sports Coaches

NYSDOH Traumatic Brain Injury Resources - Provides resources on data and statistics, prevention, and symptoms. Includes wallet cards, posters, and links to services and organizations.

Professional Organizations

American Association of Neurological Surgeons

Brain Injury Association of New York State (BIANYS)

Brain Trauma Foundation-Provides research checklists, videos, and therapeutic interventions.

NYSDOH - "When in Doubt-Take Them Out"-Concussion Prevention campaign provides free fact sheets, posters, magnets, and additional materials for school staff and parents.

Nationwide Children’s Hospital- An Educator’s Guide to Concussions in the Classroom Upstate University Hospital-Concussion in the Classroom

NYSPHSAA (NYS Public High School Athletic Association) Safety and Research Page

Provides information related to high school athletics including a summary of the concussion law, sample policies, guidelines and procedures, student and parent information sheets, symptom checklists, and other concussion management support materials.

Additional Resources

ESPN Video- Life Changed by Concussion

Page Updated 4/11/19