Concussion Information Sheet. A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away. Symptoms may include one or more of the following:
Concussion Information Sheet. I/We acknowledge that I/we have received, read, and understand School’s “Concussion Information Sheet.” I/We agree to sign and return the “Concussion Information Sheet” to School before the Student can participate in Athletic Activity. I/We agree to notify the Student’s coaches and athletic trainer immediately if I/we suspect that the Student has suffered a concussion or notice a change in the Student’s behavior, mental state or physical condition consistent with the signs of concussion outlined in the Concussion Information Sheet.
Concussion Information Sheet. I/We acknowledge that I/we have received, read, and understand CDC’s (Center for Disease Control and Prevention); “Concussion Fact Sheet.”
Concussion Information Sheet. A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a "ding" or a bump on the head can be serious. You can't see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away. Symptoms may include one or more of the following: Amnesia “Don’t feel right” Fatigue or low energy Sadness Nervousness or anxiety Irritability More emotional Confusion Concentration or memory problems (forgetting game plays) Repeating the same question/comment • • • • • • • • • •
Concussion Information Sheet. A concussion is a type of brain injury and all brain injuries are serious. A concussion can be caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. It can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION? Signs and symptoms of concussion may show up right after the injury or may not appear or be noticed until days or weeks after the injury. If your child reports any symptoms of concussion listed below, or if you notice the symptoms or signs of concussion yourself, your child should be kept out of play the day of the injury and until a healthcare professional, experienced in evaluating for concussion, determines that your child is symptom-free and able to return to play. Signs observed by coaching staff: Symptoms reported by athletes: • Appears dazed or stunned • Headache or “pressure” in head • Is confused about assignment or position • Nausea or vomiting • Forgets an instruction • Balance problems or dizziness • Is unsure of game, score, or opponent • Double or blurry vision • Moves clumsily • Sensitivity to light • Answers questions slowly • Sensitivity to noise • Loses consciousness (even briefly) • Feeling sluggish, hazy, foggy, or groggy • Shows mood, behavior, or personality changes • Concentration or memory problems • Can’t recall events prior to hit or fall • Confusion • Can’t recall events after hit or fall • Just not “feeling right” or “feeling down” Concussions affect people differently. While most athletes with concussion recover quickly and fully, some will have symptoms that last for days, or even weeks. A more serious concussion can last for months or longer. In rare cases, a dangerous blood clot may form on the brain and crowd the brain against the skull. An athlete should receive immediate medical attention if after a bump, blow, or jolt to the head or body she/he exhibits any of the following danger signs: • One pupil is larger than the other • Convulsions or seizures • Is drowsy or cannot be awakened • Cannot recognize people or places • Repeated ...
Concussion Information Sheet. Board Policy 7:305, Concussions and Head Injuries, requires, among other things, that a student athlete who exhibits signs and symptoms, or behaviors consistent with a concussion or head injury must be removed from participation or competition at that time and that such student will not be allowed to return to play unless cleared to do so by a physician licensed to practice medicine in all its branches or a certified athletic trainer. This form must be given to a student and their parent guardian each year with the Agreement to Participate. The Agreement to Participate must be completed and signed each year by the student and the student’s parent (meaning the student’s natural or adoptive parent or other legal guardian or person with legal authority to make medical decisions for the student) before the student may participate in interscholastic sports or intramural athletics for the school year. This form contains all language from the Concussion Information Sheet approved by the Illinois High School Association. Concussion Information A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away. Symptoms may include one or more of the following: Headaches Amnesia “Pressure in head” “Don’t feel right” Nausea or vomiting Fatigue or low energy Neck pain Sadness Balance problems or dizziness Nervousness or anxiety Blurred, double, or fuzzy vision Irritability Sensitivity to light or noise More emotional Feeling sluggish or slowed down Confusion Concentration or memory problems (forgetting game plays) Repeating the same question/comment Feeling foggy or groggy Drowsiness Change in sleep patterns ...
