Placer Union High School District
CONCUSSION PROTOCOL FOR TEAM SPORTSStep 1: A player is suspected of having a concussion
Student-Athlete removed from play/practice
Coach/Trainer makes contact with parent/guardian and gives them an Acute Concussion Care (ACE) Plan (coach or student can complete top section) and Return to Play Protocol.
Coach/Trainer to inform parent that they must take their student with the ACE/RTP forms to their doctor before being allowed to return to play.
If the parent is not there, the coach will give forms to the athlete and follow up with a phone call that day informing the parent of the incident.
Coach/Trainer completes Student Accident Report (On and Off Campus Coaches)
Go to Placer Union High School District website
Click “Resources for Staff”
Click “Student Accident Report”
Complete and submit online report
Coach/Trainer will email the AD and designated office staff the day of the incident
Step 2: Day after Incident
The online student accident report will generate an email to notify designated office staff.
Designated office staff will follow up with the coach and review the accident report as necessary.
All information will be put into the shared Google spreadsheet (sample provided) and Aeries.
Designated office staff will also notify the Counselor/AD/AP/Attendance/DN.
The AD or Coach/Trainer will make follow-up phone call to parent(s) reminding them that they must take their child (with ACE Plan) to their doctor if needed.
Step 3: Doctor follow-up orders and care plans
When the student-athlete goes to the doctor and is “cleared”
Student/parent must provide a doctor note stating that student is cleared and able to return to play/school and give it to designated office staff
Office staff will scan and send it to the Counselor/AD/AP/Attendance/DN and note it in Aeries/spreadsheet.
If the athlete is “not cleared” and the doctor provides a Care Plan
Student/parent will give care plan to designated office staff.
The plan needs to state how long of a period that the athlete will be under doctor care. A follow-up appointment date should also be noted.
The designated office staff will scan and send it to the Counselor/AD/AP/Attendance/DN and note it into Aeries/spreadsheet.
Counselors will send any doctor’s recommendations regarding classroom instruction or homework to the teachers.
When an athlete is finally cleared, student/parent must provide a doctor note stating that student is cleared and able to return to play/school and give it to designated office staff
If the student-athlete continues with symptoms, counselor will determine if SST is required in support of student achievement.
If no information has been received concerning the student’s condition after 7 days, designated office staff will inform the DN, who will then contact the parent directly to obtain info and share with staff.
NOTE: If a student does not report an injury at the time it occurs, and only later notifies coaches and/or office staff, make sure to make a note of the date the injury was reported to staff (along with injury date) on the shared Google spreadsheet. Begin at Step 2 after notification.