The Professional Softball Club, Inc. is the parent company of the ASBA, ASBA Futures, ASBA Shop, and ASBA Network.
HEAD INJURY EMERGENCY ACTION PLAN:
Definition: A concussion is a traumatic brain injury that interferes with normal brain function. Concussions can range from mild to severe and can disrupt the way the brain normally works. Concussions can occur in any organized or unorganized sport or recreational activity and can result from a fall or from players colliding with each other, the ground, or with obstacles. Concussions occur with or without loss of consciousness, but the vast majority of concussions occur without loss of consciousness.
Evaluation: Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion shall be immediately removed from the event and shall not return to play until cleared by an appropriate health care professional. Appropriate health care professionals are defined as: physicians licensed to practice medicine in all its branches and certified athletic trainers. Any athlete seeing a physician will need written clearance before returning to play. An athlete does not have to lose consciousness (be “knocked out”) to have suffered a concussion. A concussion should be suspected if any of the following symptoms are present: Headache, Dizziness, Amnesia, Loss of consciousness, Blurred vision, Seizure or convulsion, Balance problems, Confusion, Nausea or vomiting, Drowsiness, Sensitivity to light, Difficulty remembering, Fatigue or low energy, Sensitivity to noise, “pressure in head,” Feeling slowed down, Behavioral changes, Neck pain, Feeling “in a fog,” Irritability, Sadness, not “feeling right,” Nervous or anxious, Difficulty concentrating.
Management: Once an athlete self-reports or exhibits behaviors, signs, or symptoms consistent with a concussion, the following protocol should be followed: 1. The athlete is immediately refrained from participating in all physical activity (including practice, games, weight training & conditioning). 2. The athlete should be referred to their primary care provider or the nearest emergency room. 3. If evaluation results in a diagnosis of a concussion, the athlete will be withheld from all physical activity for the remainder of the day. 4. Release to return to play shall be in an incremental fashion in coordination with the Concussion Oversight Team and the athlete’s primary care physician.
Concussion Oversight Team: The Professional Softball Club, Inc. appointed a Concussion Oversight Team responsible for implementing and complying with return-to-play and return-to-learn protocols. These protocols are based on the peer-reviewed scientific evidence consistent with guidelines from the Centers for Disease Control and Prevention.
Expectation: All athletes & coaches will accept responsibility to report all signs and symptoms of concussion to the appropriate director.
Returning to Learn: The athlete’s physician will provide input into the readiness for resumed cognitive activity following a concussion. This will be on an athlete-by-athlete basis. The athlete should have the physician complete a note (such as the attached physician statement) outlining the appropriate return to learn status. The athlete should notify the appropriate Professional Softball Club, Inc. director of concussive injuries and activity progression when returning to activity. The following graduated return to learn protocol is suggested:
RETURN TO LEARN PROTOCOL:
Stage 1 – Complete physical and cognitive rest until medical clearance. (No school attendance, Strict limits on technology usage, Rest)
Stage 2 – Return to school/work with accommodations. (Continue limits on technology usage, Avoid heavy backpacks, No tests, No PE, No band, No chorus, Rest)
Stage 3 – Continue academic/work accommodations. (Attend school/work full time – if possible, Increase work load gradually, Incorporate light aerobic activity, Rest)
Stage 4 – Full recovery to academics/workforce. (Attend school/work full time, Self-advocate, Resume normal activities, Resume sports following “Return to Play” protocol)
Returning to Play: Athletes will follow a step progression program when returning to play. Athletes must be completely asymptomatic, without medication, for 24 hours before initiating. If symptoms return, the athlete may re-try that step again once asymptomatic for 24 hours. If symptoms persist longer than 24 hours, the athlete must wait until symptom free then return to Step 1. Each step requires 24 hours.
RETURN TO PLAY PROTOCOL:
Step 1 – Light Aerobic Activity (Stationary cycling keeping heart rate <70% maximum predicted heart rate. No resistance training. Increase heart rate without the onset of symptoms.)
Step 2 – Sport Specific Exercise (Non-contact training drills may begin. Add more advanced movements without the onset of symptoms.)
Step 3 – Non-Contact Training (Progression to more complex training drills in a non-contact environment. Exercise, coordination, and cognitive load without symptoms.)
Step 4 – Full Contact Practice Following Medical Clearance (Participation in normal training and practice activities. Restore confidence and assess functional skills by coaching staff. Complete without symptoms.)
Step 5 – Return to Game Play (Normal Game Play. Post-Concussion Consent Form must be signed by athlete and parent, if athlete is under 18.)
SIGNS AND SYMPTOMS REPORTED BY ATHLETE:
- Headache or “pressure” in head
- Nausea or vomiting
- Balance problems or dizziness
- Double or blurry vision
- Sensitivity to light
- Sensitivity to noise
- Feeling sluggish, hazy, foggy, or groggy
- Concentration or memory problems
- Just not “feeling right” or is “feeling down”
SIGNS AND SYMPTOMS OBSERVED BY OTHERS:
- Appears dazed or stunned
- Is confused about assignment or position
- Forgets an instruction
- Is unsure of game, score, or opponent
- Moves clumsily
- Answers questions slowly
- Loses consciousness (even briefly)
- Shows mood, behavior, or personality changes
DANGER SIGNS (Be alert for symptoms that worsen over time. Athlete should be seen in an emergency department right away):
- One pupil (the black part in the middle of the eye) larger than the other
- Drowsiness or cannot be awakened
- A headache that gets worse and does not go away
- Weakness, numbness, or decreased coordination
- Repeated vomiting or nausea
- Slurred speech
- Convulsions or seizures
- Difficulty recognizing people or places
- Increasing confusion, restlessness, or agitation
- Unusual behavior
- Loss of consciousness (even a brief loss of consciousness should be taken seriously)
IF YOU THINK AN ATHLETE HAS A CONCUSSION:
- SEEK MEDICAL ATTENTION RIGHT AWAY
- A health care professional will be able to decide how serious the concussion is and when it is safe to return to regular activities, including sports.
- REFRAIN FROM “PLAY”
- Concussions take time to heal. Don’t return to play the day of the injury and until a health care professional says it’s OK. Athletes who return to play too soon – while the brain is still healing – risk a greater chance of having a second concussion. Repeat or later concussions can be very serious, they can cause permanent brain damage.
- DISCLOSE PREVIOUS CONCUSSIONS
- Coaches should know if you had a previous concussion.
HELP PREVENT A CONCUSSION OR OTHER SERIOUS BRAIN INJURY:
- Follow coach’s rules for safety and the rules of the sport.
- Encourage good sportsmanship at all times.
- Ensure proper protective equipment is worn, fits properly, and is well maintained.
- Wearing a helmet is a must to reduce the risk of a serious brain injury or skull fracture.
- Even with a helmet, it is important to avoid hits to the head.
HOW TO RETURN TO ACTIVITY SAFELY AFTER A CONCUSSION:
- Take rest breaks as needed
- Spend fewer hours at school/work
- Be given more time to take tests or complete assignments
- Receive help with work
- Reduce time spent reading, writing, or on the computer