The CIAC Concussion Parent Consent Form

SOUTHINGTON PUBLIC SCHOOLS

Sudden Cardiac Arrest Awareness

Student & Parent Informed Consent Form 2015-16

Southington Yellow Card Packet Signature Page

Concussion Information

A concussion is an injury to the brain that can occur when a forceful motion to the head leads to mental instability such as confusion or memory loss pre/post injury. 

 

The younger an individual is the higher the probability of the concussion going un-diagnosed, with greatly increases the danger of the situation. This is because the odds of additional concussions is three(3) times more likely having had a prior concussion and eight(8) times more likely if the athlete has had two(2) prior concussions. 

 

Life Quality - "What is a concussion?"

Connecticut Concussion Task Force

This is a 14 minute video describing signs and symptoms of concussions. Going over treatments, prevention techniques, what second-impact syndrome is and how to avoid it, and post-concussion syndrome.

The Impact Test

The Southington Athletic Department Trainers use the ecommended Impact Test to judge whether an athlete can return to play after having a concussion.  Click here to learn more about The Impact Test.

Athletic Trainer Information 

Athletic trainers: 

Select Physical Therapy:

Laurie Martin:ltmartin13@att.net

Ed Gilberti

SHS injury Policy

Training Room :

The training room is athletic health care needs of student-athletes. Medical services available to the student-athlete are assessment, care, rehabilitation of athletic injuries, strengthening and flexibility programs.  The training room is located downstairs in the basement near sports locker rooms.

  

INJURIES:

All injuries should be reported to the Certified Athletic Trainer or School Nurse by the athlete and an Accident Report must be completed with the Certified Athletic Trainer. Insurance forms will be mailed to the athlete's home address only after the Accident Report has been properly filed and recorded by the Nurses office and the Main Office. The parent and/or guardian will provide the appropriate information on the insurance form and return it to the Main Office at the high school. Accident reports must be filled out in a timely fashion and will not be backdated. 

 

Injury Report Procedure:

All injuries must be reported to the Certified Athletic Trainer by the athlete. An Accident Report Form will be completed by the Certified Athletic Trainer. If medical evaluation is recommended, a physician should be consulted. A Participation Information Form (PIF) will be issued by the Certified Athletic Trainer when it is deemed necessary for an athlete to be restricted or removed from athletic participation. The athlete's physician or the Certified Athletic Trainer will make this decision. The athletes must present the PIF to the coach. Failure to follow this protocol may result in suspension from the team.

 

Head Injuries: Concussion

Southington High School follows the guidelines set forth by Connecticut's Public Act 10-62, " An Act Concerning Student Athletes and Concussion".

It is our policy that athletes who sustain a concussion, regardless of how minor, must be excluded from participation in athletics (practice or play) until he/she is evaluated by a physician.

 

Return to Play Guidlines for Post-Concusion Athletes:

Athlete must submit a written note from the physican stating the following;diagnosis, restrictions or clearance for return to activity.

Athlete must be symptom free for a minimum of 7 days or more. This may vary due to individual circumstances.

Under supervision, the athlete will be given a provacation test which will include, jogging, pushups, sit ups and squat thrusts.

The athlete must be symptom free during the test. If symptoms develop, the test will be stopped.

 

The athlete will repeat the test in one (1) wweek. Absence from sports fro a prolonged period of time will require the athlete to complete a conditioning program prior to returning to their sport.

 

The specifics of the conditioning program are dependent on the amount of missed sports participation. Specific sports training will progress from non-contact drills to full contact drills and then to game play. athletes must participate in full practices prior to returning to competition.

 

Return-to-Play: All Other Injuries 

Athletes seen by a physician will be issued a PIF clearing them for participation upon the receipt of a physician's WRITTEN NOTE indicating the injured athlete is able to resume activity. Athletes who have missed practices will not return to competition the day of medical release. Athletes who have not participated in practices will be required to condition prior to return to activity.

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