Three Steps to Creating a Concussion Protocol Policy

The dangers and lasting effects of concussions, especially in children and teens, are well documented. Not every head injury occurs during a sports activity—children and youth risk a head injury from something as simple as a fall. Because your Christian ministry may host children for sports and intramural activities, Sunday school, child care, or other programs, ministry leaders should be prepared to respond and care for the child until medical help or parents arrive. 

Prepare to respond with a three-fold policy

Increased focus on the frequency and severity of head injuries has prompted federal and state governments to take action. The National Conference of State Legislatures provides information on states that have enacted legislation to address concussive injuries. Most state legislation addresses these three areas:

1. Educate or train staff and volunteers on recognizing concussive symptoms and how to respond.

2. Evaluate the child or athlete. Remove from play or practice if you suspect a concussion.

3. Reinstate the child to practice, activity, or competition after evaluation and clearance by a designated health care provider.

These three components help give ministries a launching point to develop their own policies and protocol for training, education, and injury response. A locally licensed attorney can inform you of the specific requirements that apply to your ministry under the applicable federal and state laws.   Even if an injury does not appear to require the immediate attention of medical providers, ministry leaders should make a written record of any injury and inform the child’s parent or guardian. You can download a sample Notice of Injury form here.

Learn the symptoms of a concussion

Some concussions are mild, and most people fully recovery. Others are severe and may lead to long-term physical or mental health issues. Developing a concussion protocol policy and training your ministry staff and volunteers may help an injured child receive the necessary care for a complete recovery.

Know the signs. Head injuries are caused by trauma and can include a blow to the head, a sudden or jarring movement of the head, or a fall.  Common symptoms of concussion can occur right away or hours or days after the injury. Symptoms may include one or more of these:¹ 

•    Headache, nausea, or vomiting 
•    Feeling fatigued or drowsy
•    Sensitivity to noise and light 
•    Numbness or tingling anywhere on the body 
•    Dizziness, loss of balance, or trouble walking 
•    Being irritable or more fussy than usual 
•    Heightened emotions 
•    Change in sleeping patterns 
•    Vision problems 
•    Inability to concentrate or remember recent events

Know when to get immediate help. All head injuries should be taken seriously, regardless of severity. However, the following signs may signal a more severe injury.¹ If a headache worsens, clear fluid drains from the nose or ear, or swelling of the scalp increases, seek immediate medical help for the child. Other red flags may indicate a traumatic brain injury. Call 911 or your local emergency number if the child:

•    Experiences a seizure.
•    Complains of neck pain.
•    Is hard to wake up.
•    Vomits more than two times in 24 hours.
•    Behaves differently than usual.
•    Cannot think clearly, remember things, or recognize people or places.
•    Has weakness in the arms or legs.
•    Slurs his or her speech.
•    Passes out.

When in doubt, sit it out

Generally, treatment for a concussion includes rest. The child’s doctor may recommend other measures as a part of the overall treatment. If a child diagnosed with a concussion is in your ministry’s care, be aware of possible restrictions on his or her activities.  These may include:² 

•    Limiting physical activities like active play, PE classes and sports. 
•    Keeping surroundings calm and quiet. 
•    Attending all doctor appointments, even if the child is feeling better. 
•    Limiting activities like reading, schoolwork, and, talking on the phone. Limit screen time, including watching TV, video games, computers, and cell phones. 

Allow the child to stop and rest any time he or she experiences a worsening of symptoms. Inform the parent or guardian of any concerns. 

Be aware that your state or local government may have regulations that guide injury prevention for children in your care. Many states have implemented policies and protocols regarding how a child care provider should react to head injuries sustained by children. Check with a local attorney to see if any regulations apply to your program and, if so, how the ministry can ensure compliance.

The Centers for Disease Control and Prevention offers additional information:
•    Brain Injury Basics
•    Fact Sheets for Teachers, Counselors, and School Professionals

¹ ”Mild head injury and concussion.” Children’s Healthcare of Atlanta, 2016, https://www.choa.org/~/media/files/Childrens/medical-services/concussion/concussion-teaching-sheet.pdf. Accessed 18 December 2018.
² “A Parent’s Guide to Concussions.” Nationwide Children’s Hospital, https://www.nationwidechildrens.org/specialties/concussion-clinic/concussion-toolkit/a-parents-guide-to-concussions. Accessed 18 December 2018.