Bryn Mawr College certified athletic trainers work collaboratively with Dr. B.J. Smith, the athletic department’s sports medicine consultant and Beth Kotarski, Medical Serices Director of Bryn Mawr College Health Services, to manage concussions according to the most recent recommendations and guidelines outlined in the Consensus statement on concussion in sport – The 4th International Consensus Conference on Concussion in Sport, held in Zurich, November 2012.
For more information, please reference the NCAA guidelines on concussions here:
All contact varsity athletes are baseline tested using ImPACT software and all involved parties work to stay abreast of the latest research concerning these types of injuries
Concussion/Head Injury in Sports Protocol
Definition: Direct blow or jolt to head, face, neck or body blow with force transmitted to the head that result in rapid onset of short-lived impairment of neurological function that spontaneously resolves. The injury may result in neurological changes with acute clinical symptoms reflecting functional disturbances not structural injury that may result in clinical symptoms that may or may not include a loss of consciousness. Resolution of clinical and cognitive symptoms follows a sequential course.
Baseline Testing – ImPACT
ImPACT software will be used by the Athletic Training staff to baseline test student- athletes who participate in contact sports as part of their clearance to participate. An athlete from another sport who enters Bryn Mawr College with a significant history of head injuries may also be required to take a baseline test before competing in a varsity sport. ImPACT testing may also be used as appropriate by the Athletic Trainers to document return to play/ baseline status after athlete is asymptomatic for 24 hour and given clearance to start the return to play protocol by a physician.
Immediate Post-Concussion Assessment and Cognitive Testing
Athletic Trainers will administer immediate field/sideline standardized assessment tool. A copy of the assessment will be reviewed by Dr. Smith and the athlete will be given a head injury care plan handout. Athletes will not be returned to play the same day of injury. Any positive neurological screening abnormality necessitates formal neurological or hospital assessment. If severe head trauma symptoms are present, athletes will be transported to BMHER or the nearest hospital immediately.
Return to Play Protocol
Any athlete who suffers a concussion will not be allowed to return to play on the same day. The Athletic Trainer will notify Health Service following the injury. The Athletic Trainer will advise the athlete to rest (physical and cognitive) and give athlete handout on care after concussion. The athlete will be withheld from participation in sports and other training until he or she has been cleared by Dr. Smith. This clearance will not occur until the athlete has been asymptomatic for 24 hours and his or her neurological/cognitive function has returned to baseline levels. Once cleared, the athlete will be released to the Athletic Training staff, which will progress the athlete through a stepwise return to play progression. This progression will be as follows:
- Step 1 – light aerobic exercise
- Step 2 – increased aerobic exercise
- Step 3 – sport specific training with light resistance training
- Step 4 – non-contact drills
- Step 5 – Full contact practice
- Step 6 – Game play
Completion of each step without a reoccurrence of symptoms is required to move to the next step. If symptoms return during any of these steps, the athlete must cease activity and again meet the criteria of being asymptomatic for 24 hours and being cleared by Dr. Smith prior to starting any activity.
Criteria for Return to Play after multiple concussions
Free of symptoms, normal neurological exam, normal neuropsychological testing, and normal neuroimaging.
No athlete will play after a complex concussion until neurological and cognitive functioning has returned to baseline and he/she is symptom-free both at rest and with exertion. Freshmen/new athletes with histories of multiple concussions must provide medical records with full neurological/psychological/neuroimaging to the Health Service and/or Athletic Trainers.
Head Injury Instructions
Please read and follow these instructions carefully.
Patient should contact her dean and professors as soon as possible indicating to them that a head injury has been sustained and that they have been evaluated and are under the treatment of the athletic training staff and Dr. Smith.
If the patient shows any of these signs or symptoms, or if she should have any other persistent complaints, please arrange to have the patient brought to the emergency room as quickly as possible for examination by a physician. If the patient is taken to the emergency room, notify your certified athletic trainer or the health center when you return to campus. All patients must be cleared by Dr. Smith before returning to any physical activity.
- Any changes in personality
- Restlessness, irritability
- Unusual drowsiness or sleeping
- Difficulty in walking or talking
- Double or blurred vision or other change in vision
- Persistent or increasing headache
- Blood or clear fluid coming from nose or ears
- Nausea or vomiting
- Loss of consciousness
- Difference in pupil size
- Swollen eyelids or swelling behind ears
- Any other persistent complaint
- Areas of numbness or tingling
- Stumbling or loss of balance
In addition the patient should adhere to the following instructions:
- NO ALCOHOL CONSUMPTION
- NO DRIVING
- Normal sleep is okay and needed
- Pain relievers (acetaminophen, Tylenol) on physician’s orders only
- No computer use, television, texting or unnecessary reading
In case of emergency call 911 or Public safety at x-7911