Kenyon College Athletics

The Kenyon College Athletics concussion policy has been revised in order to clarify and demonstrate compliance with the NCAA Concussion Safety Protocol Legislation and the Class Action Settlement Agreement and Release in the In re National Collegiate Athletic Association Student-Athlete Concussion Injury Litigation, MDL No. 2492, Master Docket No. 1:13-cv-09116 (N.D. Ill.). This policy is based on a checklist recommended by the NCAA Concussion Safety Advisory Group and prescribed by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sport.  The checklist is not intended as a clinical practice guideline or legal standard of care and should not be interpreted as such. This policy serves as a guide and is not intended to govern or replace medical guidance from a healthcare professional. Individual treatment will depend on the facts and circumstances specific to each individual case.


Pre-Season Education
Kenyon College will provide and allow the opportunity to discuss concussion education material (e.g., NCAA concussion education fact sheet) or other applicable material annually to the following parties:

• Student-athletes
• Coaches
• Team physicians
• Athletic trainers
• Athletics administration
• Other personnel involved in student-athlete health and safety decision making (i.e., faculty members, academic advisors, etc.)

Furthermore, all those receiving the concussion education material must provide a signed acknowledgement of having reviewed and understood the concussion material.
                                                   
        
Pre-Participation Assessment
Each year athletes will be required to get a Pre Participation Medical Exam (PPME).  Part of the PPME is completion of a baseline neurocognitive test and balance assessment. At the time of PPME, every student-athlete will also be presented with educational materials from the institution that addresses:

• History of concussion of brain injury, neurologic disorder, and mental health symptoms and disorders
• Symptom evaluation
• Cognitive assessment
• Balance evaluation
• Team physician determines pre-participation clearance and/or the need for additional consultation or testing.

Every NCAA student-athlete at Kenyon College will undergo pre-season testing for each sport in which they participate prior to participating in practice or competition.
 
In consultation with the team physician, baseline concussion assessments may be repeated at six months or beyond for any varsity student-athlete with a documented concussion, especially those with complicated or multiple concussion history.     

                                         
Recognition and Diagnosis/Assessment of Concussion 
Medical personnel with training in the diagnosis/assessment, treatment, and initial management of acute concussion will be "present" (to be present means to be physically present at the competition field or arena) at all NCAA competitions in the following contact/collision sports: basketball, field hockey, football, lacrosse, pole vault, and soccer. Medical personnel may be from either team or may be independently contracted for the event.

Medical personnel with training in the diagnosis/assessment, treatment, and initial management of acute concussion must be "available" at all NCAA practices in the following contact/collision sports: basketball, field hockey, football, lacrosse, pole vault, and soccer. To be "available" means that, at a minimum, medical personnel can be contacted at any time during the practice via telephone, messaging, email, beeper or other immediate communication means. When appropriate, the case can be discussed through such communication, and immediate arrangements can be made for the athlete to be evaluated.

Any student-athlete with signs/symptoms/behaviors consistent with concussion:  

• Must be removed from practice or competition for evaluation.
• Must be evaluated by an athletic trainer or team physician (or physician designee) with concussion experience.
  • Must be removed from practice/play for that calendar day if concussion is confirmed or suspected.
  • May only return to play the same day if concussion is no longer suspected.

                                               
Initial Suspected Concussion Evaluation
In the event of an acute suspected head injury, the care of the student-athlete will include:

• Clinical assessment for cervical spine trauma, skull fracture, intracranial bleed and catastrophic injury.
• Symptom assessment.
• Physical and neurological exam.
• Cognitive assessment.
• Balance exam.

                                                           
Post-Concussion Management
Emergency Action Plans (EAPs) have been adopted for the management of the following scenarios:

• Prolonged loss of consciousness.
• Focal neurological deficit suggesting intracranial trauma.
• Repetitive emesis (Vomiting).
• Persistently diminished/worsening mental status or other neurological signs/symptoms.
• Spine injury or suspected spinal injury.

EAPs are in place for all athletic facilities, and generally address where to find AEDs, directions for EMS activation, and instructions for first responders EAPs may require transportation for further medical care.
                                                           
Kenyon Athletics has a mechanism for serial evaluation and monitoring following injury, including:

• Regular evaluation check-in appointments with medical personnel with training in the diagnosis/assessment, treatment, and initial management of acute concussion that may contain
  • Graded symptom checklist documentation.
  • Discussion and clarification of questions.
• Communication between different areas of campus (Athletics, SASS, Dean of Students, Academic Advising, Health Center, etc).
• Team physician availability for follow up visits.

Both student-athletes and other appropriate personnel (including, but not limited to, campus safety, roommates, coaches, parents) receive post-concussion plan of care in oral and/or written form. 

• The communication of a plan of care is documented.

There will be re-evaluation by a physician for a student-athlete with atypical presentation or persistent symptoms in order to consider additional diagnoses, best management options, and consideration for referral.

Additional diagnoses include, but are not limited to:

• Fatigue and/or sleep disorder.
• Migraine or other headache disorders.
• Mental health symptoms and disorders.
• Ocular dysfunction.
• Vestibular dysfunction.
• Cognitive impairment.
• Autonomic dysfunction.
                                                                         

Return-to-Learn
The areas of the return to learn plan include: 

• The Head Athletic Trainer for Kenyon College will serve as the point person to assist student-athletes who have suffered concussions in navigating each step of the Return-to-Learn Plan. 
• For complex Return-to-Learn cases, a multidisciplinary team shall be assigned to assist the student-athlete.  This team will include, but not be limited to, the following individuals: (1) the team physician, (2) the Head Athletic Trainer, (3) the athletic trainer responsible for the relevant sport, (4) the student-athlete's head coach, and (5) one or more coordinators from Kenyon's Student Accessibility and Support Services office.
• The Head Athletic Trainer and/or multidisciplinary team will work with the student-athlete to develop an individualized initial return-to-learn plan that includes return to classroom/studying as tolerated.
• The student-athlete will be re-evaluated by the team physician (or their designee) if concussion symptoms worsen with academic challenges.
• The student-athlete's schedule or accommodations may be modified, as indicated, with help from the Head Athletic Trainer and/or multidisciplinary team.
• Continued support for cases that cannot be managed through schedule modification and accommodations, including engagement with campus resources consistent with the ADAAA.  These resources must include at least one of the following: learning specialists, the office disability services, and/or the ADAAA office.

Re-evaluation by team physician and members of the multi-disciplinary team, as appropriate, for student-athletes with atypical presentation or persistent symptoms lasting longer than two weeks.  
        

Return-to-Sport
The return-to-sport plan specifies that:

• Final determination of unrestricted return-to-sport must come from the team physician.
• Each NCAA student-athlete with concussion must undergo a supervised stepwise progression management plan that includes*:
  • Symptom-limited activity (Symptom free in activities of daily living)
  • Light aerobic exercise without resistance training (20-30 light aerobic activity)
  • Sport-specific exercise and activity without head impact (30+ minute interval workout)
  • Non-contact practice with progressive resistance training (non-contact practice)
  • Completion of a post injury ImPACT neurocognitive test that will be reviewed by the team physician and compared to baseline test on file
  • Unrestricted training (full return to practice this can NOT be a competition)
  • Unrestricted return-to-sport. (full return including competitions)**

• *It is typical for each step to be = 24 hours.

**Unrestricted return-to-sport should not occur prior to unrestricted return-to-learn for injuries occurring while the athlete is enrolled in classes        
                       
               
Limiting Exposure to Head Trauma
Kenyon College Athletics will work in a manner consistent with The Interassociation Recommendations: Preventing Catastrophic Injury and Death in Collegiate Athletes Including:

• All practices and competitions adhere to existing ethical standards.
• Using playing or protective equipment (including the helmet) as a weapon is prohibited during all practices and competitions.
• In all practices and competitions, deliberately inflicting injury on another player is prohibited.
• All playing and protective equipment (including helmets), as applicable, meet relevant equipment safety standards and related certification requirements.
• All contact/collision, helmeted practices and competitions adhere to keeping the head out of blocking and tackling
   

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For further consultation, please contact

 

Cox Health and Counseling Center   Email: health@kenyon.edu Office Location: 104 W. Scott Lane Campus Phone: (740) 427-5525 Regarding: Concussion follow-up & management	Mark Teeples Email: teeplesm@kenyon.edu Title: Head Athletic Trainer Office Location: Lowry Center Campus Phone: (740) 427- 5017 Regarding: Athletics follow-up
Student Accessibility and Support Services    Email: sass@kenyon.edu Office Location: Chalmers Library Second floor  Regarding: Academic accommodations and support	Thomas Hawks   Email: hawkst@kenyon.edu Title: Dean for Academic Advising and Support  Office Location: Edwards House, Room 202 Campus Phone: (740) 427-5448   Regarding: Academic accommodations and support

 

                                                               
                                
                   
                                     
                                      



 
                                                                                                                         
                                                 
                                                                                                     
                           
 

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Appendix A
Concussion Symptom Score Checklist
Click here to view the Concussion Symptom Score Checklist (PDF)