The Gfeller-Waller Act: New Legislation on Traumatic Brain Injury
Gfeller-Waller Concussion Awareness Act New Legislation on Traumatic Brain InjuryPaula Hudson Hildebrand, Chief Health and Community Relations Officer, NCDPI Les Spell, Health/Physical Education/Athletics Consultant, NCDPI
Gfeller-Waller Matthew Gfeller Jaquan WallerR. J. Reynolds High School J. H. Rose High SchoolWinston-Salem, North Carolina Greenville, North Carolina
Youth Sports & Concussion LawsSports Concussion LegislationEssential components– Education (athletes, parents, coaches)– Instituting a concussion policy and emergency action plan– Removal from practice or play at the time of suspectedconcussion– Medical evaluation and return to play clearance by a healthcare provider with training in concussion management.
What is the Gfeller-Waller ConcussionAwareness Act?• A law that was implemented to protect the safety ofstudent-athletes in the state of North Carolina• Areas of focus: – Education – Emergency action and post-concussion protocol implementation – Clearance and return-to-play after concussion
Signed into law by Governor Beverly Purdue on June 16, 2011.
What is a concussion?A concussion is a brain injury that: Is caused by a bump, blow, or jolt to the head Can change the way your brain normally works Can range from mild to severe Can occur during practices or games in any sport Can happen even if you haven’t been knocked out Can be serious even if you’ve just been “dinged” or had your “bell rung”
What are the symptoms of a concussion?Nausea (feeling that you might vomit)Balance problems or dizzinessDouble or fuzzy visionSensitivity to light or noiseHeadacheFeeling sluggishFeeling foggy or groggyConcentration or memory problems (forgetting game plays)ConfusionSource: Department of Health and Human Services; Centers for Disease Controland Prevention
What problems can result from aconcussion?• Problems may occur with school work.• If returned-to-play too early after a concussion,individuals may have ongoing sadness, not feel likeyourself, or have trouble remembering things for along time.• Once you have a concussion you are more likely tohave another concussion.
What student-athletes should know• You should tell your coach, your parents, and amedical professional, if one is available, if you thinkyou have a concussion.• You should not have any symptoms at rest orduring/after activity when you return to play, as thisis a sign your brain has not recovered from the injury.• You need to be evaluated and cleared by a medicalprofessional trained in concussion management beforereturning to your activity or sport.
What parents should know• If your child has any signs and symptoms of a concussion,they should be evaluated by a medical professional trainedin concussion management.• Your child should never return-to-play while stillexperiencing signs and symptoms of a concussion.• If your child has a headache that gets worse over time,experiences loss of coordination or abnormal bodymovements, has repeated nausea, vomiting, slurredspeech, or you witness what you believe to be a severehead impact, you should refer them to appropriate medicalpersonnel immediately.
What coaches and school personnelshould know• If you suspect one of your student-athletes isexhibiting signs and symptoms consistent witha concussion, they should be removed fromplay immediately and not allowed to returnon that same day.• All student-athletes exhibiting signs andsymptoms consistent with a concussion have tohave written clearance from a medicalprofessional trained in concussionmanagement prior to returning to play.
1. No physical activity2. Low levels of physical activity (i.e., symptoms do not come back during or after the activity). This includes walking, light jogging, light stationary biking, light weightlifting (lower weight, higher reps, no bench, no squat).3. Moderate levels of physical activity with body/head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting (reduced time and/or reduced weight from your typical routine).4. Heavy non-contact physical activity. This includes sprinting/running, high- intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement).5. Full contact in controlled practice.6. Full contact in game play.
School Modifications Until fully recovered, the following supports are recommended: (check all that apply) No return to school. Return on (date) Return to school with following supports. Review on (date) Shortened day. Recommend hours per day until (date) Shortened classes (i.e., rest breaks during classes).Maximum class length:______ minutes. _ Allow extra time to complete coursework/assignments and tests. _ Lessen homework load by ______%. ______ Maximum length of nightly homework: ________minutes. ______No significant classroom or standardized testing at this time. ______Check for the return of symptoms when doing activities that require a lot of attention or concentration. ______Take rest breaks during the day as needed. ______Initiate a Medical Plan through School Nurse, instead of a 504 Plan, as 1st step. _______Request 504 Meeting with TBI Team member in attendance to discuss needed supports
Sample LEA InformationWCPSS TBI InformationIncludes information for: Parents/Guardians, School Staff, School Nurse,School Psychologist, School Counselor, Athletic Trainer, Coaching Staff,and Student Support Services (PT, OT, SLP)WCPSS TBI Notification FormSimilar to a Accident/Injury Report, but specifically designed for traumaticbrain injuries
What medical professionals shouldknowConcussion management training can be found at:http://www.cdc.gov/concussion/headsup/clinicians.html?source=govdelivery
A culture shift has been set in motion…andNorth Carolina is making a difference– Concussion education is key– Know “red flags” for a situation turning catastrophic– Establish an objective comprehensive evaluation & standardized RTP protocol (graduated exertional exercises)– Think beyond the acute trauma– Equipment safety & behavior modification– State laws will make a difference!
Gfeller-Waller Concussion Awareness ActImplications & Considerations For Schools
ResourcesMatthew Gfeller Sport-Related TBI Research Centerhttp://tbicenter.unc.edu/MAG_Center/Home.htmlSports Concussion Toolkithttp://www.aan.com/go/practice/concussionConcussion in Sportshttp://www.cdc.gov/concussion/sports/Heads Up to Clinicianshttp://www.cdc.gov/concussion/headsup/clinicians.htmlPACE – Protecting Athletes Through Concussion Educationhttps://www.mydickssportinggoods.com/pace/default.aspx
Contact InformationPaula Hudson HildebrandChief Health and Community Relations OfficerNC Department of Public Instructionpaula.email@example.comLes SpellHealth/Physical Education/Athletics ConsultantNC Department of Public Instructionles.firstname.lastname@example.org