The Gfeller-Waller Act: New Legislation on Traumatic Brain Injury

Gfeller-Waller Concussion

Awareness Act

New Legislation on Traumatic Brain Injury

Paula Hudson Hildebrand, Chief Health and Community Relations Officer, NCDPI

Les Spell, Health/Physical Education/Athletics Consultant, NCDPI

Gfeller-Waller

Matthew Gfeller Jaquan Waller

R. J. Reynolds High School

Winston-Salem, North Carolina

J. H. Rose High School

Greenville, North Carolina

Youth Sports & Concussion Laws

Sports Concussion Legislation

Essential components – Education (athletes, parents, coaches)

– Instituting a concussion policy and emergency action plan

– Removal from practice or play at the time of suspected

concussion

– Medical evaluation and return to play clearance by a health

care provider with training in concussion management.

What is the Gfeller-Waller Concussion

Awareness Act?

• A law that was implemented to protect the safety of

student-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 dizziness

Double or fuzzy vision

Sensitivity to light or noise

Headache

Feeling sluggish

Feeling foggy or groggy

Concentration or memory problems (forgetting game plays)

Confusion

Source: Department of Health and Human Services; Centers for Disease Control

and Prevention

What problems can result from a

concussion?

• Problems may occur with school work.

• If returned-to-play too early after a concussion,

individuals may have ongoing sadness, not feel like

yourself, or have trouble remembering things for a

long time.

• Once you have a concussion you are more likely to

have another concussion.

What student-athletes should know

• You should tell your coach, your parents, and a

medical professional, if one is available, if you think

you have a concussion.

• You should not have any symptoms at rest or

during/after activity when you return to play, as this

is a sign your brain has not recovered from the injury.

• You need to be evaluated and cleared by a medical

professional trained in concussion management before

returning 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 trained

in concussion management.

• Your child should never return-to-play while still

experiencing signs and symptoms of a concussion.

• If your child has a headache that gets worse over time,

experiences loss of coordination or abnormal body

movements, has repeated nausea, vomiting, slurred

speech, or you witness what you believe to be a severe

head impact, you should refer them to appropriate medical

personnel immediately.

What coaches and school personnel

should know

• If you suspect one of your student-athletes is

exhibiting signs and symptoms consistent with

a concussion, they should be removed from

play immediately and not allowed to return

on that same day.

• All student-athletes exhibiting signs and

symptoms consistent with a concussion have to

have written clearance from a medical

professional trained in concussion

management prior to returning to play.

1. No physical activity

2. 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

WCPSS TBI Information Includes 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 Form Similar to a Accident/Injury Report, but specifically designed for traumatic

brain injuries

Sample LEA Information

What medical professionals should

know

Concussion management training can be found at: http://www.cdc.gov/concussion/headsup/clinicians.html?source=govdelivery

A culture shift has been set in motion…and

North 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 Act

Implications & Considerations For Schools

Compliance Information and

Checklist

Student-Athlete Education &

Statement Form

Adult Education & Statement

Form

Guidelines for an Emergency

Action Plan

Sample Emergency Action

Plan

Post-concussion Protocol

Return to Play Written

Clearance Form

Stakeholders

Resources Matthew Gfeller Sport-Related TBI Research Center

http://tbicenter.unc.edu/MAG_Center/Home.html

Sports Concussion Toolkit

http://www.aan.com/go/practice/concussion

Concussion in Sports

http://www.cdc.gov/concussion/sports/

Heads Up to Clinicians

http://www.cdc.gov/concussion/headsup/clinicians.html

PACE – Protecting Athletes Through Concussion Education

https://www.mydickssportinggoods.com/pace/default.aspx

Contact Information

Paula Hudson Hildebrand

Chief Health and Community Relations Officer

NC Department of Public Instruction

paula.hildebrand@dpi.nc.gov

919-807-4068

Les Spell

Health/Physical Education/Athletics Consultant

NC Department of Public Instruction

les.spell@dpi.nc.gov

919-807-3637