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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
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
919-807-4068
Les Spell
Health/Physical Education/Athletics Consultant
NC Department of Public Instruction
919-807-3637
