Suspected Concussion: Information for Parents/Guardians
This sample tool is intended to be filled out (appropriate box checked) by the Teacher/Supervisor/Coach after a suspected concussion-related incident has been observed and/or reported. Once completed, share this document with the Parents/Guardians to inform them of the actions that were taken and the next steps for the Parents/Guardians.
Student Name:
Date:
The following actions were taken:
A call to 911 was made. (Red flag(s) observed or reported.)
Next steps for parents/guardians
- During the medical assessment, communicate with medical doctor or nurse practitioner about:
- whether or not a concussion was diagnosed
- Information that should be communicated with the school
- recommended next steps
- After the medical assessment, communicate with the principal/designate about:
- the results of the medical assessment and any other relevant medical information provided by the medical doctor or nurse practitioner that can assist with the student’s successful return to school.
Visible clues (signs) or symptoms observed and/or reported, or the student did not correctly answer all the orientation/awareness questions.
Next steps for parents/guardians
- Seek medical assessment by a medical doctor or nurse practitioner as soon as possible.
- During the medical assessment, communicate with the medical doctor or nurse practitioner about:
- The suspected concussion-related incident shared by the school
- Whether or not a concussion was diagnosed
- Recommended next steps
- After the medical assessment, communicate with the principal/designate about:
- the results of medical assessment and any other relevant medical information provided by the medical doctor or nurse practitioner that can assist with the student’s successful return to school.
A suspected concussion-related incident was observed and/or reported where no red flags, visual clues (signs) or symptoms of a suspected concussion were observed and/or reported, and the student correctly answered all the orientation/awareness questions.
Next steps for parents/guardians
- Student should be monitored for 48 hours (at home and at school) for delayed visual clues (signs) and/or symptoms. During this time:
- the student can continue to attend school and participate in learning activities
- resume participation in physical activity after 24 hours
If, during the 48-hour monitoring period:
- Red flags are observed or reported
- Call 911 immediately.
- Communicate with the principal/designate that red flag(s) emerged, the results of the medical assessment, and any other relevant medical information provided.
- Visual clues (signs) and/or symptoms are observed or reported
- Seek medical assessment by a medical doctor or nurse practitioner as soon as possible.
- Communicate with the principal/designate that visible clues (signs) and/or symptoms emerged, the results of the medical assessment, and any other relevant medical information provided.
- No sign(s) and or symptom(s) emerge:
- Communicate with the principal/designate that no visible clues (signs) and/or symptoms were observed and/or reported during the 48-hour period.