Concussion Management

CONCUSSION MANAGEMENT

 

Safety in Youth Sports Act Becomes Law in Pennsylvania

Governor Corbett signed the Safety in Youth Sports Act in a ceremony at Lower Dauphin High School, Dauphin County. The state General Assembly passed it on November 1. The legislation is Senate Bill 200, introduced by Sen. Patrick M. Browne (R-Lehigh). It was shepherded through the House by Rep. Timothy P. Briggs (D-Montgomery), who had introduced the companion bill, House Bill 200.

This bill establishes standards for managing concussions to student athletes. In order to return to play the athlete must be cleared by a licensed psychologist trained in neuropsychology, by a physician who is trained in the evaluation and management of concussions, or by certain other health care providers under the supervision of the physician, which includes Certified Athletic Trainers. The Pennsylvania Psychological Association’s advocacy was instrumental in this bill’s passage. The association’s past president, Dr. Mark Hogue stated, “This new law will be extremely important to any athlete who suffers a concussion. Athletes who return to play prematurely are at risk of a second concussion, which can be life-threatening.” Dr. Hogue is a clinical and sport psychologist from Erie.

The bill will require the state Departments of Health and Education to develop and post on their websites information on the nature of concussions in athletic activities and the risks associated with continuing to play or practice after a concussion. Student-athletes and their parents or guardians must sign an acknowledgment of receipt of an information sheet on concussions prior to participation in athletics. It will require coaches to complete a concussion management certification training course before coaching any athletic activity. During an athletic contest coaches will be required to remove athletes from competition if they exhibit signs of a concussion.

The legislation will become effective on July 1, 2012, in time for the next school year. It does not pertain to private schools, but only to public schools. It covers interscholastic athletics as well as other sports associated with a school entity, and includes cheerleading, practices, and scrimmages.

Information for 2015-2016

1. Nature of Concussions and Risk

The State law in Pennsylvania regarding concussions states that any athlete exhibiting the signs and symptoms of a concussion or a traumatic brain injury must be removed from the game or practice and must be evaluated by the appropriate medical professional before returning to play. 

A coach or parent may not return an athlete to play following a concussion, a written release from the above list of appropriate medical professional must be obtained. 

Mandatory education is important for all athletes, parents and coaches regarding the signs and symptoms of a concussion or traumatic brain injury. The Center for Disease Control and Prevention (CDC) is an excellent resource for Concussion in Sport and Injury Prevention and control. Information is available from the following sites:

 

* Injury Prevention & Control: Traumatic Brain Injury

* Concussionwise SPORT for Parents

 

2.   Student-athletes and their parents or guardians must sign an acknowledgment of receipt of an information sheet on concussions prior to participation in athletics.

The newly revised PIAA Comprehensive Initial Pre-participation Physical Evaluation Form (CIPPE) is available online to view and print. 

Page 3 contains the requirement that parents acknowledge the risk of concussion and traumatic brain injury in sport and sign accordingly. Our families do this when registering on FamilyId.

 

3.      Coaches Concussion Management Certification Required

All coaches of interscholastic athletic teams, other coaches of sports associated with Mt. Lebanon, and cheerleading sponsors will be required to take the online certification course sponsored by the NFHS.

For all coaches for the 2015-2016 school year, the course needs to be completed after July 1 , 2015 and prior to August 1, 2016. The certificate of completion should be given to the athletic office to be kept on file by August 1, 2015. Any coach or sponsor not completing the course and having the certificate on file will not be permitted to coach.

Coaches hired after the August 1, 2015 deadline will be obligated to complete the course, and have it on file prior to the legal start date of that respective season.

The certification is good for only one year, and must be taken again the following year after July 1, 2016.

The NFHS online course, “Concussion in Sports – What You Need to Know”. It is a complimentary online course designed to familiarize those associated with interscholastic athletics on the signs, symptoms, and treatment related to concussion in sports. The only requirement is a quick and easy registration at http://www.nfhslearn.com/.


What To Know About Concussions

Parents and coaches are not expected to be able to “diagnose” a concussion. That is the role of an appropriate healthcare professional, such as an athletic trainer. However, you must be aware of the signs, symptoms and behaviors of a possible concussion. If you suspect that an athlete may have a concussion the athlete should follow up with the athletic trainer. In severe cases (severe headache, vomiting, severe confusion), the athlete should be taken directly to the emergency room.

Signs and Symptoms of Concussion:

  • · Loss of Consciousness
  • · Clear fluid from nose/ears
  • · Numbness/Paralysis
  • · Severe Headache/Deep Throbbing
  • · Dizziness
  • · Confusion
  • · Loss of Coordination
  • · Ringing in the ears
  • · Blurred/Double Vision
  • · Unequal Pupil Size
  • · No Pupil Reaction to Light
  • · Nausea/Vomiting
  • · Slurred Speech
  • · Convulsions/Tremors
  • · Sleepiness/Grogginess
  • · Behavior/Personality Changes
  • · Inability to remember events prior to injury
  • · Inability to remember events after the injury
  • · Sensitivity to Light/Noise


Additional Information

ImPACT

A computer based online test called ImPACT is used for all contact sports at Mount Lebanon to establish a baseline of normal cognitive function for each individual athlete. This test is given every two years prior to the athlete’s sport season from grade 7-12. The baseline test will then be used as part of a comprehensive clinical evaluation to determine recovery following a concussion. The test evaluates multiple aspects of an athlete’s neuro-cognititive state, brain processing speed, memory, and visual motor skills. This baseline test does not evaluate the subject for a concussion, identify past concussions, prevent future concussions, or determine if your child is predisposed to a concussion.

MTLSD Protocol of a Suspected Concussion

The Certified Athletic Trainers at Mount Lebanon have been trained in the initial evaluation of concussions and work along with neuropsychologists from the UPMC Concussion Clinic to determine when the athlete is safely able to return to activity. Once an athlete sees the athletic trainer for a suspected concussion, they undergo a thorough evaluation. Their signs and symptoms are evaluated and rated by the athlete on a scale of 0-6. Memory and concentration tests are given using words and number combinations. Balance and coordination tests are also conducted. The parents if not already aware of the concussion, are notified and follow-up care instructions along with the athletic trainer’s contact information are given to them. The athletic trainer will continue to monitor the athlete’s symptoms daily and will ImPACT test the athlete 48-72 hours following the concussion.

Once a post-concussion test is given, the athletic trainer contacts UPMC neuropsychologist to interpret the scores and return to play criteria is established.

The exertional plan is determined by the neuropsychologist and given to the athletic trainer to conduct and monitor the athlete throughout the process. The plan usually extends over a period of time with activity intensity increasing as the athlete can tolerate. If symptom occurs at any level, the activity is stopped and that level is not begun again until the athlete is symptom-free. Following that, the athlete must have a clearance from a licensed physician in order to return to activity. In some cases, the neuropsychologist may like to see the athlete for further evaluation and that can be scheduled through the athletic trainer if this is something the parents want to do.

The criteria that must be met to return an athlete to activity are:

1. Symptom-free at rest

2. ImPACT scores back to or exceeding baseline scores

3. Symptom-free with exertional testing (monitored by athletic trainer)

4. Cleared by licensed physician


Baseline ImPACT Testing Dates

All athletes in the following sports will be tested on a specified date prior to their season. The date will be posted on the MTLSD Athletics website.

1. Football

2. Volleyball

3. Field Hockey

4. Soccer

5. Wrestling

6. Basketball

7. Lacrosse

8. Cheerleading

For any sports not listed, athletes can request to take the baseline test on a specified date by contacting the athletic trainers.