The trend this year is for politicians to get into the concussion frenzy and do what politicians do – pass laws. State associations are also acting responsibly and writing policies directing member schools in concussion management. While many feel that this is a good and responsible thing, athletic trainers must be wary of passing poorly written legislation or policies.
In an effort to ensure its member schools treat athletes who have suffered concussions properly, the Florida High School Athletic Association adopted a Concussion Action Plan at Tuesday’s board of directors meeting in Gainesville. The plan requires that any athlete who exhibits signs of a concussion be immediately removed from a game or practice and not return until cleared by a health care professional. It also calls for game officials to be aware of athletes who display concussion symptoms and immediately stop play for an injury evaluation. If available, a certified athletic trainer can assist with a sideline evaluation of the player. An athlete diagnosed with a concussion is not permitted to return to play without written clearance from a physician.
As an AT, I am concerned about the wording in this policy and many other states’ legislation specifically “cleared by a health care professional.” Many health care professions do not have any training in concussion management or treatment. The issue then becomes who decides who is a qualified health care provider? Are EMTs, CNAs, DCs, PTs, PTAs, et al all qualified to care for concussions? Are all MDs, DOs and ATs qualified to recognize and manage concussions? The key word is all.
New York State’s proposed legislation seems to get it right in my opinion:
While people on the sidelines, such as coaches, may be well-intentioned, the key is having athletes see someone who's up on the guidelines, knows how to evaluate them and knows when it's safe to return, said Bazarian, an emergency physician who runs a concussion clinic. Under the bill, students who got concussions would be removed immediately from athletic activities. They would not be able to return until they were without symptoms for at least 24 hours and received authorization from a physician.
Concussions are a major concern in the United States now and rightfully so. The high profile deaths and suicides of professional athletes with several documented concussions have public interest in the problem at an all time high. Passing legislation in effort to properly recognize and manage concussions is a noble cause, but caution must be taken to ensure the legislation will do what is supposed to do – get concussed athletes the proper care they need. In my opinion, the ONLY health care providers who should be mentioned in this legislation should be MD/DOs and ATs. And since ATs and team physicians work so closely together in most cases, leaving the AT out of the legislation wouldn’t change much anyway.
I must also add that if school administrations, state associations and youth leagues mandated athlete access to athletic trainers, much of the concussion problem would be eliminated. Much of the legislation is aimed at recognition and healthcare access. Providing a BOC certified athletic trainer on-site and easily accessible would fulfill these needs.
Written by: Paul LaDuke, MSS, CSCS, ATC