(Editor’s Note: What follows is an excerpt from an article in Concussion Litigation Reporter–November 2014, written by Chris Hummel, a Clinical Associate Professor and Athletic Trainer in the Department of Exercise and Sport Sciences at Ithaca College. To see the full article, please subscribe to Concussion Litigation Reporter.)
Sports concussion management has changed greatly in just the last few years, and is almost unrecognizable from where it was even ten years ago. So many things have changed, from the way concussions are assessed and managed, to how return to play decisions are made. Over the last five years, many national and international sports organizations have created policies and procedures to address concussion recognition and management. Every new concussion management policy brings both the potential for improved athlete care and challenges for the sports medicine staff.
Are the current policies and recommendations perfect? No, concussion management needs to grow and evolve as we learn more each and every day. We have yet to be able to create a perfect system as shown recently by the issue at the University of Michigan football game. Even with unlimited resources, we cannot always see each and every concussion that takes place on the field. The addition of an athletic trainer in the press box to watch for signs and symptoms of concussion in those on the football field is an outstanding addition, but yet this is not a perfect solution. The signs and symptoms of a concussion are not always visible and not every institution has the resources for additional personnel.
Multiple variables are now in the field of play when it comes to how to properly recognize and manage a sports concussion. It can be quite daunting when deciding where to begin with implementing a concussion management program. There are numerous resources in print and on the web to help but they can also confuse practicing clinicians, coaches, administrators, parents, and athletes. Consensus statements come out each year that describe what the best minds in concussion management think and believe with regards to concussion management, but these statements from the various groups may not always agree. Which one(s) then do you use to build your program around? The NCAA has made this somewhat easier in the recommendations and mandates that they have passed along to each member institution. Yet, as we have seen this fall, even the largest programs with seemingly unlimited resources (financial and personnel) continue to evolve their concussion management program all the while concussion management issues still arise.
When a concussion does occur, every program should start with two foundational pillars:
- Any athlete experiencing concussion-like symptoms will be treated as though a concussion has taken place and not allowed to return to activity until proper assessment is completed.
- All concussions will be treated and managed on an individual basis.
Appropriate Concussion Assessment
Prior to the start of their athletic participation, each athlete should complete a comprehensive medical history and pre-participation examination (PPE). Specific questions need to be asked to identify those athletes with previous history of concussion or those at greater risk of concussion. The specifics of each athlete’s concussion history should be discussed during the PPE, which will be the conduit to educating your athletes, coaches and parents.
To see the full article, please subscribe to Concussion Litigation Reporter.