Is there a Dr. in da house

tiger49

How would you guys handle the situation? Personally I would tell the coach when he gives me his replacement right after the injury so both the coach and the ATC know that he is not coming back unless there is a note from an MD. From the original post it sounded as if the umpire stayed silent on the situation, thus creating the confusion.

In Ontario we do have a similar procedure in place, however it is enforced by the school staff as it calls for the athlete not to participate in any activity until cleared. Activity means practice and/or game and the athlete sits out until cleared not just for the day.

ODJ

Hartee14 wrote
I would have said the same thing. The ATC would then have to take that up with the powers to be.

But, my 2 cents. We are umpires. At the end of the day, whether we are doctors, lawyers, teachers, etc, when we are on the field, WE ARE UMPIRES. WE ARE NOT DOCTORS, ATHLETIC TRAINERS, etc. If you have a Certified Athletic Trainer at the game, you need to let them make the decisions. Who am I to tell an ATC that the player who just got hit should not return to the game? That is not my call. That is his/her call. That is what they get paid for. Unless you see the athlete laying there unconscious and they have to do CPR or mouth to mouth breathing, there is no reason not to let them return. I think the umpire made the wrong call.

An AT is NOT an MD/OD. Give me the official letterhead from an MD that says the kid can play.

BoomerSooner

I know I'm late into the discussion, but I agree with the general concept that the rule should be followed to the letter. Loss of consciousness = signed release from MD/DO.

What I don't agree with, however, is some the posters that have implied that any signs, symptoms, or similarities to a head injury require a doctor's release. I understand the concept of better safe than sorry, but just because a kid takes a pitch to the head and takes a second to get up doesn't mean he was unconscious. Just because a kid takes a pitch has a knot on his forehead, doesn't mean there is a loss of consciousness. I'm sorry, but for all the preaching about following the letter of the law, there seem to be alot of posters that want to declare a kid unconscious just to be safe rather than because he was actually unconscious. This is just my interpretation of what others are saying. If we are going to play the better safe than sorry angle then shouldn't we be requiring full neuroloical work-ups including EEG, CT scans, etc? The purpose of the rule is to protect the kids, not the umpires.

eagle_12

waltjp wrote

Appears dazed or stunned

Is confused about assignment

Forgets plays

Is unsure of game, score, or opponent

Moves clumsily

Answers questions slowly

Loses consciousness

Shows behavior or personality changes

Can't recall events prior to hit

Can't recall events after hit

Or the athlete himself might report the following symptoms if he has a concussion, including a:

Headache

Nausea

Balance problems or dizziness

Double or fuzzy vision

Sensitivity to light or noise

Feeling sluggish

Feeling foggy or groggy

Concentration or memory problems

Confusion
Other important facts about concussions include that they:

are caused by a bump, blow, or jolt to the head

can occur even if the athlete doesn't lose consciousness

can happen in any sport

may not cause symptoms until days or weeks after the injury

can cause brain swelling, permanent brain damage, or even death, if an athlete has a second concussion before fulling recovering from a first one

Who are you to say that the player can't play if they exhibit signs of a concussion. We can only limit return to play in the event of an apparent LOC not a concussion.

This discussion is very trying for me because I am both and umpire and an Athletic Trainer. The rule clearly states that in the event of apparent LOC then the player must have written permission/clearance from a MD. Let me tell you something, any ATC worth anything, and that has any clue, will not allow a player to RTP if there is any thought that there was LOC. Any time I have apparent LOC with my athletes, their in the ER asap.

I think that umpires need to be aware of LOC. Reading this I'm not sure that you guys know the difference between a concussion and LOC. Dazed/Confused/Dizzy/Amnesia, all that from the list above does not equal a loss of consciousness.

I think that, and the way that I would handle this situation if there is no ATC present, is after everything calms down, as the coach and I are discussing who the replacement is, I would tell the coach that in my opinion that player had a LOC and state why that is (unresponsive, blacked out, etc). If he asks me why I feel that way, then i explain my medical experience. I truely believe that if this happens, 1. the coach doesn't try to put the kid in, and 2. he won't have a problem with me saying hey I feel this way and this is what i observed. I don't think that he needs to be told that the player cannot return unless a doc's note is present, becasue he's going to seek one out maybe. Also, it needs to be noted on the line-up cards that there was LOC and why. And if the coaches have a problem, all you have to tell them is Tough crap, let move on

jicecone

Eagle_12, the chart waltjp copied was provided by the "Department of Health and Human Services Centers for Disease Control and Prevention," or as you might say, DOHAHSCFDCAP, so if you have a problem with it, maybe you should take it out on them. But they probably don't know what they are talking about because they are not Athletic Trainers.

Their first recommendation in the Point of Emphasis was to "Remove athlete from play" if you SUSPECT, that a player has a concussion.

Being, just a "dumb ole umpire" and not an expert Athletic Trainer and also following the rules, I will not let a player return without a physicians written authorization if they exhibit the Signs and Symptons suggest by the Department of Health.

Finally, I really don't believe that you need to explain to a coach that because his player is "unresponsive or blacked out" that they had a loss of consciousness, and that you determined that because of your medical experience. DAH.

But being just a dumb ole umpire, who am I to say.

eagle_12

Please show me where it says that we can limit due to a concussion, let alone a "suspected" concussion.

azbigdawg

eagle_12 wrote
Please show me where it says that we can limit due to a concussion, let alone a "suspected" concussion.

different sport (Softball) FED rules...... Batter takes a pitch of the helmet..happens a lot..no big deal, right? well instead of going to first, she just stands there....shakes her head....and shakes it again.... I talk to her, and she doesnt respond... I tell her to look at me, and she finally looks in my direction and her eyes are unfocused.....I figured it was a concussion then, and NO WAY IN HELL was she going to continue that game. Report me, whatever. The trainer then comes up and tells me its her 3rd ONE SINCE THE start of the school year! 2 in BASKETBALL, and now this one. I told the trainer and head coach that tehre was no way she was continuing, and in my unexpert opinon, she shouldnt be playing any sports for a LONG time! (ever?)
I wrote a letter to the state association..never heard anything back..my point is...Im going to err on the side of caution...fed game, concussion= trip to the doctor, and doctors note. Period.

lawump

I'm not a health care professional...and, frankly, I haven't read all the posts in this thread: I'm too tired and its too late.

However, I will add, that as an attorney, I advise all my umpire friends:

If they themselves have first-hand knowledge that a player became "apparently unconscious" OR they are told from a reliable source (i.e. a trainer, coach, etc.) that the player was unconscious...there is no friggin' way that player is coming back in the game unless I receive a note (in triplicate 😀 ) signed by a MEDICAL DOCTOR (MD). Period, end of discussion.

Mrumpiresir

This thread has gone on too long.

A. I let a player with a suspected concussion return to play

1. He may not be reinjured
2. He may be reinjured due to his decreased ability to play

a. I may not be sued.
b. I may be sued.

1. I may win the lawsuit.
2. I may be found negligent.

a. I may not lose all I own
b. I might lose my house, my car, any savings I have etc.

B. I do not allow him to play

1. The coach will agree he should not play
2. The coach and the parents will think I am an OOO.

I can live with option B.

t-rex

Coach: "I'm bringing Johnson back in to catch. Number 4."
Umpire: "Isn't he the one who was hit in the head?"
Coach: "Yeah, our trainer checked him out. He's fine"
Umpire: "I'm not letting him in. He was hit in the head and he should sit."
Trainer: "I checked him out. I followed our shool's protocol for head injuries. I watched while he did some sit-ups and deep knee bends. It is my opinion that he is fit to play."
Umpire: "I need a note from a doctor. Until then, he sits."
Coach: "Are you saying that he was unconscious?"
Umpire: "No, I am saying that because he was hit in the head he could have a concussion, and I need a note to allow him to re-enter."
Coach: "I protest your application of 10-2-3k."

socalblue1

t-rex wrote
Coach: "I'm bringing Johnson back in to catch. Number 4."
Umpire: "Isn't he the one who was hit in the head?"
Coach: "Yeah, our trainer checked him out. He's fine"
Umpire: "I'm not letting him in. He was hit in the head and he should sit."
Trainer: "I checked him out. I followed our school's protocol for head injuries. I watched while he did some sit-ups and deep knee bends. It is my opinion that he is fit to play."
Umpire: "I need a note from a doctor. Until then, he sits."
Coach: "Are you saying that he was unconscious?"
Umpire: "No, I am saying that because he was hit in the head he could have a concussion, and I need a note to allow him to re-enter."
Coach: "I protest your application of 10-2-3k."

If IMO there was any chance the player suffered a concussion I can live with that and will have the full backing of our association.

I just happen to have a significant amount of training & experience (EMT, mountain rescue) and can rather easily determine the risk factors present in allowing the player to return.

My suggestion to any game official is this: weigh the risk - if you feel the player was suffered sufficient head injury that you are not comfortable with his/her return keep them out. No HS game is worth a child's future.

jicecone

Amen

Rich

t-rex wrote
Coach: "I'm bringing Johnson back in to catch. Number 4."
Umpire: "Isn't he the one who was hit in the head?"
Coach: "Yeah, our trainer checked him out. He's fine"
Umpire: "I'm not letting him in. He was hit in the head and he should sit."
Trainer: "I checked him out. I followed our shool's protocol for head injuries. I watched while he did some sit-ups and deep knee bends. It is my opinion that he is fit to play."
Umpire: "I need a note from a doctor. Until then, he sits."
Coach: "Are you saying that he was unconscious?"
Umpire: "No, I am saying that because he was hit in the head he could have a concussion, and I need a note to allow him to re-enter."
Coach: "I protest your application of 10-2-3k."

He appeared to momentarily lose consciousness. Play ball.

Protest that.

t-rex

The key to my post was not in that the coach can protest. The key is that the trainer followed a protocol.

The Fed provides guidelines for institutions to use in setting up protocols for dealing with head injuries. This document is found at the NFHS web site under Sports > Sports Medicine > Information on Concussions.

This document also discusses what coaches and administrators can look for if they are without a trainer or other "trained and knowledgeable" individuals at their games or practices, they being in a position to compare the athlete's normal behavior against how this person is behaving post injury.

I believe NFHS would like to see a more rigorous set of criteria placed on how to deal with returning players to action after suffering a potential head injury, but the only mandate that is written is found in 10-2-3k.

Basically, NFHS is leaving it up to the schools to decide how to deal with these situations, but in extreme cases where a player is attempting to return after losing consciousness, they have asked the umpires to prevent re-entry.

Umpires are not being asked to enforce the guidelines as suggested to the schools, or even the guidelines that the CDC may suggest. My point is only to show that the bar for when we can step in is limited.

MrUmpire

t-rex wrote
Coach: "I protest your application of 10-2-3k."

Duly noted, play ball.

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