Head injury

[Camron Rust]

Originally Posted by TimTaylor

Regardless of what "rules" are in effect for various leagues, tournaments, etc., there are laws in all 50 states that govern concussion risk management for youth sports.

You did the right thing. When in doubt, sit them out.

Exactly....and they're probably different in every state.

Oregon...we send them to the bench. If it is a private school, they're done for the game. If it is a public school, the coach can send them back in. If we observe concussion like behavior, we can send them back out. But the onus is on the coach to manage the situation.

Yeah, I know, but that is how the law came out...there are parties trying to fix the differential treatment between public and private.

[TimTaylor]

Originally Posted by Camron Rust

Exactly....and they're probably different in every state.

Oregon...we send them to the bench. If it is a private school, they're done for the game. If it is a public school, the coach can send them back in. If we observe concussion like behavior, we can send them back out. But the onus is on the coach to manage the situation.

Yeah, I know, but that is how the law came out...there are parties trying to fix the differential treatment between public and private.

Cam,

I believe that they did fix the private/public school differences issue in the last legislative session.

[Scooby]

In Michigan, MHSAA, has taken all responsibility away from the officials in regard to concussions. Here is an excerpt from a letter sent out about concussions.

1. The officials will have no role in determining concussion other than the obvious one where a player is either unconscious or apparently unconscious. Officials will merely point out to a coach that a player is apparently injured and advise that the player should be examined by a health care professional
for an exact determination of the extent of injury

4. Following the contest, an Officials Report shall be filed with a removed player’s school and the MHSAA if the situation was brought to the officials’ attention.


If a coach does not to have a player checked out and return her to the game, the official has no authority (through the MHSAA) to take action.

[Camron Rust]

Originally Posted by TimTaylor

Cam,

I believe that they did fix the private/public school differences issue in the last legislative session.

Looks like you are correct, if I am reading the reference I found correctly.....

https://www.oregonlegislature.gov/bi...5orLaw0392.pdf

Looks like a trainer or other defined healthcare professional can declare it to not be a concussion and the player can return for both public and private.

[scrounge]

Originally Posted by Camron Rust

Looks like you are correct, if I am reading the reference I found correctly.....

https://www.oregonlegislature.gov/bi...5orLaw0392.pdf

Looks like a trainer or other defined healthcare professional can declare it to not be a concussion and the player can return for both public and private.

Kind of an oddly written law....so a healthcare professional, as defined in the statute, can release an athlete but no sooner than the day after the event. However, a licensed trainer can release the athlete on the same day, regardless of consultation or opinion from a healthcare professional. Why not just include licensed athletic trainers in the definition of healthcare professional and allow them to release the athlete at any time?

Are trainers generally independent and free from undue influence from emotionally invested parties like coaches? If not, this is a fairly toothless law.

[PAlbc]

Originally Posted by scrounge

Kind of an oddly written law....so a healthcare professional, as defined in the statute, can release an athlete but no sooner than the day after the event. However, a licensed trainer can release the athlete on the same day, regardless of consultation or opinion from a healthcare professional. Why not just include licensed athletic trainers in the definition of healthcare professional and allow them to release the athlete at any time?

Are trainers generally independent and free from undue influence from emotionally invested parties like coaches? If not, this is a fairly toothless law.

As a Certified Athletic Trainer I'll chime in on this. First I would say that as a medical professional we should be able to conduct ourselves independently enough to ensure our medical decisions are not being influenced by our connection to a respective team. With that being said there are those out there that don't do that, just as there are officials out there that are biased for/against specific teams/coaches/players/etc. Again the majority out there act appropriately professional, you just hope you get to deal with those more often than the others.

With that being said ATCs have been given various levels of authority/responsibility when it comes to concussions. Much of it revolves around where the wording in a state law it goes from "suspected concussion" to "diagnosed concussion". In my state a player can be sent to me for a "suspected concussion/head injury", I can do an evaluation and say "No, this player does not have a concussion, they can return to play today." If I find they likely do have a concussion, they are not only done for the day, but they are done until cleared by a physician (and even can't be cleared by a physician same day).

If the laws and protocols didn't include athletic trainers and non-physicians in the "evaluation" process then essentially any time an official sent a kid out it would be essentially disqualification from participation for the remainder of the day and in some states permanently since wording includes "removed until evaluated by AHP". That's a lot of doctor's visits for kids based off of an official using an abundance of caution if other professionals can't handle the "evaluation" step.

I will say I have had this argument with officials who say "No, he has a concussion and can't return." I usually reply with "Thankfully my medical degree allows me to say your diagnosis of a concussion is wrong and he can return."

[Camron Rust]

Originally Posted by scrounge

Kind of an oddly written law....so a healthcare professional, as defined in the statute, can release an athlete but no sooner than the day after the event. However, a licensed trainer can release the athlete on the same day, regardless of consultation or opinion from a healthcare professional. Why not just include licensed athletic trainers in the definition of healthcare professional and allow them to release the athlete at any time?

Are trainers generally independent and free from undue influence from emotionally invested parties like coaches? If not, this is a fairly toothless law.

I don't think that is what it is saying.. If it IS deemed a concussion, they must wait a day before any clearance is valid. If it is deemed not a concussion, they can return the same day.

[scrounge]

Originally Posted by Camron Rust

I don't think that is what it is saying.. If it IS deemed a concussion, they must wait a day before any clearance is valid. If it is deemed not a concussion, they can return the same day.

That certainly seems to be what it says. As I read it, the plain text of subsection 3 (Sec1.3.a) requires the coach to hold out a player if only one of two conditions exist: signs, symptoms, or behaviors OR a diagnosed concussion. Sec1.3.b then clearly states that, if a players is held out under Sec1.3.a, upon approval of the healthcare professional (HCP), the player may return the next day if no signs, symptoms, or behaviors are present. In this case, both HCP approval AND lack of signs are required.

The only exception is that provided under subsection 4 (Sec1.4), the blanket provision allowing a licensed athletic trainer to make a final and unchallenged determination/diagnosis and same day return. This makes no sense to me - a trainer can return a player the same day but a neurologist can't. Doesn't that seem backwards?

[Camron Rust]

Originally Posted by scrounge

That certainly seems to be what it says. As I read it, the plain text of subsection 3 (Sec1.3.a) requires the coach to hold out a player if only one of two conditions exist: signs, symptoms, or behaviors OR a diagnosed concussion. Sec1.3.b then clearly states that, if a players is held out under Sec1.3.a, upon approval of the healthcare professional (HCP), the player may return the next day if no signs, symptoms, or behaviors are present. In this case, both HCP approval AND lack of signs are required.

The only exception is that provided under subsection 4 (Sec1.4), the blanket provision allowing a licensed athletic trainer to make a final and unchallenged determination/diagnosis and same day return. This makes no sense to me - a trainer can return a player the same day but a neurologist can't. Doesn't that seem backwards?

I think the protocol is that the trainer is the one that will be present, not the neurologist. If the immediate assessment is that it is not a concussion, the player can return. They'll never get to a neurologist before the game ends...but it allows for the trainer to consult with one if there is one available. However, once someone thinks it is a concussion (even the lessor trained trainer), it is treated as a concussion and the player must stay out for a minimum of time.