You Can Ring My Bell ...
 

Team A trails 56 to 55 with 60 seconds left in the game. Team A has the ball and is setting up a last second shot. A1, Team A's best player, accidentally trips over his own feet coming of a screen. A1 falls and hits his head on the floor. As he tries to stand up he stumbles a few steps. The official realizes that A1 is showing a symptom of a concussion and blows the whistle to stop the game. The official tells the coach that A1 "appears dizzy" and beckons the coach, and/or trainer, onto the court. The coach, realizing that he has used up all of his timeouts, and that if he steps onto the court he will have to remove his best player from the game, or take a time out at the expense of a technical foul, tells the official, from his bench, without ever stepping out onto the court, that, "A1 seems fine. I'll keep him in the game". By rule, if this were a normal injury, the sit a tick, or take a timeout, rule wouldn't apply because the coach and/or trainer did not come out onto the court. However, the way I read the new concussion rule, once the official feels that there is a concussion symptom, then even if the coach, and/or trainer, doesn't come out onto the court, the injured player who showed a symptom of a concussion must still sit a tick, or the coach must call a timeout, to keep him in the game. I am assuming that during the time interval to sit a tick, or during the timeout, a health care professional clears the player to continue playing in the game.

Discussion?

The player must be directed to leave the game. So, a sub is needed. You can't grant the TO until the sub is in the game. The removed player can't return until the clock has properly started.

Inquiring Minds Want To Know ...
 

Sounds good, but, citation please. I don't see anything here (below) about sitting a tick, but I've been known to be wrong in the past. Also, at our local board's interpretation meeting last night we were told that such a player could continue to play if he was cleared by a health care professional during a timeout. But that's just our little corner of Connecticut.

3-3-8: Any player who exhibits signs, symptoms or behaviors consistent
with a concussion (such as loss of consciousness, headache, dizziness,
confusion, or balance problems) shall be immediately removed from the game
and shall not return to play until cleared by an appropriate health care
professional.

There's 3 new case book plays on player injuries this year.

3.3.6SitA, B, & C.

Read 'em.

Inquiring Minds ???
 

These appear to be about "regular", that is, non concussive, injuries. Are you saying that these case plays also apply to concussions, assuming that in all cases a health care professional clears such players?

*3.3.6 SITUATION A: A1 is injured and play is stopped to permit the athletic
trainer or physician to administer aid. (a) A1 is removed from the court and
replaced within less than one minute; or (b) the injury is such that the physician
will not allow A1 to be removed from the court until being certain it is prudent to
do so. After approximately five minutes, A1 is moved from the court. RULING: No
time-out is charged in either (a) or (b), regardless of the amount of time involved.
The intent of the rule is to require an injured player to be removed without charging
a team with a 60-second time-out, regardless of how much time is consumed
prior to removal. A team may call a time-out if they wish to keep the player (if
able) in the game provided the replacement interval for the substitution has not
began. (5-8-2a)

*3.3.6 SITUATION B: A1 appears to be injured and an official properly halts
play and the Team A coach rushes onto the court to check A1. However, A1 is OK
and seems ready to play within a few seconds. RULING: A1 must be removed as
the coach came onto the court. A1 may remain in the game if the coach does not
come on the court and A1 is ready to play immediately. If the coach or other
bench personnel have come onto the court, the player must be replaced. There is
no set amount of time as to what is “immed iately,” but it should not involve more
than a few seconds and it must be without the coach, athletic trainer or doctor
being beckoned and/or entering the court. The coach may also call a time-out to
keep the player in the game provided the replacement interval for the substitution
has not began. (10-4-2)

*3.3.6 SITUATION C: A1 is injured and bench personnel are beckoned onto the
court. Once A1 has been removed from the court, the official notifies Team A’s
head coach that a replacement is required. The coach acknowledges the notification
and the official then instructs the timer to begin the 20-second replacement
interval because a substitute is not made available immediately. Team A’s head
coach then requests a time-out to keep A1 in the game. RULING: The time-out
request must be made when the official informs the coach that a replacement is
required. Once the 20-second interval has begun and A1’s replacement is pending,
a time-out shall not be granted. Once A1 is replaced by a substitute, Team A
may request and be granted a time-out, if desired. (2-12-5 Note; 3-3-6 Note 2;
5-8-3b)

Our state supervisor of officials told us he sits a tick.

So, he sits a tick.

5-8-3b

These all are great points made by everyone, but let me take this one step further. What are we classifying as proper health care professional. A athletic trainer is not always a certified doctor or medical professional. How can athletic trainer give the clearance that a player is able to return especially after a brief trip to the bench.

I have never had a concussion or been in a state of that, but from knowing a few people who have had that from other sport injuries I know it normally take a couple of preliminary test for it. A player tripping over his/her feet and falling to the floor and then getting up and being "dizzy," is a sign of a concussion I get that, but how do you let a player come back in after less than a minute. The book says no matter what the player has to come out and cannot return without the written authorization of a physician being either MD/DO (09-10 Rule Book, 2-8-5 p. 16 and 3-3-8 p. 21)

I know that is out of last years rule book but if someone has this year book in front of them could they please post the verbage for this year.

My main point here is that how could you have time to have an athletic trainer check them and clear them unless the trained is an MD/DO.

Peace,
JB

"We" (at least in this state) aren't responsible for "classifying" anyone. It's the coach's job.

And, if the player comes in and still exhibits symptoms, we can send the player right back out.

TN has instructed that if the "Referee" uses the word "concussion" in any form, then, the player must be evaluated by an MD/DO, who must sign a TSSAA provided form before the player is allow to return to any athletic activity.

The referee does not have to see the signed form but shall ask the coach if the player has been evaluated by an MD/DO and has the TSSAA form been signed? Should the coach stipulate in the affirmative, we are to allow the player to enter the game. Should further signs of potential concussion be observed we are to again remove the player and request that the player be evaluated again.

Any time a player is directed from the contest to be evaluated for symptoms of concussion regardless of re-entry or not, the Referee shall submit an "unusual occurrence" form to TSSAA within 24 hours of the contest.

The TSSAA supervisor conducting the state rules meeting alluded to the referee, having the coach remove the player, without using the word "concussion", would allow evaluation by a "trainer" and not trigger the "form" requirement.

In GA we've been told that the player must leave. If they "sit a tick" and are allowed back in (assuming they are not still displaying signs of a concussion) it's assumed they've been checked out by an appropriate health care
professional who has conveyed to the coach it's ok for the player to return. The responsibility for this is on the coach, not us. We don't ask for a note, who evaluated them, or anything. The thought is that if they are checking in the coach has taken care of that.

Don't have any idea on how defendable that position is, or if it will stand up in a potential lawsuit, but there it is. I was actually glad they clarified where/when our responsibilities begin and end because when we first heard of the rule in summer camp we were concerned about many of the things being discussed (i.e., having to be medically trained in some fashion, getting a note, etc.).

Agreed. In Missouri, if they exhibit signs or symptoms as they're coming onto the playing court we've been told to deny their entry.

Billy:

There have been a number of relevant Rules and Casebook Plays listed in this thread so far. But the key to this play is: The Game Official has stopped play because, in his judgment, thinks that the Player has suffered a concussion, has lost consciousness or has become unconscious, or is so injured that the GO believes that the Player should immediately be attended to by Bench Personnel, and therefore beckons for the Head Coach to leave the Bench and attend to his player. Once the GO beckons the HC onto the Court, the player must leave and cannot re-enter the game (if certain Rules requirements are met) until the first opportunity to substitute after the clock has started. I have highlighted the words “beckons the HC onto the Court” because it is the key action by the GO that applies to all similar situations.

MTD, Sr.

Confused ???
 

Grants a player’s/head coach’s oral or visual request for a time-out, such request being granted only when: b. The ball is dead, unless replacement of a disqualified, or injured player(s), or a player directed to leave the game is pending, and a substitute(s) is available and required.

I understand that we don't grant a time out if there is a disqualified player until he, or she, is replaced. Probably the same thing with an untucked jersey (by the book). But in the case of an injured player (not a concussion, let's say a twisted ankle), or a bleeding player, aren't we allowed to grant a time out to the coach to keep that player in the game, if the injury can be dealt with, or the bleeding can be stopped, in the time frame of a time out. If what I say is true, what rule covers that?

Bell Rung: Time Out, Or Sit A Tick ...
 

Here's what I got from one of our local "rules gurus":

If officials make a decision to "assist and defer" because they think the player is exhibiting signs or symptoms of a concussion, then that decision will require the player to have an assessment by a health care professional (HCP). Yes, such player will need to "sit a tick" unless such decision can be made by a HCP within the timeframe of a timeout. Our decision to "assist and defer" is made regardless if coach/trainer comes onto the floor or we beckoned coach/trainer to floor.

Health Care Professional ?????????
 

BM - Was at the IAABO convention and Alan Goldberger said specifically to insist on a medical doctor that is willing to clear the player for his return to the game.

You might want to give Jeff Clark a ring / e-mail and ask him.

Unfortunately, that is not supported by the new rule. In fact, the reference to an MD (and to a written authorization to RTP) was actually removed in the rule. The NFHS specifically says that the "approved medical personnel" will depend on each state's laws and regulations. So each state will need to tell its officials who is approved to decide if the player can return to the game. The state might mandate a doctor, but they might not. They might say the trainer at the game is approved to make the decision. If that person says the kid is not concussed, then by rule, he can come back into the game.

It's The Law ...
 

According to Connecticut Public Act 10-62, An Act Concerning Student Athletes And Concussions, a Health Care Professional (HCP) is defined as: a Physician, a Physician's Assistant, an Advanced Practice Registered Nurse, or an Athletic Trainer trained in the evaluation and management of concussions.

In your OP, the coach didn't have any TOs left. He was trying to keep the player in the game by not going on the court. Not allowed for any injury (unless, the player is ready to play "immediately" and it's not for concussion symptoms).

If you change the situation, you change the outcome.

Yeah, he did--in no uncertain terms!

There is a lengthy discussion of this (written by Goldberger, who is a lawyer) in the current IAABO newsletter. He does not say it must be a doctor. Instead, he quotes the rule and says officials must know what their state association determines to be "appropriate health-care professionals" which could be medical doctors, osteopathic physicians, and certified athletic trainers.

He offers this rather common sense advice:

At the end of the day, officials continue to be “empowered” to remove players, but need not obtain written credentials of the health-care professional on the sidelines.

MTD nails this situation perfectly. I am always slow to beckon the coach; but once I've made the decision to do so, it's been done and the player needs to be replaced. The coach cannot circumvent this requirement by refusing to come onto the court. Whether he comes or not, he's been beckoned.

Signs of a concussion would only make it more vital to follow the rules as written.

Showing signs of a concussion...really...did you go to school for this? Just because you fall down and hit your head doesn't mean you have a concussion. We need to be really really careful here.

Goodwill, obviously, I don't know you from Adam, so if I'm way off-base, I apologize in advance. But you seem to be WAY up on a high horse today. Your comments in three different threads seem to be talking down to others.

WTF is your comment above supposed to be getting at? BillyMac gave a GREAT example of how the new rule might play out in a real game. The rule says if the player shows "signs, symptoms or behaviors" of a concussion, the player MUST be removed from the game.

Very few refs are medical doctors who went to school to recognize concussions, yet the rules MANDATE that if we see signs, symptoms or behaviors of a concussion (and they give us several examples, plus a long training video online) that we act on that.

Obviously falling down doesn't mean that you have a concussion. But we're not given a rule about HAVING a concussion. We're given a rule about the signs, symptoms and behaviors of a concussion (which, you may recall, they have given us several examples of, as well as a long training video online).

So if you're trying to be funny somehow, or if you don't realize that you sound like an elitist prick (which I've been called on this forum many times, although I still contend I'm not an elitist), then I apologize. Otherwise, I really think you need to realize that there are lots of people on this forum who have a lot of knowledge and are trying to dig deeper into the rule than simply realizing that falling down does not necessarily give one a concussion.

Not sure what you're saying here. Are you suggesting that since Billy isn't an MD he can't recognize the signs of a concussion? You're right, of course, that just because the kid gets hit in the head does not mean he has a concussion. However, if Billy sees the hit to the head, followed by the player getting back up and stumbling in a way he hasn't before, and there's no obvious reason for the stumbling...sounds to me like Billy needs to be really, really careful to do what's right for the kid here.

Nope, Billy read the damn rule book instead. You should give it a shot because you obviously don't understand the application of the new rule that we've been given.

In the COMMENTS ON THE 2010-11 RULES REVISIONS at the back of the rulebook, we as officials are directed by the NFHS rulesmakers that "any player who exhibits signs, symptoms or behavior consistent with a concussion, such as loss of consciousness, headache, dizziness, confusion or balance problems, shall be immediately removed from play and shall not return until cleared by an appropriate health-care professional."

Yes, the FED sureashell wants us to be careful, but not in the way that you're suggesting. Their explicit instructions are "Officials, coaches and administrators should be looking for signs of concussion in all athletes and should immediately remove any suspected concussed athlete from play and make every effort to ensure a concussed athlete does not continue to participate."

Not only was your point completely wrong, it was the polar opposite of the instructions that the rules-makers have given us. Terrible advice!

As someone who knows most people from Adam, let me just ask one question.

You're saying there's a training video online?

Yes.

There's a link to it on the front page of nfhs.org

Field Sobriety Test ???
 

I didn't have to go to school to learn this. It's all on page 75 of the NFHS 2010-11 Basketball Rulebook.

Check it out:

Common Symptoms of Concussion Include:
• headache
• fogginess
• difficulty concentrating
• easily confused
• slowed thought processes
• difficulty with memory
• nausea
• lack of energy, tiredness
• dizziness, poor balance
• blurred vision
• sensitive to light and sounds
• mood changes- irritable, anxious, or tearful

Judging by those symptoms, I'm pretty sure I have a concussion this afternoon.

Land Of Steady Habits ...
 

I am not a health care professional, nor do I play one on television, however, we got this handout (below) from our state interscholastic athletics governing body:

Connecticut Interscholastic Athletic Conference Officials Concussion Protocol
To keep the role of the official relative to concussion in proper perspective, it is helpful to understand the role of the COACHES, which is clearly defined in the new law, (Public Act 1062). The law places the primary responsibility on COACHES for the health and safety of their athletes and mandates training in the recognition of the signs and symptoms of a possible concussion. The new law is specific to COACHES and there are no requirements in the law that pertains to officials.

In part, Public Act 1062 – An Act Concerning Student Athletes And Concussions…
• Mandates that all coaches complete a course in the management of concussions prior to coaching that includes training in the recognition of signs and symptoms of a concussion or head injury;
• Places the primary responsibility for the athlete’s health and safety, including the recognition of signs and symptoms of a possible concussion on the coach;
• Requires that a coach must immediately remove a student athlete from participating in a game or practice who is observed to exhibit signs, symptoms or behaviors consistent with a concussion, following an observed or suspected blow to the head or body, or if the athlete is diagnosed with a concussion;
• Emphasizes that coaches abide by the return to play procedure and protocol required by the law, which includes written medical clearance by a licensed health care professional*, followed by a gradual return to play procedure that should prohibit any student confirmed to have signs and symptoms of a concussion to return to play on the same day as the injury. *(According to CT state law, a licensed health care professional is a physician, physician’s assistant, advanced practice registered nurse, and an athletic trainer trained in the evaluation and management of concussions)
• States that any coach found in violation of the law may have his/her coaching certificate revoked. The CIAC Board of Control position is that the following information and protocol presented for Connecticut officials is consistent with the intent of the NFHS concussion rule and guidelines and in compliance with the state law that all coaches must follow.

Role Of Connecticut Officials
In light of the law in Connecticut and in keeping with the intent of the NFHS rule, the primary role of the official is to assist coaches, trainers, and health care professionals in identifying athletes that need to be checked for a possible head injury, and then defer to the judgment of these trained individuals. The NFHS “concussion rule” does not create a duty that officials are expected to perform a medical diagnosis. Officials are simply being asked to use their best judgment in observing and being more cognizant of athletes that may be displaying signs, symptoms and behaviors, consistent with a concussion, such as loss of consciousness, headache, dizziness, confusion or balance problems, and stop play to provide the opportunity for the athlete to be properly checked by the coach, trainer, or other health care professional, trained in the evaluation and management of concussions. The game official is NOT responsible for the evaluation or management of the athlete after he or she is checked by the coach, trainer, or other appropriate health care professionals or goes to the sideline. The coach, trainer, and other health care professionals assume full responsibility for the health and safety of the athlete. To this end, if an appropriate healthcare professional on the sideline determines that the athlete HAS NOT suffered a concussion and has no signs and symptoms of a concussion, the athlete may go back in the game. If there is no appropriate health‐care professional available to further evaluate an athlete exhibiting definite signs and symptoms of a concussion, the law states that the athlete SHOULD NOT be allowed, by the COACH, to return to play. According to NFHS guidelines, the official does not need written permission for an athlete to go back in the game, nor does the official need to verify the credentials of the appropriate health‐care professional. If the athlete returns to play, the officials are to assume an appropriate health care professional approved the return. Ensuring compliance with the NFHS suggested concussion guidelines is a health and safety issue and should be the responsibility of the head coach and school administration, NOT the game official.

Suggested Protocol For Connecticut Officials
• If an official observes a player exhibiting any signs or symptoms of a possible concussion, he/she shall provide the opportunity for the coach, trainer, or other appropriate health care professionals to properly check the athlete and then defer to the their judgment.
• The official should stop play and either beckons the coach onto the field or escort the player to the coach, depending on the circumstance. State that “the player should be checked out, and if necessary, provide other information you deem appropriate”. Do not say that the athlete has a concussion. At this point the official’s job is done.
• If it is determined the athlete is not injured or the injury is NOT related to a concussion the athlete may return to the game in accordance with NFHS rules.
• If an athlete is returned to the game and the official again observes signs and symptoms of a possible concussion, the protocol should be repeated. The protocol for handling these situations may vary depending on the circumstances. This is just one sound way to ensure that the athlete gets checked out properly by the coach, trainer, or other appropriate health care professionals, but may not fit all situations. CIAC will defer to the expertise of officials to handle the situation as you deem appropriate.

NFHS Concussion Rule – “Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate healthcare professional”.

Adam Is On The Left ...
 

Hell, I got just about all of those symptoms and it's got nuthin' to with a concussion. I'm just old.

Only this afternoon? ;)

It's just worse today.

Oh, and shut up.

You're really en fuego today.

Dang, I am now enlightened, my Wife has been concussed for 20+ years. :eek:

Now that I've got that first shut up behind me, it really feels like the season is here! :)

It's like watching the leaves fall.

What I am getting at is that we shouldn't all of a sudden go crazy and start thinking everyone has a concussion everytime they bump their heads. Let the medical staff on site do their jobs. (If I was a prick yesterday in my post I apologize, bad day at work!)

Sounds like most teenagers I know!

I agree completely, but I think your concern is misplaced. No one anywhere is saying that we should go crazy on this issue. Everyone knows that a bump on the head does not equal a concussion. I don't expect to see players sent off willy-nilly. I do expect that officials will at least take a quick look to see if a kid is wobbly as he walks away from a collision.

Que to late night television commercial:

"Help! I've fallen down and I can't get up." Sounds like me now, :D.

MTD, Sr.