VSBA School Law Conference – 2011
Student-Athletes & Concussions:
Getting Your Head OUT of the Game
Joel S. Brenner, MD, MPH
Children's Hospital of The King's
Daughters
Wendell C. Roberts, Esquire
Staff Attorney, VSBA
Student-Athlete Concussions
A local, state, and national issue
• As of May 2011, 17 states
have passed laws protecting
student-athletes from
concussions.
• In addition, similar
legislation is pending in 23
other states.
• On January 26, 2011, 11
members of Congress
introduced H.R. 469 –
“Protecting Student Athletes
from Concussions Act of
2011”
• If passed, the legislation
would require states to
enact regulations that
would require local school
division to develop and
implement concussion
safety plans.
Recent Research Findings
•
H.R. 469 cites research reporting that between the 2005-2008 school years,
over 400,000 students sustained concussions while participating in high school
athletics.
•
A national study published in Pediatrics Journal reported that emergency
room visits for suspected concussions more than tripled among students aged
14-19 in the decade between 1997 and 2007; and doubled for younger
student aged 8-13 over the same time period.
•
The Center for Injury Research and Policy found that last year 40% of high
school concussion sufferers returned to play too quickly (as per AAN “returnto-play” guidelines); and
•
During the 2007-2008 season alone, 1 in 6 football players who sustained a
concussion and lost consciousness (15.8 %) returned to play the same day.
What does all the research mean?
• Our culture has changed in
that we are recognizing
concussions, we are seeking
treatment.
• Our culture has not
changed with regard to the
“return-to-play” decision.
Our kids are coming back to
the play way too soon after
being treated for the injury.
Concussions Remain in the News
Virginia Law – S.B. 652
Sen. Ralph S. Northam – (6th
District, Pediatric Neurologist)
2010 General Assembly
• The law directs the BOE to
develop and distribute
concussion management
guidelines to local school
divisions.
• In accordance with the BOE’s
guidelines, each local school
division shall develop policies
and procedures regarding the
identification and handling of
suspected concussions in
student-athletes.
VA DOE – Developed Guidelines
(BOE adopted on January 13, 2011)
DOE staff worked with
numerous stakeholder groups
• Virginia High School League,
the Department of Health, the
Virginia Athletic Trainers
Association, representatives of
the Children’s Hospital of The
King’s Daughters and the
Children’s National Medical
Center, the Brain Injury
Association of Virginia, the
American Academy of
Pediatrics, the Virginia College
of Emergency Physicians and
other interested stakeholders.
Five “Pillars” of the DOE Guidelines
• Training of Coaches/Adults
• Educate Parent/Students
• Removal From Play
• Return To Play
• Record Keeping
Training of Coaches
and Adults
•Annual training of all Coaches, Staff,
and Volunteers who serve in and
coaching capacity.
•Recognition of the student-athlete that
may have sustained a concussion.
• Extracurricular activities; games,
practices, tryouts, and after-school
intramurals.
RESOURCES
Online Training
www.nfhs.org
www.cdc.gov
Providing information to
the Student/Athlete and
Parent
•Provide information
annually on the risks of
sustaining concussions
&
•The risks of further injury if
returned to play before a
concussion is fully healed.
RESOURCES
www.cdc.gov/ConcussionsInYouthSports
Develop a Process for
Conducting Sideline
Assessments
•Decide what sideline assessment instrument is
going to be used; and
•Decide who is going to conduct the assessment.
Popular Assessment Tools:
SCAT2: Sports Concussion Assessment Tool 2
BESS: Balance Error Scoring System
“If in doubt, sit them out.”
RESOURCES
Sideline Assessment Forms
• Sideline Assessment Training
• SCAT2 – www.sportsconcussions.com
• BESS - www.knowconcussion.org
• Google
Collaborative effort by the VHSL
Sports Medicine Committee,
Brain Injury Association of
Virginia, Virginia Athletic
Trainers Association to
provide training to local
school divisions.
The
“Return-To-Play”
Decision
•The Virginia DOE guidelines stated that a student-athlete should not be allowed to
return to play until - “the student receives a written medical release from a licensed
health care provider.”
•VSBA model policy recommends clarification that written medical release should
come from the student-athlete’s licensed health care provider.
•VSBA model policy recommends that the written medical release contain
certification that the licensed health care provider that (i) they are aware of the
current medical guidance on concussion evaluation and management; (ii) the
student-athlete no longer exhibits signs symptoms or behaviors consistent with a
concussion; and (iii) that the student-athlete has successfully completed a
progressive return to sports participation program.
Record Keeping
•Creation of a Concussion Management Team –
Appointed by Superintendent, division wide
and broad membership to coordinate training
and information efforts.
•Communicate recordkeeping school based
recordkeeping requirements with regard to
training of coaches, staff, and volunteers and
efforts to inform parents.
•Track the care and treatment of all studentsathletes removed from play due to suspected
concussions.
QUESTIONS???
THANK YOU!!!
Joel S. Brenner, MD, MPH
Children's Hospital of The King's Daughters
&
Wendell Roberts, Staff Attorney
Virginia School Boards Assn.
wroberts@vsba.org
(434) 295-8722