RSU 10 focusing on concussion policy

RUMFORD -- The focus on concussion-related sports injuries will be further heightened by a new state law in 2013.

When the law takes effect Jan. 1, Maine will be one of 39 states with laws regarding concussions suffered by youths.

By this date, all Maine school boards will have to use similar protocols for diagnosing and treating head injuries, and training coaches, athletic directors and other school personnel. This also requires a concussion management policy for determining when students can return to the playing field and the classroom.

On Monday, the RSU 10 Board of Directors unanimously approved the first reading of three policies related to this -- concussion procedures, management of concussions and other head injuries, and a concussion information sheet. These policies will be adopted once the board approves a second reading, likely to be at their next meeting on Dec. 10.

Barbara Chow, who chairs the policy committee, told board members that this policy not only concerns the athletes, but all students who sustain a concussion because the ability to learn is affected when one sustains a concussion.

She noted that athletic trainer Aaron Perreault indicated some 19 or 20 concussions (various grades) have been sustained by athletes throughout RSU 10 since the beginning of this school year.

Under concussion procedures (Policy JJIF-R), any student/athlete who has symptoms of a concussion, and who is not stable (i.e., condition is changing or deteriorating), is to be transported immediately to the nearest emergency department via emergency vehicle.

The Certified Athletic Trainer (ATC) will assess the injury, or provide guidance to the employee if unable to personally attend to the athlete.

Immediate referral to the athlete’s primary care physician or to the hospital will be made when medically appropriate.

The ATC will notify the athlete’s parents and give written and verbal home and follow-up care instructions. The ATC will notify the school nurse of the injury, prior to the next school day.

The ATC/School Nurse is responsible for administering post-concussion ImPact testing. ImPact is a computerized neurocognitive exam that's used to determine when a student who has had a concussion can resume physical, or mental, activities.

Return to play procedures after concussion would involve the following five-step gradual return program:

Day 1: Light aerobic exercise (walking, swimming , or stationary cycling) keeping exercise heart rate less than 70% of maximum predicted heart rate. No resistance training.

Day 2: Sport-specific exercise, any activities that incorporate sport-specific skills. No head impact activities.

Day 3: Non-contact training drills.

Day 4: Full contact practice, participate in normal practice activities

Day 5: Return to competition.

If any concussion symptoms return during any of the above activities, the athlete should return to the previous level, after resting for 24 hours.

Under management of concussions and other head injuries (Policy JJIF), all school personnel, including coaches and volunteer coaches, must undergo annual training in the identification and management of concussive and other head injuries prior to assuming their responsibilities. The training must be consistent with such protocols as may be identified or developed by the Maine Department of Education (DOE) and include instruction in the use of such forms as the DOE may develop or require.

Coaches shall be required to undergo refresher training every two years or when protocols and/or forms have been revised.

Students and parents of students who will be participating in school-sponsored athletic activities will be provided information by the athletic director annually regarding:

A. The risk of concussion and other head injuries and the dangers associated with continuing to participate when a concussion or other head injury is suspected;

B. The signs and symptoms of concussion and other head injuries;

C. The school unit’s protocols for 1. Removal from the activity when a student is suspected of having sustained a concussion or other head injury; 2. Evaluation; and 3. return to participation in the activity (“return to play”).

The student and his/her parent(s)/guardian(s) must sign a statement acknowledging that they have received and read this information before the student will be allowed to participate in any school-sponsored athletic activity.

The superintendent will appoint a concussion management team including a school administrator to be responsible, under the administrative supervision of the Superintendent, to meet annually to make recommendations related to implementation of this policy. The concussion management team will include the athletic director and school nurse and may include one or more principals or assistant principals, the school physician, athletic trainer, and such other school personnel or consultants as the superintendent deems appropriate.

Policy JJIF-E is a concussion information sheet.

This policy states that any student suspected of having sustained a concussion or other head injury during a school-sponsored activity including but not limited to competition, practice or scrimmage, must be removed from the activity immediately.

No student will be permitted to return to the activity or to participate in any other school-sponsored athletic activity on the day of the suspected concussion.

Any student who is suspected of having sustained a concussion or other head injury shall be prohibited from further participation in any school-sponsored student/athletic activities until he/she has been evaluated and received written

medical clearance to do so from a licensed health care provider who is qualified and trained in concussion management.

While you can diagnose a broken leg on the sidelines because the athlete can't move, it's harder to diagnose a concussion because it's easier to tough it out. Part of the risk is that if you tough it out, you could get a second impact which would inflict significant longterm brain damage.

Last January, pro football hall of fFamer and former New England Patriot Andre Tibbett, along with medical professionals and young athletes, spoke in Augusta to Maine lawmakers about about cutting down on dangerous sports head injuries.

He proposed legislation aimed at better managing head injuries, which includes concussions, and direct the state establish across the board protocols for identifying concussions during a sporting event and developing a plan as to when the student athlete could return to the field and the classroom.

Tippett said, "It's all about education. When it's all said and done, it comes down to the education of the athletes, the parents, the coaches and understanding when it's okay for the kids to return."

The new law mirrors many of the requirements that the Maine Principals' Association and school districts have already imposed.

The principals' association is in its second year of requiring all high school coaches to get concussion management training.

They must watch a 20- to 30-minute training video provided by the National Federation of State High School Associations.

The Center for Disease Control says about three million young athletes suffer from sports related concussions each year, but there are concerns that many more are not being diagnosed. If left untreated, some concussion symptoms can lead to a lifetime of problems.

A couple of related statistics regarding concussions:

* Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

* A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free.