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‘Tough It Out?’: Teaming up for pro-active concussion identification, treatment
Written by Denise Freitag Burdette   
Wednesday, August 15, 2012 8:13 PM

“Aww. He just got his bell rung. Send him back on to the field.”

No big deal, right?

Now try this.

“Aww. He just has a mild tramatic brain injury. Send him back on the field.”

As the high school football season kicks off this week throughout the Hoosier state, so are changes in the way possible concussions are handled in high school sports.

The changes were a topic of conversation at two summer Dearborn County school board meetings attended by Ed Brush, physical therapy director at Dearborn County Hospital.

The hospital is working with Lawrenceburg, South Dearborn, Milan and Rising Sun schools to help put the best possible program in place to protect athletes with possible and confirmed concussions.

The program includes an expanding partnership with the concussion clinic at Cincinnati Children’s Medical Center.

Meanwhile, East Central High School also has its own program in place working with Beacon Orthopaedics and Sports Medicine.

The new law boils down to stricter guidelines for the removal of an athlete from play who may have a concussion. The clearance requirements to allow an athlete to return to play also are more defined, said Brush.

Brief overview
A brief overview of the new law, Indiana Code 20-34-7, is given in a webinar presentation posted on the Indiana Department of Education website. Information provided in the presentation includes:
*Each year, before beginning practice for an interscholastic or intramural sport, a high school athlete and the student athlete’s parent must be given information concerning the nature and risk of concussion and head injury and shall sign and return a form acknowledging receipt of the information to the coach.
*A high school student athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from play and may not return to play until the student athlete has received a written clearance.
*A high school student athlete who has been removed from play may not return to play until the student athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussion and head injuries and receives a written clearance to return to play from the health care provider who evaluated the student athlete.

The new law applies to students in grades nine through 12 playing an interscholastic or intramural sport.

Although an athletic trainer can conduct the initial assessment when a student athlete has a bump, blow or jolt to the head or body, only a licensed health care provider trained in the evaluation and management of concussions and head injuries can return an athlete with a suspected concussion to play, according to the webinar information.

According to Children’s Hospital Medical Center Pediatric Sports Medicine web page a concussion is “an injury to the brain that can be caused by a blow to the head, a jolt or hard hit to the body, or whiplash type event. Your child does not need to have a loss of consciousness for his/her injury to be a concussion. A concussion is not a ‘brain bruise.’ A concussion is a change in the way the brain works. While concussions are generally not life threatening, the effects can be serious.”

Positive impact
Last month, Brush attended school board meetings for South Dearborn and Lawrenceburg schools to discuss the new law, conducting baseline neurological testing on athletes, and the partnership between the schools, Dearborn County Hospital and Children’s Hospital Medical Center.

Thanks to a grant received from Dick’s Sporting Goods, ImPACT baseline testing will performed on athletes in school corporations working together with the DCH physical therapy department.

The testing license covers 700 students. The test will probably be conducted with between 500 to 600 students, said Brush, adding Lawrenceburg schools started the baseline testing last year.

The testing is not required by the law, but will serve has a back-up, another source of information, he said.
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) “provides computerized neurocognitive assessment tools and services that are used by medical doctors, psychologists, athletic trainers, and other licensed healthcare professionals to assist them in determining an athlete’s ability to return to play after suffering a concussion. ... A baseline ImPACT test is like a sports physical for your brain,” according to CMHC Pediatric Sports Medicine web page.

The testing takes 20 to 30 minutes. Athletes take part in computer-based programs such as word-sequence and memory activities, said Brush.

Baselines will probably be given every two years. The goal is to have all athletes in the DCH partner high schools tested by Sept. 1, he said.

Lawrenceburg is ahead of the curve on baseline testing, said Brush during the district’s July school board meeting.

“I think this school more than any should know,” said Brush, referring to the importance of proper concussion treatment.

In 2003, quick thinking by school trainer Ray Furney and physician Dr. Jim Swanson are credited with helping save the life of former LHS football player Jared Harrell when he received a dangerous injury to the brain during a football game.

DCH works closely with Furney, while the DCH staff attends home football games for South Dearborn and Milan. Rising Sun schools do not have a football team.

He is working to find ways, with consents, the baseline data can be shared with Children’s Hospital, and other medical professional who may benefit from the information if someone is hurt, said Brush.

Meanwhile, for two full years, three including a trial year, East Central has been participating in ImPACT testing, said athletic director Don Stonefield.

The school is partnered with Beacon Orthopaedics and Sports Medicine, he said.

Baseline testing has been mandatory for the football players. The other sports were able to decide if there would be participation or not. Now it is mandatory for everyone, said Stonefield.

The school will continue to take certain precautions such as sitting out a football player for at least one play if a helmet comes off and providing high quality helmets, he said.

Of course, they also will be following all the mandatory requirements of the new law, in addition to the precautions already taken, he said.

Last Updated on Wednesday, August 15, 2012 8:25 PM