By Myrna Trauntvein
Traumatic head injury has been a much discussed topic in state and national news in past months.
"Concussion has been a hot topic in the news recently," said Dale Whitlock, Juab School District Board President. "It is good that we are addressing our policy on dealing with concussions."
In keeping with the Utah State Board of Education, Rule R277-614, requiring compliance and with the Utah High School Activities Association (UHSAA) and the National Federation of State High School Associations recommendations that all schools develop a concussion management policy. Juab School District Board of Education reviewed the policy they have and updated it according to new requirements.
"I have suffered a few of these myself," said Dr. Rick Robins, superintendent.
He had been knocked out at a few of the football games he had played in, specifically in high school, and knew the importance of the policy in providing recognition of concussions.
The policy introduction states that medical management of sports-related concussion continues to evolve and that recently there has been significant amount of new research done.
"The district in compliance with Utah State Board of Education Rule R277-614 and based on the model policy issued by the Utah State Office of Education and Utah State Risk Management, has established this protocol to provide education about concussion for coaches, school personnel, parents and students," said Robins.
"Notice of the concussion and head injury policy must be provided annually to parents of students who participate in sporting events and should require parent's signatures acknowledging that they received notice," said Robins.
One item added to the policy, said Robins, was an item concerning training. Under the new wording, it is made clear that all appropriate staff attend a yearly in-service meeting in which procedures for managing sporting event-related concussions are discussed.
There needed to be a base-line established, as well.
The policy seeks to provide a safe return to activity for all students following any injury, but particularly following a concussion.
County or state health department employees and physical education specialists will review the protocol annually and any changes or modifications will be reviewed and given in writing to athletic department staff including coaches and other appropriate school personnel.
"Return to activity and play is a medical decision," said Robins.
The student must be asymptomatic at rest and with exertion including the mental exertion in school, and have written clearance from the student's primary care provider or concussion specialist, The student must be cleared by a physician other than an emergency room physician.
One topic covered in the policy is the recognition of concussion.
"A concussion is a type of traumatic brain injury that interferes with normal function of the brain," reads the policy. "It occurs when the brain is rocked back and forth or twisted inside the skull as a result of a blow to the head or body."
What may appear to be only a mild jolt or blow to the head or body can result in a concussion and one can occur even if a student is not knocked out.
Common signs are listed for both the observer and the student so that they can be recognized.
More importantly, management and referral guidelines are set out.
A medical emergency requires activation of the Emergency Medical System.
Any student with a witnessed loss of consciousness of any duration should be spine boarded and transported to the nearest emergency department.
"Any student who has symptoms or a concussion, and who is not stable (i.e., condition is worsening), is to be transported Immediately to the nearest emergency department via emergency vehicle," reads the policy.
Those with symptoms of deteriorating of neurological function, decreasing level of consciousness, decrease or irregularity in respirations, signs or symptoms of associated injuries such as spine or skull fracture or bleeding, mental status changes or seizure activity should be given medical attention.
Guidelines for procedures for coaches and teachers supervising contests and games are that they recognize, remove and refer.
That means that students exhibiting signs, symptoms or behaviors consistent with concussion are to be immediately removed from the sporting event and not returned to it until they are cleared by an appropriate health care professional.
"When in doubt, sit 'em out," it states.
Refer the student for medical evaluation. The district employee is responsible for notifying the student's parents of the injury.
A medical evaluation is required before returning to play.
If the parents cannot be reached, the district's employee should insure that the student will be with a responsible individual and the student should not be allowed to drive home.
When something happens at a sporting event, said Robins, there is often a rush of concerned people who come to the side of the victim.
Usually there were medical doctors at the events who could be relied on.
"I prefer that it be one of the M.D.s at the event," said Robins. "We need to fall back on the one who has the most expertise."