Children with TBISo, what about in youth sports? What do you do in youth sports? I think that's a big issue and that's a real challenge. You've got to remember in professional sports you have professional athletic trainers by the sidelines. You have doctors. You have many team doctors on both sides. And they're able and skilled to perform these sideline exams. Now, what happens if you're in rural America-- your daughter is playing soccer--and she gets a concussion? What we're hoping is that, if you don't have an athletic trainer, there is a parent out there that will be able to assess the child. The first thing that they have to do is if they're in doubt they sit them out--end of discussion. If there is any question of whether a child had an injury--a concussion-- You shouldn't even have to worry about the sidelines test--just pull them out. Having said that, these are tests that a nurse can perform an athletic trainer can perform, Obviously, a physician who is skilled in understanding the concussion. And what we are doing right now, which is pretty remarkable-- on the 6th of October, the CDC-- the Centers for Disease Control--is rolling out a toolkit that's available online-- that was designed by the CDC and the NFL, paid for by the NFL. So, our committee--the committee that we run of medical doctors for the Head, Neck, and Spine Committee-- put together a toolkit so that if you're an eyedoctor out in Dubuque, Iowa or you're a nurse in Texas, and you go through this toolkit on the CDC you can be trained better than you are now. It doesn't give you a certificate or any of that, but you can get educated in how to do a sidelines exam. So, yes, it has the pieces of the sideline exam there that is applicable to somebody who is a healthcare professional of any kind-- that can learn this to kind of take a test and see how well you understand the concepts and, then, at least feel more comfortable in doing that. It doesn't give you a license to practice medicine. What it does is make you more knowledgeable, and it makes the situation better than it is now. Because the states that are passing the Zack Lystedt Law said, "Well, who is going to train the healthcare professionals?" I mean, we need something that will train them to recognize concussion, to treat it, and then to figure out how to return them to play. Because if you have a concussion and you're seen in the Emergency Room or seen by your kid's father or mother who is a physician or a nurse by the sidelines, you don't go back to practice the next day. You have to slowly wait until you're recovered, and then be brought back to practice. So, it's a very slow process. And for high school kids it might take a month. In the professionals, it takes at least a week. They don't get back to playing until the next week--at the soonest. So, it is really an evolving field.
Not every school or team has a medical expert or athletic trainer on the sidelines to test players after a suspected concussion. But there are simple guidelines and resources to help.
See all videos with Dr. Richard Ellenbogen.
Posted on BrainLine October 23, 2012.
About the author: Richard Ellenbogen, MD, FACS
Richard Ellenbogen, MD is a University of Washington professor and chairman of the Department of Neurological Surgery. He is chief and attending of neurological surgery, Harborview Medical Center and the co-chair of the NFL's Head, Neck, and Spine Committee.
Produced by Vicky Youcha, Ashley Gilleland, Justin Rhodes, and Erica Queen, BrainLine.
