By R. Eugene Bailey, MD, Daniel Rancier, MD
Concussion litigation is gaining momentum. Educate your staff to require the best protection for the athlete, coach and school administration. It’s not the medical professionals that are getting sued; it’s the non-medical staff (mostly coaches) that take most of the risk.
“A three-judge panel of the state Commonwealth Court on Tuesday rejected an attempt by the Pennsylvania Interscholastic Athletic Association, or PIAA, to have the suit against it tossed out.“ (The Inquirer Oct 17, 2017, http://www.philly.com/philly/news/high-school-concussion-lawsuit-Pennsylvania-piaa-20171012.html) “…the suit raised important questions about how coaches and others responded to injured players.”
- “Two boys suffered concussions while playing football and a girl while diving to catch a softball.” according to the lawsuit
- The lawsuit also claims that “…policies regarding concussions are “insufficient and ineffective” to protect younger athletes.”
- “Rebecca Bell-Stanton, a lawyer for the students, said Wednesday a major issue was a lack of qualified trainers at practices.”
They also contend that athletic staffs are not trained sufficiently to identify the signs and symptoms of concussion and that sometimes they fail to “mandate the removal of athletes who appear to suffer concussions in practice as well as in games.”
If there were an Athletic Trainer at all games and all practice sessions, there would be no issues since they are trained to know how to handle concussions. However, there never are enough Athletic Trainers to attend all school events. It falls on the coaches to manage many suspected concussions with little adequate training.
When in Doubt Sit Them Out – Not Good Enough Anymore
In the past and present, many times coaches sit the student with a suspected concussion on the bench and ignore them for the rest of the game. They might not even get a medical evaluation until the next day. That’s not good enough anymore. What if they need hospital care right away? They might not know until it’s too late.
When a “Brain Rattling” Event Occurs, The following Should Happen
If a medical Professional is present; (including an Athletic Trainer, Medical Doctor or Nurse) a sideline evaluation is made and documented. That documentation must be protected against damage and modification after the fact, or it might not be trusted in court. The medical professional continues until an evaluation is made and re-made multiple times.
If a medical professional is not present; a non-medical professional must document what, when, where it happened, and what are the signs and symptoms (less extensive but like the above NATA and CISG guidelines). Those data are sent immediately to a medical professional to decide to:
- Continue play
- Sit them out for more evaluation and treatment
- Go directly to the emergency room
As soon as the non-medical assessment is turned over to the medical staff, it is out of coach’s hands and is the responsibility of the medical staff.
According to NATA and the Concussion in Sports Group (CISG), a multi-faceted set of tests is required on the sideline to screen for a potential concussion. These tests should include, symptoms, physical signs, cognitive impairment, behavioral changes, sleep disturbances, balance impairment.
Any delay could cause more damage to the athlete. The treatment continues based on best medical practices.
“A Tidal Wave of Litigation is Coming” (Bloomberg News)
Litigation concerning concussions in youth sports is now started and making national headlines. School staff should act now to change the way schools manage head trauma.
More than half (55% – 85%) the concussions in high school sports go unrecognized, creating the dangerous potential for the second deadly concussion.
What We Need for Concussion Sideline Assessments
- Rapid head impact assessment on all significant blows to the body and head
- Accessible, secure, comprehensive documentation of the injury
- National or even International guidance used for development of the assessment protocol
- Non-Medical staff collect and document injury data with immediate collaboration with on-site or remote medical personnel
easySCAT Sideline Concussion Assessment Mobil App
When using easySCAT Sideline, non-medical staff gather and document the injury data on the sideline and immediately collaborate with medical professionals to evaluate the injury and decide.
easySCAT Sideline ensures your athletes will be adequately assessed when they receive a concussion-related hit whether a medical professional is present or not.
easySCAT Sideline is the only digital solution that uses the NATA recommended CISG (Berlin 2016 meeting) evidence-based, best practice standard to allow non-medical personnel such coaches, Phys Ed teachers, and other staff to quickly capture the signs and symptoms caused by a concussion-related hit. The data can be shared immediately with doctors and AT’s that might not be present allowing more diagnostic evaluations to be performed.