SCAT5 A School Physician’s Tool for Concussion Assessment and Training

SCAT5 A School Physician’s Tool for Concussion Assessment and Training

by Dr. Daniel Rancier MD


When there is an injury, especially a concussion, there are times when even the student athlete’s parents don’t seem to share the same concern for safety. It is these times when it is the physician’s job to protect the students from harm even when their parents don’t seem to understand. It takes a diplomatic approach and sound evidence to help parents understand how to properly manage an injury like a concussion.

Several years ago I was at a home football game for the school that I am responsible for. Partway through the first quarter the other team was on offense and as their running back turned the corner to make a run-up field. As he rounded the corner along the sideline where I was standing the cornerback for our team came out of nowhere and tackled him to the ground. The most sickening “THWACK” was heard when they collided and when the dust cleared the opposing team’s running back was lying face down on the field and not moving.

We immediately ran over and found him conscious but confused and with a headache. He was taken to the sideline where we evaluated him with the method we used back then for assessing concussions. At the time there was no internationally recognized protocol, so we did what we were taught. I held onto his helmet and informed his coach that he would not return to the game.

Even back then his coach didn’t question my decision but the Dad did.

I proceeded to go to the stands where Dad was and had to explain to him why his
“star” son couldn’t go back into the game that night.

Did you know that my son is probably the best player on his team?” Dad barked at me!

I don’t care if he is the only quarterback left on our team. He has had a concussion and isn’t going back into the game.” I calmly replied.

After much convincing and persuading he finally relented as he, of course, did have his son’s best interest at heart. But they don’t always know how dangerous a concussion can be. They need to be educated and during a game is not the right time, and the education they receive must be believable.

Credibility is key here. Even though I am a certified Medical Doctor, and have treated hundreds of concussions, convincing a parent on the other team that you only want what is best for their son can be troublesome without some official backup criteria. If only I had an internationally recognized tool like the SCAT 5 to aid me.

I could have shown the criteria to the parent and stop the questioning right then. It would have made it so much quicker and easier. Educating a parent on the sidelines when their son has just be injured is not the easiest time and place.

The next day our local newspaper featured that game on the front page of the sports section. It described in detail the play where the running back sustained his concussion. It went as far as to describe the hit and the awful sound that resonated throughout the stadium. Had I let him back into the game it not only would have put the player at risk but it would have appeared incompetent to the whole community.

The SCAT 5 is the most universal and respected method for assessing sideline concussions. It is the standard that should be used by all coaches, Athletic Trainers, school nurses, Nurse Practitioners, Physician’s Assistants, MD/DO’s and anyone else who assesses concussions on the sideline. It is the only tool we use at my school since it was introduced in 2013 and it has made assessing concussions and managing the return to play standardized, efficient, and clear to the athlete and parents. It is the most widely used standard for assessing concussions and it will support the decisions made on the sideline in a court of law should it come to that.

The young football player didn’t return to that game and he uneventfully recovered without any long-term consequences. Once again the health and safety of our students and athletes was upheld.

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