A couple of weeks ago we posted a news story about the Massachusett’s Senate passing a scholastic concussion law. Today we added the language of that law to this blog: http://www.tbilaw.com/blog/2010/06/massachusetts-senate-approves-sports-concussion-bill.html In reviewing the proposed law, it is clear that the law does not go far enough.
While I have several concerns about the law, the biggest concern is that it makes a distinction between a return to play decision depending on whether an athlete is knocked out or not. The law creates a bright line rule that there is no return to play if the athlete is knocked out. But if there is no loss of consciousness, then the athlete is only kept out of the same game if “a medical professional” makes the diagnosis of concussion.
This is inadequate to provide the protection necessary. Until all scholastic athletic programs are attended by team physicians competent to make a concussion diagnosis, this invariably means that coaches and players will have an excuse to allow a return to play. As I have said repeatedly on my blogs and webpages, it is not possible to tell the difference between the insignificant concussion and the significant concussion until at a minimum hours after the event. The best way to determine concussion severity is amnesia, which may not become apparent for hours or days afterwards. If we can’t distinguish between the severe and the mild concussion, we must error on the side of safety and hold out all concussed athletes.
The Lystedt law in Washington is the impetus behind this latest round of state actions to create more protection for high school athletes. See http://www.subtlebraininjury.com/blog/2010/05/nfl-commissioner-goodell-asks-44-governors-to-pass-youth-concussion-laws.html It is the Washington law based on the Lystedt case that Commissioner Goodell and the NFL have been pushing the other 44 states to pass. That legislation is named after Zackery Lystedt, a high school player who went back into a game in 2008 after sustaineing a concussion, and then had to be hospitalized and nearly died. Yet, the law as proposed in Massachusetts would not have prevented Zachary Lystedt’s catastrophic brain injury because he was not unconscious after his first concussion.
One of the good aspects of the proposed legislation in Massachusetts is the calls for the development of a “an interscholastic athletic Head Injury Safety Training program to be completed by the following individuals: coaches, trainers and parent volunteers for any extracurricular athletic activity; physicians who are employed by a school or school district, or who volunteers to assist with an extracurricular athletic activity; directors responsible for a school marching band; and a parent or legal guardian of a child who participates in an extracurricular athletic activity.”
The problem of course is that unless the program focuses on the right diagnostic tools, it will just ensure that more excuses to send athletes back in exist, not to keep them back out. The vast majority of concussions do not involve loss of consciousness (LOC). Particularly with concerns about “second impact syndrome”, the distinguish with respect to LOC is dangerous and counter productive.
For more on second impact syndrome, see our blog today at http://waiting.com/blog/2010/06/second-impact-syndrome-from-cdc.html
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