Tuesday, September 13, 2016
Marin [County] focuses on monitoring concussions of student athletes
Blog note: this article references a February 2016 grand jury report on the subject.
A group of representatives from local hospitals, county government, the Marin County Office of Education, Marin Athletic Foundation and others is seeking ways to prevent Marin student athletes who sustain concussions from suffering permanent harm.
“We’ve been meeting for over a year now as this collaborative,” said Lara Trahan, director of education services at the Marin County Office of Education. “The focus of the group is to approach brain safety as one entity instead of little pockets.”
The effort has already begun to pay dividends. In the fall of 2015, both Marin General Hospital and Novato Community Hospital began providing athletic trainers to schools in their areas.
Marin General is providing athletic trainers who work with students at San Rafael, Terra Linda and Tomales high schools, and the hospital is in the process of hiring a third trainer to assist with those schools. Novato Community is in its second year of providing two athletic trainers for Novato Unified School District — one at Novato High School and one at San Marin High School.
“The athletic trainers do concussion baseline testing of all student athletes at no charge to the parents or the school district,” said Novato Community spokeswoman Mary Strebig.
Marin General’s arrangement with schools is somewhat different.
“All of our athletic trainer services, including baseline testing, are provided to the schools at below our cost, and we do not make a profit on the program within our contracts with the school districts,” said Terese O’Malley, Marin General’s manager of wellness programs.
Athletes involved in contact sports at all these schools are required to undergo baseline testing.
Baseline neurocognitive tests provide a snapshot of a healthy athlete’s decision-making ability, reaction time, attention and memory. If an athlete suffers a concussion, the test is readministered and helps doctors know when it is safe for the student to return to competition.
Trahan said that during the 2015-16 school year, Marin County high school athletes suffered an estimated 232 concussions. During that same period, San Rafael High School’s 500 student athletes alone suffered 47 concussions, said Shana McKeever, the athletic trainer dealing with concussions at San Rafael High.
San Rafael High received a $5,000 community service grant from county supervisors in June to expand its use of electronic head impact monitors, which it began using in 2015. The sensors are being used at San Rafael High for soccer, football and lacrosse, and the school is looking to extend the program to water polo and other sports.
The devices, worn in headbands or skullcaps, record head impacts and transmit data from the playing field to a smartphone or computer tablet on the sideline.
The Marin Athletic Foundation also received a $5,000 community service grant from supervisors to underwrite baseline testing at high schools and expanded use of impact monitors.
In February 2016, the grand jury issued a report, “Head Injuries and Concussions: Are Our High Schools Keeping Our Children Safe?” The grand jury’s report included several recommendations.
One recommendation was that each Marin school district require and pay for baseline neurocognitive testing of all high school athletes and mandatory re-testing after an injury. Another was that each school district pay for the hiring of certified athletic trainers at each of its high schools, who would attend high-risk sporting events.
Trahan said she wasn’t sure which schools in Marin have hired athletic trainers to monitor concussions, although she believes most have.
Another grand jury recommendation was that each school adopt protocols for reporting head injuries and for determining how long injured players should wait before returning to school and athletic activities. The grand jury said that each district should provide mandatory concussion education for student athletes. And it recommended that the Marin County Office of Education collect head injury data and compile the data in a centralized database.
Trahan said the collaborative is in the early stages of discussing how to meet most of these goals.
Getting needed care
Dr. Srinivas Ganesh, a sports medicine physician at Kaiser Permanente Medical Center in San Rafael, said, “We’ve had a set of protocols that we’ve created to make sure our Kaiser athletes are able to get the care they need. We want to work with the community to make sure that best practices are shared and standardization is noted across Marin for student athletes.”
Kit Holsten, the athletic trainer monitoring concussions at Terra Linda and Tomales high schools, said if it is suspected that an athlete has suffered a concussion during a game or practice, they are removed from play and a standardized medical questionnaire is administered.
Steve DeHart, the athletic trainer at Novato High School, said the assessment he does also includes a cranial nerve test along with balance testing.
If there is evidence of trauma, the athlete could be taken to an emergency room; otherwise they would be required to visit their personal physician for further evaluation.
“Does every one of these kids go to the doctor immediately? No,” DeHart said. “One of the challenges is the consistency of treatment.”
DeHart said emergency room doctors are often reluctant to diagnose a concussion. If a concussion is confirmed by a doctor, under state law the athlete is required to complete a graduated return-to-play protocol of no less than seven days in duration under the supervision of a licensed health care provider.
September 10, 2016
Marin Independent Journal
By Richard Halstead