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Dr. Joseph Waeckerle: Concussion laws ensure right steps

NFL Evolution will feature a guest columnist every Tuesday, each with a different viewpoint of player health and safety from the youth level to pro football.

By Dr. Joseph F. Waeckerle, NFL Evolution columnist

Last week, the NFL hosted officials from the National Athletic Trainers' Association, and the American Medical Society for Sports Medicine completed two days of meetings and programs with representatives from all 50 state high school athletic associations.

Their focus was to expand the reach of the laws enacted by all 50 states that protect athletes who might have sustained a concussion. The basics of these youth concussion laws help medical professionals ensure the right steps are being followed.

The overall intent of these legislative efforts is to better protect the concussed student-athlete by:

• Mandating proper evaluation and care for potentially concussed or concussed student-athletes

• Minimizing the potential risk for the concussed student-athlete to incur short- or long term complications of concussions

• Promoting educational opportunities for involved and interested parties, and providing researchers with a better understanding of the clinical picture and public health problem of sports-related concussions.

A vast majority of state legislatures and state officials, health care professionals, and others dedicated to providing "best practices" care to the potentially concussed or concussed student-athlete agree that there should be at least three integral components to any state law on concussions. They should:

  • Provide information and education on concussions for student-athlete and their parents/guardians and require them to sign a concussion information form.
  • Require the immediate removal of student-athlete from any athletic participation, practice or play, if a concussion is suspected.
  • Require medical clearance by licensed health care professional trained in evaluation and management of concussions prior to return to practice or play. Most of the state laws contain these three principles consequently the laws establish minimum requirements of quality concussion care and define, in general terms, who is competent to provide that concussion care.

In addition, there are additional components worthy of consideration for inclusion in state laws. These components further enhance beneficial care to student-athletes and their families. Various states have included some of these considerations in their youth concussion laws:

  • The school should have a specific concussion plan
  • The school concussion plan must have an emergency action plan
  • School administrators, boards, and staff including the athletic staff should be accountable for the school concussion plan
  • Baseline testing of student-athletes is encouraged/required
  • Training for coaches is required
  • Distribution of concussion information including the school plan to coaches, student-athletes, and parents/guardians is required
  • Concussion requirements apply to private youth sports organizations as well as schools/school systems
  • Maintain records and institute a surveillance program and review yearly
  • Consider civil liability provisions

By enacting these laws, states have partnered with student-athletes and their families, school systems, health care professionals, and communities to foster optimal concussion care. Certainly, these laws are an excellent start but as the scientific community advances the knowledge and management principles about concussions, the laws must evolve accordingly.

The goal of providing "best practice" care for the student-athlete from recognition of a potential concussion to complete recovery, return to well-being, remains foremost for all involved.

Dr. Joseph F. Waeckerle is clinical professor of emergency medicine at the University of Missouri-Kansas City School of Medicine. He also is editor emeritus of Annals of Emergency Medicine. He has practiced Emergency Medicine and Sports Medicine and has been a team physician at the grade school, high school, college, and profession level for over 30 years. He currently serves on the NFL Head, Neck, and Spine Injury Committee and the Mackey White Brain Injury Committee of the NFL Players Association.

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