Concussion plan to help local student-athletes

Published 3:58 pm Thursday, February 19, 2009

AHOSKIE – Concussions are serious – and can be deadly.

A New York-based organization that involves former Roanoke-Chowan News-Herald Sports Copy Editor Jennipher Dickens is working to make sure student-athletes receive appropriate medical care when they experience a concussion.

That medical care is something local leaders say they want to make sure happens.

Hertford County High School Athletic Director Charles Simmons and Medical First Responder Darrell McCalop said in a recent interview that both the school and the state are taking concussions seriously.

“We have had four concussions during this sports year that have resulted in me holding the kids out of games,” McCalop said. “Three of them were in football and the other happened in basketball.”

A concussion is defined as a change in mental status caused by trauma (shock). It is accompanied by confusion, loss of memory, and, sometimes, loss of consciousness. It is also medically termed as a form of “mild” traumatic brain injury (TBI); however, the term “mild” is misleading since no form of brain injury is ever truly mild, according to experts in the field.

McCalop has been involved in Sports Medicine since 1975 and said the four cases at HCHS this year are a high number. He said in each case the young man suffered from mild memory loss, inability to focus and disorientation.

Simmons said in his nearly 20 years as Athletic Director at Hertford County High he had seen student-athletes miss more than a week on several occasions.

“At this school, we take concussions very seriously,” McCalop said. “We’re not playing. If a young person suffers a concussion, we’re not going to allow them to play without a doctor’s release.”

Simmons chimed in, “Not only are we taking it seriously here, but the state of North Carolina is taking them seriously. The North Carolina Coaches Association board, which I sit on, requires each school to have an emergency plan for both concussions and heat stroke.”

Simmons said each coach at Hertford County and all other schools are required to read the procedures and sign off on them.

The HCHS plan gives signs and symptoms of a concussion and treatment is advised immediately.

“Although a concussion can range from mild to severe, no concussion should be treated as a ‘minor’ injury as any injury to the brain can cause loss of proper functioning,” the plan reads. “Treatment for concussions should be immediate and supervised by a medical professional.”

The Sarah Jane Brain Project, based in New York, NY has developed a continuum of care model for pediatric acquired brain injuries (PABIs) which includes concussions. Any injury to the brain that occurs before the age of 25 is considered a pediatric brain injury, since the brain’s frontal lobes are still developing in young adults until that time.

Dr. Gerard A. Gioia, the Chief of the Division of Pediatric Neuropsychology and Director of the Safe Concussion Outcome, Recovery and Education program of the Children’s National Medical Center, said the project’s goals will eventually benefit all young people with head injuries from sports.

“We are committed to building an active, responsive prevention and education program for families, coaches and student-athletes as well as early implementing procedures for early identification on the sidelines and in the Emergency Room and pediatricians offices,” Dr. Gioia said. “We are also working on development of a network of sport concussion trained clinicians for follow-up evaluation and treatment and implementation of the Youth Sport-specific Return to Play guidelines.”

Dr. Gioia, who is also a National Advisory Board member for the Sarah Jane Brain Foundation and helped draft the organization’s 63-page National PABI Plan, also backed up the assertion by McCalop and Simmons that concussions are not something to be taken lightly.

“Concussions are very serious – the more study that is conducted on this issue, the more we understand that the developing brain in youths may be at greater risk for a bad outcome following a concussion,” he said. “In my work with the CDC, we revised the estimates of this problem and now believe that up to 3.8 million people in the US sustain these injuries each year.”

Dr. Gioia continued, “The effects on the student’s academic functioning and the possibility of a concussed student – whose brain is in a very vulnerable state – returning back to the sport too early and becoming reinjured is a significant problem that we must prevent.”

McCalop said many of the student-athletes don’t realize the risk they are taking and push to get back on the playing fields too quickly, thus adding to the very problem Dr. Gioia discussed.

“Some kids will tell you they are okay when the truth is that their head is pounding,” McCalop said. “We need guidelines so that we don’t allow a situation like what happened in Greenville earlier this year.”

In the incident in Pitt County, a student-athlete returned to the playing field too quickly. According to Time Magazine, “Last September, Jaquan Waller, 16, suffered a concussion during football practice at J.H. Rose High School in Greenville, N.C. A certified athletic trainer educated in concussion management wasn’t onsite, and the school’s first responder who examined Waller cleared him to play in a game two days later.

“During that game, Waller was tackled,” the article written by Sean Gregory continued. “Moments later, he collapsed on the sidelines. He died the next day. A medical examiner determined Waller died from what is called second-impact syndrome, noting that ‘neither impact would have been sufficient to cause death in the absence of the other impact.’”

McCalop said that type of problem is one of the very reasons he and Simmons take concussions at Hertford County High School so seriously.

Dr. Gioia said that’s where the Sarah Jane Brian Project and the National PABI Plan will help.

“Given that sports and recreation injuries are one of the top three to four causes of mild traumatic brain injury, and our cultural embracing of kids’ involvement in sports, this will be an important part of the project,” he said. “Fifty percent of the kids we see in our Concussion clinic at Children’s National Medical Center are due to sports causes. I am a part of the International Concussion in Sport Group consensus panel, tasked this year with addressing this project within youth sports.

“As a Sarah Jane Brain Foundation Advisory Board member, I will make this a major aspect of the project,” he continued. “The benefits of addressing the sport-related TBI issue will benefit all kids regardless of whether their injury was sustained in sports or not.”

Dickens, who now serves as Director of Communications for the Sarah Jane Brain Project, said the continuum of care model could be especially beneficial to rural schools.

“We’re working to make sure that every student-athlete, coach, and anyone else involved in sports has the same education beforehand and care afterward all over the nation,” Dickens said. “That will mean that children who suffer concussions in Bertie, Gates, Hertford and Northampton County in North Carolina will receive the same knowledgeable treatment as a student-athlete in New York, Chicago or San Francisco.”

McCalop said he would welcome that.

“I think it would be beneficial to our student-athletes if there was a set standard of care,” McCalop closed. “We work hard to keep our students safe, but every school may not be as conscientious as we try to be.”

To find out more information on the Sarah Jane Brain Project or to view the National PABI Plan, visit the organization’s website at