Not just a bump to the head

Health professionals, coaches and parents discuss group efforts

Ian Lord

By Ian Lord

Staff Writer

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“You have to be really cognizant. It’s very important to recognize an injury when it happens.”

- Ruby Souhan, NMC nurse practitioner

ST. ALBANS — Health care professionals, coaches and parents in the St. Albans area are trying to stay ahead of the curve when it comes to concussions suffered by young athletes.

A small group of parents and high school and youth coaches attended a concussion management presentation at Northwestern Medical Center (NMC) on Thursday. Ruby Souhan, an NMC emergency room nurse practitioner who specializes in traumatic head injuries, led the discussion.

Concussions have been in the national spotlight recently due to high-profile professional athletes in all major sports suffering from head injuries. More recently, Souhan added, the attention is being trained on how to prevent concussions among younger athletes, who tend to be more susceptible to the injury.

“This is where we as health care professionals, coaches and parents need to be really aware,” Souhan said. “There is really a big push and a big pull to have safe players.”

Luke Cioffi, the BFA-St. Albans girls’ hockey coach, has been coaching in different sports for years. He said he always keeps head injuries in mind. But with national news coverage, he said he’s recently noticed greater attention to the topic.

“Having it in the media all the time, it definitely makes parents think about it,” Cioffi said. “There’s always that risk.”

A concussion, as defined by the Centers for Disease Control, is a type of traumatic brain injury caused by a “bump, blow or jolt” to the head that can change how the brain normally works. Concussions also can occur when the head and brain are forced to move back and forth too quickly due to a blow to the body.

Souhan said between 1.6 million and 3.8 million sports-related concussions are reported annually in the U.S.

Depending on the severity, Souhan said symptoms can range from mild dizziness and nausea to more serious side effects such as personality and mood changes.

One of the most important things for coaches and personal trainers is having an immediate response to such an event.

“You have to be really cognizant,” Souhan said. “It’s very important to recognize an injury when it happens.”

Before deferring care to a doctor, a coach or personal trainer can make observations about an athlete who doesn’t lose consciousness from an impact. Important things to check are whether limbs and the neck can move, and whether speech, eye movements, headache, nausea, dizziness and general awareness are involved.

Asking an athlete simple questions — such as what his or her name is and where he or she is — helps determine the severity of an injury.

Even with minor symptoms showing up, athletes who suffer an injury should be immediately removed from the game situation, Souhan said.

If an athlete does require further medical care, Souhan said there are comprehensive guidelines that pediatricians and emergency room specialists have when dealing with traumatic guidelines.

CAT scans are generally only used when several symptoms of a concussion are apparent and when the person loses consciousness. Souhan said giving x-rays to young people who don’t absolutely need them gives an unnecessary exposure to radiation.

After a concussion, giving an athlete enough recovery time is vital for the healing process, Souhan said. If a young person isn’t allowed to fully recuperate, a second traumatic brain injury could be much worse, she said.

“The second concussion will be far more severe if there isn’t enough recovery time,” Souhan said.

Even with adequate time, an athlete can develop chronic head injuries with multiple concussions.

Getting back on the field is important to athletes, coaches and parents, but national guidelines are enforced to guide a player through a recovery stage and back to playing.

Julie Pecor, the athletic trainer at BFA-St. Albans, said the high school has its own step-by-step process for an athlete returning from a head injury.

Before a player can begin the formal return process, the school has to receive a note from the athlete’s pediatrician, Pecor said. She’ll then take the player through five steps of varying physical exertion to see how they hold up.

The athlete begins with five to 10 minutes of light aerobic activity, such as riding a stationary bike. Pecor said at this point it’s important to keep the head from moving too much.

If the player clears that hurdle without feeling any concussion symptoms, he or she can move up to more moderate exercise, like jogging. Pecor said she’ll have the player go through a few rounds of this aerobic activity, checking in at different intervals.

For the third step, a player can participate in a non-contact practice. If there are still no symptoms, the player then can participate in full, contact practice the next day. The final step is returning to competition, Pecor said.

Before the fall sports season starts this year, Pecor said all coaches will go over guidelines for handling players with head injuries. She said they stress that taking extra time for recovery is the smart move.

“With this type of injury, you really do have to be conservative,” Pecor said. “It’s really all about the athletes’ safety.”