The expression used to be “had his bell rung.” That was a dismissive way of explaining a concussion.
With a seemingly endless list of horror stories showing up in the national media, the hazards of brain injuries are being taken more seriously these days. Yet there is still work to be done to raise awareness and lessons to be learned by athletes, coaches and parents.
“The biggest misconception is the idea people have of what a concussion is,” said Jason Hollar, a Newport News Public Schools trainer who is assigned to Menchville. “Everyone used to think you lose consciousness and have certain characteristics, but that's not so much the case anymore.
“Everyone reacts to a brain injury differently. We need to focus on how each individual acts differently to a concussion.”
With that in mind, NNPS is changing the way it tests athletes for concussions. Before, athletes were given an ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) concussion evaluation prior to their season. After a concussion, they were retested to compare the results and allowed to play only after their results return to the baseline level.
The problem, Hollar said, is that there are few doctors in Hampton Roads who are able to read the ImPACT results. So NNPS is switching to the Sports Concussion Assessment Tool 2, which Hollar said is easier to read and less expensive.
SCAT 2 is a standardized way of evaluating athletes who are at least 10 years old. It is a screening tool to be used only by qualified medical professionals.
Hampton City Schools uses ImPACT in addition to a sideline test that is similar to SCAT 2. Scott Allyn, the sports medicine coordinator for Sentara Healthcare who oversees HCS trainers, has had no problems finding doctors who can read the ImPACT results.
Dr. Joel Brenner, medical director of the sports medicine program at Children's Hospital of the King's Daughters, said not all physicians are trained to read ImPACT.
“That is one of the difficulties with ImPACT,” he said. “It's kind of like an EKG — not every physician knows how to read an EKG with great confidence.
“ImPACT is similar, but it's not that difficult to learn how to interpret. It's not a reason to necessarily get rid of it.”
Brenner sees ImPACT and SCAT 2 (as well as the newer version, SCAT 3) as completely different tools.
“SCAT 2 and 3, they're more of a sideline assessment,” he said. “ImPACT is a computerized test to look at how the athlete is doing cognitively with memory, reaction time, and how fast the brain is working. You don't necessarily have to use the ImPACT, but it's not like a ‘one or another.' You get different information, but you also get more information by using both.”
The SCAT 2 test has 22 questions regarding symptoms — headache, nausea, sensitivity to light, etc. There is a memory test, in which words are given and the athlete is asked to repeat them in order. There are basic questions like what the month is. And there are physical tests, like balancing on one foot.
“It's a one-on-one test,” Hollar said. “You add all the components and they give you the score. You (have) all the baseline scores on file, and if something happens, you have something to compare the scores to if you suspect a concussion. We have to make sure we keep our athletes safe.”
Hollar said Menchville had nine football players who sustained concussions last fall. On average, he said girls and boys soccer has around five a year. For both sports, that's counting varsity and junior varsity.
The baseline test will be given to those athletes who have a history of concussions and/or compete in “high-risk” sports — football, soccer, wrestling and cheerleading. Hampton does the same.Copyright © 2015, The Baltimore Sun