Tackling concussion awareness from the sideline

A group of leading neuroscientists in Kalispell is changing the game when it comes to sideline recognition of concussions.

Doctors and nurses at the Neuroscience and Spine Institute at Kalispell Regional Medical Center have identified inconsistencies in concussion diagnosis protocol that can be dangerous, and even fatal.

“As a collective group, we started to see people referred to us for concussions, and there was a huge variability in how things were being treated,” said Paul Coats, nurse practitioner at the Neuroscience and Spine Institute. “There were a lot of clear concussion symptoms being missed and not treated appropriately. And that’s still going on.”

This summer, the institute rolled out the Save the Brain campaign aimed at educating coaches, parents and even medical professionals about how to recognize a concussion and what actions to take if a head injury is suspected. Local experts in the neuroscience arena established the concussion toolkit that will be distributed to schools across the region beginning this year.

“We came up with a consensus of how we should be managing concussions in the northern Montana region,” Coats said about the campaign.

The Whitefish Middle School seventh- and eighth-grade football teams were the first to participate in the new program. Last month, players on both teams took part in a cognitive and balance assessment that will be used as a baseline if the player is ever suspected of suffering a concussion.

Players were asked to repeat phrases and stand on one leg with their eyes closed, among other tasks. The baseline test measures an athlete’s long- and short-term memory, motor speed and reaction time. Results are later used by medical professionals in determining the extent of a head injury.

Coats led the assessment and talked with dozens of parents and coaches in attendance about why sideline recognition of a concussion is so important.

“A concussion is a traumatic brain injury and it effects how the brain functions,” Coats said.

As part of the campaign, coaches are given a laminated card that helps them quickly recognize the red flags of a concussion — neck pain, vomiting, seizures, headaches, and other symptoms are clearly listed.

Coats says it’s the second hit to the head after a concussion that can be deadly.

“The very worst thing that a coach can do is have an athlete with a concussion, not recognize it, and then send them back into the arena,” Coats said. “That’s where the real damage is done. We’re really trying to avoid that second hit phenomenon. If there’s any doubt, you take them out.”

“At this youth level, a coach is much more likely to save an athlete’s career [by taking them out if a concussion is suspected] than if they put them back in the game to score the winning touchdown. I don’t care if it’s the state championship.”

He notes the tragedy to Dylan Steigers, a standout football player from Missoula, who was killed in 2010 after taking a blow to the head during a scrimmage at Eastern Oregon University.

In 2013, the Montana Legislature passed the Dylan Steigers Act that mandates an athlete suspected of having a concussion be removed from the activity. They aren’t allowed to return until they are evaluated and cleared by a licensed healthcare provider.

A key component of the Save the Brain campaign is establishing standard protocol for post concussion evaluation. The goal is to have all medical professionals in northwest Montana using the same guidelines.

“If people are using the same tools, that helps tighten up the way concussions are managed,” Coats said. “We’re training health professionals to use these tools — physicians, nurse practitioners, physician assistants, chiropractors, physical therapists, and school nurses.”

A final part of the campaign deals with recovery and when it’s an appropriate time to send a player back to the field.

“Brain and body rest is the most important after a concussion,” Coats said. “It’s not OK to rest a day then go back to full activity.”

Concussed players often stay off the field for a week or more.

Coats notes that while football has garnered many headlines related to concussions, they can happen in nearly any sport.

“Everyone thinks football and rugby, and certainly those are high risk, but so is cheerleading, horseback riding and skiing,” Coats said. “There is a wide range of activities at high risk for concussions.”

Whitefish High School is on board with the Save the Brain campaign.

“The awareness of concussions has been great, and continues to increase,” Whitefish athletic director Aric Harris says.

All coaches and volunteers for Whitefish teams are required to take an extensive course in concussion recognition prior to each season.

“We also have a five-step process our kids go through with our trainer and a doctor,” Harris said. “It’s a team effort.”

Whitefish uses the ImPACT neurocognitive concussion test to establish a baseline — similar to the test used with Save the Brain.

“The game is changing, football specifically,” Harris said. “It’s all about player safety — first and foremost.”

“The days of shaking it off are over.”

For more information about the Save the Brain campaign, call the Neuroscience and Spine Institute at 406-752-5170.