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Panel tightens rules on player concussions

Posted October 9, 2008

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— A panel of sports medicine experts said Thursday that any high school athlete suspected of suffering a concussion must be cleared by a physician before he or she can play or practice.

The medical committee of the North Carolina High School Athletic Association also established a task force to determine whether high schools should be required to have certified athletic trainers on staff. The task force is expected to make a recommendation at the association's annual meeting in December.

The moves come in the wake of the recent deaths of three North Carolina high school football players, two of whom died from head injuries. The committee rescheduled its regular meeting from March 2009 to more quickly address the issues surrounding their deaths.

"We need to err on the side of caution. Keep them out. Get them referred to a physician," said Dr. Kevin Guskiewicz, chairman of the Department of Exercise and Sport Science at the University of North Carolina-Chapel Hill and a committee member.

The committee received reports outlining the deaths of Atlas Fraley, 17, of Chapel Hill High School, Juquan Waller, 17, of J.H. Rose High School in Greenville, and Matt Gfeller, 15, of Reynolds High School in Winston-Salem.

Fraley’s parents found him unresponsive on the evening of Aug. 12 at the family’s home, hours after he had participated in a football scrimmage.

An autopsy report hasn't been completed, but the NCHSAA report noted he collapsed from heat exhaustion.

Fraley called 911 that afternoon and said he felt dehydrated. Paramedics were sent to his home, but he wasn't taken to a hospital for treatment.

Both Orange County EMS and Chapel Hill-Carrboro City Schools are investigating the circumstances surrounding Fraley's death. Neither investigation has been completed.

Waller, a junior running back, left the field after being tackled in a game and then collapsed on the sideline. He was taken to Pitt Memorial Hospital, where he was placed on life support. He died on Sept. 20.

He had been hit in practice two days before the game and suffered a mild concussion, and a medical examiner determined the cause of death to be "second-impact syndrome," where a person receives two or more blows to the head in a short period.

Gfeller died Aug. 24, two days after a hit that he took in a game against Greensboro Page High School led to cranial bleeding.

The committee's recommendation requiring written permission from a physician before a player can resume practice and game play after suffering a suspected concussion is effective immediately, members said.

The panel also said schools need to file emergency action plans with the NCHSAA detailing how they respond to player injuries, and they also need to certify the credentials of their athletic trainers or first-responders.

Schools now must have a first-responder trained in CPR and first aid on staff. Although some committee members argued that training isn't enough to prevent another sports-related death, others feared hiring certified athletic trainers would be too expensive for some schools.

"(Trainers) have a lenghty course of study on sports-related injuries that includes that of sport concussion," Guskiewicz said.

Less than 35 percent of North Carolina high schools have certified trainers, who have an average salary of about $40,000 a year.

Guskiewicz said the risk of injury is so great that schools without certified trainers shouldn't be playing contact sports.

"If we can't put kids out on the fields in a safe manner, then we shouldn't be putting them out there," he said.

Chapel Hill High has a certified athletic trainer on staff, and he was at the football scrimmage the morning of Fraley's death, Principal Jackie Ellis said.


This story is closed for comments.

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  • wolfpackfan15 Oct 9, 2008

    I think that they should tighten up on this. It's not right to play kids that aren't "ready" to play yet. I think this is a smart move on the panel's side.

  • TheAdmiral Oct 9, 2008

    Ummmm... Are they just now getting to the point where the rest of the world is? I mean really - at every football game and at every training session there is an EMT present.

  • olsaltydog Oct 9, 2008

    Trainers are dealing with the injury. Part of the problem is prevention and some of this goes to how well the coaches are trained to teach the sport in question. The young man over in Winston area lost his life to a hit in a game. He had his head down from reports. Was this just an error on his part or is this due to not being taught in the proper way?

    For the first time today it was reported on another local news program that Chapel Hill High has a certified trainer that was present at the practice where the young Fraley man was playing before he went home.

  • SaltlifeLady Oct 9, 2008

    ANy good and responsible coach should have been recommending this anyway regardless of it the parents or player wanted to continue playing. There are parents and players who only see that college scholarship in front of them, or a chance to play pro and at what expense? A head CT Scan takes 10 minutes. You can find out pretty quick in the ER if you have more than a bump on the head or get cleared for playing.

  • scorekeep Oct 9, 2008

    Schools can afford trainers-at the expense of teaching positions.

  • Garnerwolf1 Oct 9, 2008

    I'm waiting for someone suggest we wrap them in bubble-wrap!

  • Justin T. Oct 9, 2008

    I do think that the increasing size of players and emphasis on developing players that can move on to pro careers does mean they are hitting harder.

    I've also heard that safer equipment is available, at least in the NFL, but it isn't used because it will detract from the "pop" you hear and may restrict mobility to some degree.

    I say let's throw a little more high-tech equipment at this problem before we require every school to have expensive medical personnel on the sidelines. We should at least weigh the possibility of safer equipment against having a medical specialist.

    Also, wouldn't the hit (and therefore the damage) be done anyway? The sideline diagnosis would be quicker but you could still have the player die from the initial injury.

    Maybe we could pay retired pros to wear rainbow uniforms and wedge themselves between the kids to keep them from getting hurt. Geez.

  • bgmulder Oct 9, 2008

    Here are my suggestions, although I know they will never get anywhere.

    #1 If a school is unable to afford trainers part-time they should at least be made available during all practice hours and game time. What cost more a child's life or a trainer?

    #2 If a student is injured in a game or practice and requires immediate medical attention, that student should not be allowed to play for a minimum of 2 weeks. (This would have possibly prevented the death at JH Rose)

    #3 Anytime a student dies while playing a sport, I feel the athletic department should immediately be put on hold until investigations can rule out that the death could have been prevented

    #4 I don't think any athletes with a past medical history should be allowed to play sports, because it is just tooo dangerous!

  • ECUPirate68 Oct 9, 2008

    Nav - Wher are you in eastern NC to be so blessed with licensed athletic trainers? There are some school systems who have licensed ATC - others across the state who do not. One of the deaths in question recently was in "eastern NC" in a school system which only has 1 for 6 high schools.

  • Navaho1 Oct 9, 2008

    Yea - they are bigger (maybe fatter) - today 275 Lb tackles are fairly common. This would certainly contribute to increased momentum as well as inertia. The "old coach" thinks they maybe faster too - again more momentum.

    Here in the poor eastern part of the state - we have certified trainers - so I am a bit surprised that they are not common in the heart of carolina. Not sure what help they would be in the case of the catastrophic deaths that I have read about.