Cities have come to expect increased calls for emergency help on game days, usually because of alcohol and overzealous fans. But what about when calls for help come directly from the field? One mother whose son experienced a significant head trauma on the football field remembers a game in which six players from the same high school got concussions in the same game. “There were four ambulances on the school’s football field at the same time,” according to the story on thepostgame.com. That’s a lot of head trauma in one game—and a lot of response for a small town EMS system.
So what is this head trauma doing to young players, and what’s our role in keeping the damage to a minimum? The answers to these questions are both frightening and hopeful: the potential long-term damage to players is significant and can be life-altering, but a swift and appropriate response, and correct and accurate instructions to players and parents, can mitigate the harm quite a bit.
Traumatic brain injury is terrifying in part because its long-term effects are not well known. According to neurosurgeon Alexander Powers, “repeated concussions could put a child at risk for such crippling conditions as early onset dementia, Parkinson’s disease and other neurological disorders.” Perhaps more alarming for parents, the Alzheimer’s Association reports that trauma doesn’t necessarily have to be severe to cause long-term damage. Even repeated mild injuries to the brain may increase the risk of dementia later in life.
Then there are the significant, immediately-obvious brain traumas, the ones that lay players out on the field or cause clear behavioral changes. Youth football players have reported symptoms including forgetting what’s happened to them, dizziness and vomiting, short-term memory damage (including, for example, not being able to follow a simple TV show), difficulties in school, numbness or tingling in extremities, and inability to process new information. Given that many of these traumas occur in key developmental periods like early adolescence, the resulting mental problems, even if temporary, can change the course of the young person’s life.
Unfortunately, the problem may lie as much with the players’ own ethic as with the sport itself. After all, a player has to report a concussion to be treated for one (unless he’s clearly behaving oddly or obviously out cold). According to a report by the U.S. Department of Health and Human Services, “Many U.S. high school football players say they would keep playing after experiencing a concussion, even though they know it would put them at risk for serious harm.” And another report, cited in the postgame.com article, found that trainers are missing “nine out of 10 concussions” in some cases—largely because players are not reporting that they’ve been hit. They want to keep playing.
Given that the CDC estimates that 135,000 children ages 5 to 18 are treated in emergency departments for sports-related brain injuries each year, and given that a Virginia Tech study found that players in the 6 to 8 age range take around 107 hits per season, some as forceful as those taken by college players, what can emergency services do to reduce the damage?
There are three steps. The first is accurate identification of head trauma. Once EMS has been called, the best indicator of serious damage is alertness; if the player is not acting 100% normally after taking a hit, that’s a bad sign. The second step is rest. According to most neurologists, if a player rests until he or she feels totally normal—that is, until all the symptoms are gone—long-term damage can be averted or minimized. This means that providing good instructions to parents and players is critically important. Finally, head trauma should never be dismissed by emergency personnel. Even a series of small hits can cause serious problems, and taking a second hit while recovering from a first can be fatal.
[And keep in mind: while I’m focusing on American football here, similar concussion numbers have been seen in hockey, soccer, boxing, and other contact sports worldwide.]
As long as children and young people continue to play full-contact sports, EMS personnel will find themselves on the phone and on the field with concerned parents, supportive but sometimes skeptical coaches, and vulnerable but deeply committed players. Managing such a situation is a balancing act. It’s vital that we get it right, not just to protect the children they are now, but to help ensure that they become the adults they are meant to be.