Report: Concussion Report

Transcript (~18 min @ 40:45)

▶ 40:41 programs and personnel. And tonight we have one item on our agenda. It is our annual concussion report, which we are legally bound to review once a year. And we're going to look at the number of concussions that happened last year and discuss them with Mr. Fogarty. Thank you for being here tonight to inform our discussion. There's no need for a vote on this. Welcome. Thank you for having me. Good evening. Do you want to just give us an overview, and then we'll- Sure ... open up questions? This tracking of concussions and reporting out on it has been going on since 2014. And last year we had eight concussions. And that's diagnosed by a doctor, not by a coach, not by the athletic trainer. That is medical personnel who make those decisions.

▶ 41:31 So that's body-to-body contact, that's body-to-ground contact. That's an object-to-the-body contact. And at this age, a lot of the ones that we see are actually the body and the ground that cause that type of damage, if you will, or injury. Thank you. Anything you want to add, Superintendent Berman? No. I think last year was the first year that I presented this. Certainly, we had a much higher amount last year. It becomes kind of a challenge because of student confidentiality. It's really difficult because we can't say, like, "Oh, there were three female athletes and five male athletes," or, "Two happened in soccer, and one happened..." We can't really specify, which makes it hard because I know there's a lot of

▶ 42:19 questions, and we want to know, are we doing things differently? I think we are monitoring it very closely, right? We have the concussion protocols. All of our educators, our guidance staff is working with students if they do have concussions. Our trainer is certainly ... Students have to be cleared. Mm-hmm. That's the other piece. So it's not like, "Oh, I feel better. I don't have a concussion anymore." Nope. They actually have to go back to the doctor and get the information to then bring to the trainer, who then gives to the coach. I think that's the protocol. Correct me if I'm wrong. But it's hard to say why there were so many last year and so few this year. I think you see the variability, though, in this report

▶ 43:00 throughout the years. As few as four in 2020, kind of probably not the best year to use. However, there were four. 2019 there were eight. But this seems like a low number. And I think Mr. Fogarty and I had a conversation earlier today. We're averaging 11 a year. And this is for all of our students and all of our athletes. So, I don't know if there's anything else you want to add, but- Well, clubs and activities are also included in this. Yep. So band, whatnot. Safety's paramount with what we do, and we try to keep all of our coaches, the medical staff, the athletic trainer, and the nurses are in concert with one another. If something happens in the classroom, they bounce things off. "This happened earlier in the day.

▶ 43:47 Please check on him when he shows up at the event later." So we're working together with it. At this level, typically about 300,000 concussions occur in the high school age in a given year. Two-thirds of those are during games, which leaves about a third at practices. Practices are very structured. We try to use our best practices as educators to put people in situations where they're going to be successful. And that includes professional development. They're going to trainings. They're learning from programs around here that open up workshops or clinics, things like that. So constantly, we're trying to get better at what we do. And part of that, a huge part of that, is the safety component.

▶ 44:35 So With that, it comes back to the game, where two-thirds of these are happening, and you have less controls over that. Mm-hmm. There's a stronger effort, greater forces, greater speed usually. So it's not shocking. That's not a huge revelation right there, but it's factual. Thank you. Thank you. Any questions, comments from the committee? Mr. Hartman, go ahead. Thank you, and thank you for continuing to pay close attention to this. I think we had a large discussion last year, and to Ms. Berman's point, 21 was a much higher number than previous years. Certainly alarming to a number of members to see that come forward that way. I think just so I understand some of the process around the concussion, while we

▶ 45:20 have the advantage of your time tonight, around the concussion protocol and how we learn about these. These are not necessarily concussions that are diagnosed even on the night of an incident, right? This is something where a student reports from their doctor that they've received a concussion, and that's how we find out about it. Is that correct? Sometimes it could happen during a practice, and right away it's seen or it's heard. You hear that hit, and questions start happening. But whoever's on site will take first command of that. If the athletic trainer's there, it's that person. If not, it starts at the head coach. And from there, the student may exhibit symptoms right away, and then you take action. It dictates where you go through questioning.

▶ 46:08 Mm-hmm. Student may go home and feel worse at night, and then that parent may take them to the doctor that evening or in the morning, and then we find out later. Mm-hmm. So it happens in a lot of ways. Yeah. Most recently I found out through a guidance counselor that a student had a concussion. Mm-hmm. Right. So- It wasn't reported to the coach, wasn't reported to the trainer. Yeah. It happened somewhere else. Right. So yeah, I'm trying to think about what information we have access to, which from your reporting is sometimes somewhat limited from what you're saying. We see the number eight at the end of the day. Correct. And it seems like, is there always an incident report that's associated with that

▶ 46:56 when you get a concussion report, or is it documented on the night of an incident that you think a concussion might be coming? If the athletic trainer were to see that student, yes. Mm-hmm. Okay. So take scrupulous notes at all injuries, all situations. Could be a hand got cut off, somebody with cleats may have stepped on that. Something as significant as a potential concussion, obviously there's going to be more detail- Mm-hmm ... to that type of injury. Okay. Yeah. Because I think one of the things I'm most concerned about learning more about is multiple concussions with students, which is the most dangerous situation for sure, that students could be having repeated concussions. And I don't know if there's any way that we can track that better to understand

▶ 47:40 with the information we have access to, without exposing student information, but to have a better understanding of when we're seeing multiple concussions happen. And what is our protocol around that if a student has a second concussion or a third concussion? So going back to Ms. Berman's speaking about once the doctor's cleared, part of that protocol is coming back five more days or five more workouts to get that student ready to play. Mm-hmm. All right? So anybody has that initial concussion, we're aware of that. Happens again, maybe the next season, then there's going to be more time involved. There's going to be more conversation with doctors. That doctor's going to probably step in and have more to say about something like

▶ 48:27 that. But once that clearance comes from the doctor, we take more time to evaluate and make sure that that person is coming back with the skills that they need to be successful. Mm-hmm. So the athletic trainer would have that information. A coach may not if they're not coaching season to season. I'm not familiar with any of repeated ones within a same season. Mm-hmm. Okay. I'll just conclude then I think with, I think it might be helpful just if there's ways of relaying the information to the committee that don't identify students, of course, but maybe reflect certain areas of concern, if there are concerning patterns that come out of the concussion analysis with the information that you have certainly access to, to understand if there...

▶ 49:15 I think one of our questions is always, are there certain sports that are dangerous for our students? And are we doing everything we can to protect our students? Simply seeing an overall number is not enough for us to interpret where to focus our attention. So if there are ways of saying, "This sport is a red category because it has a high level of concussions happening year after year after year," I think that's information that would be helpful to the committee without exposing student information. And we can look at that on a more annual basis to see in a year like '21, this sport was red. In a year where there's only eight, it was very yellow, very green, because we just really didn't see much happening with the

▶ 49:51 concussions. That is a non-numeric way of displaying information in a way that could help us understand better what's going on. So just one suggestion there if we want to-- I think the committee, judging from previous conversations, wants to lean in a little more to understand this. So that's my suggestion. I can tell you this, if you're comparing two sports where both genders are offered- Mm-hmm ... say soccer, basketball, tennis, females are more likely to be concussed than a male. Mm-hmm. All sports that you can compare as the same. Mm-hmm. So. Yeah. Thank you. That information would be very helpful. Any other questions or comments from anyone on the committee? Yes, Ms. Driscoll, go ahead.

▶ 50:29 Sure. So I think now that you have the trainer, are you finding that-- We have gone through a period where we didn't have a trainer. I looked hard for a trainer, and that was tough to get back. Do you feel that there is added value with having a trainer? Absolutely. Okay. Can you describe a little bit, you touched on it, but in the protocol. So those 18 months were 18 of the worst months of my life. So to have someone competent to be in there every day, approachable and knowledgeable, and able to share that with people, it's invaluable. So. That's helpful. Thank you. And I did have one question in section C in the report. It's the second question down, and it says, "Please indicate whether report of head injury forms are required to be submitted

▶ 51:23 for all students, or only for students who participate in extracurricular athletics and school sports." And it's marked unknown. So I just wondered if you could talk about that a little bit. It's below the enter how many report of head injury forms, and then the next question is how many of the report of head injury forms received were the result of extracurricular, and then it says, "Please indicate whether report of head injury forms are required to be submitted." So if it happens in a sport, to get back, yes, it is required. If it were, say, an intramural program or a club activity, there is not paperwork required to come back to that. Okay, so it's marked unknown because it's a mix? It is a mix, yes.

▶ 52:33 I would say yes to that. Okay, thank you. Thank you, Ms. Driscoll. Any other questions or comments? Just one clarifying question. It's more like you could get a concussion falling off the stage, working in the theater, being part of a big production. You could get a concussion walking down the hall, roughhousing with your friends, and all of those would be included in these numbers, right? If they were reported to you. No. These numbers are reported through the activity themselves. Any co-curricular activity or athletics. Okay. So if you take all the concussions that occur in that building, whether riding a bike, falling out of bed, things like that, those aren't included here. Okay. It's things that happened under our watch.

▶ 53:29 Okay. That's what's included here. All right. And the numbers are very comparable. So that number is usually around 10. There's usually about 10 students that are not involved in our athletics or activities- Yeah ... that are concussed each year. It's a very similar number. Okay, interesting. Did you have a follow-up question from that, Mr. Miller? Yeah, I just want to understand that point a little bit better. So we receive a report from the student's family about a concussion after they've seen a doctor. But walk me through that as if the incident happened, and what you receive and when you receive it, just so I really understand. There's a crash on the field, student goes home, might see a doctor.

▶ 54:12 How is that transmitted, and what do you receive to correlate that that is related to that activity? So if we're talking, Guidance is heavily involved in this. Usually, lights become a problem. The phones become a problem. So any type of modification needed for that student is shared with the people that are directly involved with that student. So any medical documentation that that student may have received at the doctor's office, at the emergency room, typically accompanies that student to school, and is shared with the coach, the athletic trainer, or teachers that may have to make modifications for that student. No, I think I'm trying to understand how we differentiate between concussions that

▶ 54:59 happen in the activity versus ones that don't, because we're not diagnosing concussions at the activity, right? We're diagnosing them because a doctor tells us it's a concussion. Yep. Who's telling us that it's related to the activity? If we- The doctor. The doctor. So we're getting information- Usually, the notes that I typically see, a skiing accident, a bicycle accident- Yep ... football game, gymnastics. Something like that. But we might not have a record of the incident because it could've been a small incident on the field that the coach shouldn't even notice, right, in the moment. Then it wasn't diagnosed. So it has to be diagnosed for the- No. What I'm saying is the coach on the field, sorry to interrupt, coach on the

▶ 55:43 field has a lot going on. The kid falls, doesn't even notice. Two days later, he comes in with a note from the doctor saying he got a concussion because he played soccer. Is that how it happens sometimes? Yes. So we don't have a knowledge of exactly what happened in the incident to go back to. That's what I'm trying to understand. No, that student walks away at the end of that practice, the end of that game- Right ... not sure. Okay. And sometimes those symptoms don't come on until later as well. Right. That's all I'm trying to clarify- Sure ... is how these incidents arise and how we may not know much of anything at the school level- Correct ... until we receive the report. Thank you. That's not just concussions. Sprained ankles, the adrenaline's going, the hurt

▶ 56:20 knee, the hip, the back, whatever, the adrenaline is going, and it's usually after that adrenaline relaxes a little bit, subsides, that they may feel a little different- Right ... sometime later. I see that Mayor Jen wants to- I was- ... lend a word. Go ahead ... as- Maybe as a mom of a football player. I don't know. As the parent of a 11-year-old, I think we were in the, I can disclose my own child's privacy, we were in the 21, the number 21. It happened. There was no obvious sign- Yep ... that anything had happened. There was symptoms upon return home. We sought medical attention. As the parent, I reported it to Mr. Fogarty, to Guidance, and then I will just want to really say how impressed I was

▶ 57:00 with the school response, how coordinated it was, both from the athletic department- Mm ... the school nurse, teachers, Guidance. So I do think our response is really well done. But yeah, we're never going to know. We obviously can't be in the business of diagnosing- Right ... medical situations. So I know you're largely reliant on reporting, but once you get a report, I think we do really leap into action. And the level of restriction in terms of being cleared to go back is very robust. Thank you so much. Thank you, and thank you for your patience. Sure. I'm just trying to work through, understand exactly what we have access to and what we don't. Yeah. Yeah. And ultimately, the decision to play a sport is really based on the child and

▶ 57:38 the family. Because they know the ins and outs of the medical incidents that they've had. Mr. Fogarty, you have the last word. Sure. And playing sports, these injuries, it's inherent. Mm-hmm. Somebody's going to get hurt at some point, and we do everything we can to minimize. That's job security on our end. We need these students to compete, to fill those rosters, to go out and have a product, and for them to have those rewarding experiences. So we want them healthy. We want them out there. But at the same time, you got to create those safe spaces where you can minimize any type of situation. Well, thank you all. Thank you for coming in and discussing this with us. And without any further comments, we're done with this part of our agenda.