Most team doctors and athletic trainers at Arizona high schools use a sideline assessment tool called a SCAT (Sport Concussion Assessment Tool)  to diagnose head injuries during a game. That includes Matt Maddox, M.D., team doctor at O’Connor High School for the past two years.

“It gives us a way to determine the severity of concussion by index of suspicion,” he explained. The athlete who is suspected of having a head injury is evaluated for loss of consciousness or unresponsiveness and asked memory questions such as “Who scored last?” and “What team did we play last?” The athlete is also asked to recite the months of the year in reverse order. Finally, a neurologic screening is conducted.

The SCAT card states that athletes should not be returned to play the same day of injury. However, a player’s bravado often gets in the way. Shaking off a “ding,” “bell ringer” or “fuzzy” and returning to the game is a badge of courage for some.

Often, overzealous parents put pressure on the coach and player to get back in the game. Finally, experts say the sideline checklists schools use can’t really tell about the severity of the damage.

Young athletes who return to action too soon are especially at risk, according to Mattie Cummins, executive director of the Brain Injury Association of Arizona, which co‑sponsored a local conference on concussions among student‑athletes earlier this year.

“Concussions can range from mild to severe and can disrupt the way the brain normally works,” she explained. “Another hit can overwhelm the body’s ability to regulate blood flowing to the brain.” This “second‑impact syndrome” can cause irreversible brain damage, or worse. At least two young athletes die each year as a result.

When an athlete at O’Connor High School suffers a concussion, parents are told to watch the student‑athlete overnight for such symptoms as nausea, vomiting and headaches. If the symptoms get worse, they are advised to take their child to the emergency room.

“Unfortunately,” says Maddox, an orthopaedic surgeon, “the action parents take is often driven by their insurance plan.” If the symptoms progress after an emergency room visit the athlete and his parents are advised to see a neurologist.

Usually a player may not return to the team until his physician signs off.  Even then, the athlete should usually be eased back into action. Experts recommend a gradual return to exercise, starting with simple aerobic activity like walking or riding a stationary bike.

About 600 high schools around the country have decided to take the guesswork out of deciding when to return student‑athletes to action. They are now using one of the computerized testing systems that work like video games. The tests are taken before the season and again after a concussion. Athletes aren’t cleared to play until their results return to baseline.

Of the high schools using computerized testing, only two are in Arizona: Hamilton and Chandler.  This season, for the first time, athletes in all contact sports at the two schools will be tested, according to J. Todd Davis, M.D., of Sonoran Sports & Family Medicine in Chandler, team doctor for Hamilton and Chandler.

Dr. Davis has been using the ImPACT (Immediate Post‑concussion Assessment and Cognitive Testing) system for about four years and is a credentialed consultant for the program. ImPACT is used by numerous teams in the NFL, Major League Baseball, the NBA and by university athletic programs, including ASU and the University of Arizona.

To help spread the word, Dr. Davis plans to talk about the computerized testing systems when he speaks to athletic directors throughout the state at their annual conference this fall.

“I’d like to see high schools throughout Arizona use a computerized testing tool like ImPACT,” he explained. “By providing a truly objective way to make informed return to play decisions, these computerized tests provide valuable assurance to the athlete, his parents and his coaches.”

Know a student‑athlete who’s had a concussion? Contact us.

Do you know a student who suffered a concussion playing sports? If so, please contact the reporter at barry@thedesertadvocate.com or (480) 488‑1204. We’d like to bring the personal experiences of a concussed athlete to our readers to emphasize the key points in the article on this page.