After several well-publicized cases of brain injury among veteran players, a pricey lawsuit, and a new movie focusing on the perils of professional football and the risk of brain injury, the NFL is working to change the way its players are treated on the sidelines. The changes come as a growing body of research implicates repetitive, subconcussive hits with long-term adverse consequences, including the neurodegenerative disease chronic traumatic encephalopathy (CTE).

Players now who experience a possible concussion undergo a physician evaluation in which the player is checked for obvious symptoms, like confusion or loss of consciousness that would warrant the immediate removal of a player from the game. The “Sideline Concussion Assessment Tool” is also used by doctors to evaluate numerous cognitive functions, such as balance, memory, and orientation.

NFL players aren’t the only ones being injured. According to the CDC, ER visits for traumatic brain injury have increased 60 percent over the past decade, which explains the need for emergency physicians to have more education on concussion recognition and care.

“Concussions are serious injuries. As physicians improve their ability to recognize and treat concussions, patients and public health will be better served. Education is critical to ensure proper diagnosis and treatment of the injury in the emergency room, on the sidelines, and elsewhere,” said Jeff Miller, NFL senior vice president of health and safety policy. Just how common is it to get a concussion if you play a contact sport? Some experts say – 19% per year of play. Between four and 20 percent of college and high school football players will sustain a brain injury over the course of one season. The risk of concussion in football is three to six times higher in players who have had a previous head injury.

Several doctor groups, such as the Emergency Medicine Foundation (EMF) and the American Academy of Family Physicians, have both partnered with the National Football League Foundation to provide a variety of resources for physicians, including an online continuing medical education course on the assessment and management of concussions, a series of webinars, and patient education materials. The Emergency Medicine Foundation (EMF) and the National Football League (NFL) Foundation partnership yielded the free online course “Concussion Essentials,” focused on the variability of concussion presentations and treatment strategies. “The goal is to provide emergency physicians with an opportunity to review and consider the best practices and approach to assess disposition of concussed patients in the ED. The course includes nine lessons covering epidemiology, prevention and mitigation strategies, recognition, evaluation, management, recovery and return to play, and prognosis.”

An App for the Sidelines

Family doctors and ER physicians may want to refer athletic kids and their families to a helpful new app to use in case of a potential head injury. The American Academy of Neurology (AAN), the world’s largest association of neurologists who treat brain injuries such as concussion, has launched a very handy new app called “Concussion QuickCheck,” to help coaches, athletic trainers, parents, and athletes quickly evaluate if someone may have a concussion and needs to see a licensed health care provider, such as a neurologist, who is specialized in concussion.

Key information and tools in the “Concussion Quick Check” app include:

• Common signs of concussion
• Symptoms of concussion
• Things the athlete may tell you
• What to do if an athlete has a head injury during a game
• What to do if it appears the athlete has a concussion
• When an athlete should return to the game
• Help finding a neurologist near you (GPS capability)