10.08 Concussions

Egg Harbor Township High School athletic trainer Kyu Lee, left, demonstrates the concussion testing procedure on football player Cory Fama at Thursday's game. At right is Michael Pellegrino, supervisor of athletics and activities.

At the beginning of the fall semester, Egg Harbor Township High School's athletes had their heads examined.

Michael Pellegrino, supervisor of Athletics and Activities, said athletes were tested on their memory and reaction time using ImPACT, or Immediate Post-Concussion Assessment and Cognitive Testing.

The computer program - which cost the district about $1,000 - can provide coaches and doctors a baseline to measure an athlete's recovery following a concussion, which can help prevent re-injury on the field, he said.

"This is not going to be fail-proof, but it enables us to send documentation when something does happen," Pellegrino said. "We use it on a daily basis - any time there's head contact or a report of an incident."

A new federal study says initiatives such as ImPACT have helped increase the number of children going to hospitals with concussions by 60 percent in the past decade. Medical officials say a major reason for that is increased awareness among coaches and parents.

"It's hard to watch a professional sports game, whether it's hockey or football or anything else, without hearing about concussions," said Rosemarie Moser, director of the Sports Concussion Center of New Jersey in Lawrenceville, Mercer County.

The estimated number of kids coming into emergency rooms with concussions rose dramatically, from about 153,000 in 2001 to nearly 250,000 in 2009, a study by the Centers for Disease Control and Prevention says.

The study was based on data from 66 hospital emergency departments that were designed to be nationally representative. The CDC looked at non-fatal data for the years 2001 through 2009 for kids and teens ages 19 and younger.

The agency looked at traumatic brain injuries, a category that mostly counts concussions, but also includes skull fractures and bleeding in the brain.

However, CDC epidemiologist Julie Gilchrist said, there was not a significant increase in the rate of children who were immediately admitted into the main hospital for further treatment.

That suggests that, moreso than in the past, more coaches and parents have been bringing kids to the ER with mild concussions and blows to the head, said Gilchrist, who led the study.

AtlantiCare Regional Medical Center data show a significant increase in concussions at its Mainland Campus and more variable numbers at its City Campus.

At the Mainland Campus, concussions nearly doubled from 41 in 2009 to 80 in 2010. With the fall sports season not yet complete, this year's figures show 48 concussions so far.

Lucienne Reid-Duncan, a neurologist with the AtlantiCare Physician Group, said people are generally becoming more careful when dealing with head injuries.

"We saw how it devastated one young population," the military, said Reid-Duncan, a former Air Force physician. "We don't want to see that occur in a child, because it can have lasting (impacts)."

The CDC says symptoms can include difficulty concentrating, headaches, irritability, nausea and changes in mood or sleep patterns.

Reid-Duncan said there are also laws in many states, including New Jersey, that require athletes to receive clearance from a specialist trained in concussion management before returning to the field.

Kathe Bagnato, manager of the AtlantiCare Health Services Athletic Training Department, said people are more familiar with the symptoms and long-term impacts of concussions than in decades past.

In her own practice, Bagnato said, her patients tend to be well-informed before the first appointment. That's helpful, particularly because health professionals often rely on the patient to describe how they feel.

"We, as athletic trainers, can't get in to feel the brain like we would if someone sprained their ankle or broke their arm," she said. "The more the athlete is aware of the problems, the easier to get in there and decipher their concussion level and healing time."

Ed Keil, president of the Egg Harbor Township Baseball Organization and an umpire with the Atlantic County Umpire Association, said he is acutely aware of the dangers.

He regularly holds coaching clinics for the baseball coaches to tell them what to look for. He's also recommended the National Federation of High School's online concussion course for fellow umpires.

"It's only 10 or 15 minutes of your life, but you can use it to save some kids' lives," he said.

Moser said awareness probably doesn't account for the entire increase in concussions.

In addition to the legislation that's now in place requiring treatment, she said, the simple fact is that more students are involved in more sports at a younger age.

"They're playing more sports year-round and begin at earlier ages, so there's definitely an increase in athletic exposures," she said.

Proper supervision and diagnostic testing, however, can help avoid and diagnose concussions, Moser said.

Since the 1990s, when Moser began offering testing similar to what's employed in Egg Harbor Township, she said the demand for testing has steadily increased.

"Back then, we'd get maybe one every week or so at the most," she said. "Now, we see multiples every day."

Pellegrino said ImPACT has been incredibly effective, particularly considering the number of athletes in the district.

"We have 600 student athletes in the fall," he said. "For a trainer to hand-test every person, he'd still be testing (now)."

The next step, Pellegrino said, is to purchase hand-held tablets that can be used to test injured athletes from the sidelines, so that coaches can send them home with a report to take their physician.

"Our job is to keep them safe," he said. "We want to take every precautionary measure we can off the field to make sure there are no future problems or symptoms."

AP Medical Writer Mike Stobbe contributed to this report.

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