"Head Case": Lack of athletic trainers can lead to missed concussions

By: Chris Renkel & Stephanie Kuzydym, WKRC Local 12

Wednesday, February 26th 2020

CINCINNATI (WKRC) - In 2012, almost every state created protocols for how to handle concussions during high school sports.

Concussion research has changed since then. The protocol has not. It leaves questions about who diagnoses possible concussions when there is no athletic trainer.

Kentucky and Ohio high school athletic handbooks have extensive rules on concussions that coaches and other school officials only need to know concussion signs and symptoms. Some of those signs and symptoms include: dizziness, nausea, irritability and depression.

Mike Gordon is the head of the Greater Cincinnati Athletic Trainers Association.

“Sometimes it’s very black and white,” Gordon said. “Sometimes, someone is dizzy and all over the place or lost their consciousness. Those are big, sustainable concussions that really don’t need a trained eye to be able to see. It’s the smaller ones.”

Both states’ handbooks also say coaches and officials cannot diagnose a concussion. They can only spot the signs and then refer them to a medical professional -- a medical professional like an athletic trainer. If there’s no athletic trainer present, it leaves those less noticeable concussions to the self-reporting of a teenager.

In Kentucky, 168 schools have no or limited access to an athletic trainer. In Ohio, it’s 456 schools. There is no pending legislation in either state to change the rules.

Is this a problem? It depends on who you ask.

“I believe Ohio has gone to the greatest degree possible for educating and requirements of coaches,” OHSAA executive director Jerry Snodgrass said. “You’re right, not to diagnose, but at least to recognize symptoms.”

TriHealth’s Concussion Program Medical Director Emily Dixon said, “Many of the concussions I see in office are athletes that have not been assessed by an athletic trainer or they’re in middle school or a club sport that don’t have athletic trainers available to them.”

Indiana’s high school concussion guidelines don’t as clearly define a coach or official’s role in the management of concussions. Like Kentucky and Ohio, it requires a student to be cleared by a medical professional, like an athletic trainer or a doctor.


State representative trying to "add a little common sense" to athletic trainers bill

By: Chris Renkel & Stephanie Kuzydym, WKRC, Local 12

Tuesday, February 18th 2020

COLUMBUS (WKRC) – 1991. It’s the year that Pete Rose was banned from the Hall of Fame, Rodney King was beaten on the streets of Los Angeles and it was the end of the USSR.

1991 was also the last time the Ohio Athletic Trainer’s Practice Act was updated.

“We’re pushing 30 years,” Ohio State Rep. Rick Carfagna, a Republican representing Genoa Township, said.

Almost three decades with no change -- state representatives say that is far too long. State representatives Carfagna and Cindy Abrams introduced House Bill 484, which would modernize the Practice Act. This is the act that governs what athletic trainers can and can’t do.

“Right now, they’re limited to what’s called topical care, and topical isn’t even really defined in the Ohio Revised Code,” Carfagna said. “It’s pretty much surface-level care.”

Can an athletic trainer:

Give over-the-counter medications like Benadryl for an athlete having an allergic reaction? No.

Inject an IV of saline to a dehydrated athlete? No.

Administer oxygen? No.

“It doesn’t make any sense to us,” Abrams said. “So we’re trying to add a little common sense to this bill.”

For Abrams and Carfagna, this bill is personal. Abrams, a representative from Harrison, has two sons who play high school sports.

“I sat down in the stands, and it gave me great comfort to see the physician and the athletic trainer,” Abrams said.

Carfagna’s father-in-law spent 30 years as an athletic trainer.

“To see the level of trust that develops between the athletes and the trainer, it really is one-of-a-kind because they want to make sure they’re getting the right levels of care,” Carfagna said.

Ohio has more athletes than you might think. The state ranks fourth in America in the total number of high school athletes. For those in charge of the state’s athletes, an update is a step in the right direction.

“Updating that is a tremendous help to serve kids and keep the game safe,” OHSAA Executive Director Jerry Snodgrass said. “I think that’s the bottom line is to keep the game and keep the kids safe.”

For Tom Lane, an Ohio athletic trainer, it’s essential.

“My practice act needs to be modernized because what’s being taught at the university level does not match with what I’m allowed to do in the real world,” Lane said.

Reading the bill is just step one of the process and their biggest opponent is time.

“We’re in the second year of a two-year general assembly,” Carfagna said.

They’re both very hopeful that 2020 will bring an update to an ever-changing playing field.