The council, made up of doctors, surgeons and certified athletic trainers, met for nearly 5 hours Thursday. It came up with several findings. The council called the emergency meeting in response to three football player deaths in North Carolina since mid-August.
On August 12th, /*Chapel Hill High School*/ player /*Atlas Fraley*/ complained of headaches during a scrimmage and later died at his home. He had a history of heat exhaustion-related symptoms. His autopsy results have not been released.
On August 22nd, Reynolds High School football player Matt Gfeller was hit under his chin in a helmet-to-helmet collision. He later died at a hospital in Winston-Salem; his autopsy shows his cause of death as traumatic brain injury that tore a small blood vessel.
And last month, on September 19th, JaQuan Waller of Rose High School in Greenville collapsed on the sideline after being tackled in a game. The cause of death on his death certificate reads, "closed head injury due to sequential impacts during a contact sport," according to a report circulated at Thursday's NCHSAA meeting. Waller suffered a concussion during a practice just two days before the game in which he died.
North Carolina's three deaths account for a disproportionate percentage of the 14 high school football-related deaths so far this season. At the meeting, the medical council decided to immediately enact the rule regarding concussions. A player will need to have medical documentation before returning to the field.
"Those athletes (exhibiting concussion-like symptoms) would not be allowed to return to practice or play until they have been given written release by a licensed medical doctor," said Que Tucker, deputy executive director of the NCHSAA.
Dr. Fred Mueller, director of the National Center for Catastrophic Sports Injury Research, said a change in attitude must accompany the new regulation.
"I think football in some cases has a different mindset than other sports that if you're injured, you play tough, and I think that's a mindset that you're talking about that you have to change," said Mueller, who is also a professor in the Exercise and Sports Science Department at UNC-Chapel Hill. "And a coach has to tell his kids that it's okay for you come up to me and say, 'I've got a headache, or I don't feel good today, or I'm nauseous" without being called weak or not being thought of as tough by his teammates. I think football needs to change that way."
The medical council decided not to enact a recommendation to require each North Carolina high school to hire a certified athletic trainer, who would have to be present at all football games and practices. Currently, schools are required to have either or certified/licensed athletic trainer or a first responder.
Kevin Guskiewicz, the chair of the Exercise and Sports Science Department at UNC, presented to the medical board a detailed proposal regarding why he thinks certified athletic trainers ought to be required. They are required to have much greater education and background in sports sciences than a first responder, who is only required to be certified in CPR, first-aid and take two 20-hour workshops in injury management.
"Having full time athletic trainers in place clearly would save lives," Guskiewicz said in an interview following his presentation. "We're putting a person in place who knows the injury, knows how to refer the injury. I think there are school administrators around here that believe that coaches with some minimal training can provide adequate care for these athletes and you just can't do it that way."
Guskiewicz said he believes less than half of North Carolina high schools have a certified athletic trainer. Such jobs typically pay between $35,000 and $40,000 for new hires. Guskiewicz suggested the legislature mandate that each school have one. He also advocated for greater education in recognizing and dealing with head-related injuries like concussions.
Most members of the medical council seemed to agree with Guskiewicz's suggestions, but rather than recommend them to the full NCHSAA board, they elected to form a task force which will further study the issues. That task force is to report to the full NCHSAA board in December.
The medical council also decided that all high school principals will have to provide the NCHSAA with the credentials of its athletic trainers and first responders.
Each school will also have to come up with a plan for how to deal with serious athletic injuries. The procedures outlined in such plans would be followed in the event of an injury like the three that claimed the lives of the North Carolina teenagers in the last two months.
"What we have here maybe would have prompted some additional steps that maybe could have made a difference," Tucker, with the NCHSAA, said. "Would it have saved those lives again? I don't know that to be a fact."