Dr. Kirelik's Testimony on Concussion Management

Sue Kirelik, MD, Leader in Concussion Management with Rocky Mountain Hospital for Children at Sky Ridge, Testifies on Colorado Senate Bill 40

An Excerpt from her Senate Committee Testimony on Senate Bill 40, "The Jake Snakenberg Youth Concussion Act"

Dr. Sue Kirelik, Pediatric Emergency Medicine
Dr. Sue Kirelik, Leader in Concussion Management, Rocky Mountain Hospital for Children at Sky Ridge Medical Center

February 10, 2011: Sue Kirelik, MD, is a pediatric emergency physician for the Rocky Mountain Hospital for Children (RMHC) at Sky Ridge Medical Center. Dr. Kirelik designed and implemented the HealthONE RMHC emergency room concussion program to facilitate diagnosis and treatment of patients with concussion in HealthONE’s emergency departments.

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Following are excerpts from her comments at the bill’s hearing before the Colorado Senate Health and Human Services Committee.

Testimony Overview

Today, more teenagers are playing highly competitive sports at earlier ages and spending more time in practices and games. Whether these athletes are coached by volunteer coaches or trained paid coaches, the vast majority of coaches have no medical training and are unaware of how to recognize the signs and symptoms of a concussion. The Brain Injury Association of Colorado estimated that there were between 1,300 and 2,500 incidences of youth sports concussions in Colorado each year.

Medical Research Supports Concussion Management

This statistic underestimates the magnitude of what is truly a public health crisis. A recent Journal of Pediatrics study reported emergency visits for concussion in organized sports has more than tripled for 14-19-year-olds in the past decade. While awareness has increased, many parents, coaches and players still don't understand how serious concussions can be.

It has been estimated that 90 percent of pediatric patients with concussion go undiagnosed and do not seek medical care because of a lack of understanding that a concussion is a serious brain injury. It is estimated that there may be almost four million undiagnosed traumatic brain injuries per year in the United States, many of which involve kids, teens and young adults.

Young Brains Are More Vulnerable to Injury

The pediatric population is considered to be most at risk when it comes to suffering concussions and developing long term complications. Young brains take longer to recover from concussion than adult brains.

The Jake Snakenberg Youth Concussion Act is an essential first step in addressing this hidden epidemic. Youth athletes are particularly at risk for having concussions and for long-term complications from concussion. It is critical to recognize a concussion at the time of the injury, because if kids are allowed to continue to play with a concussion, their injury may be much more severe and their recovery prolonged.

Often the only person who has the opportunity to recognize a concussion when it happens and protect a child’s brain from further damage is the coach on the sidelines. This bill requires coaches to learn how to recognize important signs and symptoms of concussion and if they are present remove the child from participation until they are appropriately evaluated.

We Need to Protect Children from Less Obvious Injuries

While it may be less obvious than a broken leg, a concussion is an injury to the brain and needs to be taken seriously. A blow to the head requires a medical evaluation for a number of reasons, including evaluation for a more severe injury to the brain and other associated injuries.

As these students recover, they often need help transitioning back to school. Those who fail to recover in a timely manner may require medications and/or physical or psychological therapy to deal with their symptoms. Medical evaluation also provides documentation of the injury, which may be critical to provide essential services to those who develop long-term disability from their injury.

A medical evaluation prior to returning to sports participation is essential in order to assure that they are fully recovered from their concussion. These athletes also require close monitoring as they go through the return-to-play process to assure that symptoms do not return, which may be a sign that the brain is still vulnerable to injury.

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