NATA Now

October 4, 2017 by Todd Christman

By: Shelly Jones, ATC

When I first joined the state high school athletic association medical advisory committee, the Catastrophic Sports Injury Research Annual Report was on the agenda. Being a brand-new member to the committee, I read it cover to cover. This report includes case summaries on every single catastrophic injury and fatality that occurred in sports.  Over the span of a few days, I read about every death, permanent disability, serious injury, paralysis, heat stroke, sickle-cell trait collapse, and cardiac condition. Not exactly the most uplifting read to say the least. However, along with the tragedies, there are also stories of survival and recovery due to quick and decisive actions of athletic trainers and others. Yet, after reading multiple stories of athletes being crushed by soccer goals, even after the many safety enhancements to their design, I still give soccer goals a nice wide path.Despite the depressive nature of the report, the research it provides is invaluable to our practice. What you might not realize is that the completeness of the research data also depends on us. Athletic trainers must report all catastrophic injuries.  
 
“The mission of the National Center for Catastrophic Sports Injury Research (NCCSIR) is to conduct surveillance of catastrophic injuries and illnesses related to participation in organized sports in the United States at the collegiate, high school, and youth levels of play.” [1] Their “goal is to improve the prevention, evaluation, management, and rehabilitation of catastrophic sports-related injuries.” [1]  

“NCCSIR annual reports are submitted to national organizations and individuals charged with ensuring the safety of sports for the participants including the National Collegiate Athletic Associate (NCAA), the National Federation of State High School Associations (NFHS), and the American Football Coaches Association (AFCA).” [2] “Safety and sports medicine advisory committees review this information annually to recommend changes in rule, coaching and training techniques, safety and playing equipment, improved emergency procedures and medical care for catastrophic injury and illness events, and to assess whether past recommendations resulted in fewer and/or less severe catastrophic events.” 

Previously, their data was compiled almost exclusively by media reports. Starting with newspaper clippings, progressing to internet search engine media web alerts, and later implementing a short 2-page questionnaire to be completed by school officials their data was still incomplete. As you might imagine, non-fatal catastrophic events are sometimes not reported as well as fatalities. In addition, with “the complexities surrounding catastrophic events, expanded data collection beyond the basic information of what happened (was) needed”. [4]  Therefore, the NCCSIR and the Consortium for Catastrophic Injury Monitoring in Sport developed a national centralized reporting site with an online portal where anyone can report a catastrophic event. Now more comprehensive details can be reported in conjunction with medical reports and imaging and this “continuous and expanded surveillance over time helps determine the impacts of current interventions.” [4]

The activities of NCCSIR and the Consortium include three main catastrophic research areas, guided by five research partners and is funded by five national organizations. The organizational structure is summarized by this graphic

There are multiple ways to report an injury.  Athletic trainers can visit sportinjuryreport.org and report information about the event directly.  Athletic trainers may also contact their state athletic trainer liaison to NCCSIR, or report to NCCSIR over the phone at 919-843-8357.  If you don’t know your liaison it’s possible your state might not have one.  Liaisons serve as state’s point of contact for NCCSIR to assist in monitoring and providing context for catastrophic sport-related events that occur in your state.  Individuals interested in becoming an Athletic Trainer Liaison to NCCSIR can contact Kristen Kucera, MSPH, PhD, ATC at nccsir@unc.edu.  

If you are unsure whether to report an incident or not, please report it.  NCCSIR staff will investigate and determine whether it fits the study criteria.  As a rule, “the primary focus is on events occurring in middle school, high school, collegiate, and professional athletes. Additionally, any sudden cardiac arrest or sudden cardiac death in a student-athlete (even if not directly related to athletics)” [5] should be included. Furthermore, NCCSIR and the Consortium define “catastrophic injuries as: fatalities, permanent disability injuries, serious injuries (fractured neck or serious head injury) even though the athlete has a full recovery, temporary or transient paralysis (athlete has no movement for a short time, but has a complete recovery), heat stroke due to exercise, sickle-cell trait associated collapse, sudden cardiac arrest/death, commotio cordis, or severe acquired cardiac illness.” [5]

Please report: catastrophic events occurring in middle school, high school, collegiate, and professional athletes. 
Where to report: www.sportinjuryreport.org
What to report: fatalities, permanent disability injuries, serious injuries (fractured neck or serious head injury) even though the athlete has a full recovery, temporary or transient paralysis (athlete has no movement for a short time, but has a complete recovery), heat stroke due to exercise, sickle-cell trait associated collapse, sudden cardiac arrest/death, commotio cordis, or severe acquired cardiac illness.
Additionally, any sudden cardiac arrest or sudden cardiac death in a student-athlete (even if not directly related to athletics).
Questions:  email NCCSIR@unc.edu or call 919-843-8357

Considering the likelihood of litigation surrounding catastrophic injuries it is important to note that names are kept confidential. In addition, although more complete reports better aid our decisions in rule making and safety changes, athletic trainers can report as little as they feel comfortable. 

“Participation in organized sports is at an all-time high in the United States and as sport participation numbers increase, it is more important than ever to ensure safe participation for all.”  [3]   Can you imagine our profession without the NCCSIR data driven rule changes already in place?  Imagine if spearing was still legal in football, pole vault pits were still much smaller than today’s standards, and if not a single change occurred in cheerleading safety over the last 49 years?  Let’s all help support their data collection efforts to help increase safety in sport!  After all, not reporting catastrophic injuries can be catastrophic.

Citations:
1. “About” National Center for Catastrophic Sports Injury Research (http://nccsir.unc.edu/about)
2. “FAQ” National Center for Catastrophic Sports Injury Research (http://nccsir.unc.edu/faq)
3. “Innovations by NCCSIR to Keep Sports Safe” UNC EXSS Exercising Science Solutions for  Public Impact (https://uncexss.wordpress.com/2015/03/16/sportinjuryreport-org-innovatio...)
4. “The Impact of EXSS in Preventing Catastrophic Sports Injury” UNC EXSS Exercising Science Solutions for  Public Impact (https://uncexss.wordpress.com/2014/03/24/the-impact-of-exss-in-preventin...)
5. “Definitions” National Center for Catastrophic Sports Injury Research (http://nccsir.unc.edu/definitions)
6. “Saving Lives, One Sport Injury at a Time” 2011. (http://www.npr.org/2011/11/19/142550204/saving-lives-one-sports-injury-a...)

Shelly Jones, ATC, is a liaison to the NCCSIR for Oregon and works as an athletic trainer for the Beaverton School District at Aloha High School in Beaverton, Oregon. She is a sports medicine advisor for the Oregon School Activities Association and she currently serves as the District 10 Secondary Schools Chair. She also functions as the medical director for Rugby Oregon and enjoys serving as a clinical preceptor for students from three athletic training education programs. In her free time, she enjoys volunteering at the Dove Lewis Animal Hospital & running 5Ks and 10Ks with and without her basset hound Princess Buttercup. Shelly can be reached at: ms.shellyjones@gmail.com.

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