Five Questions With: Dr. Dina Morrissey

"We are now seeing more schools focusing on concussion protocols and implementing new program elements, such as having a school nurse on property who is concussion-trained."

Dr. Dina Morrissey is the program coordinator for community activities at the Injury Prevention Center at Rhode Island Hospital. She coordinates the Injury Free Coalition for Kids in Providence program, the Safe Kids RI program, the Kohl’s Cares – Kids on the Go Program, and the IPC Home Safety programs. Morrissey earned her medical degree at the University of Massachusetts Medical School and completed a residency in pediatrics at Yale-New Haven Hospital. She recently authored a study that found with compliance with sports concussion laws in Rhode Island was inadequate.

PBN: The CDC has found that of the approximately 7.7 million children and adolescents participating in organized sports each year there are between 1.6 and 3.8 million sports-related concussions. Are there numbers for the state of Rhode Island?
MORRISSEY:
No, those are national data. The limited data we have right now in Rhode Island is collected by the Department of Health. Other states, like Massachusetts, have a directive from their Department of Health to report concussions, so they collect more detailed data. We don’t currently have a system like that in place in Rhode Island.

PBN: One of the problems you identified was that while compliance with concussion-protocol laws was good among Rhode Island Interscholastic League (RIIL) high schools, compliance among non RIIL schools was far less consistent.
MORRISSEY:
The vast majority of high schools in RI are RIIL members. The non RIIL high school and community league sports numbers were low and we looked at the data together. They did as well as the RIIL schools in some aspects of the law, but lower in others. Among all respondents, compliance with the suggested elements of the law was lower. Our conclusion was that organizations not mandated to comply with the law had lower compliance with SOME of the mandated elements and everyone had lower compliance with the suggested elements.

PBN: What is the single most important protocol that is not being followed adequately at Rhode Island youth sports contests?
MORRISSEY:
That is hard to say, they are all important and ideally should all be followed. What’s important to note is that this survey was done over two years ago now and things have begun to shift for the better in the interim. We are now seeing more schools focusing on concussion protocols and implementing new program elements, such as having a school nurse on property who is concussion-trained. That was something that we saw very little of in the survey, and it signifies a positive change in youth sports protocols in Rhode Island.

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PBN: As a doctor who has taken on the need for injury prevention, are there sports that you have a different perception of than you had before your medical training?
MORRISSEY:
I did not appreciate how high the incidence of concussion was in the sport of soccer. We usually think of concussions in high-impact sports where protective gear is worn, such as lacrosse or football, but concussions are also happening on the soccer field, on the basketball court and during cheerleading. It doesn’t take a very hard blow to the head to cause a concussion. You don’t even need to hit your head at all. A jolt to another part of the body can lead to a concussion. The concussion rates for soccer players in particular took me by surprise.

PBN: As a follow-up: are we moving away as a society from any sports that pose particular risks of brain injury or, if not, do we need to move away from any sports, medically speaking?
MORRISSEY:
I don’t believe so. What we are aiming for is to educate coaches, parents and youth athletes on appropriate prevention measures, prompt recognition of a suspected concussion and proper management to ensure the best possible outcome. We shouldn’t be afraid to let our kids play sports, we just want to make sure that they are doing so safely.

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