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How One Young Athlete's Death Inspired a Concussion-Fighting Community

Colorado passed the nation's most-sweeping youth concussion law two weeks ago, inspired by Jake Snakenberg, a high school football player who died from Second Impact Syndrome.

As sportsconcussions.org recently reported, naming the concussion law in Snakenberg's honor was only one of the ways that his tragic death ultimately shaped a concussion-fighting community.

Snakenberg, a freshman fullback, had been hit hard during a game a week before his death. He was back on the football field on Sept. 18, 2004, when he was hit again—twice. He collapsed after the second hit and died the following day.

After his death, Dr. Karen McAvoy, then the school psychologist at his school, Grandview High, brought together medical professionals, teachers, counselors, coaches, and athletic trainers to create a team dedicated to future concussion management at the school.

Dr. McAvoy also created the REAP (Reduce, Educate, Accommodate, Pace) program, a community-based model for concussion management. REAP was inspired by a 2004 Centers for Disease Control and Prevention study which found that effective concussion management depended upon education and collaboration between school officials, athletic trainers, coaches, parents, and students. (The CDC has continued to recommend collaboration among school staffRequires Adobe Acrobat Reader as a key tool for concussion management.)

As Dr. McAvoy told sportsconcussions.org:

"REAP was not a scientific design piloted in a high school. It was a labor of love that blossomed out of necessity and in reaction to a tragedy. This humble beginning proves that REAP does not take money to implement, it takes heart. ... I would like to say that we carefully designed the template of REAP, but the reality is that after Jake died, we pulled together, and this act naturally morphed into the creation of the multi-disciplinary team.

"The athletic trainer, the nurse, and myself, as the school psychologist, consulted on each and every concussion from that point forward. We found that teachers eventually learned how to help. Parents began to spread the word to other parents in the neighborhood—and parents of non-athletes demanded the same coordination and collaboration for their child who may have suffered a concussion in a motor vehicle accident or a snowboarding accident."

REAP also includes a five-step Graduated Return-to-Play model, based on recommendations from the 2008 Zurich Consensus Statement on Concussion in Sport. Once a student-athlete is 100 percent symptom-free for 24 hours, he or she would be allowed to begin light aerobic activity. The student-athlete would have to stay symptom-free for 24 hours to move between each of the remaining four steps: sport-specific exercise, non-contact training drills, full-contact practice, and finally, return to play. (The New York State Public High School Athletic Association also recommended this five-step graduated return process.

Today, Dr. McAvoy is the director of the Center for Concussion at the Rocky Mountain Youth Sports Medicine Institute. She's intent on spreading the message of REAP to other school districts—namely, the premise that concussions are best managed by a multi-disciplinary team that includes the student-athlete, his or her family, school officials, and medical professionals.

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