BREAKING: New NASCAR Concussion Protocols Mandate Post-Crash Evaluation

Photo by Barry Cantrell/Harold Hinson Photography

By Jerry Jordan, Editor

DAYTONA BEACH, Fla. – NASCAR officials will announce an overhaul to the existing concussion protocol procedures, requiring drivers take a mandatory trip to the infield care center and undergo concussion screening by a trained medical professional any time they are involved in a crash that puts their car behind the wall, even if is brought there under its own power, Kickin’ the Tires has   confirmed.

“When a vehicle sustains damage from accident or contact of any kind and must go behind the pit wall or to the garage area whether under its own power, or not, drivers are now required by the new rule to proceed to the infield care center by ambulance, or another vehicle as directed by NASCAR,” a source confided. “Once the driver is at the infield care center they will undergo an industry-recognized and approved diagnostic test to check for head injuries.”

The new procedures, known as the Sports Concussion Assessment Tool (SCAT-3), will be put into place at Daytona International Speedway and carry over to every race, at every track, on the circuit. SCAT-3 is intended as a game venue/locker room clinical assessment for concussions and takes between 10-15 minutes to administer, preferably in quiet, non-distracting environment. The policy also requires tracks to have the necessary medical professionals in the infield care center who are trained in the SCAT-3 protocols throughout the race weekend. The idea is to ensure all drivers involved in a contact collision are tested for concussion-related symptoms and cleared or referred for further observation and that test is consistent from week to week.

Click For A Sample of the SCAT-3 Test

In the past, if drivers piloted a car to the garage under its own power they were not required to visit the infield care center. Under those rules, a visit to the infield care center could have cost them precious positions on the track in the event the team repaired the car and they had not returned to the garage. However, with the new Damaged Vehicle Policy implemented by NASCAR earlier this month, cars going behind the wall due to a crash are not allowed back on the track. Instead, teams have five minutes to fix cars that have been damaged in a crash and those repairs must be done on pit road. Therefore, the new concussion protocol does not pose a competitive disadvantage to drivers because once they go behind the wall they are eliminated from competition and a trip to the infield care center has no bearing on their race finish.

“One of the things drivers were concerned about was inconsistent concussion testing from one track to another,” the source said.

Last year, when Matt DiBenedetto was held out of the car at Texas Motor Speedway because doctors thought he may be suffering from a head injury sustained during an Xfinity Series crash, he said he felt fine. Because he didn’t put his window net down immediately, it raised a red flag. But DiBenedetto knew the field was string out and he felt it was unsafe to drop the net immediately. Then, after being cramped up in a racecar and suffering with a sore knee, he wasn’t deemed as walking correctly while traversing the 20-degree banking to the ambulance.

“It was kind of a perfect storm lining up wrong for me,” DiBenedetto joked, as he headed to the airport. “I don’t want it to be anything negative from my end. It was kind of a crazy instance where they erred on the side of caution due to what they saw.”

As he elaborated more on the situation in Texas, DiBenedetto said one of the things drivers asked for was consistency and that will now come with NASCAR bringing AMR into the fold. He said the idea of having someone at the track who is familiar with each drivers’ medical situation is good because they will have a better understanding what a driver is going and how they act normally.

“Looking back, it was tough for me because I felt like I was fine,” he said. “I understand but it was just a bad set of circumstances where it looked worse that it was.

“As I waited in the care center, I was sitting there watching TV because they had the race on. I was being really quiet because I was irritated that I crashed but the doctor said that I was acting funny. We disagreed over that. And I had never met that doctor before, so he didn’t know how I would usually act but they evaluated me with a concussion. My parents were in there and they can tell you I was acting fine. I felt like I could drive the next day but they were being cautious.”

DiBenedetto said, that although he had not yet been briefed by NASCAR on the specifics of the new concussion protocols, he believed the sanctioning body is focused on safety. It is something they are always looking and seeking input on.

“Getting some of the same personnel at the track for all the race will be good,” DiBenedetto said. “That came from NASCAR listening to the drivers. We understand they are trying to make sure we are all safe and healthy and that is a good thing. They are doing a really good job and the sport has come a long way because I am sure there were guys back in the day raced with a concussion.”

Already in use by the NFL, FIFA, FEI (International Federation for Equestrian Sports) and the IOC (International Olympic Committee), SCAT-3 is considered one of the most recognized forms of testing for concussions symptoms available. While the most current SCAT model used is known as SCAT-3 based on the number of meetings held by the International Consensus on Concussions in Sport, an updated assessment will replace it in the future.

One of the doctors helping to author the updated protocol, which will be called SCAT-5, is Dr. Christopher Giza of the UCLA Brain Injury Research Center. Dr. Giza weighed-in on concussion issues for Kickin’ the Tires in 2016, just a week before Dale Earnhardt Jr. announced he would be out of the racecar for the rest of the season. Dr. Giza is the director of the UCLA Steve Tisch BrainSPORT program, has specialized in both adult and pediatric traumatic brain injuries (TBI) and currently serves on advisory committees for TBI/concussion with the Centers for Disease Control, NCAA, Major League Soccer and U.S. Soccer Federation and has been a clinical consultant for the NFL, NHL and MLS.

“The first thing you would do is talk to the driver and see if they are disoriented and whether they know what race they are in or who is leading,” Dr. Giza said. “If they don’t know those things then they are done probably but presumably if they know those things then you would have to go a little further. The SCAT-3 has three sections. The first section is the symptom checklist. There are 22 symptoms and you rate them on a scale of 0 to 6 based on how bad they feel. If you have a lot of symptoms that raises the likelihood that it is a concussion.”

Dr. Giza said it is best to have a baseline score for drivers to help determine when there is a significant change on the results. For example, a in four more points from the baseline could be an indicator that a concussion is likely.

“After you do the symptom part, you do the cognitive part, which is call the SAC or Standardized Assessment of Concussion and it has a number of different questions. You’ll ask them questions and then you will give them five words to repeat and have them say those words back to you three times. They will also ask the driver to repeat a set of number but it must be done in reverse order that I said them. You’ll then do little bit of a neurological exam and look for coordination and eye movements but then, at the end, you’ll say, ‘hey, remember those five words we went over, tell me how many of those can you remember.’

“The third part is the BEST (Balance Error Scoring System). For that, they have to stand in three different positions with their hands on their hips and their eyes closed for 20-seconds and the person doing the evaluation will check if they bobble or make a mistake, open their eyes, put their foot down or look like they are going to fall. At the end of all three parts you will get a score.”

While drivers may have been able to claim they had no symptoms in the past, with the SCAT-3 faking the results isn’t really possible because each of the criteria must be met. Dr. Giza also said the test takes some time to perform the SCAT-3 properly, so drivers should be prepared for how long the test will keep them in the infield care center.

“We argued a little bit at the Berlin (Germany) meeting about how long it takes to do the SCAT-3 properly but probably with an experienced person, maybe 12 minutes,” Giza said.

The new protocols will be implanted across all three of NASCAR’s top touring series, including when lower tier series are at standalone events. The source said NASCAR will rely on its recent partnership with AMR to ensure medical staff are trained in the SCAT-3 testing procedures and are present at every track on the circuit.

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