Hockey referees: Are they part of the solution for concussion in youth hockey?

Abstract

Since concussions pose short- (e.g., headaches) and long-term (e.g., extended absence from school) risks for youth athletes, sport organizations must ensure that athletes who display concussion symptoms are promptly removed from play. In ice hockey, officials are tasked with maintaining safety of the athletes through the enforcement of rules. Through online interviews, we explored 10 hockey officials' perspectives on expanding their safety role to be able to remove athletes with suspected concussions from games. The first resultant theme was Considerations and Importance of Protocol, where officials stated that a detailed protocol would need to be in place to maintain consistency among leagues and branches. The second theme was Officials' Knowledge of Concussions, where officials expressed that their knowledge regarding concussions affects their comfort in removing an athlete from the game. In the third theme, Required Training, participants felt that enhanced education around concussions and procedures (including communication) would be needed to give them confidence in making this decision. For the final theme, Barriers, officials felt that their current knowledge of concussions and several other barriers (e.g., power, responsibility, and stakeholder reaction) were deterrents for them adopting this role. Overall, officials confirmed that safety is at the root of their role and that removing athletes from play could be added to their role if given proper training with clear procedures to follow. Sport organizations should explore expanding officials' roles to include removal of athletes who are displaying concussion symptoms, in addition to their current concussion initiatives and procedures.