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CITY  (NewsDakota.com)  “When in doubt, sit them out.”

That phrase is a key phrase in a new concussion awareness program that has been implemented for high school athletics this season.

The policy comes into clear focus this week as the major contact sport of the fall, football, begins for most high school teams in North Dakota.  Players suspected of sustaining a concussion are to be withdrawn immediately, and not returned until checked by a licenced health care provider.

Dr. Jeff Lystad, a primary caregiver with Sanford Health in Fargo, ND, says concussions have always been around, but tragic events around the country have spurred state legislatures to get involved with setting policy on concussions in athletic events.  He says Minnesota and both Dakotas have now instituted policies for concussions, making 31 states in the nation to do so.

Lystad says the new policy is in three parts.  The first part involves an education program for all referees, athletes, coaches and parents on recognizing concussion symptoms.  The second part directs the removal of that athlete from the contest, and the third requires a licenced provider to evaluate that athlete before returning.

“The key thing is to remove that athlete, and they don’t return unitl they’ve been checked out,” says Lystad.  “We’re trying to take the pressure off the coaches.  If there’s a question, they just don’t play.”

Lystad says the policy allows for game referees and even teammates to get involved in the withdrawl of an athlete.

“Officials can do it.  Coaches can do it.  Athletic trainers can do it.  If a player sees a friend is not thinking clearly, he or she should tell the coach,” explains Lystad.

Football and hockey are the major contact sports in North Dakota, but Lystad says that soccer involves a lot of head contact, and jumpers in track can have head-and-knee collisions that lead to concussions.  He says every sport has concussion-causing situations.

Players around the country have died after returning to games with concussions,  and Lystad says many former players are likely dealing with Post-Concussion Syndrome.  According to the Mayo Clinic, the syndrome can involve headache and dizziness that usually occurs within seven to 10 days of injury, and can last for a year or more.