Transcript Concussion Management and Awareness Act

Concussion Management and
Awareness Act
Dave Boyland, PT, DPT, SCS, ATC
Maggie Reinhard, PT, DPT, ATC
Goldwyn & Boyland Physical Therapy
The Law
• A student diagnosed with a concussion is not to be
returned to athletic activities until at least 24 hours
have passed without symptoms and the student has
been assessed and cleared by a medical provider to
begin a graduated return to activities.
The 3rd International Conference on
Concussion in Sport
• Panel of Sports Medicine Physicians, Neurologists,
Psychologists, Athletic Trainers, Researchers,
Athletes, Coaches, etc.
• Endorsed by FIFA, IOC, IRB, IIHF
The 3rd International Conference on
Concussion in Sport
• Concussion is defined as a complex
pathophysiological process affecting the brain,
induced by traumatic biomechanical forces.
▫ Eliminated the terms “complex” and “simple”
concussion
• Established Return to Play (RTP) Guidelines
Direct/Indirect Observation
• Any student suspected of having a concussion either
based on the disclosure of a head injury, observed or
reported symptoms, or by sustaining a significant
blow to the head or body must be removed from
athletic/physical activity and observed until an
evaluation can be completed by a medical provider.
The Team
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Medical Director
School Nurse
Certified Athletic Trainer
Director of Physical Education/Athletics
School Administrator
Teacher
Coach
Student
Parent/Guardian
Training Course
• NYSED approved training course
▫ Heads up to Clinicians (CDC)
• Every 2 years
Who Must Take the Course?
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School Nurse
Certified Athletic Trainer
Physical Education Teacher
Coach
Neurocognitive Computerized Testing
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Impact
CogSport
Headminders
ANAM (Automated Neuropsychological Assessment
Metrics)
Identification
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Amnesia
Confusion
Headache
LOC
Balance Difficulty/Dizziness
Double or Blurred Vision
Sensitivity to Light and/or Sound
Nausea/Vomiting/Loss of Appetite
Identification
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Irritability/Sadness/Changes in Personality
Feeling Sluggish or Light-headed
Concentration or focusing problems
Slowed Reaction Times
Fatigue/Sleep Issues
Immediate Referral
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Headache that Worsens
Seizures
Looks drowsy or cannot be awakened
Repeated Vomiting
Slurred Speech
Unable to recognize people or places
Weakness or Numbness
Unsteady Gait
Dilated or Pinpoint Pupils
Sideline Assessment Tools
• SCAT 2
• SAC
• BESS
SAC
Diagnosis
• Licensed Physician
• Nurse Practitioner
• Physician Assistant
Post-concussion Management
• Cognitive Rest
▫ Avoidance of participation or exposure to:
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Computer and Video Games
Television Viewing
Texting
Reading or Writing
Studying or Homework
Taking a Test or Completing a Significant Project
Loud Music
Bright Lights
School Responsibility
• Providing Accommodations
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Shorter School Day
Rest Periods
Peer Note Takers
Extended Time for Tests and Assignments
Post-concussion Management
• Physical Rest
▫ Adequate Sleep
▫ Taking Frequent Rest Periods and Naps
▫ Avoiding Exertion
Post-concussion Management
• 24 Hours SYMPTOM FREE
• Clearance for Return to Activity
▫ Private Medical Provider
▫ Medical Director
Return to Activity
• Phase 1
▫ Low impact, non-strenuous light aerobic activity
• Phase 2
▫ Higher impact, higher exertion, moderate aerobic activity
• Phase 3
▫ Sport specific, non-contact activity, low resistance weight
training
• Phase 4
▫ Sport specific, non-contact activity, higher resistance weight
training
• Phase 5
▫ Full contact training drills, intense aerobic activity
Return to Activity
• Phase 6
▫ Return to full activity without restrictions
▫ Determined by Medical Director
Second Impact Syndrome (SIS)
• A Severe, Life Threatening Condition That Causes
Irreversible Brain Damage, Hemorrhage, And
Cerebral Edema
▫ Almost Exclusively In Individuals Under Age 25
References
• http://www.nysphsaa.org/safety/pdf/NYSEDGuidelin
esforConcussionManagement.pdf
• http://preventingconcussions.org
• McCrory P, Meeuwisse W, Johnston K etal.
Consensus Statement on Concussion in Sport: The 3rd
International Conference on Concussion in Sport
Held in Zurich, November 2008. J Ath Training.
2009;44:434-448.
• Wojtys EM, Hovda D, Landry G et al. Concussion in
Sports. Am J Sports Med. 1999;27:676-687.
Questions?