Transcript Training
Management of Concussion For Administrators in High School Athletics MICHELE C. BENZ, ATC, LAT, CSCS, HFS What Do I Need To Know? 1. What are the new guidelines on treatment and management of concussion 2. how can we develop a second impact syndrome prevention program? Treatment, Management & Prevention of SIS Helmet Fitting Performed by ATC Viewing of Concussion Video Prior to Play Baseline Testing (ImPACT) Use Concussion Evaluation Form (SCAT/SAC) Return To Play Guidelines, Zurich 2008 What Is A Concussion? Complex pathophysiological process that affects the brain, induced by traumatic biomechanical forces. -Zurich Concussion Conference, 2008 Blow to the head resulting in Concussion=BRAIN DAMAGE!!! Facts About Concussion 1.2 Million Youth Concussions Per Year 50% FB Players Have Sustained A Concussion 35% Suffered Multiple Concussions 80% Symptoms Worsen Over Weeks 50% Return To Play Too Soon 70% Would RTP Concussed 41% Would Not Leave A Game 50 H.S. Football Players Have Died Since 97 “It’s not dangerous to play with a concussion,” said Kelby Jasmon, a senior two-way player for his high school in Springfield, Ill., who has had three concussions. “You’ve got to sacrifice for the sake of the team. The only way I come out is on a stretcher.” Recognizing A Concussion 1. 2. Know the cognitive level of the student Learn to recognize the signs and symptoms Signs: •Athlete stumbles after play •Shakes head in attempt to “shake it off” •Goes to wrong huddle or in wrong direction •Takes a knee/bent over •Runs the wrong play •Eyes don’t focus/follow Symptoms •Headache •Nausea •Sensitivity to Light •Lethargic •Personality Changes Baseline Testing and Videos Testing Online 20 minute test Inexpensive Printed test score Tests – – – – – – – Reaction time Working & Design memory Attention span Non-verbal problem solving Visual processing speed Impulse control Response inhibition Videos Heads Up CDC/NFHS Youth Concussion ESPN’s – E:60 (5.4.10) – Outside The Lines (11.4.07) Example Evaluation Form Treatment National Federation of State High Schools: February, 2010 – – 1) 2) 3) 4) 5) 6) 7) Removal from participation, even if symptoms clear within 15 minutes. In absence of medical staffing, officials now charged with removal from participation without LOC. SCAT evaluation Parental/guardian contact Dialogue with coach/athlete Referral/Diagnostic testing* Post-Injury ImPACT test Graduated RTP Head Injury Reporting Form *Referral based upon results of evaluation. Diagnostic testing diagnoses structural abnormality, not concussion. Return To Play New guidelines (Zurich Conference, 2008) recommend a graduated RTP “Step-Wise Return to Play Protocol” 1) 2) 3) 4) 5) 6) Complete physical and cognitive rest Light aerobic activity Sport specific exercise Non-contact training drills Full contact practice Return to game play Athletes should also be back to baseline and depending on grade of concussion, be cleared by a neurologist and/or neuropsychologist. The NFL changed their RTP guidelines on Dec. 3rd, 2009 stating: “Any player suffering signs/symptoms of a concussion should not return to play the same day and should be checked out by proper medical staff.” Non-Athletic Injured Students •Physical Education Classes •Fighting or other accident *Have a plan in place prior to the school year* 1. 2. 3. 4. Do not move the student Have an administrator decide whether or not EMS is needed Contact the parent or guardian If transport is not necessary-advise the parent to have the student checked out by their doctor. 5. Fill out accident report Second Impact Syndrome (SIS) Second concussion before previous concussion has completely resolved Metabolic volcano within the brain Athletes under 23 at greatest risk Catastrophic brain injury or Death Second Impact Syndrome is PREVENTABLE Before & After SIS Prevention Miami Palmetto SIS Prevention Program 1) 2) 3) 4) 5) 6) 7) 8) Coaches are on board with program Baseline testing-ImPACT Concussion awareness videos Parent/Athlete Information Sheet Equipment fit by ATC Use of Sideline Evaluation Test Responsibility Clause –Physical form Referral for diagnostic testing via Sports Medicine team. SIS is PREVENTABLE ESPN’s E:60 Questions?