Transcript Document

MSYSA
Annual General Meeting
January 19, 2008
Management and Treatment of Concussions
Heat Related Illness
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Concussion
Concussion of the brain, is a traumatic injury to
the brain as a result of a violent blow, shaking,
or spinning.
Ref: American Medical Association
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Concussions in Sports
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Complex “pathophysiological” process affecting the
brain that disrupts brain activity.
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Disruption is “Functional” rather than
“Structural”
Ref: First International Conference In Concussion in Sport, British Journal of Sports Medicine (2002), 15(2):48-55
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Comparison of Annual Incidence
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Traumatic Brain Injuries
Breast Cancer
HIV/AIDS
Spinal cord injuries
Multiple Sclerosis
1,500,000
176,300
43,681
11,000
10,400
Soccer concussions are increasing but is it a real increase in
numbers OR awareness.
Ref: Brain Injury Association of America, Centers for Disease Control and Prevention, American Cancer Society,
National Multiple Sclerosis Society
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Incidence of Concussions are
“Under-Reported” by Athletes
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Athlete did not believe injury was serious
Not wanting to leave game / practice
Not knowing injury was a concussion
“macho” attitude
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Signs Observed by Staff
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Appears dazed or stunned
Confused
Unsure of game, score, or opponent
Disoriented, clumsy
Answers questions slowly
Loses consciousness (even temporarily)
Behavior or personality change
Forgets events prior to injury (retrograde)
Forgets events after injury (anterograde)
Ref:www..impacttest.com
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Symptoms reported by athlete
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Headache
Nausea
Balance problems / dizziness
Double or fuzzy vision
Sensitivity to light or noise
Feeling sluggish
Feeling “foggy”
Change in sleep pattern
Concentration or memory problems
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On-Field Cognitive Testing
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Orientation
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What field are we on?
Who is the opposing team?
What month is it?
What day is it?
Anterograde Amnesia
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Ask athlete to repeat following words:
Girl, dog, green
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On-Field Cognitive Testing II.
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Retrograde Amnesia
What happened before your injury?
 What was the score of the game before injury?
 Do you remember how you were injured?
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Concentration
Repeat the days of the week backwards
 Repeat these numbers backward
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63 (36 correct); 419 (914 correct)
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On Field Cognitive Testing III
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Ask the athlete to repeat the three words from
earlier
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Word List Memory Test
Girl
Dog
Green
Ref: Impact Test, Impact Applications, Inc. Hilton Head SC.
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Coaches ACTION Plan
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Remove athlete from PLAY
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Ensure that athletes receive professional medical
care
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Inform parents or guardians about the
concussion
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Allow RTP (Return to Play) with permission
from medical practitioner
Ref: Bollinger Sports Forum, Dr. Vito A. Periello, Jr. MD
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Risk Assessment of Concussions
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Each concussion reduces the person’s resistance
to additional concussions. (Unlike structural
injuries, e.g. broken bones, etc.)
 athlete has 4 times greater chance
2nd concussion, 3rd, 4th,……..
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of suffering
RTP before complete recovery:
“Second Impact Syndrome” –
Catastrophic Damage
Ref: Bollinger Sports Forum, Dr. Vito A. Periello, Jr. MD
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New Data concerning CONCUSSIONS
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Children and Females are more vulnerable and
take longer to recover.
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Exercise and stress can exacerbate symptoms if
the brain does not fully recover
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RTP before medical clearance increases risk of
“second impact syndrome” and catastrophic
consequences
Ref: Bollinger Sports Forum, Dr. Vito A. Periello, Jr. MD
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US Soccer Federation
Statement on Use of Padded Headgear
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Fifa laws of the game, Law 4, “Players
Equipment” does not include headbands.
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“Safety” clause: “players who opt to use padded
headgear should be permitted to do so as long as the
referee confirms that equipment is not dangerous to the
player or another player”.
Ref: U.S. Soccer Federation Statement on Use of Padded Headgear, 8/25/2005
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US Soccer Federation
Statement on Use of Padded Headgear
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It is not permissible for a USSF member or affiliate to require use
of headgear by players.
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FIFA’s sports medicine committee concluded that headgear provides
no measurable benefit in head to ball impacts.
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There is “measurable benefit” in subconcussive head to head
impacts.
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Headgear is not a substitute for proper medical evaluation and
treatment of concussions.
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Headgear may create a false sense of security causing players to play
more aggressively
Ref: U.S. Soccer Federation Statement on Use of Padded Headgear, 8/25/2005
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MSYSA Annual General
Meeting
May 20, 2007
Heat Related Syndromes
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Risk Management
Heat Related Syndromes
Heat Stroke is DEADLY and
it’s Preventable
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Heat Related Syndromes
 Recognition
of risk factors
 Recognition of symptoms
 Emergency care plan
 Primary Care
 Secondary Care
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Risk Factors
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Clothing (light colored / light weight
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Age (extremes of age – young / old)
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Hydration – Pre game / Post game
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High Body Fat
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Poor Acclimatization / Fitness Level
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Additional Risk Factors
 Febrile
Illness
 Medications
 Sickle cell Trait
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Symptoms of Heat Illness
Muscle spasms / cramps
 Skin is flushed or cool and pale
 Headache
 Dizziness
 Rapid Pulse, nausea, weakness
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Symptoms of Heat Illness
(continued)
 Disoriented,
confusion
 Cessation of sweating
 Red, Dry Skin
 Shallow breathing
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Heat Illness –
WHAT HAPPENS?
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Core body temperature rises because:
 The
body cannot perspire –
 Removal
of excess heat evaporating thru the pores
When perspiration stops
– body temp. rises !!
----- HEAT ILLNESS
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Environmental Factors Contributing To
Heat Illnesses
Heat and Humidity
Temp
90 F
90 F
90 F
95 F
Humidity
40%
55%
70%
55%
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App. Temp
93 F
98 F
106 F
110 F
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Health Alert Categories
Temperature / Humidity
Category
App TempEffect
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Ext. Danger
>= 130F
Heat Stroke
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Danger
105-130 F
Heat Exhaustion
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Ext. Caution 90-105 F
Heat Cramps
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Caution
Fatigue
80-90 F
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Heat Illness Prevention Techniques
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Acclimatization – A child needs 8-10 days (45-60
minutes /day) to acclimate before beginning intense
practice and game situations.
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During this period – drink adequate amounts of
fluid to build the body’s fluid volumes.
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Wear light colored / lightweight clothing to facilitate
evaporation of sweat.
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Allow more water breaks and encourage fluid intake
Ref: U.S. Soccer Federation: 2006 Youth Soccer Heat and HydrationGuidelines.
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Fluid Guidelines
U.S. Soccer Federation
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Before prolonged physical activity, the child should be
well hydrated.
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During the activity periodic drinking should be enforced.
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Each 15-20 minutes the child or adolescent should
consume:
- 5 oz. of fluid (90 lbs. or less)
- 9 oz. of fluid (more than 90 lbs.)
Ref: U.S. Soccer Feferation; 2006 Youth Soccer Heat and Hydration Guidelines
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Fluid Guidelines
U.S. Soccer Federation
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To ensure proper hydration – child should drink
12-16 oz. of fluid approximately 30 minutes
before getting on the field.
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After the activity players should drink water or a
sports drink every 15 – 20 minutes for the first
hour.
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Ref:Ref: U.S. Soccer Feferation; 2006 Youth Soccer Heat and Hydration Guidelines
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Risk Management Strategies
Schedule practice at the coolest times of
the day
 Allow for water breaks
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 Referees
may allow water breaks (5 minute
break in the middle of each half)
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Quick recognition of any athlete who
shows signs of heat illness
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Plan to prevent Heat illness
 Pre-hydration
– fluid intake prior to
practice / game
 Clothing
– light material that
efficiently dissipates heat
 RECOGNITION
of Risk Factors
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Dehydration
Loss of 2% of body weight during exercise in heat
Symptoms
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Noticeable thirst
Irritability
Decreased performance
Fatigue
Weakness
Nausea
Headache
Muscle cramping
Dark yellow urine
Lightheaded / dizzy
Ref:
Treatment
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Rest the player in a cool place
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Provide a sports drink containing
electrolytes (no caffeine)
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Prevent dehydration by insuring player
consume fluids before, during and
after activity.
U.S. Soccer Federation; 2006 Youth Soccer Heat and Hydration Guidelines
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Muscle Cramping
Symptoms
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Muscle spasms
“knotting” of muscles and
pain
Treatment
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Drink fluids with electrolytes
(no caffeine).
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Gently stretch and massage
cramped muscles
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Rest in cool, shaded area
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Excessive sweat loss
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Apply ice to the cramped
area
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Excessive dehydration
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Consider additional sodium
in palatable food source, like
pretzels, etc.
Ref:
U.S. Soccer Federation; 2006 Youth Soccer Heat and
Hydration Guidelines
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Heat Exhaustion
Symptoms
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Feeling chilly
Rapid Pulse
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Treatment
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Rest the child in a cool, shaded
place
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Drink a sports drink that contains
electrolytes
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Have child lie down with legs
elevated to promote circulation
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Athlete should begin to feel better
soon, if not, assume heat stroke.
U.S. Soccer Federation; 2006 Youth Soccer Heat and Hydration Guidelines
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Heat Stroke
Medical Emergency
Symptoms
Treatment
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Very high core temperature
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Ice packs over as much
of the body as possible
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Altered CNS function
(confusion, extreme lethargy,
etc.)
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Cool, wet towels
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Cool shower
Athlete may collapse during
intense exercise in the heat.
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Water spray
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Do not provide fluids
(vomiting is common)
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Ref:
U.S. Soccer Federation; 2006 Youth Soccer Heat and Hydration Guidelines
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Energy Drinks
Health Related Issues
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Loaded with caffeine, sugar,
ginseng, taurine, guarana, and Bvitamins
Adverse Effects
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“Red Bull” – is marketed as
increasing “physical endurance,
reaction speed, mental alertness,
and stamina”.
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Other brands: 180, Adrenalin Rush,
Atomic Energy, Blue Ox, Whoop
Ass, etc.
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Dehydration
Insomnia
Headaches
Nervousness
Vomiting
Seizure
Heart arrhythmia
Death
Ref: Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention.
InfoFacts Resources. www.higherdcenter.org
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Banning Energy Drinks
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Sweden: banned in some restaurants
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Norway: sold only in pharmacies
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France: banned Red Bull
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Denmark: banned Red Bull
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European Union: In 2004, requiring Red Bull and other energy drinks to carry
a health warning about their “high caffeine content”
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Virginia: One county has banned energy drinks from High schools
Ref: Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention. InfoFacts
Resources. www.higherdcenter.org
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What is Risk Management?
Why is it important?
The safety and well being of our players
is our FIRST PRIORITY.
Education and being aware of the risks
associated with playing soccer will
minimize our risk.
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MSYSA Annual Workshop
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Goal Post Safety
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