HB 2038 Coaches Training July 2012 Objectives • Definition • Natasha’s Law (HB 2038) • Concussion Oversight Team • Sign/Symptoms of Concussion • Return to Play • Coaching/Administration.
Download ReportTranscript HB 2038 Coaches Training July 2012 Objectives • Definition • Natasha’s Law (HB 2038) • Concussion Oversight Team • Sign/Symptoms of Concussion • Return to Play • Coaching/Administration.
Slide 1
HB 2038 Coaches
Training
July 2012
Slide 2
Objectives
• Definition
• Natasha’s Law (HB 2038)
• Concussion Oversight Team
• Sign/Symptoms of Concussion
• Return to Play
• Coaching/Administration Role
Slide 3
Slide 4
Coaches Concussion
Training
• HB 2038~Natasha’s Law
• Named after Natasha
Helmick, a soccer player
who sustained at least 5
concussions
• Signed into law September
1, 2011
• Goal is to reduce injuries
from second impact
syndrome
• Allen, TX
Slide 5
The Law
• The new law applies to all interscholastic athletic
activity, including practice and competition sponsored
or sanctioned by the UIL
• All schools are required to take a training course in the
subject of concussions-must be completed no later that
September 1, 2012
Slide 6
What the law does!
• Concussion Management Team
• Removal from Play
• Waiver and Graded Protocol to Return to Play
• Specific Education/Training for all HCP’s
• State Wide Tracking/Logging of Concussions
Slide 7
What is the
Concussion Oversight
Team
• The governing body of each school district and openenrollment charter school with students enrolled who
participate in an interscholastic athletic activity shall
appoint or approve a concussion oversight team.
• Who is the COT-at least one member, a Texas licensed
physician, Texas licensed athletic trainer or Texas
licensed health care professional.
• Steve Jones MD-Required to take additional training
• Tom Lewis-Required to take additional training
Slide 8
Concussion Oversite
Team
Each concussion oversight team shall establish
a return-to-play protocol, based on peerreviewed scientific evidence, for a student's
return to interscholastic athletics practice or
competition following the force or impact
believed to have caused a concussion.’
Slide 9
Additional
Information:
Required!
• Each student athlete and their parent/guardian will be
required to sign, for that school year, a form
acknowledging that both the student athlete and
guardian have received and read written information
that explains concussion prevention, symptoms,
treatment, and oversight and that includes guidelines
for safely resuming participation in an athletic activity
following a concussion.
Slide 10
What do you know about
concussions?
Slide 11
Concussion Quiz
• You have to be knocked out to have a
concussion.
• True
• False
Slide 12
False
• Most kids who have a
concussion are never knocked
out.
Slide 13
What is a concussion?
• A complex pathophysiological process affecting the
brain, induced by traumatic biomechanical force or “An
injury to the brain that effects function.
• Usually no damage to brain anatomy
-as far as we can tell
• Disturbance in brain metabolism
• Common features:
Direct blow to the head or body
Loss of consciousness not necessary
Rapid onset of symptoms (usually)
Traditional medical test usually normal (CT/MRI)
• .
Slide 14
CONCUSSIONS
Slide 15
Slide 16
It’s a Chemical Thing!
Slide 17
It’s a Chemical Thing
!
Phone Disconnect
Slide 18
You don’t have to be
knocked out to get a
concussion
Slide 19
Concussion Quiz
• Concussions are only a problem
for boys, and girls don’t need to
worry about it.
• True
• False
Slide 20
False
• Girls have concussions at least as
often as boys
Slide 21
Here’s the Problem
Slide 22
The Facts
•
A concussion is a brain injury
•
All concussions are serious
•
Concussions can occur without loss of consciousness or other obvious signs
•
Concussions can occur from blows to the body as well as to the head
•
Concussions can occur in any sport
•
Recognition and proper response to concussion when they first occur can help
prevent further injury or death
•
Athletes may not report their symptoms for fear of losing playing time
•
Athletes can still get a concussion even if they are wearing a helmet
•
Data from the NCAA injury surveillance system suggest that concussion represent
5 to 18 percent of all reported injuries, depending on the sport
Slide 23
The Facts
• A concussion can occur in any sport and all
concussions are serious.
• 10% of all contact sports sustain concussions
• 63% of all concussions occur in football.
• Girls soccer report second highest # of concussions.
Slide 24
The Facts
• An athlete who sustains a
concussion is 4-6 times more
likely to sustain a 2nd
concussion.
• “Bell ringers” account for
75% of all concussive
injuries.
• Effects of concussions are
cumulative in athletes who
return to play prior to
complete recovery.
Slide 25
The Facts
• 80% of all concussions get
better in one week; 20%
usually takes 3 weeks or
longer to recover.
• Repeat concussions can
result in brain swelling,
permanent brain damage,
and even death.
Slide 26
Can you which kid
has a concussion?
Slide 27
Does Age Matter?
• Children may be less prepared for a blow to the head
• Parents may be inclined to believe child is “fine” due to
negative imagining and the “he looks fine to me” factor.
• Other concerns may override safety issues, and often youth
sports may not have a protocol in place for dealing with
concussion
• Children may underreport symptoms to go back to play
sooner for fear of appearing weak, losing position, feeling
invulnerable
• Concussion MAY be 10-20 X more prevalent in children
• Children are more at risk for second impact syndrome
Slide 28
Concussion Quiz
• A concussion can make school
work harder.
• True
• False
Slide 29
True
• After have a concussion, kids
often can’t concentrate as well
and reading and doing math can
cause headaches.
Slide 30
Recovery of the
Young Athlete
• Kids are not the same
as PROS
• The brain of athletes
under the age of 18
heals at a slower rate
than older athletes
following a concussion
Slide 31
Prevention
• Helmets decrease risk of
skull fractures and
intracranial hemorrhage.
• Mouthguards decrease
dental and oral trauma.
• Role of protective
equipment in prevention of
concussion not established
Slide 32
Recovery and Return to
Play-Grades and
Guidelines
• Are not scientifically based
• Assumes standard use for
gender and age groups
• Poor job distinguishing “mild”
concussion
• Assigns too much importance
in LOC
• Did not provide useful
prognostic information
• Did no account for risk
factors/individuals factors
Slide 33
Commonly Reported
Symptoms
•
High School & College athletes – within 3 days of injury
1. Headache
71%
2. Feeling slowed down
58%
3. Difficulty concentrating
57%
4. Dizziness
55%
5. Fogginess
53%
6. Fatigue
50%
7. Visual blurring/double vision
49%
8. Light sensitivity
47%
9. Memory dysfunction
43%
10. Balance problems
43%
Slide 34
Factor Analysis, post-concussion symptom
scale (Pardini et al 2004) N=327 High
school and University Athletics witin 7
Days of Concussion
Emotionality
Somatic Symptoms
-Visual problems
-Dizziness
-Balance difficulties
-Headaches
-Light sensitivity
-Nausea
-More emotional
-Sadness
-Nervousness
-Irritability
Sleep Disturbance
-Difficulty falling
asleep
-Sleeping less than
usual
Cognitive symptoms
-Attention problems
-Memory dysfunction
-“fogginess”
-Fatigue
-Cognitive slowing
Slide 35
Symptom Evaluation
Concussion Signs
Appears dazed
Confused about play
Moves clumsily
Answers questions slowly
Personality/behavior
change
Forgets plays prior to hit
Anterograde amnesia
Loses consciousness
• Concussion symptoms
•
•
•
•
•
•
•
•
•
Headache
Nausea
Balance problems
Double vision
Photosensitivity
Feeling sluggish
Feeling foggy
Change in sleep pattern
Cognitive changes
Slide 36
Concussion Quiz
• If I feel ok right after a hit, it
means I am fine and do not have
a concussion
• True
• False
Slide 37
False
• Many athletes don’t have a
headache or other symptoms for
hours after a concussion.
Slide 38
Slide 39
Later Signs of
Concussion PostConcussion Syndrome
• Decreased Processing Speed
• Short-term Memory Impairment
• Concentration Deficit
• Irritability/Depression
• Fatigue/Sleep Disturbance
• General Feeling of “fogginess”
• Academic Difficulties
Slide 40
Relative Impacts
• video
Slide 41
Second Impact
Syndrome
Occurs in athletes with prior concussion following
often relatively minor second impact
Athlete returns to competition before resolution of
symptoms
Catastrophic increase in intracranial pressure
vasomotor paralysis, edema, massive swelling,
herniation, death
Neuro-chemical processes appear to differ in developing
brain
Slide 42
Slide 43
Second Impact
• 2nd IMPACT USUALLY
OCCURS WITHIN 14
DAYS OF THE FIRST
CONCUSSION AND
UNDER AGE 21
Slide 44
Slide 45
On field assessment card
Signs and symptoms
evaluation
Signs observed by staff:
Appears to be dazed or
stunned
Unsure of game score or
opponent
Lack of coordination
Poor reaction time
Losses consciousness (even
temporarily)
Shows behavior, mod or
personality change
Forgets events prior to injury
(retrograde)
Unequal or dilated pupils
Bleeding or clear fluid
coming from nose or ears
• Symptoms reported by
athlete:
• Headache
• Nausea or vomiting
• Balance problems or
dizziness
• Double or fuzzy vision
• Sensitivity to light or noise
• Feeling sluggish
• Feeling foggy
• Change in sleep pattern
• Concentration or memory
problems
• Lightheadedness
• Easily fatigued
• confusion
Slide 46
Symptoms may worsen
with exertion.
Athlete should not
return to play until
symptom-free
Slide 47
On-field Cognitive
testing
Orientation
Ask the athlete the following questions:
What stadium is this?
What city is this?
Who is the opposing team?
What month is it?
What day is it?
Anterograde amnesia
Ask the athlete to remember the following words:
Retrograde amnesia
Ask the athlete the following questions:
What happened in the prior quarter/period?
What do you remember just prior to the hit?
What was the score of the game prior to the hit?
Concentration
Girl, dog, green
Ask the athlete to do the following:
Repeat the days of the week backwards
Repeat these numbers backwards: 63 (36 is correct): 419 (914 is correct)
Word list memory
Ask the athlete to repeat the three words from earlier
Slide 48
SCAT II
• SCAT II Form
Slide 49
Concussion
Management
• Rule out more serious intracranial pathology
• CT, MRI, neurologic examination primary diagnostic test
• Prevent second impact syndrome
• Prevent presence of post-concussion syndrome (Home
Program)
•
•
•
•
•
Avoid video games
Text messages
Watching tv
Playing or doing homework on computer
Long periods of reading
Slide 50
Return to Play
Protocol
• Exercise Progressions
Slide 51
Slide 52
Return To
Classroom Protocol
• Classroom Progressions
Slide 53
What do we need to
do as football
coaches
• Teach proper technique-UIL requires that all football
coaches teach there athlete about “Heads UP in
Football”
• Before-Mid-season
• Heads-Up in Football Video
Slide 54
Home with a
Concussion
• A person with a concussion may:
•
•
•
•
•
Use acetaminophen (Tylenol) for headaches
Use ice pack on head and neck as needed for comfort
Eat a light diet
Go to sleep
Rest (no strenuous activity or sports)
Slide 55
Home Care
• There is no need to:
• Wake up every hour
• Test reflexes
• Stay in bed
• Observe and monitor athlete. If there is a decline in
symptoms, see physician
Slide 56
Home Care
Do not:
Drink alcohol
Drive while symptomatic
Exercise or lift weights
Use a computer or test message
Watch TV for long periods of time
Take Ibuprofen, aspirin, naproxen or
other non-steroidal anti-inflammatory
medications
Slide 57
ImPACT
• ImPact Test
• ImPact Test Modules
Slide 58
High School vs Pros
Slide 59
Long Term Research
Slide 60
Long Term
Slide 61
Long Term Research
Slide 62
Concussion Quiz
• The brain needs to rest after a
concussion.
• True
• False
Slide 63
True
• The Brain needs a lot of rest after a concussion
and you may need to sleep more than usual.
You should not play video games, read a lot, or
do other things to make your brain work hard.
If you rest, you will be able to return to normal
activities quicker! If you try to go back playing
a sport too soon, your concussion could take
longer to get better.
Slide 64
Slide 65
Most Important Take
Away
• Improved awareness and
increase in concussion
recognition!
Slide 66
Questions?
Slide 67
Reminders
• The Rules Compliance Program (RCP) is required for
coaches of grades 7-12. See UIL web page.
• CPR Refresher GISD web site. Go to my web page.
• Email me once you have gone over the refresher.
HB 2038 Coaches
Training
July 2012
Slide 2
Objectives
• Definition
• Natasha’s Law (HB 2038)
• Concussion Oversight Team
• Sign/Symptoms of Concussion
• Return to Play
• Coaching/Administration Role
Slide 3
Slide 4
Coaches Concussion
Training
• HB 2038~Natasha’s Law
• Named after Natasha
Helmick, a soccer player
who sustained at least 5
concussions
• Signed into law September
1, 2011
• Goal is to reduce injuries
from second impact
syndrome
• Allen, TX
Slide 5
The Law
• The new law applies to all interscholastic athletic
activity, including practice and competition sponsored
or sanctioned by the UIL
• All schools are required to take a training course in the
subject of concussions-must be completed no later that
September 1, 2012
Slide 6
What the law does!
• Concussion Management Team
• Removal from Play
• Waiver and Graded Protocol to Return to Play
• Specific Education/Training for all HCP’s
• State Wide Tracking/Logging of Concussions
Slide 7
What is the
Concussion Oversight
Team
• The governing body of each school district and openenrollment charter school with students enrolled who
participate in an interscholastic athletic activity shall
appoint or approve a concussion oversight team.
• Who is the COT-at least one member, a Texas licensed
physician, Texas licensed athletic trainer or Texas
licensed health care professional.
• Steve Jones MD-Required to take additional training
• Tom Lewis-Required to take additional training
Slide 8
Concussion Oversite
Team
Each concussion oversight team shall establish
a return-to-play protocol, based on peerreviewed scientific evidence, for a student's
return to interscholastic athletics practice or
competition following the force or impact
believed to have caused a concussion.’
Slide 9
Additional
Information:
Required!
• Each student athlete and their parent/guardian will be
required to sign, for that school year, a form
acknowledging that both the student athlete and
guardian have received and read written information
that explains concussion prevention, symptoms,
treatment, and oversight and that includes guidelines
for safely resuming participation in an athletic activity
following a concussion.
Slide 10
What do you know about
concussions?
Slide 11
Concussion Quiz
• You have to be knocked out to have a
concussion.
• True
• False
Slide 12
False
• Most kids who have a
concussion are never knocked
out.
Slide 13
What is a concussion?
• A complex pathophysiological process affecting the
brain, induced by traumatic biomechanical force or “An
injury to the brain that effects function.
• Usually no damage to brain anatomy
-as far as we can tell
• Disturbance in brain metabolism
• Common features:
Direct blow to the head or body
Loss of consciousness not necessary
Rapid onset of symptoms (usually)
Traditional medical test usually normal (CT/MRI)
• .
Slide 14
CONCUSSIONS
Slide 15
Slide 16
It’s a Chemical Thing!
Slide 17
It’s a Chemical Thing
!
Phone Disconnect
Slide 18
You don’t have to be
knocked out to get a
concussion
Slide 19
Concussion Quiz
• Concussions are only a problem
for boys, and girls don’t need to
worry about it.
• True
• False
Slide 20
False
• Girls have concussions at least as
often as boys
Slide 21
Here’s the Problem
Slide 22
The Facts
•
A concussion is a brain injury
•
All concussions are serious
•
Concussions can occur without loss of consciousness or other obvious signs
•
Concussions can occur from blows to the body as well as to the head
•
Concussions can occur in any sport
•
Recognition and proper response to concussion when they first occur can help
prevent further injury or death
•
Athletes may not report their symptoms for fear of losing playing time
•
Athletes can still get a concussion even if they are wearing a helmet
•
Data from the NCAA injury surveillance system suggest that concussion represent
5 to 18 percent of all reported injuries, depending on the sport
Slide 23
The Facts
• A concussion can occur in any sport and all
concussions are serious.
• 10% of all contact sports sustain concussions
• 63% of all concussions occur in football.
• Girls soccer report second highest # of concussions.
Slide 24
The Facts
• An athlete who sustains a
concussion is 4-6 times more
likely to sustain a 2nd
concussion.
• “Bell ringers” account for
75% of all concussive
injuries.
• Effects of concussions are
cumulative in athletes who
return to play prior to
complete recovery.
Slide 25
The Facts
• 80% of all concussions get
better in one week; 20%
usually takes 3 weeks or
longer to recover.
• Repeat concussions can
result in brain swelling,
permanent brain damage,
and even death.
Slide 26
Can you which kid
has a concussion?
Slide 27
Does Age Matter?
• Children may be less prepared for a blow to the head
• Parents may be inclined to believe child is “fine” due to
negative imagining and the “he looks fine to me” factor.
• Other concerns may override safety issues, and often youth
sports may not have a protocol in place for dealing with
concussion
• Children may underreport symptoms to go back to play
sooner for fear of appearing weak, losing position, feeling
invulnerable
• Concussion MAY be 10-20 X more prevalent in children
• Children are more at risk for second impact syndrome
Slide 28
Concussion Quiz
• A concussion can make school
work harder.
• True
• False
Slide 29
True
• After have a concussion, kids
often can’t concentrate as well
and reading and doing math can
cause headaches.
Slide 30
Recovery of the
Young Athlete
• Kids are not the same
as PROS
• The brain of athletes
under the age of 18
heals at a slower rate
than older athletes
following a concussion
Slide 31
Prevention
• Helmets decrease risk of
skull fractures and
intracranial hemorrhage.
• Mouthguards decrease
dental and oral trauma.
• Role of protective
equipment in prevention of
concussion not established
Slide 32
Recovery and Return to
Play-Grades and
Guidelines
• Are not scientifically based
• Assumes standard use for
gender and age groups
• Poor job distinguishing “mild”
concussion
• Assigns too much importance
in LOC
• Did not provide useful
prognostic information
• Did no account for risk
factors/individuals factors
Slide 33
Commonly Reported
Symptoms
•
High School & College athletes – within 3 days of injury
1. Headache
71%
2. Feeling slowed down
58%
3. Difficulty concentrating
57%
4. Dizziness
55%
5. Fogginess
53%
6. Fatigue
50%
7. Visual blurring/double vision
49%
8. Light sensitivity
47%
9. Memory dysfunction
43%
10. Balance problems
43%
Slide 34
Factor Analysis, post-concussion symptom
scale (Pardini et al 2004) N=327 High
school and University Athletics witin 7
Days of Concussion
Emotionality
Somatic Symptoms
-Visual problems
-Dizziness
-Balance difficulties
-Headaches
-Light sensitivity
-Nausea
-More emotional
-Sadness
-Nervousness
-Irritability
Sleep Disturbance
-Difficulty falling
asleep
-Sleeping less than
usual
Cognitive symptoms
-Attention problems
-Memory dysfunction
-“fogginess”
-Fatigue
-Cognitive slowing
Slide 35
Symptom Evaluation
Concussion Signs
Appears dazed
Confused about play
Moves clumsily
Answers questions slowly
Personality/behavior
change
Forgets plays prior to hit
Anterograde amnesia
Loses consciousness
• Concussion symptoms
•
•
•
•
•
•
•
•
•
Headache
Nausea
Balance problems
Double vision
Photosensitivity
Feeling sluggish
Feeling foggy
Change in sleep pattern
Cognitive changes
Slide 36
Concussion Quiz
• If I feel ok right after a hit, it
means I am fine and do not have
a concussion
• True
• False
Slide 37
False
• Many athletes don’t have a
headache or other symptoms for
hours after a concussion.
Slide 38
Slide 39
Later Signs of
Concussion PostConcussion Syndrome
• Decreased Processing Speed
• Short-term Memory Impairment
• Concentration Deficit
• Irritability/Depression
• Fatigue/Sleep Disturbance
• General Feeling of “fogginess”
• Academic Difficulties
Slide 40
Relative Impacts
• video
Slide 41
Second Impact
Syndrome
Occurs in athletes with prior concussion following
often relatively minor second impact
Athlete returns to competition before resolution of
symptoms
Catastrophic increase in intracranial pressure
vasomotor paralysis, edema, massive swelling,
herniation, death
Neuro-chemical processes appear to differ in developing
brain
Slide 42
Slide 43
Second Impact
• 2nd IMPACT USUALLY
OCCURS WITHIN 14
DAYS OF THE FIRST
CONCUSSION AND
UNDER AGE 21
Slide 44
Slide 45
On field assessment card
Signs and symptoms
evaluation
Signs observed by staff:
Appears to be dazed or
stunned
Unsure of game score or
opponent
Lack of coordination
Poor reaction time
Losses consciousness (even
temporarily)
Shows behavior, mod or
personality change
Forgets events prior to injury
(retrograde)
Unequal or dilated pupils
Bleeding or clear fluid
coming from nose or ears
• Symptoms reported by
athlete:
• Headache
• Nausea or vomiting
• Balance problems or
dizziness
• Double or fuzzy vision
• Sensitivity to light or noise
• Feeling sluggish
• Feeling foggy
• Change in sleep pattern
• Concentration or memory
problems
• Lightheadedness
• Easily fatigued
• confusion
Slide 46
Symptoms may worsen
with exertion.
Athlete should not
return to play until
symptom-free
Slide 47
On-field Cognitive
testing
Orientation
Ask the athlete the following questions:
What stadium is this?
What city is this?
Who is the opposing team?
What month is it?
What day is it?
Anterograde amnesia
Ask the athlete to remember the following words:
Retrograde amnesia
Ask the athlete the following questions:
What happened in the prior quarter/period?
What do you remember just prior to the hit?
What was the score of the game prior to the hit?
Concentration
Girl, dog, green
Ask the athlete to do the following:
Repeat the days of the week backwards
Repeat these numbers backwards: 63 (36 is correct): 419 (914 is correct)
Word list memory
Ask the athlete to repeat the three words from earlier
Slide 48
SCAT II
• SCAT II Form
Slide 49
Concussion
Management
• Rule out more serious intracranial pathology
• CT, MRI, neurologic examination primary diagnostic test
• Prevent second impact syndrome
• Prevent presence of post-concussion syndrome (Home
Program)
•
•
•
•
•
Avoid video games
Text messages
Watching tv
Playing or doing homework on computer
Long periods of reading
Slide 50
Return to Play
Protocol
• Exercise Progressions
Slide 51
Slide 52
Return To
Classroom Protocol
• Classroom Progressions
Slide 53
What do we need to
do as football
coaches
• Teach proper technique-UIL requires that all football
coaches teach there athlete about “Heads UP in
Football”
• Before-Mid-season
• Heads-Up in Football Video
Slide 54
Home with a
Concussion
• A person with a concussion may:
•
•
•
•
•
Use acetaminophen (Tylenol) for headaches
Use ice pack on head and neck as needed for comfort
Eat a light diet
Go to sleep
Rest (no strenuous activity or sports)
Slide 55
Home Care
• There is no need to:
• Wake up every hour
• Test reflexes
• Stay in bed
• Observe and monitor athlete. If there is a decline in
symptoms, see physician
Slide 56
Home Care
Do not:
Drink alcohol
Drive while symptomatic
Exercise or lift weights
Use a computer or test message
Watch TV for long periods of time
Take Ibuprofen, aspirin, naproxen or
other non-steroidal anti-inflammatory
medications
Slide 57
ImPACT
• ImPact Test
• ImPact Test Modules
Slide 58
High School vs Pros
Slide 59
Long Term Research
Slide 60
Long Term
Slide 61
Long Term Research
Slide 62
Concussion Quiz
• The brain needs to rest after a
concussion.
• True
• False
Slide 63
True
• The Brain needs a lot of rest after a concussion
and you may need to sleep more than usual.
You should not play video games, read a lot, or
do other things to make your brain work hard.
If you rest, you will be able to return to normal
activities quicker! If you try to go back playing
a sport too soon, your concussion could take
longer to get better.
Slide 64
Slide 65
Most Important Take
Away
• Improved awareness and
increase in concussion
recognition!
Slide 66
Questions?
Slide 67
Reminders
• The Rules Compliance Program (RCP) is required for
coaches of grades 7-12. See UIL web page.
• CPR Refresher GISD web site. Go to my web page.
• Email me once you have gone over the refresher.